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1.
PLoS One ; 18(7): e0283874, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37494364

RESUMEN

Prior research on pool testing focus on developing testing methods with the main objective of reducing the total number of tests. However, pool testing can also be used to improve the accuracy of the testing process. The objective of this paper is to improve the accuracy of pool testing using the same number of tests as that of individual testing taking into consideration the probability of testing errors and pool multiplicity classification thresholds. Statistical models are developed to evaluate the impact of pool multiplicity classiffcation thresholds on pool testing accuracy using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). The findings indicate that under certain conditions, pool testing multiplicity yields superior testing accuracy compared to individual testing without additional cost. The results reveal that selecting the multiplicity classification threshold is a critical factor in improving the pool testing accuracy and show that the lower the prevalence level the higher the gains in accuracy using multiplicity pool testing. The findings also indicate that performance can be improved using a batch size that is inversely proportional to the prevalence level. Furthermore, the results indicate that multiplicity pool testing not only improves the testing accuracy but also reduces the total cost of the testing process. Based on the findings, the manufacturer's test sensitivity has more significant impact on the accuracy of multiplicity pool testing compared to that of manufacturer's test specificity.


Asunto(s)
COVID-19 , Humanos , COVID-19/diagnóstico , COVID-19/epidemiología , Curva ROC , Modelos Estadísticos , Sensibilidad y Especificidad
2.
Exp Biol Med (Maywood) ; 248(7): 641-655, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-37309741

RESUMEN

General anesthetics are potent neurotoxins when given during early development, causing apoptotic deletion of substantial number of neurons and persistent neurocognitive and behavioral deficits in animals and humans. The period of intense synaptogenesis coincides with the peak of susceptibility to deleterious effects of anesthetics, a phenomenon particularly pronounced in vulnerable brain regions such as subiculum. With steadily accumulating evidence confirming that clinical doses and durations of anesthetics may permanently alter the physiological trajectory of brain development, we set out to investigate the long-term consequences on dendritic morphology of subicular pyramidal neurons and expression on genes regulating the complex neural processes such as neuronal connectivity, learning, and memory. Using a well-established model of anesthetic neurotoxicity in rats and mice neonatally exposed to sevoflurane, a volatile general anesthetic commonly used in pediatric anesthesia, we report that a single 6 h of continuous anesthesia administered at postnatal day (PND) 7 resulted in lasting dysregulation in subicular mRNA levels of cAMP responsive element modulator (Crem), cAMP responsive element-binding protein 1 (Creb1), and Protein phosphatase 3 catalytic subunit alpha, a subunit of calcineurin (Ppp3ca) (calcineurin) when examined during juvenile period at PND28. Given the critical role of these genes in synaptic development and neuronal plasticity, we deployed a set of histological measurements to investigate the implications of anesthesia-induced dysregulation of gene expression on morphology and complexity of surviving subicular pyramidal neurons. Our results indicate that neonatal exposure to sevoflurane induced lasting rearrangement of subicular dendrites, resulting in higher orders of complexity and increased branching with no significant effects on the soma of pyramidal neurons. Correspondingly, changes in dendritic complexity were paralleled by the increased spine density on apical dendrites, further highlighting the scope of anesthesia-induced dysregulation of synaptic development. We conclude that neonatal sevoflurane induced persistent genetic and morphological dysregulation in juvenile rodents, which could indicate heightened susceptibility toward cognitive and behavioral disorders we are beginning to recognize as sequelae of early-in-life anesthesia.


Asunto(s)
Anestésicos por Inhalación , Éteres Metílicos , Humanos , Niño , Animales , Ratas , Ratones , Sevoflurano/toxicidad , Sevoflurano/metabolismo , Calcineurina/metabolismo , Calcineurina/farmacología , Animales Recién Nacidos , Anestésicos por Inhalación/toxicidad , Éteres Metílicos/toxicidad , Hipocampo/metabolismo
3.
Br J Anaesth ; 130(2): 154-164, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36428160

RESUMEN

BACKGROUND: The novel synthetic neuroactive steroid (3ß,5ß,17ß)-3-hydroxyandrostane-17-carbonitrile (3ß-OH) blocks T-type calcium channels but does not directly modulate neuronal γ-aminobutyric acid type A (GABAA) currents like other anaesthetic neurosteroids. As 3ß-OH has sex-specific hypnotic effects in adult rats, we studied the mechanism contributing to sex differences in its effects. METHODS: We used a combination of behavioural loss of righting reflex, neuroendocrine, pharmacokinetic, in vitro patch-clamp electrophysiology, and in vivo electrophysiological approaches in wild-type mice and in genetic knockouts of the CaV3.1 T-type calcium channel isoform to study the mechanisms by which 3ß-OH and its metabolite produces sex-specific hypnotic effects. RESULTS: Adult male mice were less sensitive to the hypnotic effects of 3ß-OH compared with female mice, and these differences appeared during development. Adult males had higher 3ß-OH brain concentrations despite being less sensitive to its hypnotic effects. Females metabolised 3ß-OH into the active GABAA receptor positive allosteric modulator (3α,5ß,17ß)-3-hydroxyandrostane-17-carbonitrile (3α-OH) to a greater extent than males. The 3α-OH metabolite has T-channel blocking properties with sex-specific hypnotic and pharmacokinetic effects. Sex-dependent suppression of the cortical electroencephalogram is more pronounced with 3α-OH compared with 3ß-OH. CONCLUSIONS: The sex-specific differences in the hypnotic effect of 3ß-OH in mice are attributable to differences in its peripheral metabolism into the more potent hypnotic metabolite 3α-OH.


