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1.
Environ Manage ; 71(5): 1052-1064, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36525068

RESUMEN

The ability to adopt novel tools continues to become more important for governments and environmental managers tasked with balancing economic development, social needs and environmental protection. An example of an emerging technology that can enable flexible, cost-effective data collection for conservation and environmental management is Unmanned Aerial Vehicles (UAVs). It is clear that UAVs are beginning to be adopted for a diversity of purposes, identification of barriers to their use is the first step in increasing their uptake amongst the environmental management community. Identifying the barriers to UAV usage will enable research and management communities to confidently utilise these powerful pieces of technology. However, the implementation of this technology for environmental research has received little overall assessment attention. This systematic literature review has identified 9 barrier categories (namely Technological, Analytical and Processing, Regulatory, Cost, Safety, Social, Wildlife impact, work suitability and others) inhibiting the uptake of UAV technologies. Technological barriers were referenced in the literature most often, with the inability of UAVs to perform in poor weather (such as rain or windy conditions) commonly mentioned. Analytical and Processing and Regulatory barriers were also consistently reported. It is likely that some barriers identified will lessen with time (e.g. technological and analytical barriers) as this technology continues to evolve.


Asunto(s)
Animales Salvajes , Dispositivos Aéreos No Tripulados , Animales , Tecnología de Sensores Remotos , Tecnología , Recolección de Datos
2.
Sci Total Environ ; 527-528: 185-202, 2015 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-25958366

RESUMEN

Carbon capture and storage (CCS) is a technological solution that can reduce the amount of carbon dioxide (CO2) emissions from the use of fossil fuel in power plants and other industries. A leading method today is amine based post-combustion capture, in which 2-aminoethanol (MEA) is one of the most studied absorption solvents. In this process, amines are released to the atmosphere through evaporation and entrainment from the CO2 absorber column. Modelling is a key instrument for simulating the atmospheric dispersion and chemical transformation of MEA, and for projections of ground-level air concentrations and deposition rates. In this study, the Weather Research and Forecasting model inline coupled with chemistry, WRF-Chem, was applied to quantify the impact of using a comprehensive MEA photo-oxidation sequence compared to using a simplified MEA scheme. Main discrepancies were found for iminoethanol (roughly doubled in the detailed scheme) and 2-nitro aminoethanol, short MEA-nitramine (reduced by factor of two in the detailed scheme). The study indicates that MEA emissions from a full-scale capture plant can modify regional background levels of isocyanic acid. Predicted atmospheric concentrations of isocyanic acid were however below the limit value of 1 ppbv for ambient exposure. The dependence of the formation of hazardous compounds in the OH-initiated oxidation of MEA on ambient level of nitrogen oxides (NOx) was studied in a scenario without NOx emissions from a refinery area in the vicinity of the capture plant. Hourly MEA-nitramine peak concentrations higher than 40 pg m(-3) did only occur when NOx mixing ratios were above 2 ppbv. Therefore, the spatial variability and temporal variability of levels of OH and NOx need to be taken into account in the health risk assessment. The health risk due to direct emissions of nitrosamines and nitramines from full-scale CO2 capture should be investigated in future studies.


Asunto(s)
Contaminantes Atmosféricos/análisis , Atmósfera/química , Monitoreo del Ambiente/métodos , Etanolamina/análisis , Modelos Químicos , Combustibles Fósiles , Nitrosaminas , Centrales Eléctricas
3.
Chem Commun (Camb) ; 51(19): 4089-92, 2015 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-25665602

RESUMEN

Oxidative Heck couplings have been successfully developed for 2,2-disubstituted cyclopentene-1,3-diones. The direct coupling onto the 2,2-disubstituted cyclopentene-1,3-dione core provides a novel expedient way of enantioselectively desymmetrising all-carbon quaternary centres.


