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1.
Am J Clin Nutr ; 2024 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-39209154

RESUMEN

BACKGROUND: Ultraprocessed foods (UPFs) comprise most calories in the United States diet. Glycemic index (GI) and glycemic load (GL) are measures of the quality and quantity of carbohydrates in food based on their effect on postprandial blood glucose. Diets high in UPFs and GI/GL are associated with chronic metabolic diseases but the relationship between them is unclear. OBJECTIVES: Our objective was to examine the GI and GL of foods assigned to NOVA food processing groups. We hypothesized that GI and GL would be lowest in minimally processed foods (MPFs) compared to processed food (PRF) and UPF (with no difference between PRF and UPF). METHODS: GI and GL values produced by healthy individuals for 1995 food items were collated from published sources. Food items were manually coded by processing levels according to NOVA classification. In addition, as the effects of processing on glycemic potential may vary between types of foods, food items were coded into 8 groups (beans, nuts, and seeds; beverages; dairy; fats and sweets; fruit; grains; fish, meat, and poultry; and vegetables). Multilevel linear modeling was used to determine significance with an α value of 0.05. RESULTS: The effect of food processing on GI and GL was contrary to our hypothesis as means did not differ significantly across processing levels: GI-MPF: 54.1 ± 19.5, PRF: 53.2 ± 18.9, UPF: 49.3 ± 18.1 (P = 0.712); GL-MPF: 17.1 ± 10.3, PRF: 15.8 ± 12.4, UPF; 11.5 ± 7.9 (P = 0.890). Within food groups, there was no significant association between processing level and GI (P = 0.184), but GL was inversely associated with grains and vegetables (P < 0.001). CONCLUSIONS: Across analyzed foods, GI and GL do not differ between processing levels, whereas GL was lower in ultraprocessed grains and vegetables than MPF. Any potential adverse outcomes associated with UPF are unlikely to be related to effects on glycemia. This project was preregistered at the Open Science Framework (OSF) Registries through the Center for Open Science as 10.17605/OSF.IO/PJWG9.

2.
Nat Commun ; 15(1): 3900, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38724552

RESUMEN

By incompletely understood mechanisms, type 2 (T2) inflammation present in the airways of severe asthmatics drives the formation of pathologic mucus which leads to airway mucus plugging. Here we investigate the molecular role and clinical significance of intelectin-1 (ITLN-1) in the development of pathologic airway mucus in asthma. Through analyses of human airway epithelial cells we find that ITLN1 gene expression is highly induced by interleukin-13 (IL-13) in a subset of metaplastic MUC5AC+ mucus secretory cells, and that ITLN-1 protein is a secreted component of IL-13-induced mucus. Additionally, we find ITLN-1 protein binds the C-terminus of the MUC5AC mucin and that its deletion in airway epithelial cells partially reverses IL-13-induced mucostasis. Through analysis of nasal airway epithelial brushings, we find that ITLN1 is highly expressed in T2-high asthmatics, when compared to T2-low children. Furthermore, we demonstrate that both ITLN-1 gene expression and protein levels are significantly reduced by a common genetic variant that is associated with protection from the formation of mucus plugs in T2-high asthma. This work identifies an important biomarker and targetable pathways for the treatment of mucus obstruction in asthma.


Asunto(s)
Asma , Proteínas Ligadas a GPI , Interleucina-13 , Lectinas , Mucina 5AC , Moco , Niño , Humanos , Asma/genética , Asma/metabolismo , Citocinas , Células Epiteliales/metabolismo , Proteínas Ligadas a GPI/genética , Proteínas Ligadas a GPI/metabolismo , Interleucina-13/genética , Interleucina-13/metabolismo , Lectinas/genética , Lectinas/metabolismo , Mucina 5AC/genética , Mucina 5AC/metabolismo , Moco/metabolismo , Mucosa Nasal/metabolismo , Polimorfismo Genético , Mucosa Respiratoria/metabolismo
3.
Plant Dis ; : PDIS09231788SR, 2024 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-38616394

