Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 80
Filtrar
1.
Nature ; 608(7923): 528-533, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35585230

RESUMEN

Evidence exists that tree mortality is accelerating in some regions of the tropics1,2, with profound consequences for the future of the tropical carbon sink and the global anthropogenic carbon budget left to limit peak global warming below 2 °C. However, the mechanisms that may be driving such mortality changes and whether particular species are especially vulnerable remain unclear3-8. Here we analyse a 49-year record of tree dynamics from 24 old-growth forest plots encompassing a broad climatic gradient across the Australian moist tropics and find that annual tree mortality risk has, on average, doubled across all plots and species over the last 35 years, indicating a potential halving in life expectancy and carbon residence time. Associated losses in biomass were not offset by gains from growth and recruitment. Plots in less moist local climates presented higher average mortality risk, but local mean climate did not predict the pace of temporal increase in mortality risk. Species varied in the trajectories of their mortality risk, with the highest average risk found nearer to the upper end of the atmospheric vapour pressure deficit niches of species. A long-term increase in vapour pressure deficit was evident across the region, suggesting that thresholds involving atmospheric water stress, driven by global warming, may be a primary cause of increasing tree mortality in moist tropical forests.


Asunto(s)
Atmósfera , Estrés Fisiológico , Árboles , Clima Tropical , Agua , Aclimatación , Atmósfera/química , Australia , Biomasa , Carbono/metabolismo , Secuestro de Carbono , Deshidratación , Calentamiento Global/estadística & datos numéricos , Historia del Siglo XX , Historia del Siglo XXI , Humedad , Densidad de Población , Riesgo , Factores de Tiempo , Árboles/clasificación , Árboles/crecimiento & desarrollo , Árboles/metabolismo , Agua/análisis , Agua/metabolismo
2.
Malar J ; 22(1): 97, 2023 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-36932389

RESUMEN

BACKGROUND: Malaria, a treatable disease mainly caused by Plasmodium falciparum has remained a health challenge in Africa, a continent that accounted for 96% of total global cases and deaths in 2021. Uganda, a malaria endemic country is experiencing malaria parasite resistance to some of the drugs used in the artemisinin-based combination therapy (ACT). In an effort to prioritize herbal medicines for new product development, this review synthesized the available safety and efficacy literature on the Ugandan anti-malarial plants to suggest most effective herbal plants. METHODS: Literature was exhaustively searched using engines and databases, such as Google scholar, Pubmed, and Scopus-indexed journals during the period of June 2020-December 2021. In the first phase, information on ethnobotanical uses of anti-malarial plants in Uganda was gathered and synthetized to generate a list of plants, followed by data on anti-malarial efficacy (both in vitro and in vivo) on each listed plant. Minimum inhibitory concentrations (µg/ml), and % parasite suppression for every plant were scored using The Research Initiative on Traditional and Antimalarial Methods (RITAM) scoring system. The best twenty (20) plants were evaluated for acute safety (LD50) data in rat model, plant parts used, ease of cultivation, presence of clinical studies and other relevant factors for suggesting the best three (3) plants for future anti-malarial product development. RESULTS: Over one hundred twenty-six (126) plant species are used in Uganda for treatment of malaria in local communities. Out of these, about 33% (41) have been studied for efficacy and safety, with Artemisia annua and Vernonia amygdalina being the most extensively studied and among the best twenty (20) anti-malarial plants in Uganda. Both are limited by parasite recrudescence in clinical studies. Microglossa pyrifolia, a very potent plant (IC50 = 0.03 - 0.05 µg/ml has potential to penetrate the liver and could ameliorate the challenge of recrudescence if combined with A. annua and V. amygdalina in a polyherbal formulation. CONCLUSION: There are many plants with promising potential for malaria treatment in Uganda and a herbal combination of A. annua, V. amydalina and M. pyrifolia could offer the next herbal ACT if carefully studied and developed.