Asunto(s)
Ciclopentanos/química , Cetonas/química , Oxidación-Reducción , Estereoisomerismo
4.
Eur J Clin Microbiol Infect Dis ; 31(8): 1819-31, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22234573

RESUMEN

Automatic stop-orders (ASOs) have been utilized to discourage inappropriately prolonged antibiotic therapy. An ASO policy, which required reordering of antibiotics after 7 days of therapy, had been in place at our institution prior to 2002, but was revoked after instances of compromised patient care due to inadvertent and inappropriate interruption of antimicrobial treatment. The objective of this study was to evaluate the impact of revoking the ASO policy on the duration of antibiotic therapy, infection-related outcome (cure vs failure), relapsing infection, occurrence of resistant bacteria and superinfection in patients with nosocomial pneumonia. A retrospective chart review of adult patients (≥ 18 years old) admitted to Sunnybrook Health Sciences Centre with nosocomial pneumonia requiring antibiotic therapy was conducted. Duration of antibiotic therapy, infection-related outcome (cure vs failure), rate of relapsing infection, resistant organisms and superinfection were determined for each cohort. Forty-six eligible adults with nosocomial pneumonia per cohort were included [corrected]. Duration of antibiotic therapy was not significantly different in the pre- (11.4 ± 3.8 days) compared with the post-ASO revocation cohort (10.8 ± 4.1 days; p=0.43). There were also no significant differences between the cohorts with regard to infection-related outcome (cure vs failure), relapsing infection, or the occurrence of resistant bacteria or superinfection (p>0.5). Revocation of the ASO policy for antibiotics at our institution was not associated with a longer duration of antibiotic therapy, or increased incidence of infection-related mortality, relapsing infection, resistant bacteria or superinfection for patients with nosocomial pneumonia.


Asunto(s)
Antibacterianos/administración & dosificación , Infección Hospitalaria/tratamiento farmacológico , Investigación sobre Servicios de Salud , Neumonía Bacteriana/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Infección Hospitalaria/mortalidad , Farmacorresistencia Bacteriana , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neumonía Bacteriana/epidemiología , Neumonía Bacteriana/microbiología , Neumonía Bacteriana/mortalidad , Recurrencia , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
5.
Eur J Clin Microbiol Infect Dis ; 31(6): 1141-50, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21975605

RESUMEN

Cefazolin plus tobramycin have been determined to be effective for community-acquired FN, but have not been evaluated in the treatment of nosocomial FN. This study compared the incidence of mortality from 2002 to 2004 with 2008 to 2009 in patients with nosocomial FN treated with cefazolin plus tobramycin and compared characteristics of patients with nosocomially acquired FN to community acquired FN. A retrospective chart review of 45 nosocomial FN episodes from 2008 to 2009, and 54 episodes from 2002 to 2004 treated with cefazolin plus tobramycin was conducted. Data on the community acquired FN episodes was obtained from our previous research. Nosocomial FN mortality increased from 4% in 2002-2004 to 13% in 2008-2009 (p = 0.08). The nosocomial cohort was at higher risk of medical complications and mortality than the community-acquired cohort based on several variables (neutrophil nadir, duration of neutropenia and fever, hematological malignancy, MASCC and Talcott score; p < 0.05). As a result, the nosocomial cohort was treated with longer courses of antibiotic therapy (14 days vs 7 days; p < 0.0001) and were more likely to require broader spectrum antibiotics (64 out of 99 vs 34 out of 96; p < 0.0001). There was an observed increased risk of mortality from 2002 to 2004 compared with 2008 to 2009 in patients treated with cefazolin plus tobramycin for nosocomial FN, this was notable despite not attaining statistical significance. Therefore, this regimen is not appropriate for nosocomial FN.