Asunto(s)
Canales de Calcio Tipo T , Neuroesteroides , Ratas , Ratones , Femenino , Masculino , Animales , Hipnóticos y Sedantes/farmacología , Esteroides/farmacología , Receptores de GABA-A
4.
Neurobiol Dis ; 175: 105923, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36371060

RESUMEN

Preclinical models demonstrate that nearly all anesthetics cause widespread neuroapoptosis in the developing brains of infant rodents and non-human primates. Anesthesia-induced developmental apoptosis is succeeded by prolonged neuropathology in the surviving neurons and lasting cognitive impairments, suggesting that anesthetics interfere with the normal developmental trajectory of the brain. However, little is known about effects of anesthetics on stereotyped axonal pruning, an important developmental algorithm that sculpts neural circuits for proper function. Here, we proposed that neonatal ketamine exposure may interfere with stereotyped axonal pruning of the infrapyramidal bundle (IPB) of the hippocampal mossy fiber system and that impaired pruning may be associated with alterations in the synaptic transmission of CA3 neurons. To test this hypothesis, we injected postnatal day 7 (PND7) mouse pups with ketamine or vehicle over 6 h and then studied them at different developmental stages corresponding to IPB pruning (PND20-40). Immunohistochemistry with synaptoporin (a marker of mossy fibers) revealed that in juvenile mice treated with ketamine at PND7, but not in vehicle-treated controls, positive IPB fibers extended farther into the stratum pyramidale of CA3 region. Furthermore, immunofluorescent double labeling for synaptoporin and PSD-95 strongly suggested that the unpruned IPB caused by neonatal ketamine exposure makes functional synapses. Importantly, patch-clamp electrophysiology for miniature excitatory postsynaptic currents (mEPSCs) in acute brain slices ex vivo revealed increased frequency and amplitudes of mEPSCs in hippocampal CA3 neurons in ketamine-treated groups when compared to vehicle controls. We conclude that neonatal ketamine exposure interferes with normal neural circuit development and that this interference leads to lasting increase in excitatory synaptic transmission in hippocampus.


Asunto(s)
Anestésicos , Ketamina , Ratones , Animales , Ketamina/toxicidad , Transmisión Sináptica/fisiología , Hipocampo , Sinapsis/fisiología , Fibras Musgosas del Hipocampo , Anestésicos/farmacología
5.
PLoS One ; 17(10): e0273867, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36260603

RESUMEN

We describe a new genus with a new species belonging to Araceae, from southern Ecuador. Vivaria calvasensis gen. et sp. nov. inhabits semi-arid inter- Andean mountains at altitudes ranging between 1100-1300 m a.s.l. The species belongs to the tribe Spathicarpae, which in Ecuador is represented by two other genera, Incarum and Croatellia, both typical for humid environments such as montane forests. This new genus is clearly supported by molecular evidence based on the matK gene, and morphological traits that separate it from the closely-related genera included in this tribe. The analyzed material was collected during several field campaigns carried out during four years in two populations from Loja province (Calvas and Macará), southern Ecuador, near the border with Peru.


Asunto(s)
Araceae , Lepidópteros , Animales , Ecuador , Bosques , Perú
6.
Br J Anaesth ; 129(4): 555-566, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35701270

