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1.
Food Res Int ; 99(Pt 1): 336-347, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28784491

RESUMEN

Mate (Ilex paraguariensis A.St.-Hil.) is generally recognized as safe (GRAS status) and has a high content of alkaloids, saponins, and phenolic acids. Addition of mate extract to broilers feed has been shown to increase the oxidative stability of chicken meat, however, its effect on beef quality from animals supplemented with mate extract has not been investigated so far. Addition of extract of mate to a standard maize/soy feed at a level of 0.5, 1.0 or 1.5% w/w to the diet of feedlot for cattle resulted in increased levels of inosine monophosphate, creatine and carnosine in the fresh meat. The content of total conjugated linoleic acid increased in the meat as mate extract concentration was increased in the feed. The tendency to radical formation in meat slurries as quantified by EPR spin-trapping decreased as increasing mate extract addition to feed, especially after storage of the meat, indicating higher oxidative stability. Mate supplementation in the diet did not affect animal performance and carcass characteristics, but meat from these animals was more tender and consequently more accepted by consumers. Mate extract is shown to be a promising additive to feedlot diets for cattle to improve the oxidative stability, nutritive value and sensory quality of beef.


Asunto(s)
Alimentación Animal , Comportamiento del Consumidor , Suplementos Dietéticos , Manipulación de Alimentos/métodos , Calidad de los Alimentos , Ilex paraguariensis , Extractos Vegetales/administración & dosificación , Carne Roja/análisis , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Bovinos , Humanos , Juicio , Metabolómica/métodos , Estado Nutricional , Valor Nutritivo , Odorantes , Percepción Olfatoria , Oxidación-Reducción , Extractos Vegetales/metabolismo , Carne Roja/normas , Gusto , Percepción del Gusto
3.
Sci Rep ; 6: 39493, 2016 12 22.
Artículo en Inglés | MEDLINE | ID: mdl-28004777

RESUMEN

Residual feed intake (RFI), a measure of feed efficiency (FE), is defined as the difference between the observed and the predictable feed intake considering size and growth of the animal. It is extremely important to beef production systems due to its impact on the allocation of land areas to alternative agricultural production, animal methane emissions, food demand and cost of production. Global differential gene expression analysis between high and low RFI groups (HRFI and LRFI: less and more efficient, respectively) revealed 73 differentially expressed (DE) annotated genes in Longissimus thoracis (LT) muscle of Nelore steers. These genes are involved in the overrepresented pathways Metabolism of Xenobiotics by Cytochrome P450 and Butanoate and Tryptophan Metabolism. Among the DE transcripts were several proteins related to mitochondrial function and the metabolism of lipids. Our findings indicate that observed gene expression differences are primarily related to metabolic processes underlying oxidative stress. Genes involved in the metabolism of xenobiotics and antioxidant mechanisms were primarily down-regulated, while genes responsible for lipid oxidation and ketogenesis were up-regulated in HRFI group. By using LT muscle, this study reinforces our previous findings using liver tissue and reveals new genes and likely tissue-specific regulators playing key-roles in these processes.


Asunto(s)
Alimentación Animal , Bovinos/genética , Regulación de la Expresión Génica , Músculo Esquelético/metabolismo , Animales , Digestión , Proteína 1 de la Respuesta de Crecimiento Precoz/metabolismo , Perfilación de la Expresión Génica , Estudios de Asociación Genética/veterinaria , Flujo Genético , Genoma , Lípidos/química , Masculino , Metano/química , Estrés Oxidativo , Oxígeno/química , Fenotipo , Análisis de Secuencia de ARN , Xenobióticos/química
4.
BMC Genomics ; 17(1): 961, 2016 11 22.
Artículo en Inglés | MEDLINE | ID: mdl-27875996