Asunto(s)
Antibacterianos/administración & dosificación , Cefazolina/administración & dosificación , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infección Hospitalaria/tratamiento farmacológico , Fiebre de Origen Desconocido/tratamiento farmacológico , Neutropenia/diagnóstico , Tobramicina/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Infecciones Comunitarias Adquiridas/mortalidad , Infección Hospitalaria/mortalidad , Femenino , Fiebre de Origen Desconocido/complicaciones , Fiebre de Origen Desconocido/mortalidad , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Análisis de Supervivencia , Adulto Joven
6.
Nutr Metab Cardiovasc Dis ; 22(2): 141-8, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20708390

RESUMEN

BACKGROUND AND AIMS: Evaluation of metabolic syndrome (MetS) characteristics across an age spectrum from childhood to adulthood has been limited by a lack of consistent MetS criteria for children and adults and by a lack of adjustment for environmental factors. We used the pediatric and adult International Diabetes Federation (IDF) criteria to determine whether gender-specific and race-specific differences in MetS and its components are present in adolescents as in adults after adjustment for socio-economic status (SES) and lifestyle factors. METHODS AND RESULTS: Waist circumference, blood pressure, triglycerides, HDL cholesterol, and fasting glucose measures were obtained from 3100 adolescent (12-19 years) and 3419 adult (20-69 years) non-Hispanic white, non-Hispanic black, and Mexican-American participants of the 1999-2006 National Health and Nutrition Examination Surveys. We compared odds of having MetS and its components across racial/ethnic groups by age group, while adjusting for income, education, physical activity and diet quality. After adjusting for possible confounding influences of SES and lifestyle, non-Hispanic-black adolescent males exhibited a lower odds of MetS and multiple components (abdominal obesity, hypertriglyceridemia, low HDL, hyperglycemia) compared to non-Hispanic-white and Mexican-American adolescents. Compared to non-Hispanic-white adolescent males, Mexican-American adolescent males had less hypertension. There were no differences in MetS prevalence among adolescent females, though non-Hispanic-black girls exhibited less hypertriglyceridemia. CONCLUSION: Racial/ethnicity-specific differences in MetS and its components are present in both adolescence and adulthood, even after adjusting for environmental factors. These data help strengthen arguments for developing racial/ethnic-specific MetS criteria to better identify individuals at risk for future cardiovascular disease.


Asunto(s)
Negro o Afroamericano/estadística & datos numéricos , Ambiente , Hispánicos o Latinos/estadística & datos numéricos , Síndrome Metabólico/epidemiología , Población Blanca/estadística & datos numéricos , Adaptación Psicológica , Adolescente , Adulto , Anciano , Presión Sanguínea , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/epidemiología , Niño , HDL-Colesterol/sangre , Estudios Transversales , Femenino , Humanos , Hipertensión/sangre , Hipertensión/epidemiología , Estilo de Vida , Modelos Logísticos , Masculino , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Encuestas Nutricionales , Oportunidad Relativa , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Factores Socioeconómicos , Triglicéridos/sangre , Circunferencia de la Cintura , Adulto Joven
7.
Diabetes Obes Metab ; 11(5): 498-505, 2009 May.
Artículo en Inglés | MEDLINE | ID: mdl-19187286

RESUMEN

AIMS: Albiglutide is a glucagon-like peptide-1 (GLP-1) mimetic generated by genetic fusion of a dipeptidyl peptidase-IV-resistant GLP-1 dimer to human albumin. Albiglutide was designed to retain the therapeutic effects of native GLP-1 while extending its duration of action. This study was conducted to determine the pharmacokinetics and initial safety/tolerability profile of albiglutide in non-diabetic volunteers. METHODS: In this single-blind, randomized, placebo-controlled trial, 39 subjects (18-60 years, body mass index 19.9-35.0 kg/m(2)) received placebo (n = 10) or escalating doses of albiglutide (n = 29) on days 1 and 8 in the following sequential cohorts: cohort 1: 0.25 + 1 mg; cohort 2: 3 + 6 mg; cohort 3: 16 + 24 mg; cohort 4: 48 + 60 mg; and cohort 5: 80 + 104 mg. Dose proportionality was evaluated based on area under the plasma drug concentration versus time curve [area under the curve (AUC((0-7 days)))] and maximum plasma drug concentration (C(max)) for cohorts 2-5 during week 1. RESULTS: Albiglutide had a terminal elimination half-life (T(1/2)) of 6-8 days and time to maximum observed plasma drug concentration (T(max)) of 3-4 days. A greater-than-dose proportional increase in albiglutide exposure was observed. Albiglutide demonstrated a dose-dependent trend in reductions of glucose weighted mean AUC and fructosamine levels in healthy subjects. The incidence and severity of adverse events (AEs) was similar between placebo and albiglutide groups. Headache was the most frequent drug-related AE, followed by constipation, flatulence and nausea. CONCLUSIONS: Albiglutide has a half-life that favours once weekly or less frequent dosing with an acceptable safety/tolerability profile in non-diabetic subjects.


