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1.
Nature ; 607(7918): 256-259, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35831603

RESUMEN

Fast radio bursts (FRBs) are millisecond-duration flashes of radio waves that are visible at distances of billions of light years1. The nature of their progenitors and their emission mechanism remain open astrophysical questions2. Here we report the detection of the multicomponent FRB 20191221A and the identification of a periodic separation of 216.8(1) ms between its components, with a significance of 6.5σ. The long (roughly 3 s) duration and nine or more components forming the pulse profile make this source an outlier in the FRB population. Such short periodicity provides strong evidence for a neutron-star origin of the event. Moreover, our detection favours emission arising from the neutron-star magnetosphere3,4, as opposed to emission regions located further away from the star, as predicted by some models5.

2.
Mol Psychiatry ; 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38719894

RESUMEN

Post-traumatic stress disorder (PTSD) is a hypermnesic condition that develops in a subset of individuals following exposure to severe trauma. PTSD symptoms are debilitating, and include increased anxiety, abnormal threat generalization, and impaired extinction. In developing treatment strategies for PTSD, preclinical studies in rodents have largely focused on interventions that target post-encoding memory processes such as reconsolidation and extinction. Instead, here we focus on forgetting, another post-encoding process that regulates memory expression. Using a double trauma murine model for PTSD, we asked whether promoting neurogenesis-mediated forgetting can weaken trauma memories and associated PTSD-relevant behavioral phenotypes. In the double trauma paradigm, consecutive aversive experiences lead to a constellation of behavioral phenotypes associated with PTSD including increases in anxiety-like behavior, abnormal threat generalization, and deficient extinction. We found that post-training interventions that elevate hippocampal neurogenesis weakened the original trauma memory and decreased these PTSD-relevant phenotypes. These effects were observed using multiple methods to manipulate hippocampal neurogenesis, including interventions restricted to neural progenitor cells that selectively promoted integration of adult-generated granule cells into hippocampal circuits. The same interventions also weakened cocaine place preference memories, suggesting that promoting hippocampal neurogenesis may represent a broadly useful approach in hypermnesic conditions such as PTSD and substance abuse disorders.

3.
Proc Natl Acad Sci U S A ; 119(34): e2122667119, 2022 08 23.
Artículo en Inglés | MEDLINE | ID: mdl-35972961

RESUMEN

Field biology is an area of research that involves working directly with living organisms in situ through a practice known as "fieldwork." Conducting fieldwork often requires complex logistical planning within multiregional or multinational teams, interacting with local communities at field sites, and collaborative research led by one or a few of the core team members. However, existing power imbalances stemming from geopolitical history, discrimination, and professional position, among other factors, perpetuate inequities when conducting these research endeavors. After reflecting on our own research programs, we propose four general principles to guide equitable, inclusive, ethical, and safe practices in field biology: be collaborative, be respectful, be legal, and be safe. Although many biologists already structure their field programs around these principles or similar values, executing equitable research practices can prove challenging and requires careful consideration, especially by those in positions with relatively greater privilege. Based on experiences and input from a diverse group of global collaborators, we provide suggestions for action-oriented approaches to make field biology more equitable, with particular attention to how those with greater privilege can contribute. While we acknowledge that not all suggestions will be applicable to every institution or program, we hope that they will generate discussions and provide a baseline for training in proactive, equitable fieldwork practices.


Asunto(s)
Discusiones Bioéticas , Biología , Biología/ética , Humanos
4.
J Environ Manage ; 352: 120042, 2024 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-38198843

RESUMEN

An increasing number of countries and regions consider the bioeconomy transition a strategic policy priority. When approached through the lens of a circular economy perspective, investments in bioeconomy have the potential to enhance resource utilisation efficiency, preserve biodiversity and ecosystems, and foster sustainable development with low emissions. At the same time, if requirements and contextual factors of bioeconomy strategies are not formally analysed, bioeconomic investments might lead to unintended negative consequences. This paper proposes a decision support procedure to design, assess, prioritise, and monitor bioeconomy investments and policies. The flexibility and scalability of our decision support procedure is tested in Colombia to foster a regional and local transition to bioeconomy initiatives that consider the local capital assets and the stakeholders' views. The heterogeneous character of the Colombian environment, economy, society and culture represents an ideal condition to test the strength of the decision support procedure to promote bioeconomy in low and middle-income countries. Our empirical results highlight the benefit of adopting a formal assessment framework that includes strategic national indicators, regional features and stakeholders' views. In terms of the Colombian regional bioeconomy ambitions, we highlight the need for expanding knowledge hubs and participatory stakeholder networks and buttressing appropriate financial mechanisms.