Asunto(s)
Antimaláricos , Malaria , Plantas Medicinales , Ratas , Animales , Antimaláricos/farmacología , Antimaláricos/uso terapéutico , Uganda , Malaria/tratamiento farmacológico , Malaria/parasitología , Fitoterapia
3.
Ann Intern Med ; 175(3): 325-334, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34978855

RESUMEN

BACKGROUND: Benign adrenal tumors are commonly discovered on cross-sectional imaging. Mild autonomous cortisol secretion (MACS) is regularly diagnosed, but its effect on cardiometabolic disease in affected persons is ill defined. OBJECTIVE: To determine cardiometabolic disease burden and steroid excretion in persons with benign adrenal tumors with and without MACS. DESIGN: Cross-sectional study. SETTING: 14 endocrine secondary and tertiary care centers (recruitment from 2011 to 2016). PARTICIPANTS: 1305 prospectively recruited persons with benign adrenal tumors. MEASUREMENTS: Cortisol excess was defined by clinical assessment and the 1-mg overnight dexamethasone-suppression test (serum cortisol: <50 nmol/L, nonfunctioning adrenal tumor [NFAT]; 50 to 138 nmol/L, possible MACS [MACS-1]; >138 nmol/L and absence of typical clinical Cushing syndrome [CS] features, definitive MACS [MACS-2]). Net steroid production was assessed by multisteroid profiling of 24-hour urine by tandem mass spectrometry. RESULTS: Of the 1305 participants, 49.7% had NFAT (n = 649; 64.1% women), 34.6% had MACS-1 (n = 451; 67.2% women), 10.7% had MACS-2 (n = 140; 73.6% women), and 5.0% had CS (n = 65; 86.2% women). Prevalence and severity of hypertension were higher in MACS-2 and CS than NFAT (adjusted prevalence ratios [aPRs] for hypertension: MACS-2, 1.15 [95% CI, 1.04 to 1.27], and CS, 1.37 [CI, 1.16 to 1.62]; aPRs for use of ≥3 antihypertensives: MACS-2, 1.31 [CI, 1.02 to 1.68], and CS, 2.22 [CI, 1.62 to 3.05]). Type 2 diabetes was more prevalent in CS than NFAT (aPR, 1.62 [CI, 1.08 to 2.42]) and more likely to require insulin therapy for MACS-2 (aPR, 1.89 [CI, 1.01 to 3.52]) and CS (aPR, 3.06 [CI, 1.60 to 5.85]). Urinary multisteroid profiling revealed an increase in glucocorticoid excretion from NFAT over MACS-1 and MACS-2 to CS, whereas androgen excretion decreased. LIMITATIONS: Cross-sectional design; possible selection bias. CONCLUSION: A cardiometabolic risk condition, MACS predominantly affects women and warrants regular assessment for hypertension and type 2 diabetes. PRIMARY FUNDING SOURCE: Diabetes UK, the European Commission, U.K. Medical Research Council, the U.K. Academy of Medical Sciences, the Wellcome Trust, the U.K. National Institute for Health Research, the U.S. National Institutes of Health, the Claire Khan Trust Fund at University Hospitals Birmingham Charities, and the Mayo Clinic Foundation for Medical Education and Research.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales , Enfermedades Cardiovasculares , Síndrome de Cushing , Diabetes Mellitus Tipo 2 , Hipertensión , Neoplasias de las Glándulas Suprarrenales/complicaciones , Enfermedades Cardiovasculares/complicaciones , Estudios Transversales , Síndrome de Cushing/complicaciones , Síndrome de Cushing/diagnóstico , Síndrome de Cushing/patología , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Humanos , Hidrocortisona , Hipertensión/complicaciones , Masculino
4.
Glob Chang Biol ; 28(4): 1414-1432, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34741793

RESUMEN

A better understanding of how climate affects growth in tree species is essential for improved predictions of forest dynamics under climate change. Long-term climate averages (mean climate) drive spatial variations in species' baseline growth rates, whereas deviations from these averages over time (anomalies) can create growth variation around the local baseline. However, the rarity of long-term tree census data spanning climatic gradients has so far limited our understanding of their respective role, especially in tropical systems. Furthermore, tree growth sensitivity to climate is likely to vary widely among species, and the ecological strategies underlying these differences remain poorly understood. Here, we utilize an exceptional dataset of 49 years of growth data for 509 tree species across 23 tropical rainforest plots along a climatic gradient to examine how multiannual tree growth responds to both climate means and anomalies, and how species' functional traits mediate these growth responses to climate. We show that anomalous increases in atmospheric evaporative demand and solar radiation consistently reduced tree growth. Drier forests and fast-growing species were more sensitive to water stress anomalies. In addition, species traits related to water use and photosynthesis partly explained differences in growth sensitivity to both climate means and anomalies. Our study demonstrates that both climate means and anomalies shape tree growth in tropical forests and that species traits can provide insights into understanding these demographic responses to climate change, offering a promising way forward to forecast tropical forest dynamics under different climate trajectories.