Asunto(s)
Péptido 1 Similar al Glucagón/farmacología , Adulto , Área Bajo la Curva , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Relación Dosis-Respuesta a Droga , Femenino , Péptido 1 Similar al Glucagón/análogos & derivados , Hemoglobina Glucada/metabolismo , Semivida , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven
8.
J Chemother ; 19(4): 392-7, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17855183

RESUMEN

Fluoroquinolone-resistance among pneumococci is low; however the number of isolates with a single ParC mutation has increased. Consequently, more potent agents are needed to minimize resistance selection. We investigated the efficacy of ertapenem versus gatifloxacin in a temperature-sensitive mouse model of pneumonia caused by a wildtype Streptococcus pneumoniae strain (A66) and an isogenic mutant with a ParC mutation (R222). Treatment started at 24 h and lasted for 5 days. Temperature was used to assess disease progression before and during treatment. Of mice infected with either strain and treated at an early stage of infection, 79-94% of those given ertapenem survived compared with 56-61% given gatifloxacin. If treated at a later stage, the results were similar for ertapenem (71-84%) but were considerably lower for gatifloxacin (17-33%). Ertapenem was as bactericidal as gatifloxacin against A66 (94-100% vs 92-100%) but was superior to gatifloxacin against R222 (95-100% vs 50-77%). Ertapenem is a promising new treatment for patients with pneumococcal pneumonia, including those at risk of infection with a fluoroquinolone-resistant strain.


Asunto(s)
Antibacterianos/uso terapéutico , Fluoroquinolonas/uso terapéutico , Neumonía Neumocócica/tratamiento farmacológico , Streptococcus pneumoniae/efectos de los fármacos , beta-Lactamas/uso terapéutico , Animales , Antibacterianos/farmacología , Topoisomerasa de ADN IV/genética , Modelos Animales de Enfermedad , Ertapenem , Fluoroquinolonas/farmacología , Gatifloxacina , Ratones , Ratones Endogámicos , Mutación , Streptococcus pneumoniae/genética , Temperatura , Resultado del Tratamiento , beta-Lactamas/farmacología
9.
J Chemother ; 18(6): 634-40, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17267342

RESUMEN

Standard 7-14 day (d) courses of antimicrobial therapy for community-acquired pneumonia (CAP) are thought to have contributed to the emergence of resistant pneumoccoci. Consequently, short-course fluoroquinolone regimens have been proposed to minimize resistance. To test this, we examined 2-day versus 5-day regimens of gemifloxacin and levofloxacin for treatment of pneumonia in a murine model. In doing so, we also investigated whether the enhanced potency of gemifloxacin would influence outcomes. CD1 Swiss mice were infected intratracheally with 10(5)-CFU of a virulent Streptococcus pneumoniae strain. Drugs were administered every 8 h for 2 d and 5 d, starting at 24 h postinfection. Temperature was used to assess disease progression. Gemifloxacin remained effective for 2 d and 5 d, with survival rates of 100%-83% compared with 40%-58% for levofloxacin. Eighty-nine to 100% of gemifloxacin-treated mice were clear of pulmonary bacteria compared with only 0%-20% for levofloxacin. For levofloxacin-treated mice, 2 of 7 (29%) isolates with a levofloxacin minimum inhibitory concentration (MIC) 4 times that of the infecting parent strain had ParC mutations. By contrast, no isolates recovered from gemifloxacin-treated mice were reduced in susceptibility. Gemifloxacin could be effective in shortening duration of therapy for CAP treatment as well as minimize resistance development.