RESUMEN

BACKGROUND: General anaesthesia in the neonatal period has detrimental effects on the developing mammalian brain. The impact of underlying inflammation on anaesthesia-induced developmental neurotoxicity remains largely unknown. METHODS: Postnatal day 7 (PND7) rats were randomly assigned to receive sevoflurane (3 vol% for 3 h) or carrier gas 12 h after bacterial lipopolysaccharide (LPS; 1 µg g-1) or vehicle injection. Pharmacological inhibition of caspase-1 by Vx-765 (two doses of 50 µg g-1 body weight) was used to investigate mechanistic pathways of neuronal injury. Histomorphological injury and molecular changes were quantified 2 h after the end of anaesthesia. Long-term functional deficits were tested at 5-8 weeks of age using a battery of behavioural tests in the memory and anxiety domains. RESULTS: Sevoflurane or LPS treatment increased activated caspase-3 and caspase-9 expression in the hippocampal subiculum and CA1, which was greater when sevoflurane was administered in the setting of LPS-induced inflammation. Neuronal injury induced by LPS+sevoflurane treatment resulted in sex-specific behavioural outcomes when rats were tested at 5-8 weeks of age, including learning and memory deficits in males and heightened anxiety-related behaviour in females. Hippocampal caspase-1 and NLRP1 (NLR family pyrin domain containing 1), but not NLRP3, were upregulated by LPS or LPS+sevoflurane treatment, along with related proinflammatory cytokines, interleukin (IL)-1ß, and IL-18. Pretreatment with Vx-765, a selective caspase-1 inhibitor, led to reduced IL-1ß in LPS and LPS+sevoflurane groups. Caspase-1 inhibition by Vx-765 significantly decreased activated caspase-3 and caspase-9 immunoreactivity in the subiculum. CONCLUSIONS: Systemic inflammation promotes developmental neurotoxicity by worsening anaesthesia-induced neuronal damage with sex-specific behavioural outcomes. This highlights the importance of studying anaesthesia-induced neurotoxicity in more clinically relevant settings.


Asunto(s)
Lipopolisacáridos , Síndromes de Neurotoxicidad , Animales , Animales Recién Nacidos , Caspasa 1 , Caspasa 3/metabolismo , Caspasa 9/metabolismo , Citocinas/metabolismo , Inflamación/inducido químicamente , Interleucina-18/metabolismo , Lipopolisacáridos/toxicidad , Masculino , Mamíferos/metabolismo , Síndromes de Neurotoxicidad/etiología , Ratas , Sevoflurano/toxicidad
7.
Biol Reprod ; 105(3): 720-734, 2021 09 14.
Artículo en Inglés | MEDLINE | ID: mdl-34258621

RESUMEN

Each year, millions of infants and children are anesthetized for medical and surgical procedures. Yet, a substantial body of preclinical evidence suggests that anesthetics are neurotoxins that cause rapid and widespread apoptotic cell death in the brains of infant rodents and nonhuman primates. These animals have persistent impairments in cognition and behavior many weeks or months after anesthesia exposure, leading us to hypothesize that anesthetics do more than simply kill brain cells. Indeed, anesthetics cause chronic neuropathology in neurons that survive the insult, which then interferes with major aspects of brain development, synaptic plasticity, and neuronal function. Understanding the phenomenon of anesthesia-induced developmental neurotoxicity is of critical public health importance because clinical studies now report that anesthesia in human infancy is associated with cognitive and behavioral deficits. In our search for mechanistic explanations for why a young and pliable brain cannot fully recover from a relatively brief period of anesthesia, we have accumulated evidence that neonatal anesthesia can dysregulate epigenetic tags that influence gene transcription such as histone acetylation and DNA methylation. In this review, we briefly summarize the phenomenon of anesthesia-induced developmental neurotoxicity. We then discuss chronic neuropathology caused by neonatal anesthesia, including disturbances in cognition, socio-affective behavior, neuronal morphology, and synaptic plasticity. Finally, we present evidence of anesthesia-induced genetic and epigenetic dysregulation within the developing brain that may be transmitted intergenerationally to anesthesia-naïve offspring.


Asunto(s)
Anestesia/efectos adversos , Animales Recién Nacidos/genética , Epigenoma/efectos de los fármacos , Primates/genética , Animales , Humanos , Recién Nacido , Ratones , Ratas
8.
Neurosci Lett ; 753: 135854, 2021 05 14.
Artículo en Inglés | MEDLINE | ID: mdl-33785378

RESUMEN

Physical inactivity is positively associated with anxiety and depression. Considering physical inactivity, anxiety, and depression each have a genetic basis for inheritance, our lab used artificial selectively bred low-voluntary running (LVR) and wild type (WT) female Wistar rats to test if physical inactivity genes selected over multiple generations would lead to an anxiety or depressive-like phenotype. We performed next generation RNA sequencing and immunoblotting on the dentate gyrus to reveal key biological functions from heritable physical inactivity. LVR rats did not display depressive-like behavior. However, LVR rats did display anxiogenic behavior with gene networks associated with reduced neuronal development, proliferation, and function compared to WT counterparts. Additionally, immunoblotting revealed LVR deficits in neuronal development and function. To our knowledge, this is the first study to show that by selectively breeding for physical inactivity genes, anxiety-like genes were co-selected. The study also reveals molecular insights to the genetic influences that physical inactivity has on anxiety-like behavior.


