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1.
JACC Case Rep ; 29(11): 102358, 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38765201

RESUMEN

A 63-year-old woman who underwent heart transplantation for cardiac sarcoidosis developed new headache and vision changes. Extensive workup resulted in a diagnosis of neurosarcoidosis treated with pulse dose steroids and infliximab. Recurrence of sarcoidosis after transplantation for isolated cardiac sarcoidosis occurs, but optimal surveillance methods remain unknown.

2.
Viruses ; 15(12)2023 12 16.
Artículo en Inglés | MEDLINE | ID: mdl-38140688

RESUMEN

Influenza antiviral drugs are important tools in our fight against both annual influenza epidemics and pandemics. Polyphenols are a group of compounds found in plants, some of which have demonstrated promising antiviral activity. Previous in vitro and mouse studies have outlined the anti-influenza virus effectiveness of the polyphenol epigallocatechin-3-gallate (EGCG); however, no study has utilised the ferret model, which is considered the gold-standard for influenza antiviral studies. This study aimed to explore the antiviral efficacy of EGCG in vitro and in ferrets. We first performed studies in Madin-Darby Canine Kidney (MDCK) and human lung carcinoma (Calu-3) cells, which demonstrated antiviral activity. In MDCK cells, we observed a selective index (SI, CC50/IC50) of 77 (290 µM/3.8 µM) and 96 (290 µM/3.0 µM) against A/California/07/2009 and A/Victoria/2570/2019 (H1N1)pdm09 influenza virus, respectively. Calu-3 cells demonstrated a SI of 16 (420 µM/26 µM) and 18 (420 µM/24 µM). Ferrets infected with A/California/07/2009 influenza virus and treated with EGCG (500 mg/kg/day for 4 days) had no change in respiratory tissue viral titres, in contrast to oseltamivir treatment, which significantly reduced viral load in the lungs of treated animals. Therefore, we demonstrated that although EGCG showed antiviral activity in vitro against influenza viruses, the drug failed to impair viral replication in the respiratory tract of ferrets.


Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Gripe Humana , Animales , Perros , Humanos , Ratones , Gripe Humana/tratamiento farmacológico , Antivirales/farmacología , Antivirales/uso terapéutico , , Hurones
3.
Ann Surg Open ; 4(1): e260, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37600898

RESUMEN

Background: Surgeon productivity is measured in relative value units (RVUs). The feasibility of attaining RVU productivity targets requires surgeons to have enough allocated block time to generate RVUs. However, it is unknown how much block time is required for surgeons to attain specific RVU targets. We aimed to estimate the effect of surgeon and practice environment characteristics (SPECs) on block time needed to attain fixed RVU targets. Methods: We computationally simulated individual surgeons' annual caseloads under a variety of SPECs in the following way. First, empirical case data were sampled from ACS NSQIP in accordance with surgeon specialty, case-mix complexity, and RVU target. Surgeons' operating schedules were then constructed according to the block length, turnover time, and scheduling flexibility of the practice environment. These 6 SPECs were concurrently varied over their ranges for a 6-way sensitivity analysis. Results: Annual operating schedules for 60,000,000 surgeons were simulated. The number of blocks required to attain RVU targets varied significantly with surgeon specialty and increased with increased case-mix complexity, increased turnover time, and decreased scheduling flexibility. Intraspecialty variation in block requirement with variation in environmental characteristics exceeded interspecialty variation with fixed environmental characteristics. Multivariate linear models predicted block utilization across surgical specialties with consideration for the stated factors. An online tool is shared with which to apply these results to one's particular practice. Conclusions: Block time required to attain RVU targets varies widely with SPECs; intraspecialty variation exceeds interspecialty variation. The feasibility of attaining RVU targets requires alignment between targets and allocated operating time with consideration for surgical specialty and other practice conditions.

