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1.
J Food Prot ; 87(4): 100247, 2024 04.
Article in English | MEDLINE | ID: mdl-38369192

ABSTRACT

Developing countries such as Ecuador carry a heavy food safety burden but reports on the microbiological quality of their foods are scarce. In this investigation, the microbial diversity of 10 high-risk and mass-consumption street-vended foods including bolones, encebollado, food dressings, ceviche, chopped fruits, fruit juices, fruit salads, cheese, raw chicken, and ground beef in Quito, Guayaquil, and Cuenca, three major population centers in Ecuador, were evaluated using 16S rRNA gene High Throughput Sequencing. In total, 1,840 amplicon sequence variants (ASVs) were classified into 23 phyla, 253 families, 645 genera, and 829 species. In the tested food samples, Proteobacteria and Firmicutes were the most abundant phyla accounting for 97.41% of relative abundance (RA). At genus level, 10 dominant genera were identified: Acinetobacter (12.61% RA), Lactococcus (12.08% RA), Vibrio (8.23% RA), Weissella (7.43% RA), Aeromonas (6.18% RA), Photobacterium (6.32% RA), Pseudomonas (3.92% RA), Leuconostoc (3.51% RA), Klebsiella (3.49% RA), and Cupriavidus (2.86% RA). The highest microbial diversity indices were found in raw chicken, encebollados, fruit salads, and fruit juices from Guayaquil and Cuenca. From sampled foods, 29 species were classified as food spoilage bacteria and 24 as opportunistic pathogenic bacteria. Two groups associated with human diseases were identified, including 11 enteric species and 26 species of fecal bacteria. The occurrence of recognized and opportunistic pathogenic bacteria, as well as enteric and fecal microorganisms, in the street-vended foods indicated extensive risks for the consumers' health. This study demonstrated the application of culture-independent amplicon sequencing in providing a more comprehensive view of microbial safety for street-vended food, which could be a useful tool to facilitate the control of foodborne diseases.


Subject(s)
Food Microbiology , Vibrio , Animals , Cattle , Humans , RNA, Ribosomal, 16S/genetics , Ecuador , Food Safety , Vibrio/genetics
2.
Urogynecology (Phila) ; 30(1): 17-25, 2024 01 01.
Article in English | MEDLINE | ID: mdl-37326237

ABSTRACT

IMPORTANCE: Limited studies have examined patient aversion to mesh use in pelvic surgery, especially in Latinas. OBJECTIVE: This study aimed to assess aversion to pelvic surgery with mesh for urinary incontinence and pelvic organ prolapse in a sample of Latinas on the U.S.-Mexico border. STUDY DESIGN: This was a cross-sectional study of self-identified Latinas with symptoms of pelvic floor disorders, recruited at their initial consultation visit at a single, academic urogynecology clinic. Participants completed a validated survey to assess perceptions of mesh use in pelvic surgery. Participants also completed questionnaires assessing the presence and severity of pelvic floor symptoms and level of acculturation. The primary outcome was aversion to mesh surgery, as indicated by a response of "yes" or "maybe" to the question "Based on what you already know, would you avoid surgery using mesh?" Descriptive analysis, univariate relative risk, and linear regression analysis were completed to identify characteristics associated with mesh avoidance. Significance was assessed and considered at P values <0.05. RESULTS: Ninety-six women were included. Only 6.3% had prior pelvic floor surgery using mesh. Sixty-six percent indicated that they would be likely to avoid pelvic surgery that uses mesh. Only 9.4% indicated that they obtained information regarding mesh directly from medical professionals. Levels of concern regarding the use of mesh varied widely (29.2% not worried, 19.1% somewhat worried, 16.9% very worried). Higher percentages of "more acculturated" participants indicated a desire to avoid mesh surgery (58.7% vs 27.3%, P < 0.05). CONCLUSIONS: In this Latina population, a majority of patients indicated an aversion to using mesh in pelvic surgery. Few patients obtained information regarding mesh directly from medical professionals, relying instead on nonmedical sources.