RESUMEN

BACKGROUND: Lipids are a class of molecules that play an important role in cellular structure and metabolism in all cell types. In the last few decades, it has been reported that long-chain fatty acids (FAs) are involved in several biological functions from transcriptional regulation to physiological processes. Several fatty acids have been both positively and negatively implicated in different biological processes in skeletal muscle and other tissues. To gain insight into biological processes associated with fatty acid content in skeletal muscle, the aim of the present study was to identify differentially expressed genes (DEGs) and functional pathways related to gene expression regulation associated with FA content in cattle. RESULTS: Skeletal muscle transcriptome analysis of 164 Nellore steers revealed no differentially expressed genes (DEGs, FDR 10%) for samples with extreme values for linoleic acid (LA) or stearic acid (SA), and only a few DEGs for eicosapentaenoic acid (EPA, 5 DEGs), docosahexaenoic acid (DHA, 4 DEGs) and palmitic acid (PA, 123 DEGs), while large numbers of DEGs were associated with oleic acid (OA, 1134 DEGs) and conjugated linoleic acid cis9 trans11 (CLA-c9t11, 872 DEGs). Functional annotation and functional enrichment from OA DEGs identified important genes, canonical pathways and upstream regulators such as SCD, PLIN5, UCP3, CPT1, CPT1B, oxidative phosphorylation mitochondrial dysfunction, PPARGC1A, and FOXO1. Two important genes associated with lipid metabolism, gene expression and cancer were identified as DEGs between animals with high and low CLA-c9t11, specifically, epidermal growth factor receptor (EGFR) and RNPS. CONCLUSION: Only two out of seven classes of molecules of FA studied were associated with large changes in the expression profile of skeletal muscle. OA and CLA-c9t11 content had significant effects on the expression level of genes related to important biological processes associated with oxidative phosphorylation, and cell growth, survival, and migration. These results contribute to our understanding of how some FAs modulate metabolism and may have protective health function.


Asunto(s)
Ácidos Grasos/metabolismo , Perfilación de la Expresión Génica , Músculo Esquelético/metabolismo , Transcriptoma , Animales , Bovinos , Calidad de los Alimentos , Regulación de la Expresión Génica , Redes Reguladoras de Genes , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Redes y Vías Metabólicas , Ácido Oléico/metabolismo , Fenotipo , Carne Roja/normas , Reproducibilidad de los Resultados
6.
BMC Genomics ; 17: 235, 2016 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-26979536

RESUMEN

BACKGROUND: Nelore is the major beef cattle breed in Brazil with more than 130 million heads. Genome-wide association studies (GWAS) are often used to associate markers and genomic regions to growth and meat quality traits that can be used to assist selection programs. An alternative methodology to traditional GWAS that involves the construction of gene network interactions, derived from results of several GWAS is the AWM (Association Weight Matrices)/PCIT (Partial Correlation and Information Theory). With the aim of evaluating the genetic architecture of Brazilian Nelore cattle, we used high-density SNP genotyping data (~770,000 SNP) from 780 Nelore animals comprising 34 half-sibling families derived from highly disseminated and unrelated sires from across Brazil. The AWM/PCIT methodology was employed to evaluate the genes that participate in a series of eight phenotypes related to growth and meat quality obtained from this Nelore sample. RESULTS: Our results indicate a lack of structuring between the individuals studied since principal component analyses were not able to differentiate families by its sires or by its ancestral lineages. The application of the AWM/PCIT methodology revealed a trio of transcription factors (comprising VDR, LHX9 and ZEB1) which in combination connected 66 genes through 359 edges and whose biological functions were inspected, some revealing to participate in biological growth processes in literature searches. CONCLUSIONS: The diversity of the Nelore sample studied is not high enough to differentiate among families neither by sires nor by using the available ancestral lineage information. The gene networks constructed from the AWM/PCIT methodology were a useful alternative in characterizing genes and gene networks that were allegedly influential in growth and meat quality traits in Nelore cattle.