Asunto(s)
Fluoroquinolonas/uso terapéutico , Naftiridinas/uso terapéutico , Neumonía Neumocócica/tratamiento farmacológico , Animales , Antibacterianos/farmacocinética , Antibacterianos/uso terapéutico , Área Bajo la Curva , Temperatura Corporal/efectos de los fármacos , Recuento de Colonia Microbiana , Topoisomerasa de ADN IV/genética , Modelos Animales de Enfermedad , Farmacorresistencia Bacteriana/genética , Femenino , Fluoroquinolonas/farmacocinética , Gemifloxacina , Humanos , Levofloxacino , Pulmón/efectos de los fármacos , Pulmón/metabolismo , Pulmón/microbiología , Ratones , Ratones Endogámicos , Pruebas de Sensibilidad Microbiana , Mutación Missense , Naftiridinas/farmacocinética , Ofloxacino/farmacocinética , Ofloxacino/uso terapéutico , Neumonía Neumocócica/mortalidad , Neumonía Neumocócica/fisiopatología , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/genética , Análisis de Supervivencia , Tasa de Supervivencia , Factores de Tiempo , Resultado del Tratamiento
10.
Avian Dis ; 48(2): 238-43, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15283410

RESUMEN

Proper sanitation practices and the use of efficacious disinfectants in a hatchery have an effect on chick quality. Aerosol bacterial counts, egg moisture loss, hatchability, chick quality, and broiler productivity were evaluated when egg surfaces were contaminated by immersion of each egg into a broth medium containing a field isolate of Pseudomonas aeruginosa and incubated with exposure to one of three disinfectant treatments administered by fine spray: distilled water, BioSentry 904 (904), and a 1:1 ratio of 904 and ethylenediaminetetraacetic acid (EDTA)-Tris. The aerosol bacteria levels were statistically greater on day 21 of incubation in the group treated with distilled water than in those receiving disinfectants. Overall hatch of fertile eggs and egg moisture loss were comparable among all three treatments. At 1 day of age, the chicks incubated with 904 had a statistically lower yolk sac contamination rate than those incubated with 904+EDTA-Tris or distilled water. The 2-wk mortality rates, body weights, feed conversion ratios, yolk sac weights, and yolk sac contamination rates were all similar among the three treatments.


Asunto(s)
Pollos/microbiología , Desinfectantes/farmacología , Ácido Edético/farmacología , Huevos/microbiología , Pseudomonas aeruginosa/efectos de los fármacos , Compuestos de Amonio Cuaternario/farmacología , Animales , Animales Recién Nacidos/metabolismo , Animales Recién Nacidos/microbiología , Desinfección/métodos , Combinación de Medicamentos , Incubadoras/microbiología , Incubadoras/veterinaria , Pruebas de Sensibilidad Microbiana , Pseudomonas aeruginosa/aislamiento & purificación , Saco Vitelino/metabolismo , Saco Vitelino/microbiología
11.
Avian Dis ; 46(4): 826-30, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12495042

RESUMEN

Studies have indicated variations in the degree of efficacy of certain commercial disinfectants used in poultry production facilities. We used an adequate method of in vitro testing to compare the efficacy of disinfectants while testing them in conditions similar to those of the poultry facilities. BioSentry 904, ethylenediaminetetracetic acid (EDTA)-Tris, and a combination of the two were tested by this method against five field isolates of Pseudomonas aeruginosa at 10(3), 10(6), and 10(9) colony-forming units (CFU)/ml. At the 10(9) CFU/ml concentration, most compounds failed to achieve a total kill with a contact time of 15 min. When tested at bacterial concentrations of 10(3) CFU/ml, the combination of EDTA-Tris mixed at a 1:1 ratio with BioSentry 904 killed the bacteria upon initial contact (< or = 0.05 min). This disinfectant mixture exhibited antagonistic, indifferent, or synergetic effects when exposed to different bacterial isolates at a concentration of 10(6) CFU/ml.