Asunto(s)
Desarrollo Económico , Ecosistema , Colombia , Desarrollo Sostenible , Políticas
5.
Stroke ; 54(10): 2652-2665, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37694402

RESUMEN

BACKGROUND: Cognitive dysfunction is a frequent stroke sequela, but its pathogenesis and treatment remain unresolved. Involvement of aberrant hippocampal neurogenesis and maladaptive circuitry remodeling has been proposed, but their mechanisms are unknown. Our aim was to evaluate potential underlying molecular/cellular events implicated. METHODS: Stroke was induced by permanent occlusion of the middle cerebral artery occlusion in 2-month-old C57BL/6 male mice. Hippocampal metabolites/neurotransmitters were analyzed longitudinally by in vivo magnetic resonance spectroscopy. Cognitive function was evaluated with the contextual fear conditioning test. Microglia, astrocytes, neuroblasts, interneurons, γ-aminobutyric acid (GABA), and c-fos were analyzed by immunofluorescence. RESULTS: Approximately 50% of mice exhibited progressive post-middle cerebral artery occlusion cognitive impairment. Notably, immature hippocampal neurons in the impaired group displayed more severe aberrant phenotypes than those from the nonimpaired group. Using magnetic resonance spectroscopy, significant bilateral changes in hippocampal metabolites, such as myo-inositol or N-acetylaspartic acid, were found that correlated, respectively, with numbers of glia and immature neuroblasts in the ischemic group. Importantly, some metabolites were specifically altered in the ipsilateral hippocampus suggesting its involvement in aberrant hippocampal neurogenesis and remodeling processes. Specifically, middle cerebral artery occlusion animals with higher hippocampal GABA levels displayed worse cognitive outcome. Implication of GABA in this setting was supported by the amelioration of ischemia-induced memory deficits and aberrant hippocampal neurogenesis after blocking pharmacologically GABAergic neurotransmission, an intervention which was ineffective when neurogenesis was inhibited. These data suggest that GABA exerts its detrimental effect, at least partly, by affecting morphology and integration of newborn neurons into the hippocampal circuits. CONCLUSIONS: Hippocampal GABAergic neurotransmission could be considered a novel diagnostic and therapeutic target for poststroke cognitive impairment.


Asunto(s)
Disfunción Cognitiva , Accidente Cerebrovascular , Masculino , Animales , Ratones , Ratones Endogámicos C57BL , Infarto de la Arteria Cerebral Media , Disfunción Cognitiva/etiología , Hipocampo , Neurogénesis
6.
J Anim Ecol ; 92(4): 925-935, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36744653

RESUMEN

Climate temporality is a phenomenon that affects species activity and distribution patterns across spatial and temporal scales. Despite the global availability of microclimatic data, their use to predict activity patterns and distributions remains scarce, particularly at fine temporal scales (e.g. < month). Predicting activity patterns based on climatic data may allow us to foresee some of the consequences of climate change, particularly for ectothermic vertebrates. The Gila monster exhibits marked daily and seasonal activity patterns linked to physiology and reproduction. Here we evaluate whether ecological niche models fitted using microclimate data can predict temporal activity patterns using the Gila monster Heloderma suspectum as a study system. Furthermore, we identified whether the activity patterns are related to physiological constraints. We used dated occurrences from museum specimens and human observations to generate and test ecological niche models using minimum volume ellipsoids. We generated hourly microclimatic data for each occurrence site for 10 years using the NicheMapR package. For ecological niche modelling, we compared the traditional seasonal approach versus a daily activity pattern strategy for model construction. We tested both using the omission rate of independent observations (citizen science data). Finally, we tested whether unimodal and bimodal activity patterns for each season could be recreated through ecological niche modelling and whether these patterns followed known physiological constraints. The unimodal and bimodal activity patterns previously reported directly from tracking individuals across the year were recovered using niche modelling and microclimate across the species' geographical range. We found that upper thermal tolerances can explain the daily activity patterns of this species. We conclude that ecological niche models trained with microclimatic data can be used to predict activity patterns at high temporal resolutions, particularly on ectotherm species of arid zones coping with rapid climate modifications. Furthermore, the use of high temporal resolution variables can lead to a better niche delimitation, enhancing the results of any research objective that uses correlative models.