RESUMEN

Coffee berry disease is caused by Colletotrichum kahawae, a quarantine fungus still absent from most coffee-producing countries. Given the potential adverse effects on coffee berry production, it is a severe worldwide threat to farmers and industry. Current biosecurity management focuses on exclusion by applying quarantine measures, including the certification of coffee plants and their products. However, methods for detecting C. kahawae by National Plant Protection Organization (NPPO) laboratories still need approval. This research aims to functionally demonstrate, standardize, and validate a method for detecting and discriminating C. kahawae from other Colletotrichum species that may be present in coffee plant samples. The method proposes to use an end-point PCR marker for the mating type gene (MAT1-2-1) and a confirmatory test with a real-time quantitative PCR (qPCR) marker developed on the glutamine synthetase gene. The C. kahawae amplicons for the Cen-CkM10 qPCR marker exhibited specific melting temperature values and high-resolution melt profiles that could be readily differentiated from other tested species, including their relatives. Given the fungus's quarantine status, specificity was tested using artificial mixtures of DNA of C. kahawae with other Colletotrichum species and coffee plant DNA. The described method will enable NPPOs in coffee-producing and exporting countries, especially Colombia, to prevent this pathogen's entry, establishment, and spread.[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

4.
Life Sci Alliance ; 7(3)2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38176727

RESUMEN

Activating transcription factor 4 (Atf4), which is modulated by the protein kinase RNA-like ER kinase (PERK), is a stress-induced transcription factor responsible for controlling the expression of a wide range of adaptive genes, enabling cells to withstand stressful conditions. However, the impact of the Atf4 signaling pathway on airway regeneration remains poorly understood. In this study, we used mouse airway epithelial cell culture models to investigate the role of PERK/Atf4 in respiratory tract differentiation. Through pharmacological inhibition and silencing of ATF4, we uncovered the crucial involvement of PERK/Atf4 in the differentiation of basal stem cells, leading to a reduction in the number of secretory cells. ChIP-seq analysis revealed direct binding of ATF4 to regulatory elements of genes associated with osteoblast differentiation and secretory cell function. Our findings provide valuable insights into the role of ATF4 in airway epithelial differentiation and its potential involvement in innate immune responses and cellular adaptation to stress.


Asunto(s)
Estrés del Retículo Endoplásmico , eIF-2 Quinasa , Animales , Ratones , eIF-2 Quinasa/genética , Estrés del Retículo Endoplásmico/genética , Factor de Transcripción Activador 4/genética , Factor de Transcripción Activador 4/metabolismo , Diferenciación Celular/genética , Sistema Respiratorio/metabolismo
6.
Microbiol Resour Announc ; 12(11): e0044423, 2023 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-37791781

RESUMEN

Coffee leaf rust, caused by the fungus Hemileia vastatrix (Basidiomycota; Pucciniomycota), is a devastating disease spread worldwide. To improve the available genomes, we use PacBio HiFi sequencing enhanced by Dovetail Omni-C chromatin conformation capture to assemble a highly contiguous 747.98 Mb genome of an isolate collected from Coffea arabica.