Subject(s)
Pelvic Floor , Surgical Mesh , Urinary Incontinence , Female , Humans , Cross-Sectional Studies , Pelvic Floor/surgery , Urinary Incontinence/epidemiology , Hispanic or Latino , Patient Preference
3.
Front Neural Circuits ; 17: 1253609, 2023.
Article in English | MEDLINE | ID: mdl-37941893

ABSTRACT

While external stimulation can reliably trigger neuronal activity, cerebral processes can operate independently from the environment. In this study, we conceptualize autogenous cerebral processes (ACPs) as intrinsic operations of the brain that exist on multiple scales and can influence or shape stimulus responses, behavior, homeostasis, and the physiological state of an organism. We further propose that the field should consider exploring to what extent perception, arousal, behavior, or movement, as well as other cognitive functions previously investigated mainly regarding their stimulus-response dynamics, are ACP-driven.


Subject(s)
Brain , Head , Brain/physiology , Cognition , Arousal/physiology , Movement/physiology
4.
J Surg Case Rep ; 2023(6): rjad289, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37274632

ABSTRACT

The occurrence of diffuse large B-cell lymphoma (DLBCL) of the appendix presenting as acute appendicitis is rare, constituting only a minuscule portion (0.015%) of gastrointestinal lymphoma cases. We present a case of a 55-year-old woman that was admitted to the emergency department with symptoms of acute appendicitis and underwent an interval laparoscopic appendectomy with a right hemicolectomy and lymph node resection. Pathological examination revealed the presence of DLBCL in the appendix. The patient is undergoing chemotherapy.

5.
Eur J Neurosci ; 57(11): 1870-1891, 2023 06.
Article in English | MEDLINE | ID: mdl-37032582

ABSTRACT

Playing specific genres of video games (e.g., action video games) has been linked to improvements in cognitive skills mostly related to attentional phenomena. Nonetheless, do video games have features or dimensions in common that impact cognitive improvements beyond the game genre? Here, we argue that the sensorimotor demand-the amount of demand for precise coordination between movement and perception-is a key element in the improvements associated with playing video games. We conducted a two-part study to test this hypothesis: a self-report online gaming instrument development and validation and an in-lab behavioural and electrophysiological study. In the first study, data from 209 participants were used to devise the sensorimotor demand instrument (SMDI). The SMDI was split into three dimensions of video game playing: sensorimotor contingency, immersion and unfocused gaming. Criterion validity related to video gamers' characteristics supported that the SMDI is sensitive to the input device (e.g., keyboard or touchscreens), and the most recent experience gained during gaming sessions while not being sensitive to the game genre. In the second study, data from 20 participants who performed four visual-attentional tasks previously reported in the literature showed that the SMDI's dimensions were associated with behavioural performance measures and the latency and amplitude of event-related potentials (N1, P2 and P3). Despite the challenge of studying the video gamer population, our study remarks on the relevance of sensorimotor demands in the performance of attentional tasks and its potential use as a dimension to characterize the experience of playing video games beyond the game genre.


Subject(s)
Immersion , Video Games , Humans , Attention/physiology , Video Games/psychology , Movement
6.
Front Syst Neurosci ; 17: 1045940, 2023.
Article in English | MEDLINE | ID: mdl-37025165

ABSTRACT

Background: There are different ways to learn a sensorimotor task. This research focuses on whole versus part learning in a complex video game that involves sensorimotor adaptations and skill learning. The primary aim of this research is to compare the changes in (1) event-related potentials (ERP) and (2) Alpha and Beta event-related desynchronization/synchronization [ERD(S)] of EEG between whole and part practice protocols. Materials and methods: 18 Healthy young participants practiced for 5 days a video game with distorted kinematic (advancing skill) and dynamic features (shooting skill) to test the ability to combine sensorimotor skill components learned modularly (part learning, 9 participants) or combined (whole practice, 9 participants). We examined ERP and ERD(S) in EEG channels in the baseline test (day 1) and the retention test (day 5), dissociating epochs with advancing or shooting. We focus the analysis on the main activity of ERP or ERD(S) in different time windows. Results: In the advancing epochs (distorted kinematic), both groups showed a decrease in time for ERP and an increase in Beta ERD activity in central and posterior channels. In the shooting epochs (distorted dynamic), the Whole group showed a decrease in time for ERPs in anterior and central-posterior channels. Additionally, the shooting ERS in the Beta band decreases within sessions in central channels, particularly for the Part group. Conclusion: Neural correlates of kinematic and dynamic control [ERP and ERD(S)] were modulated by sensorimotor learning, which reflects the effect of the type of practice on the execution and the evaluation of the action. These results can be linked with our previous report, where the simultaneous practice of kinematic and dynamic distortions takes advantage of the motor performance on retention tests, indicating a more automatic control for the whole practice group.