4.
J Med Internet Res ; 25: e41092, 2023 07 19.
Artículo en Inglés | MEDLINE | ID: mdl-37467015

RESUMEN

BACKGROUND: With rising time constraints, health care professionals increasingly depend on technology to provide health advice and teach patients how to manage chronic disease. The effectiveness of video-based tools in improving knowledge, health behaviors, disease severity, and health care use for patients with major chronic illnesses is not well understood. OBJECTIVE: The aim of this study was to assess the current literature regarding the efficacy of video-based educational tools for patients in improving process and outcome measures across several chronic illnesses. METHODS: A systematic review was conducted using CINAHL and PubMed with predefined search terms. The search included studies published through October 2021. The eligible studies were intervention studies of video-based self-management patient education for an adult patient population with the following chronic health conditions: asthma, chronic kidney disease, chronic obstructive pulmonary disease, chronic pain syndromes, diabetes, heart failure, HIV infection, hypertension, inflammatory bowel disease, and rheumatologic disorders. The eligible papers underwent full extraction of study characteristics, study design, sample demographics, and results. Bias was assessed with the Cochrane risk-of-bias tools. Summary statistics were synthesized in Stata SE (StataCorp LLC). Data reporting was conducted per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. RESULTS: Of the 112 studies fully extracted, 59 (52.7%) were deemed eligible for inclusion in this review. The majority of the included papers were superiority randomized controlled trials (RCTs; 39/59, 66%), with fewer pre-post studies (13/59, 22%) and noninferiority RCTs (7/59, 12%). The most represented conditions of interest were obstructive lung disease (18/59, 31%), diabetes (11/59, 19%), and heart failure (9/59, 15%). The plurality (28/59, 47%) of video-based interventions only occurred once and occurred alongside adjunct interventions that included printed materials, in-person counseling, and interactive modules. The most frequently studied outcomes were disease severity, health behavior, and patient knowledge. Video-based tools were the most effective in improving patient knowledge (30/40, 75%). Approximately half reported health behavior (21/38, 56%) and patient self-efficacy (12/23, 52%) outcomes were improved by video-based tools, and a minority of health care use (11/28, 39%) and disease severity (23/69, 33%) outcomes were improved by video-based tools. In total, 48% (22/46) of the superiority and noninferiority RCTs and 54% (7/13) of the pre-post trials had moderate or high risk of bias. CONCLUSIONS: There is robust evidence that video-based tools can improve patient knowledge across several chronic illnesses. These tools less consistently improve disease severity and health care use outcomes. Additional study is needed to identify features that maximize the efficacy of video-based interventions for patients across the spectrum of digital competencies to ensure optimized and equitable patient education and outcomes.


Asunto(s)
Diabetes Mellitus , Infecciones por VIH , Insuficiencia Cardíaca , Enfermedad Pulmonar Obstructiva Crónica , Adulto , Humanos , Enfermedad Crónica , Diabetes Mellitus/terapia
5.
Front Immunol ; 14: 1163858, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37197659

RESUMEN

The threat of viral influenza infections has sparked research efforts to develop vaccines that can induce broadly protective immunity with safe adjuvants that trigger robust immune responses. Here, we demonstrate that subcutaneous or intranasal delivery of a seasonal trivalent influenza vaccine (TIV) adjuvanted with the Quillaja brasiliensis saponin-based nanoparticle (IMXQB) increases the potency of TIV. The adjuvanted vaccine (TIV-IMXQB) elicited high levels of IgG2a and IgG1 antibodies with virus-neutralizing capacity and improved serum hemagglutination inhibition titers. The cellular immune response induced by TIV-IMXQB suggests the presence of a mixed Th1/Th2 cytokine profile, antibody-secreting cells (ASCs) skewed toward an IgG2a phenotype, a positive delayed-type hypersensitivity (DTH) response, and effector CD4+ and CD8+ T cells. After challenge, viral titers in the lungs were significantly lower in animals receiving TIV-IMXQB than in those inoculated with TIV alone. Most notably, mice vaccinated intranasally with TIV-IMXQB and challenged with a lethal dose of influenza virus were fully protected against weight loss and lung virus replication, with no mortality, whereas, among animals vaccinated with TIV alone, the mortality rate was 75%. These findings demonstrate that TIV-IMXQB improved the immune responses to TIV, and, unlike the commercial vaccine, conferred full protection against influenza challenge.