Asunto(s)
Bovinos/crecimiento & desarrollo , Bovinos/genética , Redes Reguladoras de Genes , Carne Roja , Animales , Brasil , Estudios de Asociación Genética , Pleiotropía Genética , Genotipo , Desequilibrio de Ligamiento , Masculino , Fenotipo , Polimorfismo de Nucleótido Simple , Factores de Transcripción/genética
7.
BMC Genomics ; 16: 242, 2015 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-25887532

RESUMEN

BACKGROUND: Efficiency of feed utilization is important for animal production because it can reduce greenhouse gas emissions and improve industry profitability. However, the genetic basis of feed utilization in livestock remains poorly understood. Recent developments in molecular genetics, such as platforms for genome-wide genotyping and sequencing, provide an opportunity to identify genes and pathways that influence production traits. It is known that transcriptional networks influence feed efficiency-related traits such as growth and energy balance. This study sought to identify differentially expressed genes in animals genetically divergent for Residual Feed Intake (RFI), using RNA sequencing methodology (RNA-seq) to obtain information from genome-wide expression profiles in the liver tissues of Nelore cattle. RESULTS: Differential gene expression analysis between high Residual Feed Intake (HRFI, inefficient) and low Residual Feed Intake (LRFI, efficient) groups was performed to provide insights into the molecular mechanisms that underlie feed efficiency-related traits in beef cattle. A total of 112 annotated genes were identified as being differentially expressed between animals with divergent RFI phenotypes. These genes are involved in ion transport and metal ion binding; act as membrane or transmembrane proteins; and belong to gene clusters that are likely related to the transport and catalysis of molecules through the cell membrane and essential mechanisms of nutrient absorption. Genes with functions in cellular signaling, growth and proliferation, cell death and survival were also differentially expressed. Among the over-represented pathways were drug or xenobiotic metabolism, complement and coagulation cascades, NRF2-mediated oxidative stress, melatonin degradation and glutathione metabolism. CONCLUSIONS: Our data provide new insights and perspectives on the genetic basis of feed efficiency in cattle. Some previously identified mechanisms were supported and new pathways controlling feed efficiency in Nelore cattle were discovered. We potentially identified genes and pathways that play key roles in hepatic metabolic adaptations to oxidative stress such as those involved in antioxidant mechanisms. These results improve our understanding of the metabolic mechanisms underlying feed efficiency in beef cattle and will help develop strategies for selection towards the desired phenotype.


Asunto(s)
Bovinos/genética , Hígado/metabolismo , Carne , Transcriptoma , Alimentación Animal , Animales , Bovinos/metabolismo , Digestión , Carne/economía , Fenotipo
8.
Genet Sel Evol ; 47: 15, 2015 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-25880074

RESUMEN

BACKGROUND: Beef cattle require dietary minerals for optimal health, production and reproduction. Concentrations of minerals in tissues are at least partly genetically determined. Mapping genomic regions that affect the mineral content of bovine longissimus dorsi muscle can contribute to the identification of genes that control mineral balance, transportation, absorption and excretion and that could be associated to metabolic disorders. METHODS: We applied a genome-wide association strategy and genotyped 373 Nelore steers from 34 half-sib families with the Illumina BovineHD BeadChip. Genome-wide association analysis was performed for mineral content of longissimus dorsi muscle using a Bayesian approach implemented in the GenSel software. RESULTS: Muscle mineral content in Bos indicus cattle was moderately heritable, with estimates ranging from 0.29 to 0.36. Our results suggest that variation in mineral content is influenced by numerous small-effect QTL (quantitative trait loci) but a large-effect QTL that explained 6.5% of the additive genetic variance in iron content was detected at 72 Mb on bovine chromosome 12. Most of the candidate genes present in the QTL regions for mineral content were involved in signal transduction, signaling pathways via integral (also called intrinsic) membrane proteins, transcription regulation or metal ion binding. CONCLUSIONS: This study identified QTL and candidate genes that affect the mineral content of skeletal muscle. Our findings provide the first step towards understanding the molecular basis of mineral balance in bovine muscle and can also serve as a basis for the study of mineral balance in other organisms.