La estacionalidad climática es un fenómeno que afecta la actividad de las especies y los patrones de distribución a diferentes escalas espaciales y temporales. A pesar de la disponibilidad global de datos microclimáticos para estudiar dichos patrones, su uso sigue siendo escaso, particularmente en escalas temporales finas (e.g., < mes). La predicción de patrones de actividad basados en datos climáticos puede permitirnos prever algunas de las potenciales consecuencias del cambio climático, particularmente para los vertebrados ectotérmicos. El monstruo de Gila (Heloderma suspectum) exhibe marcados patrones de actividad diarios y estacionales vinculados a la fisiología y la reproducción. En este trabajo evaluamos cómo los modelos de nichos ecológicos ajustados con datos de microclima, pueden predecir patrones de actividad temporal, utilizando al monstruo de Gila como sistema de estudio. Además, identificamos si los patrones de actividad están relacionados con restricciones fisiológicas. Usamos registros de presencia provenientes de colecciones científicas y de ciencia ciudadana para generar y probar modelos de nichos ecológicos usando elipsoides de volumen mínimo. Generamos datos microclimáticos para cada hora en cada sitio de presencia durante diez años utilizando el paquete NicheMapR. Para el modelado de nichos ecológicos, comparamos el enfoque estacional tradicional con una estrategia de patrón de actividad diaria para la construcción del nicho. Ambos enfoques fueron probados utilizando la tasa de omisión de observaciones independientes (provenientes de datos de ciencia ciudadana). Finalmente, probamos si los patrones de actividad unimodales y bimodales para cada estación podían recrearse a través de modelos de nichos ecológicos y si estos patrones seguían restricciones fisiológicas conocidas. Los patrones de actividad unimodal y bimodal previamente informados directamente del seguimiento de individuos a lo largo del año, sí se recuperaron mediante el uso de modelos de nicho y microclimas en todo el rango geográfico de la especie. Encontramos también que las tolerancias térmicas superiores pueden explicar los patrones de actividad diaria de esta especie. Concluimos que los modelos de nichos ecológicos entrenados con datos microclimáticos pueden usarse para predecir patrones de actividad en altas resoluciones temporales, particularmente en especies ectotermas de zonas áridas que se enfrentan a modificaciones climáticas rápidas. Además, consideramos que el uso de variables con alta resolución temporal puede conducir a una mejor delimitación de nichos, mejorando los resultados de cualquier objetivo de investigación que utilice estos modelos correlativos.


Asunto(s)
Ecosistema , Microclima , Animales , Humanos , Vertebrados , Modelos Teóricos , Geografía
7.
Graefes Arch Clin Exp Ophthalmol ; 261(5): 1331-1338, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36480049

RESUMEN

PURPOSE: This study is to describe the clinical outcome of penetrating keratoplasty combined with implantation of a novel intraocular lens with an artificial iris, aided by continuous vitreous chamber infusion, in patients with severe aniridia and corneal alterations. METHODS: This was a prospective single-center case series study involving five patients with corneal alterations and aniridia. All subjects underwent simultaneous penetrating keratoplasty and implantation of a new intraocular lens with an artificial iris with the assistance of infusion into the vitreous chamber to regulate intraocular pressure during the surgical procedure. Visual acuity, corneal endothelial cell density, and intraocular pressure assessments were performed in the postoperative period. The final cosmetic outcome of the iris prosthesis placement was also evaluated. RESULTS: In all cases, increased visual acuity and a good aesthetic result were observed in all affected eyes except one in which, despite the excellent aesthetic outcome, the eye was very hypotonic as it had high myopia and had undergone several previous surgeries. CONCLUSION: The single surgical procedure combining implantation of an intraocular lens-iris prosthesis with penetrating keratoplasty is an effective technique for the simultaneous treatment of aphakia and aniridia. However, larger series with longer-term follow-up are needed to definitively establish the benefits of this technique.