Asunto(s)
Desinfectantes/farmacología , Ácido Edético/farmacología , Pseudomonas aeruginosa/efectos de los fármacos , Compuestos de Amonio Cuaternario/farmacología , Animales , Pollos , Vivienda para Animales , Pruebas de Sensibilidad Microbiana , Pseudomonas aeruginosa/clasificación , Pseudomonas aeruginosa/aislamiento & purificación
12.
Avian Dis ; 46(4): 1045-50, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12495073

RESUMEN

In mid-2000, a broiler chicken company in Alabama experienced high early mortality rates in chicks from two different hatcheries. Five isolates of Pseudomonas aeruginosa, obtained from these contaminated hatcheries and resulting broiler chicks with omphalitis, were selected to determine virulence of the bacteria. One-day-old specific-pathogen-free white leghorn chicks were placed into positive pressure isolation units (10 chicks per unit); feed and water were provided ad libitum. The five isolates of P. aeruginosa (1 x 10(1) or 1 x 10(1) colony-forming units/bird) were used to challenge two replicates of 10 chicks via yolk sac inoculation. Two control groups were injected with 0.1 ml of phosphate-buffered saline, and two groups received no treatment. Mortality was recorded daily, and the chicks that died were necropsied and liver and yolk sacs were cultured. After 14 days, the remaining chickens were euthanatized and necropsied. Bacterial isolates retrieved from liver and yolk sacs were identified by the API 20 NE typing system to confirm that they were the same as the challenge isolate. Virulence varied greatly among the isolates, resulting in mortality rates from 0 to 90%. The challenge isolates produced different and often distinctive postmortem lesion patterns. Antibiotic sensitivity tests showed that all five isolates were resistant to sulfisoxazole, ceftiofur, penicillin, lincomycin, bacitracin, oxytetracycline, erythromycin, naladixic acid, and tetracycline. The isolates varied in sensitivity to other antibiotics, but all isolates were sensitive to gentamicin.


Asunto(s)
Enfermedades de las Aves de Corral/microbiología , Infecciones por Pseudomonas/veterinaria , Pseudomonas aeruginosa/aislamiento & purificación , Alabama/epidemiología , Animales , Pollos , Brotes de Enfermedades/veterinaria , Enfermedades de las Aves de Corral/epidemiología , Enfermedades de las Aves de Corral/mortalidad , Infecciones por Pseudomonas/epidemiología , Infecciones por Pseudomonas/mortalidad , Pseudomonas aeruginosa/patogenicidad
13.
Ann Rheum Dis ; 61(5): 387-90, 2002 May.
Artículo en Inglés | MEDLINE | ID: mdl-11959760

RESUMEN

BACKGROUND: Rice bodies can occur in the joints in many rheumatic conditions, but they are most common in rheumatoid arthritis. They are generally believed to occur rarely in patients with osteoarthritis, but one study reported rice bodies with apatite crystals. OBJECTIVE: To report on a series of joint fluids with rice bodies containing apatite clumps and examine their clinical pictures. METHODS: All synovial fluid analysis reports for 10 years were reviewed for rice bodies and eight patients were reported on. A series of patients with a variety of diseases with synovial fluid rice bodies found to contain calcific material is described. All were examined by compensated polarised light and alizarin red stain, and four were examined by electron microscopy. RESULTS: The eight patients all had alizarin red S chunks embedded throughout the rice body. Transmission electron microscopy disclosed the presence of a matrix of collagen, fibrin, and amorphous materials containing typical apatite crystals. Clinical diagnoses, radiographic findings, and leucocyte counts varied, but six of the eight patients had had previous repeated corticosteroid injections into the joints. CONCLUSION: Aggregates of apatites may be more common than previously recognised in rice bodies as they are not routinely sought. Whether they are a result of joint damage or depot steroid injections and whether that might contribute to further joint injury now needs to be investigated.