Asunto(s)
Árboles , Clima Tropical , Cambio Climático , Bosques , Hojas de la Planta
5.
J Stroke Cerebrovasc Dis ; 26(4): e72-e73, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28236596

RESUMEN

We report a case of a 58-year-old Hispanic man who developed ascending paraparesis over several weeks secondary to recurrent hemorrhages and resulting in spinal cord ischemia from a low thoracic spinal cord cavernous malformation. The patient's deterioration was attributed to recurrent hemorrhage of a thoracic intramedullary cavernous malformation at T11 resulting in vascular congestion and spinal cord ischemia. The patient was found to have a heterozygous mutation on exon 13 of gene KRIT1, which was consistent with autosomal dominant familial cerebral cavernous malformations. Expedited surgical intervention potentially could have prevented this patient's progressive paraplegia.


Asunto(s)
Vías Aferentes/patología , Hemangioma Cavernoso del Sistema Nervioso Central/complicaciones , Infarto/complicaciones , Médula Espinal/patología , Vías Aferentes/diagnóstico por imagen , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico por imagen , Humanos , Infarto/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Médula Espinal/diagnóstico por imagen
6.
Mo Med ; 114(2): 125-128, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-30228559

RESUMEN

This review seeks to educate clinicians and advocate for patients having acute-onset pediatric autoimmune encephalopathy. Primary care providers caring for children are not fully aware of the debilitating illness that changes the life of a child and a family overnight. Our goal is to heighten awareness of a) the initial diagnosis, b) treatment and c) information about referral of affected children by health professionals in Missouri and surrounding states.

7.
Plant Dis ; 99(1): 119-124, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30699747

RESUMEN

Root-knot nematodes (RKNs; Meloidogyne spp.) and Ralstonia solanacearum, the causal agent of bacterial wilt, are major soilborne pathogens in U.S. tomato production. Methyl bromide has been used for decades to effectively manage RKN but its phase-out and the high cost of other effective fumigants such as 1,3-dichloropropene has resulted in a need to develop sustainable alternatives. Many of the commercially popular varieties used by the tomato industry do not have resistance to RKNs and R. solanacearum. Recent studies worldwide have shown the potential for grafting using resistant rootstocks as a sustainable and ecofriendly practice for R. solanacearum management. However, the effectiveness of R. solanacearum-resistant rootstocks on RKN management is not known. In this study, three commercially available R. solanacearum-resistant tomato rootstocks ('RST-04-106-T', 'BHN 998', and 'BHN 1054') were evaluated for resistance to Meloidogyne incognita in field tomato production in four field trials conducted for two consecutive years in two geographical locations: Florida and Virginia. Grafting rootstocks onto 'BHN 602' a tomato scion susceptible to bacterial wilt and RKNs, significantly reduced root galling caused by RKNs in all four field trials and increased yield in two of the trials compared with the nongrafted treatment. This study demonstrates the potential of grafting for managing multiple soilborne pathogens using the same rootstocks.

8.
J Environ Qual ; 43(1): 208-14, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25602553

RESUMEN

The Soil and Water Assessment Tool (SWAT) is a basin-scale hydrologic model developed by the United States Department of Agriculture Agricultural Research Service. SWAT's broad applicability, user-friendly model interfaces, and automatic calibration software have led to a rapid increase in the number of new users. These advancements also allow less experienced users to conduct SWAT modeling applications. In particular, the use of automated calibration software may produce simulated values that appear appropriate because they adequately mimic measured data used in calibration and validation. Autocalibrated model applications (and often those of unexperienced modelers) may contain input data errors and inappropriate parameter adjustments not readily identified by users or the autocalibration software. The objective of this research was to develop a program to assist users in the identification of potential model application problems. The resulting "SWAT Check" is a stand-alone Microsoft Windows program that (i) reads selected SWAT output and alerts users of values outside the typical range; (ii) creates process-based figures for visualization of the appropriateness of output values, including important outputs that are commonly ignored; and (iii) detects and alerts users of common model application errors. By alerting users to potential model application problems, this software should assist the SWAT community in developing more reliable modeling applications.

9.
Bioorg Med Chem Lett ; 22(1): 76-81, 2012 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-22172704

RESUMEN

Hypoxia and ischemia are linked to several serious public health problems that affect most major organ systems. Specific examples include diseases of the cardiovascular, pulmonary, renal, neurologic, and musculoskeletal systems. The most significant pathway for cellular response to hypoxia is the hypoxia inducible factor (HIF) pathway. HIFs are transcription factors responsible for the activation of genes which encode proteins that mediate adaptive responses to reduced oxygen availability. A high-throughput cell-based HIF-mediated gene reporter screen was carried out using the NIH's Molecular Libraries Small Molecule Repository to identify activators of the HIF pathway. This communication describes the subsequent medicinal chemistry optimization of a triazine scaffold that led to the identification of the new molecular probe ML228. A discussion of HIF activation SAR within this chemotype as well as detailed in vitro characterization of the probe molecule is presented here.