7.
Mov Disord ; 38(9): 1625-1635, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37469269

RESUMEN

BACKGROUND: Sex differences in Parkinson's disease (PD) risk are well-known. However, the role of sex chromosomes in the development and progression of PD is still unclear. OBJECTIVE: The objective of this study was to perform the first X-chromosome-wide association study for PD risk in a Latin American cohort. METHODS: We used data from three admixed cohorts: (1) Latin American Research consortium on the Genetics of Parkinson's Disease (n = 1504) as discover cohort, and (2) Latino cohort from International Parkinson Disease Genomics Consortium (n = 155) and (3) Bambui Aging cohort (n = 1442) as replication cohorts. We also developed an X-chromosome framework specifically designed for admixed populations. RESULTS: We identified eight linkage disequilibrium regions associated with PD. We replicated one of these regions (top variant rs525496; discovery odds ratio [95% confidence interval]: 0.60 [0.478-0.77], P = 3.13 × 10-5 replication odds ratio: 0.60 [0.37-0.98], P = 0.04). rs5525496 is associated with multiple expression quantitative trait loci in brain and non-brain tissues, including RAB9B, H2BFM, TSMB15B, and GLRA4, but colocalization analysis suggests that rs5525496 may not mediate risk by expression of these genes. We also replicated a previous X-chromosome-wide association study finding (rs28602900), showing that this variant is associated with PD in non-European populations. CONCLUSIONS: Our results reinforce the importance of including X-chromosome and diverse populations in genetic studies. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.


Asunto(s)
Cromosomas Humanos X , Enfermedad de Parkinson , Femenino , Humanos , Masculino , Estudio de Asociación del Genoma Completo , Hispánicos o Latinos , América Latina , Enfermedad de Parkinson/genética , Factores Sexuales , Cromosomas Humanos X/genética , Desequilibrio de Ligamiento/genética
8.
Animal ; 17 Suppl 5: 100896, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37500377

RESUMEN

To reduce P excretion and increase the sustainability of poultry farms, one needs to understand the mechanisms surrounding P metabolism and its close link with Ca metabolism to precisely predict the fate of dietary P and Ca and related requirements for birds. This study describes and evaluates a model developed to estimate the fate of Ca and P consumed by broilers. The Ca and P model relies on three modules: (1) digestion of Ca and P; (2) dynamics of Ca and P in soft tissue and feathers; and (3) dynamics of body ash. Exogenous phytase affects the availability of Ca and P; thus, to predict the absorption of those minerals, the model also accounts for the effect of phytase on Ca and P digestibility. We used a database to estimate the consequences of dietary Ca, P, and phytase over feed intake response. This study followed a four-step process: (1) Ca and P model development and its coupling with a growth broiler model; (2) model behavior assessment; (3) sensitivity analysis to identify the most influential parameters; and (4) external evaluation based on three databases. The proportion of P in body protein and the Ca to P ratio in bone are the most sensitive parameters of P deposition in soft tissue and bone, representing 91 and 99% of the total variation. The external evaluation results indicated that body water and protein had an overall mean square prediction error (rMSPE) of 7.22 and 12.3%, respectively. The prediction of body ash, Ca, and P had an rMSPE of 7.74, 11.0, and 6.56%, respectively, mostly errors of disturbances (72.5, 51.6, and 90.7%, respectively). The rMSPE for P balance was 13.3, 18.4, and 22.8%, respectively, for P retention, excretion, and retention coefficient, with respective errors due to disturbances of 69.1, 99.9, and 51.3%. We demonstrated a mechanistic model approach to predict the dietary effects of Ca and P on broiler chicken responses with low error, including detailed simulations to show the confidence level expected from the model outputs. Overall, this model predicts broilers' response to dietary Ca and P. The model could aid calculations to minimize P excretion and reduce the impact of broiler production on the environment. A model inversion is ongoing that will enable the calculation of Ca and P dietary quantities for a specific objective. This will simplify the use of the model and the feed formulation process.


Asunto(s)
6-Fitasa , Fósforo Dietético , Animales , Calcio de la Dieta/metabolismo , Fósforo/metabolismo , Pollos/fisiología , 6-Fitasa/análisis , Minerales/metabolismo , Dieta/veterinaria , Fósforo Dietético/metabolismo , Proteínas/metabolismo , Alimentación Animal/análisis , Suplementos Dietéticos/análisis , Fenómenos Fisiológicos Nutricionales de los Animales
10.
J Am Soc Mass Spectrom ; 34(6): 1105-1116, 2023 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-37163770