Asunto(s)
Ansiedad/genética , Conducta Sedentaria , Selección Artificial/genética , Animales , Ansiedad/patología , Ansiedad/fisiopatología , Giro Dentado , Depresión/genética , Depresión/patología , Depresión/fisiopatología , Modelos Animales de Enfermedad , Femenino , Humanos , Masculino , RNA-Seq , Ratas , Ratas Wistar , Carrera/fisiología
9.
Glob Chang Biol ; 26(6): 3552-3568, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32020698

RESUMEN

Understanding the vulnerability of tree species to anthropogenic threats is important for the efficient planning of restoration and conservation efforts. We quantified and compared the effects of future climate change and four current threats (fire, habitat conversion, overgrazing and overexploitation) on the 50 most common tree species of the tropical dry forests of northwestern Peru and southern Ecuador. We used an ensemble modelling approach to predict species distribution ranges, employed freely accessible spatial datasets to map threat exposures, and developed a trait-based scoring approach to estimate species-specific sensitivities, using differentiated trait weights in accordance with their expected importance in determining species sensitivities to specific threats. Species-specific vulnerability maps were constructed from the product of the exposure maps and the sensitivity estimates. We found that all 50 species face considerable threats, with an average of 46% of species' distribution ranges displaying high or very high vulnerability to at least one of the five threats. Our results suggest that current levels of habitat conversion, overexploitation and overgrazing pose larger threats to most of the studied species than climate change. We present a spatially explicit planning strategy for species-specific restoration and conservation actions, proposing management interventions to focus on (a) in situ conservation of tree populations and seed collection for tree planting activities in areas with low vulnerability to climate change and current threats; (b) ex situ conservation or translocation of populations in areas with high climate change vulnerability; and (c) active planting or assisted regeneration in areas under high current threat vulnerability but low climate change vulnerability, provided that interventions are in place to lower threat pressure. We provide an online, user-friendly tool to visualize both the vulnerability maps and the maps indicating priority restoration and conservation actions.


Asunto(s)
Conservación de los Recursos Naturales , Árboles , Cambio Climático , Ecuador , Bosques , Perú
10.
Br J Anaesth ; 124(3): e81-e91, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31980157

RESUMEN

Exposure to anaesthetic drugs during the fetal or neonatal period induces widespread neuronal apoptosis in the brains of rodents and non-human primates. Hundreds of published preclinical studies and nearly 20 clinical studies have documented cognitive and behavioural deficits many months or years later, raising the spectre that early life anaesthesia exposure is a long-term, perhaps permanent, insult that might affect the quality of life of millions of humans. Although the phenomenon of anaesthesia-induced developmental neurotoxicity is well characterised, there are important and lingering questions pertaining to sex differences and neurodevelopmental sequelae that might occur differentially in females and males. We review the relevant literature on sex differences in the field of anaesthesia-induced developmental neurotoxicity, and present an emerging pattern of potential sex-dependent neurodevelopmental abnormalities in rodent models of human infant anaesthesia exposure.


Asunto(s)
Anestésicos/efectos adversos , Trastornos del Neurodesarrollo/inducido químicamente , Animales , Ansiedad/inducido químicamente , Apoptosis/efectos de los fármacos , Trastorno por Déficit de Atención con Hiperactividad/inducido químicamente , Trastornos del Conocimiento/inducido químicamente , Metilación de ADN , Femenino , Humanos , Masculino , Síndromes de Neurotoxicidad/etiología , Caracteres Sexuales
11.
Mol Neurobiol ; 57(1): 11-22, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31512116

RESUMEN

Large body of animal work and emerging clinical findings have suggested that early exposure to anesthetics may result in increased risk of learning disabilities and behavioral impairments. Recent studies have begun to investigate anesthesia-induced epigenetic modifications to elucidate their role in behavioral and neurodevelopmental abnormalities. Here we examine sevoflurane-induced transgenerational modifications of subicular neuronal DNA methylation and expression of immediate early genes (IEGs), arc and junB, crucial to synaptic plasticity and normal neuronal development. We show that 6 h sevoflurane exposure in postnatal day 7 rat pups resulted in decreased neuronal 5-methycytosine, indicating reduced DNA methylation. This effect is transgenerationally expressed in offspring born to exposed mothers which is of importance considering that decreased DNA methylation in the brain has been linked with functional decline in learning and memory. We further show that sevoflurane exposure induces upregulation of Arc and JunB mRNA expression, 42.7% and 35.2%, respectively. Transgenerational changes in Arc and JunB mRNA were sexually dimorphic only occurring in males born to exposed females, expressed as upregulation of Arc and JunB mRNA, 71.6% and 74.0%, respectively. We further investigated correlation between altered arc promoter methylation and observed upregulation of Arc mRNA and observed that sevoflurane reduced methylation in the 5-upstream promoter region of females exposed to sevoflurane. Transgenerational hypomethylation and modifications to IEGs crucial to synaptic plasticity, observed following neonatal sevoflurane exposure could contribute to morphological and cognitive deficits known to occur with neonatal sevoflurane exposure.