Asunto(s)
Química Farmacéutica/métodos , Factor 1 Inducible por Hipoxia/metabolismo , Sondas Moleculares/farmacología , Piridinas/síntesis química , Triazinas/síntesis química , Animales , Relación Dosis-Respuesta a Droga , Diseño de Fármacos , Humanos , Hipoxia/tratamiento farmacológico , Modelos Químicos , Conformación Molecular , Neovascularización Patológica , Estructura Terciaria de Proteína , Piridinas/farmacología , Relación Estructura-Actividad , Triazinas/química , Triazinas/farmacología , Factor A de Crecimiento Endotelial Vascular/metabolismo
10.
Inorg Chem ; 51(24): 13096-102, 2012 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-23214426

RESUMEN

The successful preparation and isolation of the mixed-metal endohedral fullerene, LaSc(2)N@I(h)-C(80), and its structural characterization by single-crystal X-ray diffraction are reported. Results from chemically adjusting plasma temperature, energy, and reactivity (CAPTEAR) experiments indicate that a 10 wt % addition of Cu(NO(3))(2)·2.5H(2)O to a mixture of La(2)O(3) and Sc(2)O(3) decreases the amount of C(60) and C(70) found in soot extracts by an order of magnitude. By combining a stoichiometric 2-fold excess of La to Sc atoms in the plasma reactor, an extract containing a greater abundance of LaSc(2)N@I(h)-C(80) relative to Sc(3)N@I(h)-C(80) was obtained. Alternatively, the stir and filter approach (SAFA method) can be used to remove the empty cage fullerenes from a carbon soot sample prepared without using Cu(NO(3))(2)·2.5H(2)O. LaSc(2)N@I(h)-C(80) has been characterized by UV/vis absorption spectroscopy and by single-crystal X-ray diffraction. Ordered crystals with nearly identical orientations of the endohedral relative to the porphyrin have been obtained by cocrystallization of LaSc(2)N@I(h)-C(80) with either Ni(II)(OEP) or H(2)(OEP). The LaSc(2)N unit is planar, although earlier computations suggested that it would be pyramidal.

11.
J Trop Med ; 2022: 8392005, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35686208

RESUMEN

In 2015, emergent cases of localized cutaneous leishmaniasis (LCL) were reported in Tinum, Yucatan, Mexico. As part of an eco-epidemiological study to characterize the elements that trigger Leishmania infection in that area, we conducted a field study to investigate the occurrence of Leishmania infection in wild rodents. From November 2019 to February 2020, rodents were caught from three sites located in the municipality of Tinum, Yucatan. For each specimen, clinical signs suggestive of Leishmania infection were recorded. Samples from the tail, liver, and spleen were taken for the identification of Leishmania DNA by PCR. Twenty rodents belonging to two species were caught including Heteromys gaumeri (55%, 11/20) and Ototylomys phyllotis (45%, 9/20). Fifty-five percent of the animals presented white spots on the tail, 15% had splenomegaly, and 5% had hepatomegaly. Fifty-five percent (11/20) of the animals were found infected by Leishmania. Heteromys gaumeri was caught in all trapping sites and was the most infected species (63.6%, 7/11). The percentage of infection for O. phyllotis was 44.4% (4/9). Leishmania (Leishmania) mexicana was identified as the infecting species in two H. gaumeri. This study provides, for the first time, evidence of Leishmania infection in wild rodents from the Yucatan state. Heteromys gaumeri and O. phyllotis may be involved in the transmission cycle of L. mexicana in this emergent focus; however, further longitudinal studies are needed to confirm their role as primary reservoirs.

12.
Trop Med Infect Dis ; 7(12)2022 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-36548699

RESUMEN

Environmental changes triggered by deforestation, urban expansion and climate change are present-day drivers of the emergence and reemergence of leishmaniasis. This review describes the current epidemiological scenario and the feasible influence of environmental changes on disease occurrence in the state of Yucatan, Mexico. Relevant literature was accessed through different databases, including PubMed, Scopus, Google, and Mexican official morbidity databases. Recent LCL autochthonous cases, potential vector sandflies and mammal hosts/reservoirs also have been reported in several localities of Yucatan without previous historical records of the disease. The impact of deforestation, urban expansion and projections on climate change have been documented. The current evidence of the relationships between the components of the transmission cycle, the disease occurrence, and the environmental changes on the leishmaniasis emergence in the state shows the need for strength and an update to the intervention and control strategies through a One Health perspective.