RESUMEN

Proteomics research has been transformed due to high-throughput liquid chromatography (LC-MS/MS) tandem mass spectrometry instruments combined with highly sophisticated automated sample preparation and multiplexing workflows. However, scaling proteomics experiments to large sample cohorts (hundreds to thousands) requires thoughtful quality control (QC) protocols. Robust QC protocols can help with reproducibility, quantitative accuracy, and provide opportunities for more decisive troubleshooting. Our laboratory conducted a plasma proteomics study of a cohort of N = 335 patient samples using tandem mass tag (TMTpro) 16-plex batches. Over the course of a 10-month data acquisition period for this cohort we collected 271 pooled QC LC-MS/MS result files obtained from MS/MS analysis of a patient-derived pooled plasma sample, representative of the entire cohort population. This sample was tagged with TMTzero or TMTpro reagents and used to inform the daily performance of the LC-MS/MS instruments and to allow within and across sample batch normalization. Analytical variability of a number of instrumental and data analysis metrics including protein and peptide identifications, peptide spectral matches (PSMs), number of obtained MS/MS spectra, average peptide abundance, percent of peptides with a Δ m/z between ±0.003 Da, percent of MS/MS spectra obtained at the maximum injection time, and the retention time of selected tracking peptides were evaluated to help inform the design of a robust LC-MS/MS QC workflow for use in future cohort studies. This study also led to general tips for using selected metrics to inform real-time troubleshooting of LC-MS/MS performance issues with daily QC checks.


Asunto(s)
Proteómica , Espectrometría de Masas en Tándem , Humanos , Espectrometría de Masas en Tándem/métodos , Proteómica/métodos , Cromatografía Liquida/métodos , Reproducibilidad de los Resultados , Péptidos/química , Control de Calidad
11.
Nat Genet ; 55(6): 952-963, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37231098

RESUMEN

We explored ancestry-related differences in the genetic architecture of whole-blood gene expression using whole-genome and RNA sequencing data from 2,733 African Americans, Puerto Ricans and Mexican Americans. We found that heritability of gene expression significantly increased with greater proportions of African genetic ancestry and decreased with higher proportions of Indigenous American ancestry, reflecting the relationship between heterozygosity and genetic variance. Among heritable protein-coding genes, the prevalence of ancestry-specific expression quantitative trait loci (anc-eQTLs) was 30% in African ancestry and 8% for Indigenous American ancestry segments. Most anc-eQTLs (89%) were driven by population differences in allele frequency. Transcriptome-wide association analyses of multi-ancestry summary statistics for 28 traits identified 79% more gene-trait associations using transcriptome prediction models trained in our admixed population than models trained using data from the Genotype-Tissue Expression project. Our study highlights the importance of measuring gene expression across large and ancestrally diverse populations for enabling new discoveries and reducing disparities.


Asunto(s)
Negro o Afroamericano , Hispánicos o Latinos , Americanos Mexicanos , Humanos , Negro o Afroamericano/genética , Estudio de Asociación del Genoma Completo , Hispánicos o Latinos/genética , Americanos Mexicanos/genética , Fenotipo , Polimorfismo de Nucleótido Simple , Transcriptoma
12.
medRxiv ; 2023 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-36778409

RESUMEN

Sex differences in Parkinson Disease (PD) risk are well-known. However, it is still unclear the role of sex chromosomes in the development and progression of PD. We performed the first X-chromosome Wide Association Study (XWAS) for PD risk in Latin American individuals. We used data from three admixed cohorts: (i) Latin American Research consortium on the GEnetics of Parkinson's Disease (n=1,504) as discover cohort and (ii) Latino cohort from International Parkinson Disease Genomics Consortium (n = 155) and (iii) Bambui Aging cohort (n= 1,442) as replication cohorts. After developing a X-chromosome framework specifically designed for admixed populations, we identified eight linkage disequilibrium regions associated with PD. We fully replicated one of these regions (top variant rs525496; discovery OR [95%CI]: 0.60 [0.478 - 0.77], p = 3.13 × 10 -5 ; replication OR: 0.60 [0.37-0.98], p = 0.04). rs525496 is an expression quantitative trait loci for several genes expressed in brain tissues, including RAB9B, H2BFM, TSMB15B and GLRA4 . We also replicated a previous XWAS finding (rs28602900), showing that this variant is associated with PD in non-European populations. Our results reinforce the importance of including X-chromosome and diverse populations in genetic studies.