Asunto(s)
Bovinos/genética , Estudio de Asociación del Genoma Completo/métodos , Minerales/análisis , Músculo Esquelético/química , Polimorfismo de Nucleótido Simple , Sitios de Carácter Cuantitativo , Animales , Teorema de Bayes , Bovinos/metabolismo , Mapeo Cromosómico , Simulación por Computador , Genómica/métodos , Genotipo , Minerales/metabolismo , Músculo Esquelético/metabolismo , Fenotipo
9.
BMC Genet ; 15: 100, 2014 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-25257854

RESUMEN

BACKGROUND: Feed efficiency is jointly determined by productivity and feed requirements, both of which are economically relevant traits in beef cattle production systems. The objective of this study was to identify genes/QTLs associated with components of feed efficiency in Nelore cattle using Illumina BovineHD BeadChip (770 k SNP) genotypes from 593 Nelore steers. The traits analyzed included: average daily gain (ADG), dry matter intake (DMI), feed-conversion ratio (FCR), feed efficiency (FE), residual feed intake (RFI), maintenance efficiency (ME), efficiency of gain (EG), partial efficiency of growth (PEG) and relative growth rate (RGR). The Bayes B analysis was completed with Gensel software parameterized to fit fewer markers than animals. Genomic windows containing all the SNP loci in each 1 Mb that accounted for more than 1.0% of genetic variance were considered as QTL region. Candidate genes within windows that explained more than 1% of genetic variance were selected by putative function based on DAVID and Gene Ontology. RESULTS: Thirty-six QTL (1-Mb SNP window) were identified on chromosomes 1, 2, 3, 5, 6, 7, 8, 9, 10, 12, 14, 15, 16, 18, 19, 20, 21, 22, 24, 25 and 26 (UMD 3.1). The amount of genetic variance explained by individual QTL windows for feed efficiency traits ranged from 0.5% to 9.07%. Some of these QTL minimally overlapped with previously reported feed efficiency QTL for Bos taurus. The QTL regions described in this study harbor genes with biological functions related to metabolic processes, lipid and protein metabolism, generation of energy and growth. Among the positional candidate genes selected for feed efficiency are: HRH4, ALDH7A1, APOA2, LIN7C, CXADR, ADAM12 and MAP7. CONCLUSIONS: Some genomic regions and some positional candidate genes reported in this study have not been previously reported for feed efficiency traits in Bos indicus. Comparison with published results indicates that different QTLs and genes may be involved in the control of feed efficiency traits in this Nelore cattle population, as compared to Bos taurus cattle.


Asunto(s)
Ingestión de Alimentos/genética , Polimorfismo de Nucleótido Simple , Sitios de Carácter Cuantitativo , Alimentación Animal , Animales , Teorema de Bayes , Bovinos , Estudios de Asociación Genética , Genotipo , Masculino , Fenotipo , Aumento de Peso/genética
10.
BMC Genet ; 15: 39, 2014 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-24666668

RESUMEN

BACKGROUND: Meat from Bos taurus and Bos indicus breeds are an important source of nutrients for humans and intramuscular fat (IMF) influences its flavor, nutritional value and impacts human health. Human consumption of fat that contains high levels of monounsaturated fatty acids (MUFA) can reduce the concentration of undesirable cholesterol (LDL) in circulating blood. Different feeding practices and genetic variation within and between breeds influences the amount of IMF and fatty acid (FA) composition in meat. However, it is difficult and costly to determine fatty acid composition, which has precluded beef cattle breeding programs from selecting for a healthier fatty acid profile. In this study, we employed a high-density single nucleotide polymorphism (SNP) chip to genotype 386 Nellore steers, a Bos indicus breed and, a Bayesian approach to identify genomic regions and putative candidate genes that could be involved with deposition and composition of IMF. RESULTS: Twenty-three genomic regions (1-Mb SNP windows) associated with IMF deposition and FA composition that each explain ≥1% of the genetic variance were identified on chromosomes 2, 3, 6, 7, 8, 9, 10, 11, 12, 17, 26 and 27. Many of these regions were not previously detected in other breeds. The genes present in these regions were identified and some can help explain the genetic basis of deposition and composition of fat in cattle. CONCLUSIONS: The genomic regions and genes identified contribute to a better understanding of the genetic control of fatty acid deposition and can lead to DNA-based selection strategies to improve meat quality for human consumption.