Asunto(s)
Vacunas contra la Influenza , Gripe Humana , Nanopartículas , Animales , Ratones , Humanos , Gripe Humana/prevención & control , Quillaja , Linfocitos T CD8-positivos , Adyuvantes Inmunológicos , Adyuvantes Farmacéuticos , Saponinas de Quillaja , Inmunoglobulina G
6.
JMIR Hum Factors ; 10: e40105, 2023 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-36705947

RESUMEN

BACKGROUND: Throughout the COVID-19 pandemic, patient portals have become more widely used tools of patient care delivery. However, not all individuals have equivalent access or ability to use patient portals. OBJECTIVE: The aim of this study is to evaluate the relationships between eHealth literacy (eHL) and patient portal awareness, use, and attitudes among hospitalized patients. METHODS: Inpatients completed patient portal surveys; eHL was assessed (eHealth Literacy Scale). Multivariable logistic regression analyses adjusted for age, self-reported race, gender, and educational attainment were completed with significance at P<.006 (Bonferroni correction). RESULTS: Among 274 participants, most identified as Black (n=166, 61%) and female (n=140, 51%), mean age was 56.5 (SD 16.7) years, and 178 (65%) reported some college or higher educational attainment. One-quarter (n=79, 28%) had low eHL (mean 27, SD 9.5), which was associated with lower odds of portal access awareness (odds ratio 0.11, 95% CI 0.05-0.23; P<.001), having ever used portals (odds ratio 0.19, 95% CI 0.10-0.36; P<.001), less perceived usefulness of portals (odds ratio 0.20, 95% CI 0.10-0.38; P=.001), and lower likelihood of planning to use portals in the coming years (odds ratio 0.12, 95% CI 0.06-0.25; P<.001). As time through the COVID-19 pandemic passed, there was a trend toward increased perceived usefulness of patient portals (53% vs 62%, P=.08), but average eHL did not increase through time (P=.81). CONCLUSIONS: Low eHL was associated with less awareness, use, and perceived usefulness of portals. Perceived usefulness of portals likely increased through the COVID-19 pandemic, but patients' eHL did not. Interventions tailored for patients with low eHL could ensure greater equity in health care delivery through the COVID-19 pandemic.

7.
Mem Inst Oswaldo Cruz ; 117: e220177, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36651456

RESUMEN

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in domestic animals have occurred from the beginning of the pandemic to the present time. Therefore, from the perspective of One Health, investigating this topic is of global scientific and public interest. OBJECTIVES: The present study aimed to determine the presence of SARS-CoV-2 in domestic animals whose owners had coronavirus disease 2019 (COVID-19). METHODS: Nasopharyngeal and faecal samples were collected in Uruguay. Using quantitative polymerase chain reaction (qPCR), we analysed the presence of the SARS-CoV-2 genome. Complete genomes were obtained using ARTIC enrichment and Illumina sequencing. Sera samples were used for virus neutralisation assays. FINDINGS: SARS-CoV-2 was detected in an asymptomatic dog and a cat. Viral genomes were identical and belonged to the P.6 Uruguayan SARS-CoV-2 lineage. Only antiserum from the infected cat contained neutralising antibodies against the ancestral SARS-CoV-2 strain and showed cross-reactivity against the Delta but not against the B.A.1 Omicron variant. MAIN CONCLUSIONS: Domestic animals and the human SARS-CoV-2 P.6 variant comparison evidence a close relationship and gene flow between them. Different SARS-CoV-2 lineages infect dogs and cats, and no specific variants are adapted to domestic animals. This first record of SARS-CoV-2 in domestic animals from Uruguay supports regular surveillance of animals close to human hosts.


Asunto(s)
COVID-19 , Enfermedades de los Gatos , Enfermedades de los Perros , Gatos , Animales , Humanos , Perros , SARS-CoV-2/genética , Uruguay , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/epidemiología , Animales Domésticos
8.
J Surg Educ ; 80(2): 247-255, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36328935

RESUMEN

OBJECTIVE: To investigate how the internet presence of Otolaryngology residency programs influences recruitment of diverse applicants. STUDY DESIGN: Retrospective cohort study. SETTING: Website, Instagram, and AAMC Residency Explorer data from all US, non-military, allopathic otolaryngology residency programs. METHODS: We identified 10 common ways in which residency programs communicate their commitment to diversity through web-based platforms. We then analyzed program websites and Instagram pages for the presence of these 10 diversity elements. Univariate and multivariate linear regression were used to evaluate the association between presence of a diversity elements and the proportion of underrepresented minority residents in the program. RESULTS: Review of 106 Otolaryngology residency program websites and Instagram pages was completed from February to May 2021. Most programs (69.8%) satisfied at least one diversity element. Of the programs reviewed, 83 had demographic information available for comparison. After adjusting for Doximity ranking, multivariate linear regression demonstrated that several elements were positive predictors of program diversity. Diversity and inclusion message (p < 0.0001), statement encouraging URM applicants (p < 0.0001), dedicated diversity chair/committee (p = 0.005), and diversity related articles/blog posts (p = 0.006) were independently associated with a greater proportion of URM residents in a given program. CONCLUSION: These data demonstrate that providing diversity related information on residency program websites may play a role in improving program diversity. The large percentage of programs that lack the presence of any diversity element (30.2%) demonstrates that there is significant room for improvement. This study presents a promising strategy through which programs can improve recruitment of diverse residents.