13.
J Allergy Clin Immunol ; 151(6): 1503-1512, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36796456

RESUMEN

BACKGROUND: Albuterol is the drug most widely used as asthma treatment among African Americans despite having a lower bronchodilator drug response (BDR) than other populations. Although BDR is affected by gene and environmental factors, the influence of DNA methylation is unknown. OBJECTIVE: This study aimed to identify epigenetic markers in whole blood associated with BDR, study their functional consequences by multi-omic integration, and assess their clinical applicability in admixed populations with a high asthma burden. METHODS: We studied 414 children and young adults (8-21 years old) with asthma in a discovery and replication design. We performed an epigenome-wide association study on 221 African Americans and replicated the results on 193 Latinos. Functional consequences were assessed by integrating epigenomics with genomics, transcriptomics, and environmental exposure data. Machine learning was used to develop a panel of epigenetic markers to classify treatment response. RESULTS: We identified 5 differentially methylated regions and 2 CpGs genome-wide significantly associated with BDR in African Americans located in FGL2 (cg08241295, P = 6.8 × 10-9) and DNASE2 (cg15341340, P = 7.8 × 10-8), which were regulated by genetic variation and/or associated with gene expression of nearby genes (false discovery rate < 0.05). The CpG cg15341340 was replicated in Latinos (P = 3.5 × 10-3). Moreover, a panel of 70 CpGs showed good classification for those with response and nonresponse to albuterol therapy in African American and Latino children (area under the receiver operating characteristic curve for training, 0.99; for validation, 0.70-0.71). The DNA methylation model showed similar discrimination as clinical predictors (P > .05). CONCLUSIONS: We report novel associations of epigenetic markers with BDR in pediatric asthma and demonstrate for the first time the applicability of pharmacoepigenetics in precision medicine of respiratory diseases.


Asunto(s)
Asma , Broncodilatadores , Niño , Adulto Joven , Humanos , Adolescente , Adulto , Broncodilatadores/uso terapéutico , Epigenoma , Multiómica , Asma/tratamiento farmacológico , Asma/genética , Asma/metabolismo , Albuterol/uso terapéutico , Metilación de ADN , Estudio de Asociación del Genoma Completo , Fibrinógeno/metabolismo
14.
Nat Hum Behav ; 7(3): 342-352, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36702939

RESUMEN

This work examines the possible behaviour of Neanderthal groups at the Cueva Des-Cubierta (central Spain) via the analysis of the latter's archaeological assemblage. Alongside evidence of Mousterian lithic industry, Level 3 of the cave infill was found to contain an assemblage of mammalian bone remains dominated by the crania of large ungulates, some associated with small hearths. The scarcity of post-cranial elements, teeth, mandibles and maxillae, along with evidence of anthropogenic modification of the crania (cut and percussion marks), indicates that the carcasses of the corresponding animals were initially processed outside the cave, and the crania were later brought inside. A second round of processing then took place, possibly related to the removal of the brain. The continued presence of crania throughout Level 3 indicates that this behaviour was recurrent during this level's formation. This behaviour seems to have no subsistence-related purpose but to be more symbolic in its intent.