7.
J Surg Case Rep ; 2023(3): rjad102, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36896157

ABSTRACT

A woman in her 50s was admitted to the emergency department with a 3-day history of abdominal pain, mainly in the right hypochondrium, radiating to the back, associated with postprandial vomiting and dysphagia. The abdominal ultrasound study found no abnormalities. Laboratory tests showed increased C-reactive protein levels, creatinine and high white blood cell count without a left shift. Abdominal computed tomography scan exhibited mediastinal herniation, twist and perforation of the gastric fundus associated with air-fluid levels in the lower mediastinum. The patient underwent diagnostic laparoscopy requiring laparotomy conversion due to hemodynamic instability related to the pneumoperitoneum. During the intensive care unit (ICU) stay, thoracoscopy with pulmonary decortication was performed to treat complicated pleural effusion. After ICU and standard infirmary bed recovery, the patient was discharged from the hospital. This report illustrates a case of perforated gastric volvulus as the cause of nonspecific abdominal pain.

8.
MethodsX ; 10: 102041, 2023.
Article in English | MEDLINE | ID: mdl-36814691

ABSTRACT

In this work we present SaFiDe, a deterministic method to detect eye movements (saccades and fixations) from eye-trace data. We developed this method for human and nonhuman primate data from video- and coil-recorded eye traces and further applied the algorithm to eye traces computed from electrooculograms. All the data analyzed were from free-exploration paradigms, where the main challenge was to detect periods of saccades and fixations that were uncued by the task. The method uses velocity and acceleration thresholds, calculated from the eye trace, to detect saccade and fixation periods. We show that our fully deterministic method detects saccades and fixations from eye traces during free visual exploration. The algorithm was implemented in MATLAB, and the code is publicly available on a GitHub repository.•The algorithm presented is entirely deterministic, simplifying the comparison between subjects and tasks.•Thus far, the algorithm presented can operate over video-based eye tracker data, human electrooculogram records, or monkey scleral eye coil data.

9.
Front Hum Neurosci ; 17: 1056432, 2023.
Article in English | MEDLINE | ID: mdl-36816499

ABSTRACT

Background: Amblyopia is the interocular visual acuity difference of two lines or more with the best correction in both eyes. It is treated with ocular occlusion therapy, but its success depends on neuroplasticity, and thus is effective in children but not adults. Transcranial Direct Current Stimulation (tDCS) is suggested to increase neuroplasticity. Objective: To determine if combined intervention of bilateral tDCS and ocular occlusion improves visual function in adults with amblyopia. Methods: A double-blind randomized, controlled pilot trial was conducted in 10 volunteers with amblyopia. While applying ocular occlusion and performing a reading task, participants received bilateral tDCS (n = 5) or sham stimulation (n = 5), with the anodal tDCS electrode in the contralateral visual cortex and the cathodal in the ipsilateral visual cortex in relation to the amblyopic eye. Visual function (through visual acuity, stereopsis, and contrast sensitivity tests) and visual evoked potential (with checkerboard pattern stimuli presentation) were evaluated immediately after. Results: A total of 30 min after treatment with bilateral tDCS, visual acuity improved by 0.16 (± 0.025) LogMAR in the treatment group compared with no improvement (-0.02 ± 0.02) in five controls (p = 0.0079), along with a significant increase in the amplitude of visual evoked potentials of the amblyopic eye response (p = 0.0286). No significant changes were observed in stereopsis and contrast sensitivity. No volunteer reported any harm derived from the intervention. Conclusion: Our study is the first to combine anodal and cathodal tDCS for the treatment of amblyopia, showing transient improved visual acuity in amblyopic adults.