Asunto(s)
Internado y Residencia , Otolaringología , Humanos , Estudios Retrospectivos , Grupos Minoritarios , Otolaringología/educación
9.
Emerg Infect Dis ; 28(11): 2352-2355, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36191630

RESUMEN

We assessed cross-reactivity to BA.1, BA.2, and BA.5 of neutralizing antibodies elicited by ancestral, Delta, and Omicron BA.1 SARS-CoV-2 infection in mice. Primary infection elicited homologous antibodies with poor cross-reactivity to Omicron strains. This pattern remained after BA.1 challenge, although ancestral- and Delta-infected mice were protected from BA.1 infection.


Asunto(s)
COVID-19 , Animales , Ratones , Anticuerpos Neutralizantes , Anticuerpos Antivirales , COVID-19/inmunología , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus , Proteínas del Envoltorio Viral , Reacciones Cruzadas
10.
Front Mol Biosci ; 9: 900323, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35874611

RESUMEN

Background: Chromatin falls into one of two major subtypes: closed heterochromatin and euchromatin which is accessible, transcriptionally active, and occupied by transcription factors (TFs). The most widely used approach to interrogate differences in the chromatin state landscape is the Assay for Transposase-Accessible Chromatin using sequencing (ATAC-seq). While library generation is relatively inexpensive, sequencing depth requirements can make this assay cost-prohibitive for some laboratories. Findings: Here, we benchmark data from Beijing Genomics Institute's (BGI) DNBSEQ-G400 low-cost sequencer against data from a standard Illumina instrument (HiSeqX10). For comparisons, the same bulk ATAC-seq libraries generated from pluripotent stem cells (PSCs) and fibroblasts were sequenced on both platforms. Both instruments generate sequencing reads with comparable mapping rates and genomic context. However, DNBSEQ-G400 data contained a significantly higher number of small, sub-nucleosomal reads (>30% increase) and a reduced number of bi-nucleosomal reads (>75% decrease), which resulted in narrower peak bases and improved peak calling, enabling the identification of 4% more differentially accessible regions between PSCs and fibroblasts. The ability to identify master TFs that underpin the PSC state relative to fibroblasts (via HOMER, HINT-ATAC, TOBIAS), namely, foot-printing capacity, were highly similar between data generated on both platforms. Integrative analysis with transcriptional data equally enabled direct recovery of three published 3-factor combinations that have been shown to induce pluripotency. Conclusion: Other than a small increase in peak calling sensitivity for DNBSEQ-G400 data (BGI), both platforms enable comparable levels of open chromatin identification for ATAC-seq library sequencing, yielding similar analytical outcomes, albeit at low-data generation costs in the case of the BGI instrument.

11.
NPJ Regen Med ; 7(1): 31, 2022 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-35710627

RESUMEN

The impact of aging on intestinal stem cells (ISCs) has not been fully elucidated. In this study, we identified widespread epigenetic and transcriptional alterations in old ISCs. Using a reprogramming algorithm, we identified a set of key transcription factors (Egr1, Irf1, FosB) that drives molecular and functional differences between old and young states. Overall, by dissecting the molecular signature of aged ISCs, our study identified transcription factors that enhance the regenerative capacity of ISCs.