Asunto(s)
Hombre de Neandertal , Animales , Herbivoria , Cráneo , Arqueología , España , Mamíferos
15.
Poult Sci ; 102(1): 102245, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36335739

RESUMEN

The skeletal integrity of chickens is an important area of research and detailed measures are needed to better understand the influence of experimental manipulation on bone health. The objective of this experiment was to compare 2 methods to measure the superficial tibiotarsus (tibia) morphology of broiler chickens collected in the wet laboratory (WL) or from digital images (DIG). The length, width at 90%, 75%, 50%, 25%, and 10% of the length, proximal and distal head width, medial, lateral, and distal intercondylar groove depth (ID), and proximal head angle were measured on the right and left tibias collected from broilers in 2 experiments (E1, E2). In both experiments, tibias had a greater width at 90% of the length when measured with the WL method compared with the DIG method (P ≤ 0.04), while tibias measured with the DIG method had a greater length, distal ID, and widths at 10%, 25%, 50%, and 75%, of the length compared with the WL method (P < 0.0001). In E1, tibias measured with the DIG method had a greater medial, lateral, and distal ID compared with the WL method (P ≤ 0.04). In E2, compared with the DIG method, tibias measured with the WL method had a greater distal head width and lateral ID, yet a shallower distal ID (P ≤ 0.03). The use of the DIG method provided more precise measures but, due to the limitations of measures from digital images and the opportunity for more accurate measures to be collected with the WL method, the WL method is recommended to measure the superficial morphology of broiler chickens because it was more accessible and practical.


Asunto(s)
Pollos , Tibia , Animales , Tibia/anatomía & histología , Pollos/anatomía & histología
16.
Thorax ; 78(3): 233-241, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36180068

RESUMEN

BACKGROUND: In the USA, genetically admixed populations have the highest asthma prevalence and severe asthma exacerbations rates. This could be explained not only by environmental factors but also by genetic variants that exert ethnic-specific effects. However, no admixture mapping has been performed for severe asthma exacerbations. OBJECTIVE: We sought to identify genetic variants associated with severe asthma exacerbations in Hispanic/Latino subgroups by means of admixture mapping analyses and fine mapping, and to assess their transferability to other populations and potential functional roles. METHODS: We performed an admixture mapping in 1124 Puerto Rican and 625 Mexican American children with asthma. Fine-mapping of the significant peaks was performed via allelic testing of common and rare variants. We performed replication across Hispanic/Latino subgroups, and the transferability to non-Hispanic/Latino populations was assessed in 1001 African Americans, 1250 Singaporeans and 941 Europeans with asthma. The effects of the variants on gene expression and DNA methylation from whole blood were also evaluated in participants with asthma and in silico with data obtained through public databases. RESULTS: Genomewide significant associations of Indigenous American ancestry with severe asthma exacerbations were found at 5q32 in Mexican Americans as well as at 13q13-q13.2 and 3p13 in Puerto Ricans. The single nucleotide polymorphism (SNP) rs1144986 (C5orf46) showed consistent effects for severe asthma exacerbations across Hispanic/Latino subgroups, but it was not validated in non-Hispanics/Latinos. This SNP was associated with DPYSL3 DNA methylation and SCGB3A2 gene expression levels. CONCLUSIONS: Admixture mapping study of asthma exacerbations revealed a novel locus that exhibited Hispanic/Latino-specific effects and regulated DPYSL3 and SCGB3A2.


Asunto(s)
Asma , Hispánicos o Latinos , Adolescente , Humanos , Asma/genética , Estudio de Asociación del Genoma Completo , Hispánicos o Latinos/genética , Polimorfismo de Nucleótido Simple , Estados Unidos/epidemiología , Niño , Americanos Mexicanos
17.
Poult Sci ; 102(2): 102344, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36476680