Asunto(s)
Genes Inmediatos-Precoces/efectos de los fármacos , Memoria/efectos de los fármacos , Plasticidad Neuronal/efectos de los fármacos , Sevoflurano/farmacología , Anestésicos por Inhalación/farmacología , Animales , Animales Recién Nacidos , Trastornos del Conocimiento/metabolismo , Espinas Dendríticas/metabolismo , Hipocampo/metabolismo , Aprendizaje/efectos de los fármacos , Éteres Metílicos/farmacología , Ratas Sprague-Dawley , Regulación hacia Arriba/efectos de los fármacos
12.
Sci Transl Med ; 10(424)2018 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-29343623

RESUMEN

We report a biomarker-based non-endoscopic method for detecting Barrett's esophagus (BE) based on detecting methylated DNAs retrieved via a swallowable balloon-based esophageal sampling device. BE is the precursor of, and a major recognized risk factor for, developing esophageal adenocarcinoma. Endoscopy, the current standard for BE detection, is not cost-effective for population screening. We performed genome-wide screening to ascertain regions targeted for recurrent aberrant cytosine methylation in BE, identifying high-frequency methylation within the CCNA1 locus. We tested CCNA1 DNA methylation as a BE biomarker in cytology brushings of the distal esophagus from 173 individuals with or without BE. CCNA1 DNA methylation demonstrated an area under the curve of 0.95 for discriminating BE-related metaplasia and neoplasia cases versus normal individuals, performing identically to methylation of VIM DNA, an established BE biomarker. When combined, the resulting two biomarker panel was 95% sensitive and 91% specific. These results were replicated in an independent validation cohort of 149 individuals who were assayed using the same cutoff values for test positivity established in the training population. To progress toward non-endoscopic esophageal screening, we engineered a well-tolerated, swallowable, encapsulated balloon device able to selectively sample the distal esophagus within 5 min. In balloon samples from 86 individuals, tests of CCNA1 plus VIM DNA methylation detected BE metaplasia with 90.3% sensitivity and 91.7% specificity. Combining the balloon sampling device with molecular assays of CCNA1 plus VIM DNA methylation enables an efficient, well-tolerated, sensitive, and specific method of screening at-risk populations for BE.


Asunto(s)
Esófago de Barrett/diagnóstico , Esófago de Barrett/genética , Metilación de ADN/genética , Biomarcadores de Tumor/genética , Ciclina A1/genética , Marcadores Genéticos/genética , Humanos
13.
Horm Behav ; 90: 84-89, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-28257758

RESUMEN

Women and non-human females have surprisingly high levels of circulating testosterone, yet the effects of androgens on non-reproductive behaviors, including cognition, of females are not well characterized. The current project used an aromatase inhibitor, letrozole, to block conversion of androgens to estrogens. Adult female rats were ovariectomized and administered either vehicle only, testosterone propionate only (400µg/kg, TP only), letrozole only (1mg/kg, Letro only), or the combination of letrozole and testosterone (TP+Letro) over 4weeks. A gonadally intact group was used for comparisons. During the last 3weeks, the animals were tested for working memory in both a spatial task (radial arm maze) and a non-spatial task (object recognition). At sacrifice, uterine weights and serum testosterone and estradiol were determined. Behavioral results were the intact animals showed better working memories on the object recognition task, but that there were no differences among the ovariectomized groups. In the radial arm maze task, groups with best to worst performance were TP only>Intact=TP+Letro>vehicle=Letro only. Highest to lowest serum titers, for testosterone, were TP+Letro>TP only>Intact=Letro only>vehicle and, for estradiol, Intact>TP only>Vehicle>Letro only=TP+Letro. Our interpretation is that testosterone enhanced spatial performance when bioavailability of both TP and E2 are high, and high testosterone can rescue spatial memory when E2 bioavailability is low.


Asunto(s)
Andrógenos/metabolismo , Inhibidores de la Aromatasa/farmacología , Cognición/efectos de los fármacos , Estrógenos/metabolismo , Animales , Estradiol/sangre , Femenino , Letrozol , Aprendizaje por Laberinto/efectos de los fármacos , Nitrilos/farmacología , Ratas , Ratas Long-Evans , Testosterona/sangre , Triazoles/farmacología , Útero/anatomía & histología , Útero/efectos de los fármacos
14.
Eur J Obstet Gynecol Reprod Biol ; 210: 334-341, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28122314