13.
Biochem Biophys Res Commun ; 409(3): 500-5, 2011 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-21600878

RESUMEN

Metformin (Met), an AMP-activated protein kinase (AMPK) inducer, is primarily transported by organic cation transporters expressed at the surface of renal proximal tubular epithelial cells. However, the implication of Met in renal function remains poorly understood. Interestingly, AICAR, another AMPK inducer, has been shown to inhibit the Unfolded Protein Response (UPR) generated by tunicamycin in cardiomyocytes in an AMPK-kinase dependent fashion suggesting metformin may also block the UPR. In this work, we have examined the effect of metformin on the expression of UPR-related markers (GRP94 and CHOP) induced by glucosamine (GlcN), 2-deoxyglucose (2-DOG) and tunicamycin (TUNI) in renal proximal tubular epithelial cells and in murine mesangial cells. Met attenuated GRP94 and CHOP expression induced by GlcN and 2-DOG, but not TUNI only in renal epithelial cells, even though the AMPK activation was observed in both renal epithelial and mesangial cells. Met did not require the contribution of its AMPK kinase inducing activity to block UPR markers expression. This report has identified a novel inhibitory function of metformin on UPR, which may have a beneficial impact on kidney homeostatic function.


Asunto(s)
Hipoglucemiantes/farmacología , Túbulos Renales Proximales/efectos de los fármacos , Metformina/farmacología , Respuesta de Proteína Desplegada/efectos de los fármacos , Quinasas de la Proteína-Quinasa Activada por el AMP , Animales , Desoxiglucosa/farmacología , Células Epiteliales/efectos de los fármacos , Células Epiteliales/metabolismo , Glucosamina/farmacología , Proteínas HSP70 de Choque Térmico/metabolismo , Haplorrinos , Túbulos Renales Proximales/citología , Túbulos Renales Proximales/metabolismo , Proteínas de la Membrana/metabolismo , Proteínas Quinasas/metabolismo , Porcinos , Factor de Transcripción CHOP/metabolismo , Tunicamicina/farmacología
14.
Biol Res ; 44(2): 195-9, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22513423

RESUMEN

The aim of this study was to review the experience and outcomes of assisted reproduction cycles with embryos grown up to day 5 of development, comparing different parameters according to the ages of the patients. We retrospectively studied 1,874 assisted reproduction cycles where embryo culture was extended up to the fifth or sixth day of development. All IVF and ICSI cycles were included, comparing, according to patient age, the following rates: blastocyst formation, pregnancy, implantation and abortion. As control, we analyzed cycles with donated oocytes from young donors (OD). The number of embryos reaching the blastocyst stage is similar in all groups of patients. Only the OD group was different in terms of blastocyst formation, pregnancy and implantation rates. Patients over 39 years of age had an abortion rate of 59.1 %, which is significantly higher than the other groups. Extended embryo culture up to the blastocyst stage can be implemented in programs of assisted reproduction in order to increase the pregnancy rate. The potential of blastocyst implantation is high, allowing us to transfer fewer embryos and reduce the probability of multiple pregnancies.


Asunto(s)
Técnicas de Cultivo de Embriones/métodos , Transferencia de Embrión/métodos , Fertilización In Vitro/métodos , Embarazo Múltiple , Adulto , Criopreservación , Femenino , Humanos , Edad Materna , Embarazo , Resultado del Embarazo , Índice de Embarazo , Estudios Retrospectivos , Factores de Tiempo
15.
Artículo en Inglés | MEDLINE | ID: mdl-24427883

RESUMEN

Laboratory studies were conducted to evaluate effect of microwave irradiation of sandy loam soil on thermal energy absorption and control of plant-parasitic nematodes when air dry soil layers were placed on top of less moist, moist, and wet soil layers. The soil was packed in 12 cm high and 10 cm dia columns to a bulk density of 1.4 g/cm3. Moisture contents of air dry, less moist, moist, and wet soils were 0.75, 4.50, 6.00, and 10.30%, respectively, on dry mass basis. The top air dry soil was 4.0 cm thick and the bottom layer was 8.0 cm thick. Temperature measurements and thermal radiation absorption data were monitored in both soil layers and showed that the use of a top dry soil both increased depth of penetration of microwave radiation and it provided insulation for better absorption of thermal energy in the lower layer of soil. An exposure of 65 seconds resulted in soil temperatures high enough to cause significant decrease in nematode population in soil infested with Rotylenchulus reniformis nematodes. No such effect was observed in combination where dry soil layer was placed over dry soil at the bottom. These results are helpful in sterilizing soil used for greenhouses and nurseries.