12.
JGH Open ; 6(3): 159-165, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35355674

RESUMEN

Background and Aim: Colonic wall thickening (CWT) is commonly associated with clinically significant pathologies, but predictive factors of such pathologies are not well known. This study aims to identify the predictors of clinically significant pathologies, such as colorectal carcinoma (CRC) and inflammatory bowel disease (IBD), in patients with CWT. Methods: Subjects with an abnormal abdominal computed tomography (CT) and a follow-up colonoscopy between 2010 and 2020 were retrospectively reviewed. Patients with CWT in the CT were included and examined in this study. A multivariable logistic regression analysis was performed to assess for factors independently associated with CRC or IBD in these subjects. Receiver operating characteristic (ROC) curve analysis was used to further examine significant parameters in multivariable logistic regression analysis. Results: Among 403 patients with CWT on CT scans who underwent a colonoscopy, 269 subjects who met the inclusion criteria were identified and studied. On multivariable logistic regression models, elevated platelet count, low hematocrit, and localized CWT were found to be independently associated with CRC, while elevated platelet count and younger age were independently associated with IBD. On ROC curve analysis for CRC, area under the curve (AUC) for hematocrit, platelets, and localized CWT was 0.76, 0.75, and 0.61, respectively. On ROC curve analysis for IBD, AUC for age and platelets was 0.90 and 0.69, respectively. Conclusion: Elevated platelet count, low hematocrit, and localized CWT can be potentially used as predictors of CRC in patients with CWT. Elevated platelet count and young age can be used to predict IBD in these patients.

13.
Otolaryngol Head Neck Surg ; 167(1): 73-78, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-34520297

RESUMEN

OBJECTIVE: To evaluate the relationship between Twitter mentions and academic citations in otolaryngology literature. STUDY DESIGN: Retrospective cross-sectional analysis. SETTING: Altmetric Twitter mention and Google Scholar citation rosters. METHODS: Original research articles from 10 leading otolaryngology journals were assessed 26 months after print publication. Article Twitter mentions were tracked through the Altmetric Bookmarklet, and article citation data were determined through the Google Scholar search engine. Twitter mentions and citation metrics of articles were compared through 2-tailed t test analysis (P < .05). RESULTS: Of all articles, 50.7% (152/300) had at least 1 Twitter mention. Of all article Twitter mentions, 25% (432/1758) happened within the first week of online publication dates, while 64% (1130/1758) occurred between online and print publication dates. Articles mentioned on Twitter had 1.6-fold more Google Scholar citations (8.6 ± 0.7, mean ± SD) than articles with no Twitter mentions (5.4 ± 0.4, P < .01). A total of 8% (24/300) of publications were tweeted by their authors. Articles self-tweeted by authors were associated with an 8.4-citation increase (14.8 ± 3.1) for Google Scholar when compared with articles not shared by their authors on Twitter (6.4 ± 0.4; 2.3-fold increase, P < .01). CONCLUSION: Most otolaryngology articles are disseminated over Twitter, with greatest Twitter activity occurring before print publication date of articles. Citations within 2 years of release are positively associated with the number of mentions on Twitter. Article Twitter mentions may augment the academic influence of otolaryngology publications.


Asunto(s)
Otolaringología , Medios de Comunicación Sociales , Bibliometría , Estudios Transversales , Humanos , Factor de Impacto de la Revista , Estudios Retrospectivos
14.
Mem. Inst. Oswaldo Cruz ; 117: e220177, 2022. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1422138

RESUMEN

BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in domestic animals have occurred from the beginning of the pandemic to the present time. Therefore, from the perspective of One Health, investigating this topic is of global scientific and public interest. OBJECTIVES The present study aimed to determine the presence of SARS-CoV-2 in domestic animals whose owners had coronavirus disease 2019 (COVID-19). METHODS Nasopharyngeal and faecal samples were collected in Uruguay. Using quantitative polymerase chain reaction (qPCR), we analysed the presence of the SARS-CoV-2 genome. Complete genomes were obtained using ARTIC enrichment and Illumina sequencing. Sera samples were used for virus neutralisation assays. FINDINGS SARS-CoV-2 was detected in an asymptomatic dog and a cat. Viral genomes were identical and belonged to the P.6 Uruguayan SARS-CoV-2 lineage. Only antiserum from the infected cat contained neutralising antibodies against the ancestral SARS-CoV-2 strain and showed cross-reactivity against the Delta but not against the B.A.1 Omicron variant. MAIN CONCLUSIONS Domestic animals and the human SARS-CoV-2 P.6 variant comparison evidence a close relationship and gene flow between them. Different SARS-CoV-2 lineages infect dogs and cats, and no specific variants are adapted to domestic animals. This first record of SARS-CoV-2 in domestic animals from Uruguay supports regular surveillance of animals close to human hosts.

15.
Gland Surg ; 10(9): 2861-2866, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34733733

RESUMEN

Literature is sparse regarding the management and long-term outcomes of breast cancer in patients with Ehlers-Danlos syndrome (EDS). Of the EDS subtypes, hypermobile Ehlers-Danlos Syndrome (hEDS) is associated with cardiovascular dysautonomia which manifests as spontaneous episodes of tachycardia and hypotension. Given this clinical autonomic system impact, hEDS is known to have significant intraoperative risk and postoperative complications. However, outcomes of hEDS patients have not been specifically studied in the field of breast cancer surgery. Here we present a case of a 62-year-old female with hEDS and node-positive invasive ductal breast carcinoma. Given the patient's medical history of hEDS, close attention was given to the patient's intraoperative vital signs and predisposition for poor wound healing. The patient underwent left Goldilocks mastectomy with left axillary lymph node dissection. Due to cardiac comorbidities, she was not a candidate for neoadjuvant or adjuvant chemotherapy. The patient tolerated adjuvant radiation and endocrine therapy without side effects, and has remained free of local, regional, and distant cancer recurrence following treatment. This case report highlights a literature gap in the surgical and radiation therapy management of breast cancer in patients with hEDS. Although breast surgery and radiation therapy in patients with invasive breast cancer and hEDS can be a safe management option, we discuss how perioperative complications must be cautiously navigated and how treatment must be tailored to individuals' specific hEDS variant to ensure optimal patient safety and positive long-term outcomes.

16.
Am J Surg ; 222(4): 694-699, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34024630

RESUMEN

BACKGROUND: Wastage of surgical supplies results from inappropriate anticipation of surgical needs in the operating room and contributes to avoidable healthcare costs. METHODS: A retrospective, cross-sectional analysis of 28,768 elective cases at the University of Chicago Medical Center from 2016 through 2018 was conducted. Attending surgeon-scrub nurse and surgeon-circulating nurse familiarity scores were calculated. Odds of surgical waste generation based on surgeon-scrub nurse and surgeon-circulating nurse familiarity were estimated through multivariate logistic regression modeling. RESULTS: Teams in the third and fourth quartiles of surgeon-scrub familiarity were significantly associated with reduced odds of waste (odds ratios 0.80 [p = 0.003] and 0.83 [p = 0.030], respectively). There was no significant reduction of odds of waste generation as surgeon-circulator familiarity increased. CONCLUSIONS: Greater surgeon-scrub familiarity was associated with lower risk of waste generation. Cost savings may be realized through supporting staffing schedules that promote consistency of surgeon-scrub teams.


Asunto(s)
Residuos Sanitarios/economía , Quirófanos/economía , Grupo de Atención al Paciente/organización & administración , Chicago , Estudios Transversales , Humanos , Estudios Retrospectivos
17.
Nat Commun ; 12(1): 2665, 2021 05 11.
Artículo en Inglés | MEDLINE | ID: mdl-33976125

RESUMEN

With age, hematopoietic stem cells (HSC) undergo changes in function, including reduced regenerative potential and loss of quiescence, which is accompanied by a significant expansion of the stem cell pool that can lead to haematological disorders. Elevated metabolic activity has been implicated in driving the HSC ageing phenotype. Here we show that nicotinamide riboside (NR), a form of vitamin B3, restores youthful metabolic capacity by modifying mitochondrial function in multiple ways including reduced expression of nuclear encoded metabolic pathway genes, damping of mitochondrial stress and a decrease in mitochondrial mass and network-size. Metabolic restoration is dependent on continuous NR supplementation and accompanied by a shift of the aged transcriptome towards the young HSC state, more youthful bone marrow cellular composition and an improved regenerative capacity in a transplant setting. Consequently, NR administration could support healthy ageing by re-establishing a more youthful hematopoietic system.