Asunto(s)
Adiposidad , Bovinos/genética , Músculo Esquelético/química , Animales , Teorema de Bayes , Cruzamiento , Ácidos Grasos/química , Estudios de Asociación Genética , Masculino , Carne , Polimorfismo de Nucleótido Simple , Sitios de Carácter Cuantitativo
11.
Physiol Genomics ; 45(24): 1215-21, 2013 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-24151244

RESUMEN

The potassium inwardly rectifying channel, subfamily J, member 11 (KCNJ11) gene was investigated as a candidate for meat tenderness based on the effects reported on muscle for KCNJ11 gene knockout in rat models and its position in a quantitative trait locus (QTL) for meat tenderness in the bovine genome. Sequence variations in the KCNJ11 gene were described by sequencing six amplified fragments, covering almost the entire gene. We identified single nucleotide polymorphisms (SNP) and validated them by different approaches, taking advantage of simultaneous projects that are being developed with the same Nelore population. By sequencing the KCNJ11 in Nelore steers representing extreme phenotypes for Warner-Bratzler shear force (WBSF), it was possible to identify 22 SNPs. We validated two of the identified markers by genotyping the whole population (n = 460). Analysis of association between genotypes and WBSF values revealed a significant additive effect of a SNP at different meat aging times (P ≤ 0.05). In addition, an association between the expression levels of KCNJ11 and WBSF was found, with lower expression levels of KCNJ11 associated with more tender meat (P ≤ 0.05). The results showed that the KCNJ11 gene is a candidate mapped to a QTL for meat tenderness previously identified on BTA15 and may be useful to identify animals with genetic potential to produce tender meat. The effect of KCNJ11 observed on muscle is potentially due to changes in activity of KATP channels, which in turn influence the flow of potassium in the intracellular space, allowing establishment of the membrane potential necessary for muscle contraction.


Asunto(s)
Productos de la Carne , Músculo Esquelético , Canales de Potasio de Rectificación Interna/genética , Animales , Secuencia de Bases , Bovinos , Cartilla de ADN , Polimorfismo de Nucleótido Simple , Sitios de Carácter Cuantitativo
12.
J Radiol ; 91(9 Pt 1): 895-900, 2010 Sep.
Artículo en Francés | MEDLINE | ID: mdl-20814377

RESUMEN

PURPOSE: To determine the costs related to the embolization of intracranial aneurysms compared to "rates per activity" (T2A) reimbursements. MATERIALS AND METHODS: The hospital admissions of patients with intracranial aneurysms treated with embolization and classified under diagnosis-related group (DRG) 01K02Z in 2007 were included. The costs related to the single-use devices, neurointerventional suite and hospital stay were calculated by analytical accounting. Revenues were calculated based on DRG-based medical information system (PMSI) and medical data using the diagnosis-related groups and reimbursements from 2007 (V10 of DRG) and 2009 (V11). RESULTS: Fifty-seven patients were included. The total cost was 932.278 euro and hospital revenues were 655.648 euro in 2007 and would have been 825.211 euro in 2009. The financial loss was on average 4.853 euro per admission in 2007 and 1.878 euro in 2009, and even more in two cases of ruptured aneurysm. CONCLUSION: In 2001, embolization of intracranial aneurysms, the treatment of choice for this pathology, results in a financial loss for the hospital, larger for ruptured aneurysms compared to non-ruptured aneurysms. The updated DRG, while improving the situation, remains insufficient.