10.
Front Aging Neurosci ; 15: 1097577, 2023.
Article in English | MEDLINE | ID: mdl-36845655

ABSTRACT

Introduction: Alzheimer's disease (AD) is the leading cause of dementia worldwide, but its pathophysiological phenomena are not fully elucidated. Many neurophysiological markers have been suggested to identify early cognitive impairments of AD. However, the diagnosis of this disease remains a challenge for specialists. In the present cross-sectional study, our objective was to evaluate the manifestations and mechanisms underlying visual-spatial deficits at the early stages of AD. Methods: We combined behavioral, electroencephalography (EEG), and eye movement recordings during the performance of a spatial navigation task (a virtual version of the Morris Water Maze adapted to humans). Participants (69-88 years old) with amnesic mild cognitive impairment-Clinical Dementia Rating scale (aMCI-CDR 0.5) were selected as probable early AD (eAD) by a neurologist specialized in dementia. All patients included in this study were evaluated at the CDR 0.5 stage but progressed to probable AD during clinical follow-up. An equal number of matching healthy controls (HCs) were evaluated while performing the navigation task. Data were collected at the Department of Neurology of the Clinical Hospital of the Universidad de Chile and the Department of Neuroscience of the Faculty of Universidad de Chile. Results: Participants with aMCI preceding AD (eAD) showed impaired spatial learning and their visual exploration differed from the control group. eAD group did not clearly prefer regions of interest that could guide solving the task, while controls did. The eAD group showed decreased visual occipital evoked potentials associated with eye fixations, recorded at occipital electrodes. They also showed an alteration of the spatial spread of activity to parietal and frontal regions at the end of the task. The control group presented marked occipital activity in the beta band (15-20 Hz) at early visual processing time. The eAD group showed a reduction in beta band functional connectivity in the prefrontal cortices reflecting poor planning of navigation strategies. Discussion: We found that EEG signals combined with visual-spatial navigation analysis, yielded early and specific features that may underlie the basis for understanding the loss of functional connectivity in AD. Still, our results are clinically promising for early diagnosis required to improve quality of life and decrease healthcare costs.

11.
Cienc. Salud (St. Domingo) ; 7(2): [5], 2023. ilus
Article in Spanish | LILACS | ID: biblio-1442788

ABSTRACT

Caroli disease is a rare congenital disorder characterized by dilatation of intrahepatic bile ducts. The treatment could correspond to hepatic resection for localized disease. This paper describes a case of Caroli's disease in a 60 years old female patient, who presented jaundice and diffuse abdominal pain. Further examinations suggested the diagnosis of Caroli disease associated with cholestatic syndrome. We decided to perform a Hepp Couinaud biliodigestive bypass by video laparoscopy with Roux-en-Y reconstruction. There were no immediate complications and no longterm complications after 6 months of follow-up. The VLP biliodigestive bypass in patients with associated cholestatic syndromes should be considered a treatment prior to a more aggressive approach.


La enfermedad de Caroli es un raro trastorno congénito que consiste en una dilatación de las vías biliares intrahepáticas. Su tratamiento definitivo debe consistir en resección hepática por la enfermedad localizada. Este artículo describe un caso de enfermedad de Caroli en una paciente de sexo femenino de 60 años de edad, quien presentó ictericia y dolor abdominal difuso. Exámenes posteriores sugirieron el diagnóstico de enfermedad de Caroli asociada con síndrome colestásico. Los médicos decidieron realizar un bypass biliodigestivo de Hepp Couinaud mediante videolaparoscopia con reconstrucción en Y de Roux. No hubo complicaciones inmediatas ni complicaciones a largo plazo después de 6 meses de seguimiento. El bypass biliodigestivo VLP en pacientes con síndromes colestásicos asociados debe considerarse un tratamiento previo a un abordaje más agresivo.


Subject(s)
Humans , Female , Middle Aged , Caroli Disease , Laparoscopy
12.
Heliyon ; 8(12): e12215, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36578387

ABSTRACT

The ability of an organism to voluntarily control the stimuli onset modulates perceptual and attentional functions. Since stimulus encoding is an essential component of working memory (WM), we conjectured that controlling the initiation of the perceptual process would positively modulate WM. To corroborate this proposition, we tested twenty-five healthy subjects in a modified-Sternberg WM task under three stimuli presentation conditions: an automatic presentation of the stimuli, a self-initiated presentation of the stimuli (through a button press), and a self-initiated presentation with random-delay stimuli onset. Concurrently, we recorded the subjects' electroencephalographic signals during WM encoding. We found that the self-initiated condition was associated with better WM accuracy, and earlier latencies of N1, P2 and P3 evoked potential components representing visual, attentional and mental review of the stimuli processes, respectively. Our work demonstrates that self-initiated stimuli enhance WM performance and accelerate early visual and attentional processes deployed during WM encoding. We also found that self-initiated stimuli correlate with an increased attentional state compared to the other two conditions, suggesting a role for temporal stimuli predictability. Our study remarks on the relevance of self-control of the stimuli onset in sensory, attentional and memory updating processing for WM.

13.
Front Neurosci ; 16: 891523, 2022.
Article in English | MEDLINE | ID: mdl-35812209

ABSTRACT

Hippocampal-dependent memories emerge late during postnatal development, aligning with hippocampal maturation. During sleep, the two-stage memory formation model states that through hippocampal-neocortical interactions, cortical slow-oscillations (SO), thalamocortical Spindles, and hippocampal sharp-wave ripples (SWR) are synchronized, allowing for the consolidation of hippocampal-dependent memories. However, evidence supporting this hypothesis during development is still lacking. Therefore, we performed successive object-in-place tests during a window of memory emergence and recorded in vivo the occurrence of SO, Spindles, and SWR during sleep, immediately after the memory encoding stage of the task. We found that hippocampal-dependent memory emerges at the end of the 4th postnatal week independently of task overtraining. Furthermore, we observed that those animals with better performance in the memory task had increased Spindle density and duration and lower density of SWR. Moreover, we observed changes in the SO-Spindle and Spindle-SWR temporal-coupling during this developmental period. Our results provide new evidence for the onset of hippocampal-dependent memory and its relationship to the oscillatory phenomenon occurring during sleep that helps us understand how memory consolidation models fit into the early stages of postnatal development.

14.
eNeuro ; 9(2)2022.
Article in English | MEDLINE | ID: mdl-35365504

ABSTRACT

Variations in human behavior correspond to the adaptation of the nervous system to different internal and environmental demands. Attention, a cognitive process for weighing environmental demands, changes over time. Pupillary activity, which is affected by fluctuating levels of cognitive processing, appears to identify neural dynamics that relate to different states of attention. In mice, for example, pupil dynamics directly correlate with brain state fluctuations. Although, in humans, alpha-band activity is associated with inhibitory processes in cortical networks during visual processing, and its amplitude is modulated by attention, conclusive evidence linking this narrowband activity to pupil changes in time remains sparse. We hypothesize that, as alpha activity and pupil diameter indicate attentional variations over time, these two measures should be comodulated. In this work, we recorded the electroencephalographic (EEG) and pupillary activity of 16 human subjects who had their eyes fixed on a gray screen for 1 min. Our study revealed that the alpha-band amplitude and the high-frequency component of the pupil diameter covariate spontaneously. Specifically, the maximum alpha-band amplitude was observed to occur ∼300 ms before the peak of the pupil diameter. In contrast, the minimum alpha-band amplitude was noted to occur ∼350 ms before the trough of the pupil diameter. The consistent temporal coincidence of these two measurements strongly suggests that the subject's state of attention, as indicated by the EEG alpha amplitude, is changing moment to moment and can be monitored by measuring EEG together with the diameter pupil.


Subject(s)
Pupil , Wakefulness , Animals , Attention/physiology , Electroencephalography , Humans , Mice , Pupil/physiology , Visual Perception , Wakefulness/physiology
15.
Eur J Neurosci ; 54(4): 5249-5260, 2021 08.
Article in English | MEDLINE | ID: mdl-34109698