RESUMEN

The objective of this contribution was to summarize from scientific literature the optimal concentration of nonphytate phosphorus (NPP) in feed for laying hens. The considered studies were one meta-analysis from 2012 and original studies published since then. Dietary treatments in the studies included variation in supplementation with mineral P sources and phytase. The studies investigated different periods of production and varied in duration but data were insufficient to analyze such factors in a systematic way. No study showed a positive effect on performance and eggshell when the NPP concentration was increased above 2.2 g NPP/kg of feed without the use of phytase. At such level, no consistent impairment of various bone quality traits were found but only few studies on bone quality traits were published. Overall, the data suggested that not more than 2.2 g NPP/kg of feed is needed for laying hens in different stages of production. This value can be reduced when phytase is added to the feed. Such reduction may differ depending on factors such as phytate content of the feed and phytase dosage. However, data are insufficient for calculating precise values of reduction. While phytate degradation in laying hens was markedly increased by phytase supplementation in several studies, effects of phytase supplementation on performance and bone traits in laying hens were less conclusive probably because the hens were supplied more than their NPP requirement. Transition to a system based on digestible P for laying hens similar to broiler chickens may support more precise P nutrition and more sustainable egg production in the future.


Asunto(s)
6-Fitasa , Fósforo Dietético , Animales , Femenino , Fósforo/metabolismo , Pollos/metabolismo , Ácido Fítico/metabolismo , Alimentación Animal/análisis , Óvulo/metabolismo , Dieta/veterinaria , Fósforo Dietético/metabolismo , Suplementos Dietéticos
18.
Ann R Coll Surg Engl ; 105(S2): S22-S27, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35950512

RESUMEN

INTRODUCTION: Methoxyflurane is an historical anaesthetic agent that has undergone a renaissance with the introduction of a smaller dose in a handheld 'Penthrox' device. The benefits of Penthrox include its ease of use, with disposable individual packets, and the need for less monitoring and staff, when compared with deeper sedation. The literature acknowledges its use for analgesia and in the management of anterior shoulder dislocation but in no other procedural orthopaedic circumstance. METHODS: Following institutional approval, we undertook a retrospective review of all incidences of Penthrox use to facilitate minor procedures within a 2-month period starting 24 March 2020. Time to procedure and success were recorded using the surrogate markers of patient attendance and x-Ray occurrence times. RESULTS: Some 101 Penthrox doses were given to 89 patients over 97 unique episodes between 24 March and 26 May 2020. No complications were recorded following the use of Penthrox during this period. Patient demographics were explored. Fracture manipulations and casting (n=54) had a 100% success rate in achieving adequate and safe reduction. Joint dislocations (n=34) were treated with varying success. Native elbow dislocations were reduced most successfully (4/4, 100%). Native shoulder dislocations were seen in 17 patients and successful relocation was seen in 11 cases, giving a success rate of 65%. CONCLUSIONS: This is the first study, outside anterior shoulder dislocations, to report on the efficacy of Penthrox within emergent orthopaedic scenarios. We have demonstrated Penthrox to be a safe tool for helping to manage trauma procedures in the emergency department.


Asunto(s)
Anestésicos por Inhalación , Fracturas Óseas , Luxaciones Articulares , Metoxiflurano , Metoxiflurano/administración & dosificación , Metoxiflurano/uso terapéutico , COVID-19 , Pandemias , Anestésicos por Inhalación/uso terapéutico , Nebulizadores y Vaporizadores , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/tratamiento farmacológico , Luxaciones Articulares/diagnóstico por imagen , Luxaciones Articulares/tratamiento farmacológico , Heridas y Lesiones/diagnóstico por imagen , Heridas y Lesiones/tratamiento farmacológico , Estudios Retrospectivos , Resultado del Tratamiento , Rayos X , Alta del Paciente/estadística & datos numéricos , Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Reino Unido
19.
Artículo en Español | MEDLINE | ID: mdl-36533162

RESUMEN

AIM: To analyze the sample of pregnant patients who underwent pulmonary perfusion scintigraphy to rule out the pulmonary embolism (PE) suspicion during the acute COVID-19 infection hospitalization period in our hospital. MATERIAL AND METHODS: SPECT scintigraphy with a reduced dose (111 MBq) of 99mTc-macroaggregated albumin was performed in all of the patients (n=5). The obtained images were interpreted by comparing the findings with the radiological images according to the PISAPED criteria. RESULTS: Only one of the 5 patients was diagnosed with PE. Two patients obtained pathological findings of the scintigraphy attributable to radiological alterations due to COVID-19 pneumonia, and the other two had normal pulmonary perfussion. CONCLUSION: Given the non-specific features of the clinical manifestations and D-dimer values in COVID-19, as well as their similarity to those of PE, the pulmonary perfusion scintigraphy plays a crucial role in the screening of PE in these patients due to its high sensitivity and lower irradiation compared to CT. Despite the limited number of patients, the results obtained have special relevance related to the absence of scientific publications on this group of patients within the context of COVID-19 pandemic exceptional situation.