Asunto(s)
Calefacción/métodos , Humedad , Nematodos/fisiología , Nematodos/efectos de la radiación , Plantas/parasitología , Plantas/efectos de la radiación , Suelo/parasitología , Animales , Desinfección/métodos , Relación Dosis-Respuesta en la Radiación , Dosis de Radiación , Tasa de Supervivencia
16.
MMWR Surveill Summ ; 70(7): 1-20, 2021 11 05.
Artículo en Inglés | MEDLINE | ID: mdl-34735419

RESUMEN

PROBLEM: Sexually transmitted diseases (STDs) are a major cause of morbidity in the United States, with an estimated $15.9 billion in lifetime direct medical costs. Although the majority of STDs are diagnosed in the private sector, publicly funded STD clinics have an important role in providing comprehensive sexual health care services, including STD and HIV screening, for a broad range of patients. In certain cases, STD clinics often are the only source of sexual health care for patients, particularly among gay, bisexual, and other men who have sex with men (MSM). PERIOD COVERED: 2010-2018. DESCRIPTION OF THE SYSTEM: The STD Surveillance Network (SSuN) is an ongoing sentinel surveillance system for monitoring clinical information among patients attending STD clinics. SSuN is a collaboration of competitively selected state and city health departments that conduct facility-based sentinel surveillance in STD clinics. Information routinely collected through the course of patient encounters is obtained for all patients seeking care in the participating STD clinics. This information includes demographic, behavioral, and clinical characteristics (e.g., STD and HIV tests performed and STD and HIV diagnoses). This report presents 2010-2018 SSuN data from 14 STD clinics in five cities (Baltimore, Maryland; New York City, New York; Philadelphia, Pennsylvania; San Francisco, California; and Seattle, Washington) to describe the patient populations seeking care in these STD clinics. Estimated numbers and percentages of patients receiving selected STD-related health services were calculated for each year by using an inverse variance weighted random-effects model, adjusting for heterogeneity among SSuN jurisdictions. Trends in receipt of selected STD-related health services were examined and included HIV screening after an acute STD diagnosis among persons not previously known to have HIV infection, annual chlamydia screening among adolescent and young females, and extragenital chlamydia and gonorrhea screening among MSM. RESULTS: During 2010-2018, the total number of annual visits made in the 14 participating STD clinics decreased 29.8% (from 145,728 to 102,275 visits), and the total number of unique patients examined in the clinics decreased 35.1% (from 94,281 to 61,172 patients). Decreases in the number of unique patients occurred both among men who have sex with women only (42.4%; from 37,842 in 2010 to 21,781 in 2018) and among females (51.4%; from 36,485 in 2010 to 17,721 in 2018). The decreases in the number of female patients were observed across all age groups, although they were more pronounced among females aged ≤24 years (66.4%; from 17,721 in 2010 to 5,962 in 2018). In contrast, the number of patients identified as MSM increased 44.0% (from 12,859 in 2010 to 18,512 in 2018), with the greatest increase among MSM aged ≥25 years (58.6%; from 9,918 in 2010 to 15,733 in 2018). Among visits during which an acute STD (defined as chlamydia, gonorrhea, or primary or secondary syphilis) was diagnosed, the percentage of visits during which an HIV test was performed within approximately 14 days of the STD diagnosis increased from 58.2% in 2010 to 70.2% in 2018. Among those patients tested, 1,672 HIV infections were identified, of which 84.0% were among MSM. Among females aged 15-24 years, the percentage screened for chlamydia in any calendar year increased from 88.6% in 2010 to 90.6% in 2018. However, because fewer females aged 15-24 years attended these clinics during the study period, the crude number of adolescent and young females tested for chlamydia decreased from 14,249 in 2010 to 4,507 in 2018. During 2010-2018, the percentage of females retested after their first positive chlamydia diagnosis during the same year ranged from 11.4% to 13.3%. During 2010-2018, the percentage of MSM tested for rectal chlamydia and rectal gonorrhea increased (from 54.7% to 57.8% and from 55.0% to 58.4%, respectively). During the same period, increases were noted in the percentage of MSM with diagnosed rectal chlamydia (from 15.5% in 2010 to 17.7% in 2018) and rectal gonorrhea (from 13.3% in 2010 to 17.1% in 2018). In contrast with pharyngeal chlamydia, pharyngeal gonorrhea screening was more common (from 69.5% in 2010 to 74.6% in 2018), and the percentage positive doubled during the study period (from 7.3% in 2010 to 14.8% in 2018). Pharyngeal chlamydia testing also increased (from 50.3% in 2010 to 72.9% in 2018), with concurrent decreases in positivity (from 4.2% in 2010 to 2.6% in 2018). INTERPRETATION: During 2010-2018, changes occurred in the demographic composition of patients attending STD clinics participating in SSuN. Understanding trends in the demographic profile of STD patients and services provided can help identify addressable gaps in STD control efforts and direct public health action. Overall, fewer females, especially those aged 15-24 years, accessed care in these STD clinics during the study period. Untreated STDs among adolescent and young females can have serious consequences, including pelvic inflammatory disease and infertility. Additional efforts to monitor where adolescent and young females seek care and to ensure they are receiving quality STD-related health services are needed, especially considering increases in reported cases of STDs among females. Increases in the number of MSM attending STD clinics present a unique opportunity to reach this population with STD and HIV prevention services. Although a large percentage of STD cases are diagnosed outside of STD clinics, publicly funded STD clinics are an important safety-net provider of STD-related health services and provide vital STD-related health services for patient populations at risk for the consequences of STDs and HIV infection. PUBLIC HEALTH ACTIONS: STD-related health services represent effective strategies for preventing STD and HIV transmission and acquisition or STD-related sequelae. Ensuring that all persons receive quality HIV and STD prevention and treatment services is vital for an effective public health approach to reducing STDs. STD clinics provide crucial safety-net services for preventing STD-related morbidity, including timely identification and treatment of curable STDs such as chlamydia, gonorrhea, and syphilis. Increases in the numbers of MSM attending STD clinics participating in SSuN provide additional opportunities for linking patients to high-impact HIV preventive services (e.g., pre-exposure prophylaxis), and the clinics are positioned to facilitate initiation or resumption of treatment among persons living with HIV.