Asunto(s)
Current Procedural Terminology , Embolización Terapéutica/economía , Aneurisma Intracraneal/economía , Aneurisma Intracraneal/terapia , Programas Nacionales de Salud/economía , Mecanismo de Reembolso/economía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Costos y Análisis de Costo , Grupos Diagnósticos Relacionados/economía , Femenino , Francia , Costos de Hospital/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
14.
J Radiol ; 90(4): 469-80, 2009 Apr.
Artículo en Francés | MEDLINE | ID: mdl-19503028

RESUMEN

Gastrointestinal stromal tumors (GIST) arising from interstitial cells of Cajal, represent the first type of solid tumor, which is very sensitive to a specific molecularly targeted tyrosine kinase receptor blocker (i. e., imatinib). On CT, which is considered as the reference technique, GISTs typically present as large, well-delineated, heterogeneous and sometimes exophytic masses. In contrast with the absence of lymph node involvement, hepatic metastasis as well as mesenteric involvement can be observed. MR-enteroclysis is indicated to investigate the local extent of the disease in specific cases whereas MR imaging is used to detect hepatic metastasis. Because of a specific treatment, contrast-enhanced imaging is needed for the follow-up of treated tumors. Evaluation of tumor response to treatment is best assessed with CT which still remains the reference imaging technique whereas FDG-PET imaging is used in specific cases.


Asunto(s)
Tumores del Estroma Gastrointestinal/diagnóstico , Imagen por Resonancia Magnética/métodos , Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Angiografía , Antineoplásicos/uso terapéutico , Benzamidas , Biopsia , Endoscopía Capsular , Medios de Contraste , Diagnóstico Diferencial , Endosonografía , Femenino , Estudios de Seguimiento , Tumores del Estroma Gastrointestinal/diagnóstico por imagen , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Humanos , Mesilato de Imatinib , Hígado/patología , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico , Recurrencia , Resultado del Tratamiento
15.
Gynecol Obstet Fertil ; 37(2): 131-9, 2009 Feb.
Artículo en Francés | MEDLINE | ID: mdl-19200763

RESUMEN

OBJECTIVES: Would a social handicap questionnaire with French DRG (PMSI) make it possible to know social disability parturients vaginal childbirth in a public health loss of revenue by increasing the average length of stay during the hospitalization of patients precarious? PATIENTS AND METHODS: The questionnaire of the social handicap consisted of 14 indicators associated to classify at the admission each patient in three categories of social handicap. RESULTS: The administration of a questionnaire of social handicap was carried out for 127 women giving birth by low way. Three quarters of the studied population have a strong social handicap and 18% present a means of it. The more social handicapped patients do not represent an additional cost for the establishment in terms of supplementary day of hospitalization. CONCLUSION: French DRG (PMSI) and indicators of precariousness can be used to locate the patient having social handicap. The consistency of the public action between the medical one and the social one are questioned.


Asunto(s)
Costos de la Atención en Salud , Tiempo de Internación , Parto , Clase Social , Adulto , Grupos Diagnósticos Relacionados , Femenino , Disparidades en el Estado de Salud , Humanos , Proyectos Piloto , Vigilancia de la Población , Embarazo , Apoyo Social , Factores Socioeconómicos , Encuestas y Cuestionarios
16.
J Clin Apher ; 24(1): 6-11, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19156756

RESUMEN

Current protocols for myeloma patients require more than one autologous transplant. We performed a retrospective study to determine the cost-effectiveness of large volume leukapheresis (LVL) compared with standard volume leukapheresis (SVL) collection when two transplants are required. We evaluated 87 patients who underwent a cumulative total of 260 LVL and SVL collections. The median product volume per collection was 356 ml for LVL, and this was significantly higher than the median product volume per collection for SVL (median 149.5 ml, P < 0.001). The median total CD34+ cell yield/kg was 6.4 x 10(6) for LVL and 5.2 x 10(6) for SVL. This difference was statistically significant (P = 0.005). Because the target CD34+ cell dose for a single transplant was 3 x 10(6)/kg at our institution, overall the LVL yields enough CD34+ cells that could allow for two transplants. Therefore, more patients in the LVL group were able to undergo a potential second transplant. Because of the reserved cells for a second transplant, LVL patients received significantly less CD34+ cell/kg per transplant than the patients in SVL group (P = <0.001). As a result, LVL group had statistically significant but clinically insignificant delay in neutrophil (P = <0.001) and platelet (P = 0.02) engraftments. Additionally, using LVL instead of SVL to collect >or=6 x 10(6)/kg CD34+ cells may potentially save $7,497 per patient. We therefore conclude that LVL is the method of choice for collection of multiple myeloma patients when two transplants are anticipated.


Asunto(s)
Antígenos CD34 , Movilización de Célula Madre Hematopoyética/métodos , Leucaféresis/métodos , Mieloma Múltiple/terapia , Adulto , Anciano , Análisis Costo-Beneficio , Femenino , Movilización de Célula Madre Hematopoyética/economía , Humanos , Leucaféresis/economía , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Trasplante Autólogo
17.
Rev Epidemiol Sante Publique ; 57(1): 11-5, 2009 Feb.
Artículo en Francés | MEDLINE | ID: mdl-19162418

RESUMEN

BACKGROUND: According to the framework legislation promulgated as part of the reform of finance laws in France, quality is a mandatory feature of all governmental actions. In this context, this work was conducted to assess the construction cost of a national health program designed to promote physical and sports activities and prevent doping behaviors. This program was considered to have the characteristic features of a successful governmental health intervention. METHODS: Four cost categories were evaluated: cost of the activity itself, transportation costs, communication costs and promotion costs. RESULTS: It was found that the program costs for 2002-2007 were 100,000 euro, with 15% of the costs in the communication category. CONCLUSION: Economic elements could be associated with factors of successful health service interventions in order to help decision makers responsible for the public interest and the consistency of public health actions.


Asunto(s)
Promoción de la Salud/economía , Programas Nacionales de Salud/economía , Aptitud Física , Deportes/economía , Trastornos Relacionados con Sustancias/prevención & control , Análisis Costo-Beneficio , Toma de Decisiones , Financiación de la Construcción de Edificios/economía , Francia , Humanos , Comercialización de los Servicios de Salud/economía , Programas Nacionales de Salud/normas , Estudios Retrospectivos , Encuestas y Cuestionarios , Teléfono/economía , Transportes/economía
18.
J Radiol ; 89(12): 1907-20, 2008 Dec.
Artículo en Francés | MEDLINE | ID: mdl-19106848

RESUMEN

Pneumatosis intestinalis is a rare condition, which is defined by the presence of gas within the bowel wall. In adult patients, pneumatosis intestinalis can be depicted in various circumstances. Owing to the routine use of CT to investigate patients with abdominal pain, pneumatosis intestinalis can be seen as an incidental finding or can be observed in association with a life-threatening disease such as bowel infarction. On CT images, pneumatosis intestinalis can display two different appearances; one that has a cystic or bubbly appearance can be considered as a chronic pneumatosis and is suggestive for a benign cause while the other, which has a linear appearance can be considered as a symptom and is more frequently secondary to a life-threatening cause. However, none of these two CT characteristics can be considered pathognomonic for any of these two categories of causes. In such situations, the analysis of the location, extent and, if any, associated findings may help to differentiate between benign and life-threatening causes. In these patients who present with abdominal signs that mimic symptoms that would warrant surgical exploration, the analysis of associated findings is critical to rule out a life-threatening cause of pneumatosis intestinalis and to obviate the need for unnecessary laparotomy. In adult patients with a known specific disease such as celiac disease, chronic pseudointestinal obstruction or other chronic diseases, even with accompanying pneumoperitoneum, pneumatosis intestinalis does not uniformly mandate surgical exploration. This pictorial review presents the more and the less common pneumatosis intestinalis CT features in adult patients, with the aim of making the reader more familiar with this potentially misleading sign.


