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1.
Lancet Planet Health ; 5(4): e237-e245, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33684341

RESUMEN

The rapid global spread and human health impacts of SARS-CoV-2, the virus that causes COVID-19, show humanity's vulnerability to zoonotic disease pandemics. Although anthropogenic land use change is known to be the major driver of zoonotic pathogen spillover from wildlife to human populations, the scientific underpinnings of land use-induced zoonotic spillover have rarely been investigated from the landscape perspective. We call for interdisciplinary collaborations to advance knowledge on land use implications for zoonotic disease emergence with a view toward informing the decisions needed to protect human health. In particular, we urge a mechanistic focus on the zoonotic pathogen infect-shed-spill-spread cascade to enable protection of landscape immunity-the ecological conditions that reduce the risk of pathogen spillover from reservoir hosts-as a conservation and biosecurity priority. Results are urgently needed to formulate an integrated, holistic set of science-based policy and management measures that effectively and cost-efficiently minimise zoonotic disease risk. We consider opportunities to better institute the necessary scientific collaboration, address primary technical challenges, and advance policy and management issues that warrant particular attention to effectively address health security from local to global scales.


Asunto(s)
Animales Salvajes/virología , Ecosistema , Política Ambiental , Salud Pública , Zoonosis/epidemiología , Animales , Biodiversidad , COVID-19 , Humanos , Colaboración Intersectorial , SARS-CoV-2/patogenicidad
2.
Urology ; 145: 113-119, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32721517

RESUMEN

OBJECTIVE: To understand how to potentially improve inappropriate prostate cancer imaging rates we used National Comprehensive Cancer Network's guidelines to design and implement a Clinical Reminder Order Check (CROC) that alerts ordering providers of potentially inappropriate imaging orders in real-time based on patient features of men diagnosed with low-risk prostate cancer. METHODS: We implemented the CROC at VA New York Harbor Healthcare System from April 2, 2015 to November 15, 2017. We then used VA administrative claims from the VA's Corporate Data Warehouse to analyze imaging rates among men with low-risk prostate cancer at VA New York Harbor Healthcare System before and after CROC implementation. We also collected and cataloged provider responses in response to overriding the CROC in qualitative analysis. RESULTS FIFTY SEVEN PERCENT: (117/205) of Veterans before CROC installation and 73% (61/83) of Veterans post-intervention with low-risk prostate cancer received guideline-concordant care. CONCLUSION: While the decrease in inappropriate imaging during our study window was almost certainly due to many factors, a Computerized Patient Record System-based CROC intervention is likely associated with at least moderate improvement in guideline-concordant imaging practices for Veterans with low-risk prostate cancer.


Asunto(s)
Sistemas de Entrada de Órdenes Médicas/organización & administración , Uso Excesivo de los Servicios de Salud/prevención & control , Próstata/diagnóstico por imagen , Neoplasias de la Próstata/diagnóstico , Sistemas Recordatorios , Estudios de Evaluación como Asunto , Adhesión a Directriz/organización & administración , Adhesión a Directriz/normas , Adhesión a Directriz/estadística & datos numéricos , Humanos , Masculino , Sistemas de Entrada de Órdenes Médicas/normas , Sistemas de Entrada de Órdenes Médicas/estadística & datos numéricos , Uso Excesivo de los Servicios de Salud/estadística & datos numéricos , Proyectos Piloto , Guías de Práctica Clínica como Asunto , Estados Unidos
3.
Artículo en Inglés | MEDLINE | ID: mdl-29531144