Asunto(s)
Instituciones de Atención Ambulatoria/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Vigilancia de Guardia , Enfermedades de Transmisión Sexual/terapia , Adolescente , Distribución por Edad , Femenino , Humanos , Masculino , Distribución por Sexo , Conducta Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Estados Unidos/epidemiología , Adulto Joven
17.
Transbound Emerg Dis ; 68(4): 2422-2428, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33131161

RESUMEN

The bovine trypanosomosis is responsible for economic losses from tropical and subtropical areas of Africa and Latin America. This disease is characterized by fever, anaemia, loss of production and even death. Few studies have been carried out in Ecuador regarding Trypanosoma spp. presence but the species has not been determined in cattle and those have only determined the presence of genus, but not the species. The aim of this study was to identify and characterize the trypanosome species involved in the suspected bovine trypanosomosis outbreak reported in Convento Village in Manabí Province located in the coastal region of Ecuador. Twenty cattle from three farms were sampled. Three samples were positive for T. vivax, using an end-point polymerase chain reaction (PCR) to amplify a fragment of the cathepsin L-like cysteine protease (CatL-like) gene. A phylogenetic tree analysis of these three Ecuadorian isolates showed a close relationship with isolates from South America (Colombia, Brazil and Venezuela) and West Africa (Nigeria). This is the first report of T. vivax in Ecuadorian cattle.


Asunto(s)
Enfermedades de los Bovinos , Trypanosoma vivax , Trypanosoma , Animales , Brasil , Bovinos , Enfermedades de los Bovinos/epidemiología , Brotes de Enfermedades/veterinaria , Ecuador/epidemiología , Nigeria , Filogenia , Trypanosoma/genética , Trypanosoma vivax/clasificación , Trypanosoma vivax/genética , Trypanosoma vivax/aislamiento & purificación
18.
Environ Manage ; 45(3): 577-89, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20108137