Asunto(s)
Neumatosis Cistoide Intestinal/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
19.
J Radiol ; 89(5 Pt 1): 565-70, 2008 May.
Artículo en Francés | MEDLINE | ID: mdl-18535497

RESUMEN

PURPOSE: The purpose of our study was to retrospectively evaluate the efficacy, the limitations and the complications of real-time CT fluoroscopy (Carevision) as an adjunct to CT guidance for percutaneous abdominopelvic interventional procedures. Materials and methods. During a 28 month period, 99 patients (55 men, 44 women) with a mean age of 59 years had percutaneous abdominopelvic interventional procedure under CT guidance using CT fluoroscopy. Sixty-four patients had a percutaneous drainage of an abdominopelvic fluid collection with a Seldinger technique using an 8.5- to 14-F drainage catheter and 35 patients had a percutaneous biopsy using an 18-G automatic core biopsy needle. RESULTS: In all cases, the quality of the real-time CT fluoroscopic images allowed to securely monitor needle advancement towards the target lesion and to confirm correct position of the needle tip. The diameters of target lesions ranged from 1.5 to 10 cm, with a mean value of 4.75 cm. No immediate complications were observed. The real-time CT fluoroscopy times ranged from 25 to 242 sec, with a mean time of 117 sec. All percutaneous procedures (100%) were successfully performed. CONCLUSION: Our initial clinical experience suggests that real-time CT fluoroscopy allows to perform effective and secure percutaneous abdominopelvic interventional procedures. However, because of substantial radiation exposure, its use has to be limited to specific et selected cases.


Asunto(s)
Biopsia con Aguja/métodos , Drenaje/métodos , Fluoroscopía/métodos , Pelvis/diagnóstico por imagen , Radiografía Abdominal/métodos , Radiografía Intervencional/métodos , Tomografía Computarizada por Rayos X/métodos , Abdomen/patología , Absceso Abdominal/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja/instrumentación , Cateterismo/instrumentación , Drenaje/instrumentación , Femenino , Fluoroscopía/instrumentación , Humanos , Enfermedades Linfáticas/patología , Masculino , Persona de Mediana Edad , Pelvis/patología , Radiografía Intervencional/instrumentación , Estudios Retrospectivos , Factores de Tiempo , Tomografía Computarizada por Rayos X/instrumentación
20.
Gynecol Obstet Fertil ; 36(5): 507-15, 2008 May.
Artículo en Francés | MEDLINE | ID: mdl-18472291

RESUMEN

OBJECTIVE: Reduction of maternal mortality is a major priority in the public health domain. One of the main causes of maternal mortality is postpartum haemorrhage. Because economic pressures favour the use of less expensive strategies, it is becoming now critical to know exactly the cost of the surgical procedures involved in the treatment of postpartum haemorrhage, in order to provide future guidelines in Implementing reforms in hospital. MATERIALS AND METHODS: Evaluation was made on multiple data collected in the Gynecology-Obstetrics and Central Sterile Supplies departments of a tertiary care Hospital. Analysis of the production costs was made based on the actual costs. The receipts were figured on the basis of applicable reimbursement in France in 2005, taking into account the financial decisions of the producers. RESULTS: From January 2004 to December 2005, 262 patients were treated for postpartum hemorrhage and patients files were available for review in 255 cases. Of these, surgery was performed in 52 cases. The costs of surgery in the postpartum care ranged from 275.04 euro per manual exploration of the uterine cavity (n=8), 302.48 euro per exploration with valve (n=26), 601.55 euro per vascular ligation (n=3), 725.53 euro per vaginal packing or unpacking (n=10) to 875.06 euro per hysterectomy (n=5). Cleaning and sterilizing of surgical instruments represented a substantial burden, ranging from 7.5% to 11.4% of the total cost of surgery. DISCUSSION AND CONCLUSION: The costs of surgery for postpartum haemorrhage have been calculated to provide future guidelines for the directions and follow-up of these activities in light of the T2A-EPRD and poles of activity. The actual costs could be used to determine the bases of one or more French DRGs (PMSI) "postpartum hemorrhage" evolution.


Asunto(s)
Costos de la Atención en Salud , Histerectomía/economía , Servicios de Salud Materna/economía , Hemorragia Posparto/cirugía , Guías de Práctica Clínica como Asunto , Adulto , Análisis Costo-Beneficio , Costos y Análisis de Costo , Femenino , Humanos , Hemorragia Posparto/mortalidad
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