Asunto(s)
Aniridia , Opacidad de la Córnea , Lentes Intraoculares , Humanos , Implantación de Lentes Intraoculares/métodos , Queratoplastia Penetrante/métodos , Estudios Prospectivos , Aniridia/complicaciones , Aniridia/diagnóstico , Aniridia/cirugía , Iris/cirugía , Opacidad de la Córnea/cirugía , Estudios Retrospectivos
8.
Proc Biol Sci ; 289(1989): 20221783, 2022 12 21.
Artículo en Inglés | MEDLINE | ID: mdl-36515116

RESUMEN

Traits that exhibit differences between the sexes have been of special interest in the study of phenotypic evolution. Classic hypotheses explain sexually dimorphic traits via intra-sexual competition and mate selection, yet natural selection may also act differentially on the sexes to produce dimorphism. Natural selection can act either through physiological and ecological constraints on one of the sexes, or by modulating the strength of sexual/social selection. This predicts an association between the degree of dimorphism and variation in ecological environments. Here, we characterize the variation in hummingbird dimorphism across ecological gradients using rich databases of morphology, colouration and song. We show that morphological dimorphism decreases with elevation in the understorey and increases with elevation in mixed habitats, that dichromatism increases at high altitudes in open and mixed habitats, and that song is less complex in mixed habitats. Our results are consistent with flight constraints, lower predation pressure at high elevations and with habitat effects on song transmission. We also show that dichromatism and song complexity are positively associated, while tail dimorphism and song complexity are negatively associated. Our results suggest that key ecological factors shape sexually dimorphic traits, and that different communication modalities do not always evolve in tandem.


Asunto(s)
Evolución Biológica , Selección Sexual , Animales , Selección Genética , Ecosistema , Caracteres Sexuales , Aves
9.
Acta Neurol Scand ; 146(2): 167-176, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35607843

RESUMEN

OBJECTIVES: In the absence of widely accepted criteria, determining when a patient with Parkinson's disease (PD) may benefit from more advanced treatments such as device-aided therapy (DAT) so far remains a matter of physician judgment. This analysis investigates how classification of PD varies across countries relative to measures of disease severity. MATERIALS AND METHODS: The OBSERVational, cross-sEctional PD (OBSERVE-PD) study included consecutive patients with PD at centers that offer DATs in 18 countries. In this subgroup analysis, we explore intercountry differences in identification of advanced versus non-advanced PD based on physician's clinical judgment, symptoms assessed using Delphi consensus criteria, use of DAT, motor and non-motor symptoms, and caregiver support. Demographic and clinical characteristics were obtained through review of medical records. RESULTS: Overall, 1342 of 2615 patients (51.3%) were assessed by physicians as having advanced PD. The proportion of patients in different countries identified as having advanced PD (24.4-82.2%) varied. In 15 of 18 countries, a greater proportion of patients with advanced PD, according to select Delphi criteria, were identified by physicians as having advanced PD than with non-advanced PD. There was a wide variability across countries in the proportion of patients with no dyskinesia, disabling dyskinesia, dyskinesia pain, and non-motor symptoms who were identified by physicians as having advanced versus non-advanced PD. CONCLUSIONS: The proportion of patients identified with advanced PD symptoms varies widely across countries, despite differences on the patients' profiles, indicating a need for objective diagnostic criteria to help identify patients who may benefit from DAT.


Asunto(s)
Enfermedad de Parkinson , Antiparkinsonianos/uso terapéutico , Carbidopa/uso terapéutico , Estudios Transversales , Combinación de Medicamentos , Geles/uso terapéutico , Humanos , Levodopa/uso terapéutico , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/tratamiento farmacológico , Índice de Severidad de la Enfermedad
10.
Ann Surg Oncol ; 28(2): 1158-1166, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32661847

RESUMEN

BACKGROUND: More than 90% of patients with multiple myeloma (MM) develop lytic bone lesions that can be surgically treated for symptomatic relief and functional improvement. METHODS: This was a retrospective observational analytic study conducted between 2009 and 2018, including 58 patients with MM bone disease who underwent 77 orthopedic surgical procedures and were co-managed by internal medicine. Analysis of data related to MM bone disease, different modalities of surgical treatment, perioperative complications, and survival was performed. RESULTS: Median age was 72 years (66.5-77 years) and 56.9% of patients were males; 54.43% of injuries were located in the spine, 27.85% in the pelvis or lower limbs, 15.19% in the upper limbs, and 75.32% of patients had pathologic fractures. In 29.31% of the cases, the bone lesion was the debut of MM. Surgical procedures performed were mainly kyphoplasty (48.05%) and intramedullary nailing (29.87%). The overall complication rate following surgery was 74.03%. Only 20.78% of cases had a surgical complication. Among medical complications, we registered 28.57% transfusion requirements, 25.97% acute renal failures, 24.68% developed an infection, and 10.39% developed hypercalcemia. Patients were followed-up for a mean of 6.13 years and 37.93% suffered a new fracture. The median overall survival time for patients after surgery was 32.9 months (11.6-49). The estimated overall survival at 1, 3, and 5 years after surgery was 81.17%, 57%, and 34.11%, respectively. CONCLUSIONS: The orthopedic surgical treatment of MM bone disease aims to improve symptomatology and patient quality of life; however, these patients have a high risk of perioperative complications and considerable early mortality, making multidisciplinary management with medical specialties essential.


Asunto(s)
Enfermedades Óseas , Mieloma Múltiple , Anciano , Enfermedades Óseas/etiología , Enfermedades Óseas/cirugía , Humanos , Masculino , Mieloma Múltiple/cirugía , Calidad de Vida , Estudios Retrospectivos , Resultado del Tratamiento
11.
Mov Disord ; 36(8): 1853-1862, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33908647

RESUMEN

BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) is administered directly to the small intestine of patients with advanced Parkinson's disease (APD) to help maintain stable plasma levodopa levels. OBJECTIVE: The objective of this study was to investigate the effect of LCIG in reducing polypharmacy for the treatment of APD. METHODS: The COmedication Study assessing Mono- and cOmbination therapy with levodopa-carbidopa inteStinal gel (COSMOS) is a large, real-world, multinational observational study investigating comedication use with LCIG. All enrolled patients had used LCIG for ≥12 months and data were collected cross-sectionally (study visit) and retrospectively. The primary endpoint was the percentage of patients using LCIG as monotherapy (without add-on PD medications) at initiation and at 3, 6, 9, and 12 months thereafter. RESULTS: Overall, 409 patients were enrolled from 14 countries and were treated with LCIG for a mean of 35.8 ± 23.2 months. A total of 15.2% of patients initiated LCIG as monotherapy and 31.7% were receiving monotherapy at 12 months after initiation. The mean duration of LCIG monotherapy was 39.3 ± 25.6 months. Use of add-on medications decreased over time with all LCIG regimens. From LCIG initiation to the patient visit, mean off time decreased by 3.8, 4.6, and 3.9 hours/day for LCIG monotherapy, LCIG daytime monotherapy, and LCIG polytherapy groups, respectively, while duration of dyskinesia decreased by 1.7, 2.0, and 1.9 hours/day, respectively. Adverse events likely related to study treatment occurred in 112 patients (27.4%) during LCIG treatment. CONCLUSIONS: LCIG is an effective long-term monotherapy option with a positive risk-benefit profile and contributes to reduced polypharmacy for patients with APD. © 2021 The AbbVie Inc. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.


Asunto(s)
Carbidopa , Enfermedad de Parkinson , Antiparkinsonianos , Combinación de Medicamentos , Geles , Humanos , Levodopa , Enfermedad de Parkinson/tratamiento farmacológico , Estudios Retrospectivos
12.
Retina ; 41(10): 2048-2058, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-33675333

RESUMEN

PURPOSE: To evaluate the outcomes and safety of retropupillary iris-claw intraocular lens implantation and associated pars plana vitrectomy. METHODS: Multicenter, national audit of 325 eyes (325 patients). Demographics, surgical details, and complications are described. Visual acuity, intraocular pressure, and central retinal thickness assessed by optical coherence tomography were collected at 1, 3, 6, and 12 months after surgery. Kaplan-Meier curves were created to assess the cumulative probability of postoperative visual acuity and intraocular pressure levels, macular edema development, and corneal decompensation. RESULTS: The cumulative probability of the final visual acuity ≤0.3 logarithm of the minimum angle of resolution (≥20/40 Snellen) was 75.6% at 12-month follow-up. The probability of intraocular pressure >21, ≥25, and ≥30 mmHg was 48.1%, 33.1%, and 19.0%, and the probability of intraocular pressure-lowering drops was 50.9% at 12 months. Glaucoma surgery was required in 4.3% of the eyes (14/325). The cumulative probability of macular edema was 20.5% at 12 months and was greater in complicated cataract surgery than in intraocular lens-luxation eyes (26% vs. 16.7%, P = 0.04). Corneal transplantation was required in 2.8% of the eyes (9/325). CONCLUSION: This study on 325 eyes with aphakia or intraocular lens dislocation managed with the retropupillary iris-claw intraocular lens technique provides clinical outcomes in a real-world scenario, reporting relevant data for patient counseling and preoperative discussions.


Asunto(s)
Afaquia Poscatarata/cirugía , Iris/cirugía , Implantación de Lentes Intraoculares , Lentes Intraoculares , Auditoría Médica , Vitrectomía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Afaquia Poscatarata/fisiopatología , Femenino , Humanos , Presión Intraocular/fisiología , Masculino , Persona de Mediana Edad , Diseño de Prótesis , Estudios Retrospectivos , Microscopía con Lámpara de Hendidura , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Agudeza Visual/fisiología
13.
J Card Surg ; 36(8): 2933-2934, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33768558

RESUMEN

Percutaneous coronary interventions (PCI) have become a standard of treatment worldwide. Despite high safety rates, iatrogenic complications caused by stent dislodgements do exist in 0.21% of cases and most require emergency coronary artery by-pass grafting (CABG). Here we present a case of a coronavirus disease 2019 positive 40-year-old male patient presenting with STEMI due to thrombotic lesions in his left coronary trunk. The patient is taken to PCI and stent placement. Stent dislodgement results in the need for emergency CABG and stent removal. Informed consent and ethics approval were obtained.


Asunto(s)
COVID-19 , Enfermedad de la Arteria Coronaria , Intervención Coronaria Percutánea , Adulto , Puente de Arteria Coronaria , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/cirugía , Humanos , Masculino , SARS-CoV-2 , Stents/efectos adversos , Resultado del Tratamiento
14.
Endocr Pract ; 26(6): 604-611, 2020 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-32160049

RESUMEN

Objective: Treatment of hyperglycemia with insulin is associated with increased risk of hypoglycemia in type 2 diabetes mellitus (T2DM) patients receiving total parenteral nutrition (TPN). The aim of this study was to determine the predictors of hypoglycemia in hospitalized T2DM patients receiving TPN. Methods: Post hoc analysis of the INSUPAR study, which is a prospective, open-label, multicenter clinical trial of adult inpatients with T2DM in a noncritical setting with indication for TPN. Results: The study included 161 patients; 31 patients (19.3%) had hypoglycemic events, but none of them was severe. In univariate analysis, hypoglycemia was significantly associated with the presence of diabetes with end-organ damage, duration of diabetes, use of insulin prior to admission, glycemic variability (GV), belonging to the glargine insulin group in the INSUPAR trial, mean daily grams of lipids in TPN, mean insulin per 10 grams of carbohydrates, duration of TPN, and increase in urea during TPN. Multiple logistic regression analysis showed that the presence of diabetes with end-organ damage, GV, use of glargine insulin, and TPN duration were risk factors for hypoglycemia. Conclusion: The presence of T2DM with end-organ damage complications, longer TPN duration, belonging to the glargine insulin group, and greater GV are factors associated with the risk of hypoglycemia in diabetic noncritically ill inpatients with parenteral nutrition. Abbreviations: ADA = American Diabetes Association; BMI = body mass index; CV% = coefficient of variation; DM = diabetes mellitus; GI = glargine insulin; GV = glycemic variability; ICU = intensive care unit; RI = regular insulin; T2DM = type 2 diabetes mellitus; TPN = total parenteral nutrition.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hipoglucemia , Glucemia , Humanos , Hipoglucemiantes , Pacientes Internos , Insulina , Insulina Glargina , Nutrición Parenteral Total , Estudios Prospectivos , Factores de Riesgo
15.
Graefes Arch Clin Exp Ophthalmol ; 258(9): 1857-1861, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32409979

RESUMEN

PURPOSE: To report our experience in non-contact wide-angled visualization with chandelier-assisted scleral buckling (SB) in uncomplicated primary rhegmatogenous retinal detachments (RRD). METHODS: Retrospective case series of 282 eyes that underwent non-contact wide-angled visualization with chandelier-assisted SB and were followed for a mean of 13.5 months. RESULTS: There were 160 male patients. The average age was 42.6 years old. There were 262 eyes that were phakic, 18 pseudophakic, and 2 aphakic. Two-thirds of eyes presented with the macula detached. Eyes had an average of 1.6 breaks. The single operation anatomic success rate was 85.1% (240/282). The pre-op visual acuity improved from 1.21 to 0.76 logMAR at 6 months (p < 0.0001). Complications included a case of scleral laceration, choroidal hemorrhage, 3 epiretinal membranes, 1 macular fold, and 4 eyes with buckle exposure. CONCLUSION: Non-contact wide-angled visualization with chandelier-assisted SB compares favorably with conventional SB for primary uncomplicated primary RRD.


Asunto(s)
Gonioscopía/métodos , Desprendimiento de Retina/cirugía , Curvatura de la Esclerótica/métodos , Cirugía Asistida por Computador/métodos , Agudeza Visual , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Desprendimiento de Retina/diagnóstico , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
16.
Fetal Diagn Ther ; 47(11): 834-840, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32784297

RESUMEN

OBJECTIVE: The aim of this study was to assess the clinical applicability of a new analytical software program by determining the inter- and intraobserver agreement for 2D placental biometry and three-dimensional (3D) placental volume (PV) in the first trimester. METHODS: A prospective study of 25 singleton pregnancies between 11 and 14 weeks was conducted. 3D datasets were captured, and PV was estimated using the Phillips QLAB GI3DQ ultrasound quantification software. The basal plate (BP), chorionic plate (CP), placental thickness (PT), and the free uterine surface (FUS) area not occupied by placenta were considered for 2D biometry evaluation. Each variable was measured in 2 orthogonal planes with mean values used for the analysis. Intra- and interobserver agreement was evaluated. RESULTS: Intraobserver agreement for both 2D and 3D measurements was high, particularly for the PV and PT (interclass correlation coefficient [ICC] 0.989 [95% confidence interval (CI) 0.97-0.99] and ICC 0.936 [95% CI 0.86-0.97], respectively). Interobserver agreement was good for the PV (ICC 0.963 [95% CI 0.91-0.98]), PT (ICC 0.822 [95% CI 0.63-0.91]), and CP (ICC 0.708 [95% CI 0.44-0.86]), but moderate for BP and FUS. CONCLUSIONS: PV, PT, and CP are reproducible measurements to evaluate first trimester placental biometry. Further research is needed to assess the clinical utility of these variables as predictors of poor obstetric outcomes.

17.
Stroke ; 50(10): 2922-2932, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31451099

RESUMEN

Background and Purpose- After stroke, the population of infiltrated neutrophils in the brain is heterogeneous, including a population of alternative neutrophils (N2) that express M2 phenotype markers. We explored the role of TLR4 (toll-like receptor 4) on neutrophil infiltration and polarization in this setting. Methods- Focal cerebral ischemia was induced by occlusion of the middle cerebral artery occlusion in TLR4-KO and WT (wild type) mice. Infarct size was measured by Nissl staining and magnetic resonance imaging. Leukocyte infiltration was quantified 48 hours after middle cerebral artery occlusion by immunofluorescence and flow cytometry. To elucidate mechanisms underlying TLR4-mediated N2 phenotype, a cDNA microarray analysis was performed in neutrophils isolated from blood 48 hours after stroke in WT and TLR4-KO mice. Results- As demonstrated previously, TLR4-deficient mice presented lesser infarct volumes than WT mice. TLR4-deficient mice showed higher density of infiltrated neutrophils 48 hours after stroke compared with WT mice, concomitantly to neuroprotection. Furthermore, cytometric and stereological analyses revealed an increased number of N2 neutrophils (YM1+ cells) into the ischemic core in TLR4-deficient mice, suggesting a protective effect of this neutrophil subset that was corroborated by depleting peripheral neutrophils or using mice with TLR4 genetically ablated in the myeloid lineage. Finally, cDNA microarray analysis in neutrophils, confirmed by quantitative polymerase chain reaction, showed that TLR4 modulates several pathways associated with ischemia-induced inflammation, migration of neutrophils into the parenchyma, and their functional priming, which might explain the opposite effect on outcome of the different neutrophil subsets. Conclusions- TLR4 deficiency increased the levels of alternative neutrophils (N2)-an effect associated with neuroprotection after stroke-supporting that modulation of neutrophil polarization is a major target of TLR4 and highlighting the crucial role of TLR4 at the peripheral level after stroke. Visual Overview- An online visual overview is available for this article.


Asunto(s)
Infarto de la Arteria Cerebral Media/patología , Infiltración Neutrófila/fisiología , Neutrófilos/metabolismo , Receptor Toll-Like 4/metabolismo , Animales , Infarto de la Arteria Cerebral Media/inmunología , Infarto de la Arteria Cerebral Media/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Neutrófilos/citología , Fenotipo
18.
BMC Neurol ; 19(1): 50, 2019 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-30940119

RESUMEN

BACKGROUND: There are currently no standard diagnostic criteria for characterizing advanced Parkinson's disease (APD) in clinical practice, a critical component in determining ongoing clinical care and therapeutic strategies, including transitioning to device-aided treatment. The goal of this analysis was to determine the proportion of APD vs. non-advanced PD (non-APD) patients attending specialist PD clinics and to demonstrate the clinical burden of APD. METHODS: OBSERVE-PD, a cross-sectional, international, observational study, was conducted with 2615 PD patients at 128 movement disorder centers in 18 countries. Motor and non-motor symptoms, activities of daily living, and quality-of-life end points were assessed. The correlation between physician's global assessment of advanced PD and the advanced PD criteria from a consensus of an international group of experts (Delphi criteria for APD) were evaluated. RESULTS: According to physician's judgment, 51% of patients were considered to have APD. There was a moderate correlation between physician's judgment and Delphi criteria for APD (K = 0.430; 95% CI 0.406-0.473). Activities of daily living, motor symptom severity, dyskinesia duration/disability, "Off" time duration, non-motor symptoms, and quality-of-life scores were worse among APD vs. non-APD patients (p < 0.0001 for all). APD patients (assessed by physicians) had higher disease burden by motor and non-motor symptoms compared with non-APD patients and a negative impact on activities of daily living and quality of life. CONCLUSIONS: These findings aid in identifying standard APD classification parameters for use in practicing physicians. Improvements in identification of APD patients may be particularly relevant for optimizing treatment strategies including transitioning to device-aided treatment.


Asunto(s)
Enfermedad de Parkinson/clasificación , Enfermedad de Parkinson/diagnóstico , Actividades Cotidianas , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida
19.
Ecology ; 99(7): 1693, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29701245

RESUMEN

Colombia is the country with the highest bird diversity in the world. Despite active research in ornithology, compelling morphological information of most bird species is still sparse. However, morphological information is the baseline to understand how species respond to environmental variation and how ecosystems respond to species loss. As part of a national initiative, the Instituto Alexander von Humboldt in collaboration with 12 Colombian institutions and seven biological collections, measured up to 15 morphological traits of 9,892 individuals corresponding to 606 species: 3,492 from individuals captured in field and 6,400 from museum specimens. Species measured are mainly distributed in high Andean forest, páramo, and wetland ecosystems. Seven ornithological collections in Colombia and 18 páramo complexes throughout Colombia were visited from 2013 to 2015. The morphological traits involved measurements from bill (total and exposed culmen, bill width and depth), wing (length, area, wingspan, and the distance between longest primary and longest secondary), tail (length and shape), tarsus (length), hallux (length and claw hallux), and mass. The number of measured specimens per species was variable, ranging from 1 to 321 individuals with a median of four individuals per species. Overall, this database gathered morphological information for >30% of Colombian bird diversity. No copyright, proprietary, or cost restrictions apply; the data should be cited appropriately when used.


Asunto(s)
Aves , Ecosistema , Animales , Colombia , Fenotipo , Humedales
20.
Artículo en Inglés | MEDLINE | ID: mdl-30298342

RESUMEN

The male Anna's hummingbird features a brightly reddish-pink reflecting gorget, due to large stacks of melanosomes in the feather barbules, arranged in layers separated by keratin. Direct observations together with detailed scatterometry demonstrated that the barbules reflect incident light in an approximately specular manner. The structural colouration is iridescent, i.e. varies with a changing angle of light incidence. Spectrophotometrical measurements of the barbule reflectance and absorbance can be well interpreted with calculated spectra obtained with a transfer matrix method for optical multilayers, using anatomical data and measured refractive index spectra. The organization of the reflectors as a Venetian blind presumably functions to create a high spectral contrast of the male's plumage during courtship.


Asunto(s)
Aves/anatomía & histología , Plumas/anatomía & histología , Pigmentación , Animales , Plumas/química , Iridiscencia , Masculino , Microscopía Electroquímica de Rastreo , Modelos Teóricos , Espectrofotometría
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