RESUMEN

Potential economic impacts of future climate change on crop enterprise net returns and annual net farm income (NFI) are evaluated for small and large representative farms in Flathead Valley in Northwest Montana. Crop enterprise net returns and NFI in an historical climate period (1960-2005) and future climate period (2006-2050) are compared when agricultural production systems (APSs) are adapted to future climate change. Climate conditions in the future climate period are based on the A1B, B1, and A2 CO(2) emission scenarios from the Intergovernmental Panel on Climate Change Fourth Assessment Report. Steps in the evaluation include: (1) specifying crop enterprises and APSs (i.e., combinations of crop enterprises) in consultation with locals producers; (2) simulating crop yields for two soils, crop prices, crop enterprises costs, and NFIs for APSs; (3) determining the dominant APS in the historical and future climate periods in terms of NFI; and (4) determining whether NFI for the dominant APS in the historical climate period is superior to NFI for the dominant APS in the future climate period. Crop yields are simulated using the Environmental/Policy Integrated Climate (EPIC) model and dominance comparisons for NFI are based on the stochastic efficiency with respect to a function (SERF) criterion. Probability distributions that best fit the EPIC-simulated crop yields are used to simulate 100 values for crop yields for the two soils in the historical and future climate periods. Best-fitting probability distributions for historical inflation-adjusted crop prices and specified triangular probability distributions for crop enterprise costs are used to simulate 100 values for crop prices and crop enterprise costs. Averaged over all crop enterprises, farm sizes, and soil types, simulated net return per ha averaged over all crop enterprises decreased 24% and simulated mean NFI for APSs decreased 57% between the historical and future climate periods. Although adapting APSs to future climate change is advantageous (i.e., NFI with adaptation is superior to NFI without adaptation based on SERF), in six of the nine cases in which adaptation is advantageous, NFI with adaptation in the future climate period is inferior to NFI in the historical climate period. Therefore, adaptation of APSs to future climate change in Flathead Valley is insufficient to offset the adverse impacts on NFI of such change.


Asunto(s)
Agricultura/economía , Agricultura/métodos , Cambio Climático , Participación de la Comunidad , Simulación por Computador , Productos Agrícolas , Renta , Modelos Teóricos , Montana , Reproducibilidad de los Resultados
19.
Cureus ; 12(3): e7445, 2020 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-32351824

RESUMEN

Extracranial osseous compression of the internal jugular vein (IJV) is exceedingly rare. The clinical manifestations of IJV obstruction are very heterogeneous and subtle, and arriving at a diagnosis can be challenging. We describe a case of dynamic IJV compression in a 40-year-old male with progressive, positional, ill-defined right periorbital and neck pain associated with photosensitivity. Imaging showed a hypertrophic right hyoid bone; computed tomography venogram (CTV) with challenging maneuvers demonstrated dynamic compression of the ipsilateral IJV by a hypertrophied hyoid bone and thyroid cartilage. The patient underwent decompression of the right jugular vein which resulted in the resolution of his symptoms. The clinical manifestations of extracranial IJV impingement are variable and diagnostically challenging. Disturbances in extracranial IJV outflow is a diagnosis of exclusion and could be responsible for atypical facial pain in a select group of patients. This entity should be considered in the differential of atypical facial, especially when symptoms tend to be positional.

20.
Can J Cardiol ; 36(9): 1474-1481, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32603699

RESUMEN

BACKGROUND: Aortic stiffness is an important marker of cardiovascular risk and is elevated in children and adolescents with congenital heart disease (CHD) compared with healthy children; however, in children with CHD, little is known about the interaction between aortic stiffness and physical activity-a key determinant of aortic stiffness. METHODS: For this cross-sectional cohort study, we recruited children and adolescents aged 9-16 years with moderate-to-complex CHD from British Columbia Children's Hospital and travelling partnership clinics across the province of British Columbia and the Yukon territory. Mean daily minutes of moderate-to-vigorous physical activity were objectively assessed using an ActiGraph accelerometer worn over the right hip during waking hours for 7 days. Aortic pulse wave velocity (cm/s) was measured using standard 2-dimensional echocardiography and Doppler ultrasound. RESULTS: Participants (n = 104, 61% male; 85% consent rate) had a mean (standard deviation) age of 12.4 (2.4) years. Daily moderate-to-vigorous physical activity was 46.7 (20.0) minutes/d, with 25% meeting guidelines of ≥ 60 minutes of moderate-to-vigorous physical activity per day. Mean (standard deviation) aortic pulse wave velocity was 490.5 (161.9) cm/s, which was not significantly different between cardiac diagnoses. Higher levels of moderate-to-vigorous physical activity were associated with lower aortic pulse wave velocity (r = -0.226, P = 0.021). CONCLUSION: In children and adolescents with CHD, higher levels of physical activity are associated with better vascular function. Given this association, promoting physical activity should be a high priority in the care of children and adolescents with CHD.


Asunto(s)
Ejercicio Físico/fisiología , Cardiopatías Congénitas/fisiopatología , Rigidez Vascular/fisiología , Acelerometría , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Análisis de la Onda del Pulso
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA