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2.
J Phys Chem C Nanomater Interfaces ; 128(34): 14381-14387, 2024 Aug 29.
Article in English | MEDLINE | ID: mdl-39257861

ABSTRACT

X-ray irradiation can induce chemical reactions on surfaces. In X-ray spectroscopic experiments, such reactions may result in spectrum distortion and are termed radiation damage. In this study, we investigate the X-ray-induced chemical reaction at the partially oxidized copper surface in the settings of the dip-and-pull experiment, a method that generates liquid-solid interfaces for in situ X-ray photoelectron spectroscopy (XPS) studies. In dense water vapor resembling the predipping condition, a series of time-elapsed X-ray absorption spectra acquired in total electron yield mode (TEY-XAS) shows that X-ray exposure causes copper reduction, which follows first-order kinetics and occurs only at the surface shallower than the probing depth of TEY-XAS. At the solid-water interface created by the dip-and-pull method, the chemical reduction of surface copper is also identified by XPS. We conclude that the reduction is driven by the product of water radiolysis, where the reducing solvated electron prevails against the oxidizing OH radical and results in an overall reduction of surface copper ions.

3.
Nephron ; : 1-17, 2024 Sep 22.
Article in English | MEDLINE | ID: mdl-39307127

ABSTRACT

Background Hypertension (HTN) is a common side effect of Tacrolimus (Tac), the first-line anti-rejection medication for kidney transplant recipients. The impact of immediate-release tacrolimus (Tac IR) dosed twice daily versus extended-release tacrolimus (Tac ER) dosed once daily on long-term blood pressure control in kidney transplant recipients remains understudied. This study aims to compare the use of Tac IR versus Tac ER in kidney transplant recipients and evaluate the effects of the different formulations on systolic blood pressure (SBP), diastolic blood pressure (DBP), and HTN crisis. Methods This retrospective cohort study at a single institution collected baseline characteristics, time-varying exposure to Tac IR vs Tac ER, SBP, DBP, HTN crisis, and confounders at each post-transplant visit. A marginal structural linear mixed-effects model was employed to analyze the longitudinal blood pressure control in kidney transplant recipients receiving Tac IR and Tac ER. Results The final analysis included 654 patients, with mean ages of 52.0 years for Tac IR and 50.3 years for Tac ER. Males constituted 56.7% in Tac IR and 55.0% in Tac ER. Notably, the Black population had 2.44 times higher odds of receiving Tac ER after adjusting for the rest of the baseline characteristics. No difference was found between longitudinal SBP (p=0.386, 95% CI: -1.00, 2.57) or DBP (p=0.797, 95% CI: -1.38, 1.06). Conclusion Our study indicates that post-transplant patients taking Tac ER exhibit no difference in chronic SBP and DBP controls compared to Tac IR.

6.
Am J Med Sci ; 368(3): 196-202, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38885928

ABSTRACT

BACKGROUND: The presence of "muddy" brown granular casts (MBGC) in the urine sediment is pathognomonic for acute tubular injury (ATI). Although MBGC have been noted for years, there are no reports regarding their length nor width. The objective of this study was to measure MBGC using images obtained by light microscopy and investigate associations with clinically relevant parameters. METHODS: Patients with diagnosis of ATI as evidenced by visualization of abundant MBGC (>30% low power fields) were sampled. Bright-field images were measured using ImageJ. Twenty-five patients were included: 44% women; median age 64 yrs; 52% white, 36% black. Mean MBGC width (n = 350) was 34.4 ± 13.1 µm (range: 9 to 110 µm). RESULTS: Mean MBGC length was 98.7 ± 42.7 µm (range: 33 to 317 µm). Based on a previous report of cortical tubular diameters, MBGC width corresponded well with the median reported range. MBGC width was positively correlated with patient height (ρ=0.41, p=0.04), and length was positively correlated with fractional excretion of sodium (ρ=0.57. p=0.02) and urine chloride concentration (ρ=0.90, p=0.001). Mean MBGC length was negatively correlated with age (ρ=-0.47, p=0.02) and urine phosphate concentration (ρ=-0.72, p=0.03). There were no differences between cases that required renal replacement therapy (RRT, n =10) and those that did not require RRT (n=15). CONCLUSION: This is the first study reporting dimensions of MBGC from cases with ATI. Clinical implications of these observations require further study.


Subject(s)
Acute Kidney Injury , Humans , Female , Male , Middle Aged , Aged , Acute Kidney Injury/pathology , Acute Kidney Injury/urine , Adult , Aged, 80 and over
7.
Front Immunol ; 15: 1394644, 2024.
Article in English | MEDLINE | ID: mdl-38863717

ABSTRACT

Introduction: Fostemsavir is a gp120-directed attachment inhibitor approved for heavily treatment-experienced (HTE) adults with multidrug-resistant HIV-1. We provide detailed week 240 safety results from the BRIGHTE study and evaluate the impact of immune recovery on safety outcomes. Methods: The phase 3 BRIGHTE trial is ongoing; data for this analysis were collected from the first participant's first visit (February 23, 2015) through the last participant's last visit for week 240 (March 22, 2021). Safety endpoints were assessed in participants who received fostemsavir + optimized background therapy. In participants with baseline CD4+ T-cell count <200 cells/mm3, exposure-adjusted adverse event (AE) rates were assessed among subgroups with or without CD4+ T-cell count ≥200 cells/mm3 at any time during 48-week analysis periods through week 192. Results: Through a median of 258 weeks (range, 0.14-319) of treatment, discontinuations due to AEs occurred in 30/371 (8%) participants. Serious AEs were reported in 177/371 (48%) participants, including 16 drug-related events in 13 (4%) participants. Thirty-five (9%) deaths occurred, primarily related to AIDS or acute infections. COVID-19-related events occurred in 25 (7%) participants; all resolved without sequelae. Among participants with baseline CD4+ T-cell count <200 cells/mm3, 122/162 (75%) achieved CD4+ T-cell count ≥200 cells/mm3 at week 192. Exposure-adjusted AE rates were markedly lower among participants achieving CD4+ T-cell count ≥200 cells/mm3 at any time vs those sustaining <200 cells/mm3. No new AIDS-defining events were reported after week 48 in participants with CD4+ T-cell count ≥200 cells/mm3. Conclusions: Cumulative safety findings through the BRIGHTE 240-week interim analysis are consistent with other trials in HTE participants with advanced HIV-1 and comorbid disease. Reduced rates of AIDS-defining events and AEs were observed in participants with immunologic recovery on fostemsavir-based treatment. Clinical trial number: NCT02362503, https://clinicaltrials.gov/study/NCT02362503.


Subject(s)
Anti-HIV Agents , HIV Infections , HIV-1 , Humans , Adult , HIV Infections/drug therapy , HIV Infections/immunology , Female , Male , CD4 Lymphocyte Count , Middle Aged , HIV-1/immunology , HIV-1/drug effects , Anti-HIV Agents/therapeutic use , Anti-HIV Agents/adverse effects , Organophosphates/therapeutic use , Organophosphates/adverse effects , COVID-19/immunology , SARS-CoV-2/immunology , Treatment Outcome , Viral Load , Piperazines
10.
PLoS Negl Trop Dis ; 18(5): e0011292, 2024 May.
Article in English | MEDLINE | ID: mdl-38758957

ABSTRACT

BACKGROUND: Leptospirosis is a zoonosis caused by pathogenic species of bacteria belonging to the genus Leptospira. Most studies infer the epidemiological patterns of a single serogroup or aggregate all serogroups to estimate overall seropositivity, thus not exploring the risks of exposure to distinct serogroups. The present study aims to delineate the demographic, socioeconomic and environmental factors associated with seropositivity of Leptospira serogroup Icterohaemorraghiae and serogroup Cynopteri in an urban high transmission setting for leptospirosis in Brazil. METHODS/PRINCIPAL FINDINGS: We performed a cross-sectional serological study in five informal urban communities in the city of Salvador, Brazil. During the years 2018, 2020 2021, we recruited 2.808 residents and collected blood samples for serological analysis using microagglutination assays. We used a fixed-effect multinomial logistic regression model to identify risk factors associated with seropositivity for each serogroup. Seropositivity to Cynopteri increased with each year of age (OR 1.03; 95% CI 1.01-1.06) and was higher in those living in houses with unplastered walls (exposed brick) (OR 1.68; 95% CI 1.09-2.59) and where cats were present near the household (OR 2.00; 95% CI 1.03-3.88). Seropositivity to Icterohaemorrhagiae also increased with each year of age (OR 1.02; 95% CI 1.01-1.03) and was higher in males (OR 1.51; 95% CI 1.09-2.10), in those with work-related exposures (OR 1.71; 95% CI 1.10-2.66) or who had contact with sewage (OR 1.42; 95% CI 1.00-2.03). Spatial analysis showed differences in distribution of seropositivity to serogroups Icterohaemorrhagiae and Cynopteri within the five districts where study communities were situated. CONCLUSIONS/SIGNIFICANCE: Our data suggest distinct epidemiological patterns associated with the Icterohaemorrhagiae and Cynopteri serogroups in the urban environment at high risk for leptospirosis and with differences in spatial niches. We emphasize the need for studies that accurately identify the different pathogenic serogroups that circulate and infect residents of low-income areas.


Subject(s)
Leptospira interrogans , Leptospira , Leptospirosis , Serogroup , Leptospirosis/epidemiology , Leptospirosis/microbiology , Leptospirosis/transmission , Brazil/epidemiology , Humans , Male , Adult , Female , Cross-Sectional Studies , Middle Aged , Leptospira/classification , Leptospira/immunology , Leptospira/isolation & purification , Young Adult , Adolescent , Leptospira interrogans/immunology , Leptospira interrogans/classification , Leptospira interrogans/isolation & purification , Risk Factors , Seroepidemiologic Studies , Urban Population , Antibodies, Bacterial/blood , Animals , Child , Aged
11.
Adv Kidney Dis Health ; 31(2): 87-99, 2024 03.
Article in English | MEDLINE | ID: mdl-38649221

ABSTRACT

Hepatorenal syndrome type 1 (HRS-1) is a unique form of acute kidney injury that affects individuals with decompensated cirrhosis with ascites. The primary mechanism leading to reduction of kidney function in HRS-1 is hemodynamic in nature. Cumulative evidence points to a cascade of events that led to a profound reduction in kidney perfusion. A state of increased intrahepatic vascular resistance characteristic of advanced cirrhosis and portal hypertension is accompanied by maladaptive peripheral arterial vasodilation and reduction in systemic vascular resistance and mean arterial pressure. As a result of a fall in effective arterial blood volume, there is a compensatory activation of the sympathetic nervous system and the renin-angiotensin system, local renal vasoconstriction, loss of renal autoregulation, decrease in renal blood flow, and ultimately a fall in glomerular filtration rate. Systemic release of nitric oxide stimulated by the fibrotic liver, bacterial translocation, and inflammation constitute key components of the pathogenesis. While angiotensin II and noradrenaline remain the critical mediators of renal arterial and arteriolar vasoconstriction, other novel molecules have been recently implicated. Although the above-described mechanistic pathway remains the backbone of the pathogenesis of HRS-1, other noxious elements may be present in advanced cirrhosis and likely contribute to the renal impairment. Direct liver-kidney crosstalk via the hepatorenal sympathetic reflex can further reduce renal blood flow independently of the systemic derangements. Tense ascites may lead to intraabdominal hypertension and abdominal compartment syndrome. Cardio-hemodynamic processes have also been increasingly recognized. Porto-pulmonary hypertension, cirrhotic cardiomyopathy, and abdominal compartment syndrome may lead to renal congestion and complicate the course of HRS-1. In addition, a degree of ischemic or toxic (cholemic) tubular injury may overlap with the underlying circulatory dysfunction and further exacerbate the course of acute kidney injury. Improving our understanding of the pathogenesis of HRS-1 may lead to improvements in therapeutic options for this seriously ill population.


Subject(s)
Hepatorenal Syndrome , Humans , Hepatorenal Syndrome/physiopathology , Hepatorenal Syndrome/therapy , Hepatorenal Syndrome/etiology , Liver Cirrhosis/physiopathology , Liver Cirrhosis/complications , Renal Circulation/physiology , Hemodynamics/physiology , Renin-Angiotensin System/physiology , Kidney/physiopathology , Hypertension, Portal/physiopathology , Ascites/physiopathology
12.
Am J Trop Med Hyg ; 110(6): 1245-1252, 2024 Jun 05.
Article in English | MEDLINE | ID: mdl-38593790

ABSTRACT

Tick-borne disease burdens are increasing globally, impacting mostly rural and vulnerable communities. Among the most important emerging tick-borne pathogens are the Rickettsia species within the spotted fever group (SFGR) because of their genetic diversity and high lethality rate. Colombia is highly affected by SFGR despite not being reportable diseases; thus, research and clinical management are neglected. Although some departments have demonstrated high seroprevalence rates, in others, such as Boyacá Department, seroprevalence is unknown. Rickettsioses have not been described in Boyacá since 1943, and conversations with local physicians raised suspicions of recent undiagnosed disease compatible with rickettsiosis in some rural areas of the department, warranting epidemiological investigation. Using biobanked human and canine samples from a previous 2021 vector-borne disease study in Miraflores municipality, Boyacá, we had an opportunity to unearth SFGR's exposure in the region. Samples were evaluated using IgG indirect fluorescent assays against SFGR and complemented by survey questionnaires evaluating associated factors. Findings yielded first-time SFGR serological evidence in Boyacá with a 26.5% seroprevalence among dogs and a 20.4% among humans. Human and dog seroprevalences were positively associated, suggesting the presence of domestic transmission. Owning a greater number of domestic animals (prevalence ratio adjusted for all measured factors [aPR], 1.52) and living near crop fields (aPR, 7.77) were associated with an increased likelihood of household seropositivity. Our findings are consistent with the literature in Colombia, uncovering a suspected region where the disease is endemic. Future studies are warranted to continue defining high-risk areas to determine public health intervention plans.


Subject(s)
Antibodies, Bacterial , Dog Diseases , Rickettsia , Spotted Fever Group Rickettsiosis , Dogs , Animals , Seroepidemiologic Studies , Humans , Colombia/epidemiology , Cross-Sectional Studies , Dog Diseases/epidemiology , Dog Diseases/microbiology , Male , Female , Adult , Antibodies, Bacterial/blood , Spotted Fever Group Rickettsiosis/epidemiology , Spotted Fever Group Rickettsiosis/microbiology , Middle Aged , Rickettsia/immunology , Adolescent , Young Adult , Aged , Child , Immunoglobulin G/blood
13.
Transl Anim Sci ; 8: txae036, 2024.
Article in English | MEDLINE | ID: mdl-38562212

ABSTRACT

The adoption of precision technologies on dairy farms has increased significantly in recent decades, leading to the challenge of providing employees with resources to maximize the efficient use of these tools. The objective of this study was to explore how dairy farm employees perceive the available precision technologies and to identify possible challenges they face when adapting to their use at the farm. An online survey consisting of four sections (employee demographics, precision technologies in use, perception of these technologies, and opportunities for adapting to technology use) was completed from September to December 2022 by 266 farm employees from three dairies operated under similar management. Most of the respondents were identified as male (72.2%), Hispanic or Latino (92.5%), aged between 21 and 30 (39.1%) or 31 and 40 yr (36.8%), with a bachelor's degree (34.6%) or completion of middle school (29.3%) and having basic or no English proficiency (74%). Overall, the respondents indicated being comfortable (95.6%) with and understanding (91.8%) the technology they use. Employees recognized precision technology as a tool that helps them to be more efficient (93.7%), identifying the technologies' benefits (92.1%). However, challenges for adapting to these technologies included personal limitations, such as not knowing the language of the technology (31%), visual impairments (24%), light sensitivity (14%), and not being able to read (7%). Environmental limitations were also recognized and included cold weather (64.3%), wind (46%), and surroundings that were too dark (31%) or too bright (21%). Significant associations between perception of the technology and age, level of education, and English proficiency were identified. Respondents indicated their desire to learn more about precision technologies implemented at work, which could eventually lead to improved efficiency at the dairy operation through innovations in the way users interact with these technologies, increasing employees' motivation. This study provides insights that could assist the dairy industry in addressing challenges and enhancing opportunities for a more efficient use of precision technologies at dairy farms.

15.
J Hepatol ; 81(1): 163-183, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38527522

ABSTRACT

Patients with cirrhosis are prone to developing acute kidney injury (AKI), a complication associated with a markedly increased in-hospital morbidity and mortality, along with a risk of progression to chronic kidney disease. Whereas patients with cirrhosis are at increased risk of developing any phenotype of AKI, hepatorenal syndrome (HRS), a specific form of AKI (HRS-AKI) in patients with advanced cirrhosis and ascites, carries an especially high mortality risk. Early recognition of HRS-AKI is crucial since administration of splanchnic vasoconstrictors may reverse the AKI and serve as a bridge to liver transplantation, the only curative option. In 2023, a joint meeting of the International Club of Ascites (ICA) and the Acute Disease Quality Initiative (ADQI) was convened to develop new diagnostic criteria for HRS-AKI, to provide graded recommendations for the work-up, management and post-discharge follow-up of patients with cirrhosis and AKI, and to highlight priorities for further research.


Subject(s)
Acute Kidney Injury , Hepatorenal Syndrome , Liver Cirrhosis , Humans , Acute Kidney Injury/etiology , Acute Kidney Injury/diagnosis , Acute Kidney Injury/therapy , Liver Cirrhosis/complications , Hepatorenal Syndrome/etiology , Hepatorenal Syndrome/therapy , Hepatorenal Syndrome/diagnosis , Ascites/etiology , Ascites/therapy , Ascites/diagnosis , Consensus
16.
Heliyon ; 10(5): e26355, 2024 Mar 15.
Article in English | MEDLINE | ID: mdl-38434340

ABSTRACT

This work analyzes hemodynamic phenomena within the aorta of two elderly patients and their impact on blood flow behavior, particularly affected by an endovascular prosthesis in one of them (Patient II). Computational Fluid Dynamics (CFD) was utilized for this study, involving measurements of velocity, pressure, and wall shear stress (WSS) at various time points during the third cardiac cycle, at specific positions within two cross sections of the thoracic aorta. The first cross-section (Cross-Section 1, CS1) is located before the initial fluid bifurcation, just before the right subclavian artery. The second cross-section (Cross-Section 2, CS2) is situated immediately after the left subclavian artery. The results reveal that, under regular aortic geometries, velocity and pressure magnitudes follow the principles of fluid dynamics, displaying variations. However, in Patient II, an endoprosthesis near the CS2 and the proximal border of the endoprosthesis significantly disrupts fluid behavior owing to the pulsatile flow. The cross-sectional areas of Patient I are smaller than those of Patient II, leading to higher flow magnitudes. Although in CS1 of Patient I, there is considerable variability in velocity magnitudes, they exhibit a more uniform and predictable transition. In contrast, CS2 of Patient II, where magnitude variation is also high, displays irregular fluid behavior due to the endoprosthesis presence. This cross-section coincides with the border of the fluid bifurcation. Additionally, the irregular geometry caused by endovascular aneurysm repair contributes to flow disruption as the endoprosthesis adjusts to the endothelium, reshaping itself to conform with the vessel wall. In this context, significant alterations in velocity values, pressure differentials fluctuating by up to 10%, and low wall shear stress indicate the pronounced influence of the endovascular prosthesis on blood flow behavior. These flow disturbances, when compounded by the heart rate, can potentially lead to changes in vascular anatomy and displacement, resulting in a disruption of the prosthesis-endothelium continuity and thereby causing clinical complications in the patient.

17.
J Vasc Surg Cases Innov Tech ; 10(3): 101453, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38510096

ABSTRACT

A 72-year-old man with peripheral arterial disease, an atrophic left kidney, and prior right renal chimney stent as part of a complex endovascular abdominal aortic aneurysm repair presented to our emergency department with right flank pain and anuria resulting from right artery occlusion. His serum creatinine on admission was 7.5 mg/dL. Computed tomography angiography 6 days after the onset of his symptoms revealed complete occlusion of the right renal artery stent. Percutaneous thrombectomy was performed restored renal blood flow. The urine flow started the following day, and his serum creatinine decreased to 3.5 mg/dL 7 days after discharge.

19.
Sensors (Basel) ; 24(4)2024 Feb 16.
Article in English | MEDLINE | ID: mdl-38400413

ABSTRACT

Chemosensor technology for trace gases in the air always aims to identify these compounds and then measure their concentrations. For identification, traceable methods are sparse and relate to large appliances such as mass spectrometers. We present a new method that uses the alternative traceable measurement of the ionization energies of trace gases in a way that can be miniaturized and energetically tuned. We investigate the achievable performance. Since tunable UV sources are not available for photoionization, we take a detour via impact ionization with electrons, which we generate using the photoelectric effect and bring to sharp, defined energies on a nanoscale in the air. Electron impact ionization is thus possible at air pressures of up to 900 hPa. The sensitivity of the process reaches 1 ppm and is equivalent to that of classic PID. With sharpened energy settings, substance identification is currently possible with an accuracy of 30 meV. We can largely explain the experimental observations with the known quantum mechanical models.

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