RESUMEN

BACKGROUND: Prophylactic administration of antibiotics preceding cesarean delivery is the most effective measure taken for preventing postpartum infection. While obese women are at greater risk for infection than non-obese women, evidence-based recommendations for modifying dosing in these women are limited. OBJECTIVES: The purpose of this study was to determine whether obese women undergoing cesarean delivery similarly reach adequate cefazolin concentrations within tissue and blood when weighing <120kg and dosed 2g versus weighing ≥120kg and dosed 3g. STUDY DESIGN: We prospectively studied women ≥18 years old with body mass index ≥30kg/m2 who underwent scheduled cesarean delivery with singleton pregnancy from August 2014 through March 2016. Women were dosed with 2g and 3g of cefazolin for body weights <120kg and ≥120kg, respectively. Samples of subcutaneous adipose tissue (following skin incision and before skin closure), myometrial tissue, fetal cord blood, and maternal blood were collected to assess whether cefazolin concentrations were adequate, i.e., at/above the minimum inhibitory concentration (MIC). Concentrations, based on inhibition zones for Streptococcus sanguinis, were calculated per gram of solid tissue and milliliter of blood. For all sample types, log-transformed concentrations were compared between dosage groups. Using a range of published MICs (1-8µg/mL or µg/g), odds ratios, describing differential odds of falling below the MIC between dosage groups, were also computed. RESULTS: Women who received 2g (n=65) versus 3g (n=19) of cefazolin did not significantly differ by maternal or gestational age, race/ethnicity, pre-operative hemoglobin, estimated blood loss, fluid administration, duration of surgery, or timing of sample collections relative to cefazolin administration (Ps>0.05). Dosage groups also did not differ in cefazolin concentration (median [interquartile range]) within adipose tissue following skin incision (5.30µg/g [3.00-9.60] vs. 6.35µg/g [3.90-8.40]; P=0.551), adipose tissue before skin closure (4.45µg/g [2.78-7.25] vs. 6.90µg/g [2.60-10.6]; P=0.342), myometrial tissue (13.1µg/g [8.60-19.6] vs. 15.7µg/g [10.8-21.7]; P=0.116), or maternal blood (41.6µg/mL [26.3-57.0] vs. 45.3µg/mL [36.7-68.3]; P=0.143). However, cord blood concentrations differed significantly (19.5µg/mL [13.7-28.5] vs. 27.9µg/mL [15.8-39.4]; P=0.032), and, in 3 of 5 sample types, group concentrations differed at the dosing cut-point of 120kg (Ps<0.02). Within the range of MICs considered, differences in the odds of concentration inadequacy were not detected between dosage groups for any sample type. Across all patients, inadequate concentrations in one or more solid tissue types were observed in 1.19%, 17.9%, 59.5%, and 86.9% of patients, given the MICs of 1µg/g, 2µg/g, 4µg/g and 8µg/g, respectively. In adipose tissues, specifically, and both dosage groups, mean concentrations were significantly lower than the MIC of 8µg/g (Ps<0.03). Concentrations in one or both blood sample types were inadequate for only 8.33% of patients, given the 8-µg/mL MIC. CONCLUSIONS: Adequate cefazolin concentrations were achieved in blood for the majority of our patients. However, concentration adequacy was not achieved in solid tissue for a nearly equally large proportion of patients. Larger scale studies for determining modified protocols for dosing and applying MICs are warranted.


Asunto(s)
Antibacterianos/administración & dosificación , Profilaxis Antibiótica , Cefazolina/administración & dosificación , Obesidad/complicaciones , Complicaciones Posoperatorias/prevención & control , Infección de la Herida Quirúrgica/prevención & control , Adulto , Antibacterianos/farmacocinética , Cefazolina/farmacocinética , Cesárea/efectos adversos , Femenino , Humanos , Complicaciones Posoperatorias/etiología , Embarazo , Estudios Prospectivos , Infección de la Herida Quirúrgica/etiología , Distribución Tisular
15.
J Matern Fetal Neonatal Med ; 30(22): 2734-2741, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27924651

RESUMEN

OBJECTIVES: Caffeine (CAF) and sedative/anesthetic drugs (SADs) are often coadministered to premature infants in the neonatal intensive care unit (NICU). While SAD neurotoxicity in the developing brain is well established, it is not fully clear whether CAF interacts with SADs and whether this interaction is detrimental. Using a mouse model of prematurity, we hypothesized that CAF would increase apoptotic neurotoxicity when coadministered with SADs. METHODS: Postnatal day 3 mice were treated with vehicle or 80 mg/kg CAF prior to challenge with 6 mg/kg midazolam, 40 mg/kg ketamine, or 40 µg/kg fentanyl. Six hours later, pups were sacrificed for activated caspase 3 (AC3) immunohistochemistry, and number of AC3 positive cells per mm3 throughout neocortex, hippocampus, caudate, thalamus, and colliculi was analyzed. RESULTS: CAF caused a statistically significant increase in AC3 positive cells when coadministered with midazolam (p = 0.002), ketamine (p = 0.014), or fentanyl (p < 0.001). Our composite dataset suggests that the addition of CAF to these SADs has a supra-additive effect, causing more neurotoxicity than expected. CONCLUSIONS: CAF may augment the neurotoxic action of SADs indicated for neonatal sedation/anesthesia in the NICU by triggering widespread apoptosis in the developing brains of premature infants.


Asunto(s)
Anestésicos/efectos adversos , Apoptosis/efectos de los fármacos , Cafeína/efectos adversos , Hipnóticos y Sedantes/efectos adversos , Neuronas/efectos de los fármacos , Nacimiento Prematuro/patología , Anestésicos/administración & dosificación , Animales , Animales Recién Nacidos , Cafeína/administración & dosificación , Modelos Animales de Enfermedad , Femenino , Humanos , Hipnóticos y Sedantes/administración & dosificación , Ratones , Ratones Endogámicos ICR , Neuronas/fisiología , Síndromes de Neurotoxicidad/patología , Embarazo , Nacimiento Prematuro/tratamiento farmacológico , Nacimiento Prematuro/psicología , Distribución Aleatoria
16.
Neurotoxicol Teratol ; 60: 63-68, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27876652

RESUMEN

Previously we reported that a 5-hour exposure of 6-day-old (P6) rhesus macaques to isoflurane triggers robust neuron and oligodendrocyte apoptosis. In an attempt to further describe the window of vulnerability to anesthetic neurotoxicity, we exposed P20 and P40 rhesus macaques to 5h of isoflurane anesthesia or no exposure (control animals). Brains were collected 3h later and examined immunohistochemically to analyze neuronal and glial apoptosis. Brains exposed to isoflurane displayed neuron and oligodendrocyte apoptosis distributed throughout cortex and white matter, respectively. When combining the two age groups (P20+P40), the animals exposed to isoflurane had 3.6 times as many apoptotic cells as the control animals. In the isoflurane group, approximately 66% of the apoptotic cells were oligodendrocytes and 34% were neurons. In comparison, in our previous studies on P6 rhesus macaques, approximately 52% of the dying cells were glia and 48% were neurons. In conclusion, the present data suggest that the window of vulnerability for neurons is beginning to close in the P20 and P40 rhesus macaques, but continuing for oligodendrocytes.


Asunto(s)
Envejecimiento/fisiología , Apoptosis/fisiología , Encéfalo/fisiología , Isoflurano/efectos adversos , Neuronas/fisiología , Oligodendroglía/fisiología , Animales , Animales Recién Nacidos , Apoptosis/efectos de los fármacos , Femenino , Macaca mulatta , Masculino
17.
J Matern Fetal Neonatal Med ; 30(18): 2156-2162, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27677376

RESUMEN

OBJECTIVES: Glucocorticoids (GCs) are used to improve respiratory mechanics in preterm infants despite clinical evidence linking neonatal GC therapy to cerebellar pathology. In developing mouse cerebellum, the GC dexamethasone (DEX) causes rapid GC-induced neural progenitor cell apoptosis (GINA). Focusing on pharmacological neuroprotection strategies, we investigated whether dexmedetomidine (DMT) protects against GINA. METHODS: Neonatal mice were pretreated with DMT prior to DEX challenge. Additionally, we tested clonidine and yohimbine in vivo to determine mechanism of DMT neuroprotection. For in vitro studies, cerebellar neural progenitor cells were pretreated with DMT before DEX challenge. RESULTS: In vivo, DMT attenuated GINA at 1 µg/kg and above, p < 0.0001. Clonidine significantly attenuated GINA, p < 0.0001, while yohimbine reversed DMT neuroprotection, p < 0.0001, suggesting DMT neuroprotection is likely mediated via adrenergic signaling. In vitro, DMT neuroprotection was achieved at 10 µM and above, p < 0.001, indicating DMT rescue is cell autonomous. CONCLUSIONS: DMT affords dose-dependent neuroprotection from GINA at clinically relevant doses, an effect that is cell autonomous and likely mediated by α2 adrenergic receptor agonism. DMT co-administration with GCs may be an effective strategy to protect the neonatal brain from GINA while retaining the beneficial effects of GCs on respiratory mechanics.


Asunto(s)
Apoptosis/efectos de los fármacos , Cerebelo/efectos de los fármacos , Dexmedetomidina/farmacología , Glucocorticoides/efectos adversos , Fármacos Neuroprotectores/farmacología , Animales , Animales Recién Nacidos , Técnicas de Cultivo de Célula , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Ratones , Ratones Endogámicos ICR , Distribución Aleatoria , Respiración/efectos de los fármacos , Transducción de Señal/efectos de los fármacos , Células Madre/efectos de los fármacos
18.
Cell ; 165(5): 1081-1091, 2016 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-27180225

RESUMEN

Zika virus (ZIKV) infection in pregnant women causes intrauterine growth restriction, spontaneous abortion, and microcephaly. Here, we describe two mouse models of placental and fetal disease associated with in utero transmission of ZIKV. Female mice lacking type I interferon signaling (Ifnar1(-/-)) crossed to wild-type (WT) males produced heterozygous fetuses resembling the immune status of human fetuses. Maternal inoculation at embryonic day 6.5 (E6.5) or E7.5 resulted in fetal demise that was associated with ZIKV infection of the placenta and fetal brain. We identified ZIKV within trophoblasts of the maternal and fetal placenta, consistent with a trans-placental infection route. Antibody blockade of Ifnar1 signaling in WT pregnant mice enhanced ZIKV trans-placental infection although it did not result in fetal death. These models will facilitate the study of ZIKV pathogenesis, in utero transmission, and testing of therapies and vaccines to prevent congenital malformations.


Asunto(s)
Modelos Animales de Enfermedad , Enfermedades Fetales/virología , Enfermedades Placentarias/virología , Complicaciones Infecciosas del Embarazo/virología , Infección por el Virus Zika/patología , Virus Zika/fisiología , Animales , Apoptosis , Encéfalo/embriología , Encéfalo/patología , Encéfalo/virología , Femenino , Enfermedades Fetales/patología , Masculino , Ratones , Ratones Endogámicos C57BL , Enfermedades Placentarias/patología , Embarazo , Complicaciones Infecciosas del Embarazo/patología , ARN Viral/aislamiento & purificación , Receptor de Interferón alfa y beta/genética , Receptor de Interferón alfa y beta/metabolismo , Infección por el Virus Zika/virología
19.
Neurobiol Dis ; 83: 35-43, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26319366

RESUMEN

The external granule layer (EGL) is a proliferative region that produces over 90% of the neurons in the cerebellum but can also malignantly transform into a cerebellar tumor called the medulloblastoma (the most common malignant brain tumor in children). Current dogma considers Hedgehog stimulation a potent proliferative signal for EGL neural progenitor cells (NPCs) and medulloblastomas. However, the Hedgehog pathway also acts as a survival signal in the neural tube where it regulates dorsoventral patterning by controlling NPC apoptosis. Here we show that Hedgehog stimulation is also a potent survival signal in the EGL and medulloblastomas that produces a massive apoptotic response within hours of signal loss in mice. This toxicity can be produced by numerous Hedgehog antagonists (vismodegib, cyclopamine, and jervine) and is Bax/Bak dependent but p53 independent. Finally, since glucocorticoids can also induce EGL and medulloblastoma apoptosis, we show that Hedgehog's effects on apoptosis can occur independent of glucocorticoid stimulation. This effect may play a major role in cerebellar development by directing where EGL proliferation occurs thereby morphologically sculpting growth. It may also be a previously unknown major therapeutic effect of Hedgehog antagonists during medulloblastoma therapy. Results are discussed in terms of their implications for both cerebellar development and medulloblastoma treatment.


Asunto(s)
Apoptosis , Cerebelo/crecimiento & desarrollo , Cerebelo/metabolismo , Proteínas Hedgehog/fisiología , Meduloblastoma/metabolismo , Células-Madre Neurales/metabolismo , Animales , Caspasa 3/metabolismo , Fluocinolona Acetonida/administración & dosificación , Fluocinolona Acetonida/análogos & derivados , Fluocinolona Acetonida/metabolismo , Genes p53 , Proteínas Hedgehog/antagonistas & inhibidores , Proteínas Hedgehog/metabolismo , Ratones , Ratones Endogámicos C57BL , Transducción de Señal
20.
J Biogeogr ; 41(12): 2307-2319, 2014 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-25914437

RESUMEN

AIM: Geographic, climatic, and soil factors are major drivers of plant beta diversity, but their importance for dryland plant communities is poorly known. This study aims to: i) characterize patterns of beta diversity in global drylands, ii) detect common environmental drivers of beta diversity, and iii) test for thresholds in environmental conditions driving potential shifts in plant species composition. LOCATION: 224 sites in diverse dryland plant communities from 22 geographical regions in six continents. METHODS: Beta diversity was quantified with four complementary measures: the percentage of singletons (species occurring at only one site), Whittake's beta diversity (ß(W)), a directional beta diversity metric based on the correlation in species occurrences among spatially contiguous sites (ß(R2)), and a multivariate abundance-based metric (ß(MV)). We used linear modelling to quantify the relationships between these metrics of beta diversity and geographic, climatic, and soil variables. RESULTS: Soil fertility and variability in temperature and rainfall, and to a lesser extent latitude, were the most important environmental predictors of beta diversity. Metrics related to species identity (percentage of singletons and ß(W)) were most sensitive to soil fertility, whereas those metrics related to environmental gradients and abundance ((ß(R2)) and ß(MV)) were more associated with climate variability. Interactions among soil variables, climatic factors, and plant cover were not important determinants of beta diversity. Sites receiving less than 178 mm of annual rainfall differed sharply in species composition from more mesic sites (> 200 mm). MAIN CONCLUSIONS: Soil fertility and variability in temperature and rainfall are the most important environmental predictors of variation in plant beta diversity in global drylands. Our results suggest that those sites annually receiving ~ 178 mm of rainfall will be especially sensitive to future climate changes. These findings may help to define appropriate conservation strategies for mitigating effects of climate change on dryland vegetation.

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