Asunto(s)
Apatitas/análisis , Artritis Reumatoide/metabolismo , Líquido Sinovial/química , Antraquinonas , Artritis Reumatoide/tratamiento farmacológico , Calcio , Preescolar , Femenino , Glucocorticoides/efectos adversos , Humanos , Inyecciones Intraarticulares , Articulación de la Rodilla , Masculino , Microscopía Electrónica , Persona de Mediana Edad
14.
Lupus ; 10(10): 762-8, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11721704

RESUMEN

Prolactin, a peptide hormone, acts as a cytokine. It has been hypothesized that bromocriptine, a dopamine analog that suppresses pituitary secretion of prolactin, suppresses circulating prolactin and, through this mechanism, has the potential to suppress autoimmune disease. This rationale has been applied to the treatment of systemic lupus erythematosus (SLE), a prototype autoimmune illness that occurs spontaneously in animal models such as the F1 hybrid NZBxNZW mouse, and in humans. Treatment with bromocriptine was effective in treating some induced and spontaneous autoimmune disease in experimental models. Bromocriptine did slow the course of SLE in NZBxNZW mice when treatment was started before the appearance of clinical disease. In addition, bromocriptine was effective in treating established disease in this model. In three separate clinical trials, bromocriptine showed evidence that it had a therapeutic effect in treating human lupus. Bromocriptine is currently considered an unproven therapy for SLE. Its use is entirely experimental. The fact that bromocriptine was effective in treating NZBxNZW mice, the beneficial therapeutic effects in human trials, and the low toxicity of the drug form a solid rationale for undertaking further therapeutic trials.


Asunto(s)
Bromocriptina/uso terapéutico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Animales , Autoinmunidad/efectos de los fármacos , Bromocriptina/farmacología , Modelos Animales de Enfermedad , Humanos , Prolactina/metabolismo
15.
Am J Manag Care ; 7(16 Suppl): S486-9, 2001 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-11680780

RESUMEN

The etiologic enigma of systemic lupus erythematosus (SLE) has so far precluded a fully integrated approach to understanding and managing the disease. As new findings continue to uncover relationships between the endocrine system and the besieged immune system in lupus patients, however, researchers have an opportunity to rethink the direction of their investigative efforts. A successful approach to development of long-awaited new treatments may well include modulation of specific hormones. The peptide hormone prolactin may be associated with SLE disease activity. The dopamine agonist bromocriptine, which inhibits pituitary secretion of prolactin, has been shown in a variety of small animal and human trials to reduce disease activity in SLE. Continued research may show that it can be an attractive alternative or adjacent therapy in cases where hydroxychloroquine is contraindicated.


Asunto(s)
Hormonas/uso terapéutico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Animales , Bromocriptina/farmacología , Bromocriptina/uso terapéutico , Agonistas de Dopamina/farmacología , Agonistas de Dopamina/uso terapéutico , Estrógenos/fisiología , Humanos , Lupus Eritematoso Sistémico/fisiopatología , Prolactina/antagonistas & inhibidores , Prolactina/sangre , Prolactina/metabolismo , Testosterona/fisiología
17.
Lupus ; 10(3): 197-202, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11315352

RESUMEN

Prolactin, a lactogenic hormone, is a cytokine and an important link between the immune and endocrine systems. Prolactin stimulated disease in autoimmune NZB/NZW mice. Treatment of the mice with the prolactin-lowering dopamine agonist, bromocriptine, suppressed anti-DNA and prolonged life spans. These findings have been applied to humans with systemic lupus erythematosus (SLE). An open-label study, a double blind study, and a study comparing bromocriptine to hydroxychloroquine provided evidence that bromocriptine therapy reduced flares and suppressed disease activity in SLE.