20.
Cir Cir ; 90(6): 804-812, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36472835

RESUMEN

BACKGROUND: Nodularity in thyroid tissue is extremely common. In Mexico, the only openly available treatment for benign cold thyroid nodules that cause compressive or cosmetic symptoms is surgery. This limitation in the availability of non-invasive treatments places an enormous strain on the State's health resources. OBJECTIVE: To demonstrate the cost-minimization of percutaneous ethanol injection treatment (PEIT) against radiofrequency ablation (RFA) and laser ablation for the treatment of benign solid thyroid nodules. METHOD: Prospective, comparative, quasi-experimental, longitudinal study with external controls, non-randomized, historical, prolective and open. The significant difference in volume reduction was calculated by paired 2-tailed t-test. Validation was made to prove that the reduction in the final nodule volume was non-inferior to the gold standard. The cost-analysis study was carried out using the Montecarlo method. RESULTS: 15 patients entered the study. The mean volume of the nodules was 14.46 ± 19 cc, with a final mean volume of 5.24 ± 8.44 cc, the average reduction percentage was 63 ± 17%. The cost per procedure was $ 18,807 mx, $ 16,300 mx, $ 9,248 mx and $ 1,615 for RFA, surgery, laser ablation and PEIT, respectively. CONCLUSIONS: The results of the study demonstrate the non-inferiority of the ablation of benign solid thyroid nodules with PEIT compared to laser and RFA, at a lower cost.


ANTECEDENTES: La nodularidad en el tejido tiroideo es extremadamente común. En México, el único tratamiento disponible abiertamente para los nódulos tiroideos fríos benignos que causan síntomas compresivos o estéticos es la cirugía. Esta limitante en la disponibilidad de tratamientos no invasivos pone una enorme demanda sobre los recursos de salud del Estado. OBJETIVO: Demostrar el costo-minimización del tratamiento por inyección percutánea con etanol (PEIT, percutaneous etanol injection treatment) contra la ablación por radiofrecuencia (RFA, radiofrequency ablation) y el rayo láser para el tratamiento de nódulos tiroideos sólidos benignos. MÉTODO: Estudio prospectivo, comparativo, cuasiexperimental, longitudinal, con controles externos, no aleatorizado, histórico, prolectivo y abierto. La diferencia significativa en la reducción de volumen se calculó mediante prueba t pareada a dos colas. Se validó que el porcentaje de reducción en el volumen final fue tan eficiente como el método de referencia. El estudio de análisis de costos se realizó utilizando el método de Montecarlo. RESULTADOS: Ingresaron al estudio 15 pacientes. El volumen medio de los nódulos fue de 14.46 ± 19 cc, con un volumen medio final de 5.24 ± 8.44 cc. El porcentaje de reducción medio fue del 63 ± 17%. El costo por procedimiento fue de $18,807 mx para la RFA, $16,300 mx para la cirugía, $9248 mx para la ablación láser y $1615 mx para el PEIT. CONCLUSIONES: Los resultados del estudio demuestran la no inferioridad de la ablación de nódulos tiroideos sólidos benignos con PEIT en comparación con el rayo láser y la RFA, a un costo inferior.


Asunto(s)
Nódulo Tiroideo , Humanos , Estudios Longitudinales , Estudios Prospectivos , Nódulo Tiroideo/cirugía , México , Etanol
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