ABSTRACT

It is widely accepted that the brain, like any other physical system, is subjected to physical constraints that restrict its operation. The brain's metabolic demands are particularly critical for proper neuronal function, but the impact of these constraints continues to remain poorly understood. Detailed single-neuron models are recently integrating metabolic constraints, but these models' computational resources make it challenging to explore the dynamics of extended neural networks, which are governed by such constraints. Thus, there is a need for a simplified neuron model that incorporates metabolic activity and allows us to explore the dynamics of neural networks. This work introduces an energy-dependent leaky integrate-and-fire (EDLIF) neuronal model extension to account for the effects of metabolic constraints on the single-neuron behavior. This simple, energy-dependent model could describe the relationship between the average firing rate and the Adenosine triphosphate (ATP) cost as well as replicate a neuron's behavior under a clinical setting such as amyotrophic lateral sclerosis (ALS). Additionally, EDLIF model showed better performance in predicting real spike trains - in the sense of spike coincidence measure - than the classical leaky integrate-and-fire (LIF) model. The simplicity of the energy-dependent model presented here makes it computationally efficient and, thus, suitable for studying the dynamics of large neural networks.


Subject(s)
Models, Neurological , Neurons , Action Potentials , Computer Simulation , Neural Networks, Computer
16.
Female Pelvic Med Reconstr Surg ; 27(1): e96-e100, 2021 01 01.
Article in English | MEDLINE | ID: mdl-32149869

ABSTRACT

OBJECTIVES: To explore the knowledge, attitudes, and beliefs related to pessary use in Spanish-speaking women along the US-Mexico border. METHODS: Spanish-speaking women with symptoms of vaginal bulge were recruited from the urogynecology/gynecology clinics at Texas Tech University Health Sciences Center El Paso to participate in moderated focus groups. Discussion topics included knowledge of prolapse/pessaries, pros/cons of pessaries, alternatives, and prolapse surgery. Audio-recorded group discussions were transcribed verbatim, and qualitative analysis completed by independent review using grounded theory methodology. Common themes were identified and then aggregated to form consensus concepts, agreed upon by the reviewers. RESULTS: Twenty-nine Spanish-speaking women participated in 6 focus group discussions. Approximately half of women reported little or no prior knowledge about pessaries. Three main themes were identified from analysis: knowledge/perceptions, misinformation/misconceptions, and surgery-related concerns. Concepts identified from common themes included limited knowledge of pessaries, confusing "pessary" with "mesh," willingness to try pessaries in order to avoid surgery, desire to try pessary if it was recommended by physician, limited efficacy or complications of surgery, and mesh-related concerns. Interestingly, some women reported that pessaries appear to be a treatment more often offered in the United States rather than in Mexico. CONCLUSIONS: Most participants showed a willingness to try a pessary for symptoms of pelvic organ prolapse in an effort to avoid surgery, despite expressing limited knowledge about this treatment. Physician recommendations and risks of pessary use influence their likelihood of trying a pessary. These concepts serve as focus points for effective pessary counseling to help improve education and informed decision making in this patient population.


Subject(s)
Health Knowledge, Attitudes, Practice , Pelvic Organ Prolapse/therapy , Pessaries , Adult , Aged , Female , Focus Groups , Humans , Mexican Americans , Middle Aged , Patient Acceptance of Health Care/psychology , Pelvic Organ Prolapse/psychology , Qualitative Research , Texas
17.
Addict Biol ; 26(1): e12836, 2021 01.
Article in English | MEDLINE | ID: mdl-31846188

ABSTRACT

Drug addictions are chronic mental disorders characterized by compulsive drug seeking and drug use, despite their negative consequences. It is a priority to find therapeutic alternatives to prevent relapse, as there are still no treatments that can ensure abstinence. One of the neural systems implicated in the appearance of the states of discomfort that motivate relapse is the interoceptive system, which oversees our internal body states. However, less attention has been given to the peripheral components of the interoceptive system and their role in addictions. Within these pathways, the vagus nerve represents one of the main visceral afferents of the interoceptive system. We hypothesized that the interruption of visceral afferent pathways would decrease the motivational effects of the drug, thereby either decreasing or preventing drug cravings. To test this idea, we used rats of a high-alcohol-drinking line and measured the effect that vagus nerve resection had on the relapse-like alcohol drinking, expressed as the alcohol deprivation effect, a phenomenon that has been linked to addiction-related events such as alcohol cravings. We found that even though vagotomy completely eliminates the effect of alcohol deprivation, it has no impact on water consumption or animal weight. These results give us valuable information about the relationship between the autonomic nervous system and alcohol use disorders and allow us to propose new clinical research that might have translational options.


Subject(s)
Alcoholism/surgery , Interoception/drug effects , Vagotomy , Animals , Behavior, Addictive/surgery , Chronic Disease , Craving , Ethanol/pharmacology , Female , Rats , Recurrence , Self Administration
18.
Female Pelvic Med Reconstr Surg ; 27(4): 249-254, 2021 04 01.
Article in English | MEDLINE | ID: mdl-31490847

ABSTRACT

OBJECTIVE: The aim of the study was to determine the rate of return to baseline functional status 3 months after surgery for pelvic organ prolapse (POP) in women 65 years or older. METHODS: This is a multicenter prospective cohort study of women older than 65 years undergoing POP surgery. Functional status was determined by the Activities Assessment Scale at the preoperative visit and 3 months after surgery. We compared a variety of clinical variables and preoperative functional status scores for women who worsened, improved, or returned to baseline functional status after surgery using univariable and multivariable analysis. RESULTS: A total of 192 women were enrolled in the study. Of 176 women who completed both sets of questionnaires, 59% improved, 35% returned, and 6% worsened from their baseline functional status. Variables significantly associated with postoperative functional status score were depression (P < 0.002) and preoperative functional status score (P < 0.001). The group that improved from baseline had the lowest (worst) preoperative functional status score (78.7 ± 16.4), whereas the group that worsened after surgery had the highest (best) preoperative functional status score (98.6 ± 2.2). After adjusting for age and depression, higher preoperative functional status score was predictive of failure to return to baseline functional status. CONCLUSIONS: Most older women undergoing surgery for POP, including those with low preoperative functional status, return to or improve from their baseline functional status within 3 months of surgery. Women with higher functional status before surgery are less likely to report improvement in physical functioning after surgery.


Subject(s)
Functional Status , Pelvic Organ Prolapse/surgery , Recovery of Function , Aged , Aged, 80 and over , Female , Humans , Prospective Studies , Time Factors
20.
Front Comput Neurosci ; 13: 49, 2019.
Article in English | MEDLINE | ID: mdl-31396067

ABSTRACT

A major goal of neuroscience is understanding how neurons arrange themselves into neural networks that result in behavior. Most theoretical and experimental efforts have focused on a top-down approach which seeks to identify neuronal correlates of behaviors. This has been accomplished by effectively mapping specific behaviors to distinct neural patterns, or by creating computational models that produce a desired behavioral outcome. Nonetheless, these approaches have only implicitly considered the fact that neural tissue, like any other physical system, is subjected to several restrictions and boundaries of operations. Here, we proposed a new, bottom-up conceptual paradigm: The Energy Homeostasis Principle, where the balance between energy income, expenditure, and availability are the key parameters in determining the dynamics of neuronal phenomena found from molecular to behavioral levels. Neurons display high energy consumption relative to other cells, with metabolic consumption of the brain representing 20% of the whole-body oxygen uptake, contrasting with this organ representing only 2% of the body weight. Also, neurons have specialized surrounding tissue providing the necessary energy which, in the case of the brain, is provided by astrocytes. Moreover, and unlike other cell types with high energy demands such as muscle cells, neurons have strict aerobic metabolism. These facts indicate that neurons are highly sensitive to energy limitations, with Gibb's free energy dictating the direction of all cellular metabolic processes. From this activity, the largest energy, by far, is expended by action potentials and post-synaptic potentials; therefore, plasticity can be reinterpreted in terms of their energy context. Consequently, neurons, through their synapses, impose energy demands over post-synaptic neurons in a close loop-manner, modulating the dynamics of local circuits. Subsequently, the energy dynamics end up impacting the homeostatic mechanisms of neuronal networks. Furthermore, local energy management also emerges as a neural population property, where most of the energy expenses are triggered by sensory or other modulatory inputs. Local energy management in neurons may be sufficient to explain the emergence of behavior, enabling the assessment of which properties arise in neural circuits and how. Essentially, the proposal of the Energy Homeostasis Principle is also readily testable for simple neuronal networks.

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