Asunto(s)
Bromocriptina/uso terapéutico , Antagonistas de Hormonas/uso terapéutico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Animales , Humanos
18.
Arthritis Rheum ; 45(2): 122-8, 2001 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11324774

RESUMEN

OBJECTIVE: To examine the effects of stress management training on pain behavior exhibited by persons with rheumatoid arthritis (RA) and the relationship of change in pain behavior with certain patient characteristics as well as change in self-reported levels of pain. METHODS: Patients with RA (n = 131) were randomly assigned to 1 of 3 groups: a stress management group, an attention control group, or a standard care control group. The stress management and attention control groups received a 10-week intervention followed by a 15-month maintenance phase. RESULTS: The 3 groups did not differ significantly in the change in pain behavior at any of the assessment periods. However, persons with RA who had less disease activity tended to exhibit positive changes in pain behavior over time. Changes in self-reported pain were not significantly related to changes in pain behavior. CONCLUSION: The results indicate that stress management interventions do not reduce total pain behaviors exhibited by persons with RA. Changes in pain behaviors appear to be related to disease activity, age, and disease duration, but not to changes in self-reported measures of pain.


Asunto(s)
Artritis Reumatoide/terapia , Manejo del Dolor , Estrés Psicológico/prevención & control , Artritis Reumatoide/complicaciones , Artritis Reumatoide/fisiopatología , Artritis Reumatoide/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/fisiopatología , Dolor/psicología , Dimensión del Dolor , Índice de Severidad de la Enfermedad , Estrés Psicológico/etiología , Encuestas y Cuestionarios , Resultado del Tratamiento
19.
J Pain Symptom Manage ; 21(1): 12-7, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11223310

RESUMEN

The hospice model of care of the dying patient is regarded as a model of excellence; however, outcomes of this care have been poorly demonstrated. Integrated Care Pathways (ICPs) provide a method of recording and measuring outcomes of care. The ICP document replaces all previous documentation and is a multiprofessional record of patient care. The aim of this study was to implement an ICP in an inpatient hospice setting in order to set standards of care for symptom control in the dying phase of a patient's life. ICPs were analyzed from 168 inpatients who died over a one-year period. Symptoms of pain, agitation, and respiratory tract secretions (RTS) were monitored every four hours by nursing staff as either present or absent. For each symptom, 80% of patients had one episode or complete control of the symptom, 10% had two episodes, and 10% had three episodes or more recorded. As death neared, there was a statistically significant increase in the number of patients whose pain was controlled. The ICP has provided a means to measure symptom control in the dying patient and set standards of care, which is integrated into clinical practice.


Asunto(s)
Cuidado Terminal/normas , Adulto , Anciano , Anciano de 80 o más Años , Vías Clínicas/normas , Femenino , Humanos , Masculino , Registros Médicos , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud/métodos , Cuidados Paliativos , Trastornos Respiratorios/terapia
20.
Anim Behav ; 61(1): 43-51, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11170695

RESUMEN

Some prey can distinguish between chemical cues from predators fed different diets. Here we document the first evidence of diet-based chemical discrimination of predators in a terrestrial arthropod and measure the survival value of behavioural responses to predator chemical cues. We tested activity level and avoidance behaviour of the wolf spider, Pardosa milvina, to faeces and silk associated with the predatory wolf spider, Hogna helluo, fed either P. milvina or crickets (Acheta domesticus). We then measured survival of Pardosa in the presence of Hogna when placed on blank paper or paper previously occupied by Hogna fed either crickets or Pardosa. Filter paper previously occupied by Hogna from each diet treatment or a blank control were simultaneously presented to adult female Pardosa among four treatment pairs (N=15/treatment): (1) blank paper/blank paper, (2) Hogna fed crickets/blank, (3) Hogna fed Pardosa /blank and (4) Hogna fed Pardosa / Hogna fed crickets. Cues from Hogna fed either crickets or Pardosa elicited significantly less activity relative to blank controls. Cues from Hogna fed Pardosa elicited a significantly greater reduction in activity than Hogna fed crickets. When given a choice, Pardosa initially chose the blank substrate significantly more often than either substrate with Hogna cues. Spiders survived longer in the presence of cues from either Hogna diet treatment relative to blank paper, but there was no significant effect of predator diet on survival. Results suggest diet-based predator cues elicit different levels of activity in Pardosa that reduce predation in the presence of Hogna. Copyright 2001 The Association for the Study of Animal Behaviour.

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