RESUMEN

Human activities create novel food resources that can alter wildlife-pathogen interactions. If resources amplify or dampen, pathogen transmission probably depends on both host ecology and pathogen biology, but studies that measure responses to provisioning across both scales are rare. We tested these relationships with a 4-year study of 369 common vampire bats across 10 sites in Peru and Belize that differ in the abundance of livestock, an important anthropogenic food source. We quantified innate and adaptive immunity from bats and assessed infection with two common bacteria. We predicted that abundant livestock could reduce starvation and foraging effort, allowing for greater investments in immunity. Bats from high-livestock sites had higher microbicidal activity and proportions of neutrophils but lower immunoglobulin G and proportions of lymphocytes, suggesting more investment in innate relative to adaptive immunity and either greater chronic stress or pathogen exposure. This relationship was most pronounced in reproductive bats, which were also more common in high-livestock sites, suggesting feedbacks between demographic correlates of provisioning and immunity. Infection with both Bartonella and haemoplasmas were correlated with similar immune profiles, and both pathogens tended to be less prevalent in high-livestock sites, although effects were weaker for haemoplasmas. These differing responses to provisioning might therefore reflect distinct transmission processes. Predicting how provisioning alters host-pathogen interactions requires considering how both within-host processes and transmission modes respond to resource shifts.This article is part of the theme issue 'Anthropogenic resource subsidies and host-parasite dynamics in wildlife'.


Asunto(s)
Infecciones por Bartonella/veterinaria , Quirópteros/inmunología , Inmunidad Innata , Infecciones por Mycoplasma/veterinaria , Reproducción/fisiología , Inmunidad Adaptativa , Animales , Bartonella/inmunología , Infecciones por Bartonella/epidemiología , Infecciones por Bartonella/inmunología , Infecciones por Bartonella/microbiología , Belice/epidemiología , Quirópteros/microbiología , Ingestión de Alimentos/fisiología , Femenino , Interacciones Huésped-Patógeno/inmunología , Inmunoglobulina G , Ganado/fisiología , Linfocitos/inmunología , Linfocitos/microbiología , Masculino , Mycoplasma/inmunología , Infecciones por Mycoplasma/epidemiología , Infecciones por Mycoplasma/inmunología , Infecciones por Mycoplasma/microbiología , Neutrófilos/inmunología , Neutrófilos/microbiología , Perú/epidemiología , Dinámica Poblacional
4.
J Cell Biol ; 158(4): 801-15, 2002 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-12186857

RESUMEN

Glycoprotein fucosylation enables fringe-dependent modulation of signal transduction by Notch transmembrane receptors, contributes to selectin-dependent leukocyte trafficking, and is faulty in leukocyte adhesion deficiency (LAD) type II, also known as congenital disorder of glycosylation (CDG)-IIc, a rare human disorder characterized by psychomotor defects, developmental abnormalities, and leukocyte adhesion defects. We report here that mice with an induced null mutation in the FX locus, which encodes an enzyme in the de novo pathway for GDP-fucose synthesis, exhibit a virtually complete deficiency of cellular fucosylation, and variable frequency of intrauterine demise determined by parental FX genotype. Live-born FX(-/-) mice exhibit postnatal failure to thrive that is suppressed with a fucose-supplemented diet. FX(-/-) adults suffer from an extreme neutrophilia, myeloproliferation, and absence of leukocyte selectin ligand expression reminiscent of LAD-II/CDG-IIc. Contingent restoration of leukocyte and endothelial selectin ligand expression, general cellular fucosylation, and normal postnatal physiology is achieved by modulating dietary fucose to supply a salvage pathway for GDP-fucose synthesis. Conditional control of fucosylation in FX(-/-) mice identifies cellular fucosylation events as essential concomitants to fertility, early growth and development, and leukocyte adhesion.


Asunto(s)
Carbohidrato Epimerasas/metabolismo , Proteínas de Escherichia coli/metabolismo , Fucosa/metabolismo , Integrinas/metabolismo , Cetona Oxidorreductasas/metabolismo , Leucocitosis/genética , Complejos Multienzimáticos/metabolismo , Selectinas/metabolismo , Animales , Animales Modificados Genéticamente , Carbohidrato Epimerasas/genética , Suplementos Dietéticos , Embrión de Mamíferos/anomalías , Proteínas de Escherichia coli/genética , Femenino , Viabilidad Fetal , Genotipo , Cetona Oxidorreductasas/genética , Síndrome de Deficiencia de Adhesión del Leucocito/genética , Síndrome de Deficiencia de Adhesión del Leucocito/metabolismo , Leucocitosis/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Complejos Multienzimáticos/genética , Mutación , Fenotipo , Polisacáridos/metabolismo
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