Asunto(s)
Envejecimiento , Células Madre Hematopoyéticas/efectos de los fármacos , NAD/metabolismo , Niacinamida/análogos & derivados , Compuestos de Piridinio/farmacología , Factores de Edad , Animales , Células de la Médula Ósea/citología , Células de la Médula Ósea/efectos de los fármacos , Células de la Médula Ósea/metabolismo , Células Cultivadas , Perfilación de la Expresión Génica/métodos , Regulación de la Expresión Génica/efectos de los fármacos , Células Madre Hematopoyéticas/citología , Células Madre Hematopoyéticas/metabolismo , Ratones Endogámicos C57BL , Ratones Transgénicos , Mitocondrias/efectos de los fármacos , Mitocondrias/metabolismo , Modelos Biológicos , Niacinamida/farmacología , Fosforilación Oxidativa/efectos de los fármacos
18.
Otol Neurotol Open ; 1(2): e006, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38550355

RESUMEN

Objective: To assess outcomes in autoimmune inner ear disease (AIED) after cochlear implantation (CI) through systematic review and meta-analysis. Databases Reviewed: PubMed, MedLine, Embase, and CINAHL. Methods: Databases were queried for inclusion of AIED patients who underwent CI with outcomes recorded ≥3 months postoperatively. We examined demographics, pure-tone average (PTA), speech perception, preoperative imaging, intraoperative management, and postoperative complications. Results: Twenty-six articles encompassing 124 patients met inclusion criteria. Mean implantation age was 26.2 years (range 4-65 years) with average length of follow-up at 28.2 months (range 3-120 months). Meta-analysis demonstrated significant improvement in speech perception following CI. There was a statistically significant improvement in speech recognition score (SRS) (standard mean difference [SMD] = 6.5, 95% confidence interval [CI], 4.8-8.0, P < 0.0001) as well as word recognition score (WRS) (SMD = 5.5, 95% CI, 4.2-6.8, P < 0.0001) after CI. Anomalous preoperative radiologic manifestations were reported by 57.7% (15/26) studies. Disease activity-related intraoperative adjustment was noted in 57.7% (15/26) studies; common consequences were cochlear drill-out (53.3%), difficult round window insertion (26.7%), and scala vestibuli insertion (26.7%). Frequent postoperative complications noted in 26.9% (7/26) studies included systemic AIED flares (71.4%) and wound healing delay (42.9%). Conclusion: Findings of this systematic review of AIED cochlear implant literature demonstrate a lack of consistent reporting standards for PTA and speech perception as well as a lack of long-term follow-up. Despite these findings, meta-analysis suggests that CI is a viable treatment for improving speech perception in AIED patients.

19.
PLoS One ; 14(5): e0217553, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31141574

RESUMEN

As the global population ages, and rates of dementia rise, understanding lifestyle factors that play a role in the development and acceleration of cognitive decline is vital to creating therapies and recommendations to improve quality of later life. Obesity has been shown to increase risk for dementia. However, the specific mechanisms for obesity-induced cognitive decline remain unclear. One potential contributor to diet-induced cognitive changes is neuroinflammation. Furthermore, a source of diet-induced inflammation to potentially increase neuroinflammation is via gut dysbiosis. We hypothesized that a high fat diet would cause gut microbe dysbiosis, and subsequently: neuroinflammation and cognitive decline. Using 7-month old male Sprague Dawley rats, this study examined whether 8 weeks on a high fat diet could impact performance on the water radial arm maze, gut microbe diversity and abundance, and microgliosis. We found that a high fat diet altered gut microbe populations compared to a low fat, control diet. However, we did not observe any significant differences between dietary groups on maze performance (a measure of spatial working memory) or microgliosis. Our data reveal a significant change to the gut microbiome without subsequent effects to neuroinflammation (as measured by microglia characterization and counts in the cortex, hippocampus, and hypothalamus) or cognitive performance under the parameters of our study. However, future studies that explore duration of the diet, composition of the diet, age of animal model, and strain of animal model, must be explored.


Asunto(s)
Envejecimiento/efectos de los fármacos , Cognición/efectos de los fármacos , Grasas de la Dieta/efectos adversos , Microbioma Gastrointestinal/efectos de los fármacos , Memoria a Corto Plazo/efectos de los fármacos , Memoria Espacial/efectos de los fármacos , Animales , Grasas de la Dieta/farmacología , Masculino , Aprendizaje por Laberinto/efectos de los fármacos , Ratas , Ratas Sprague-Dawley
20.
Genetics ; 209(4): 1085-1097, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29921620

RESUMEN

Many heterogametic organisms adjust sex chromosome expression to accommodate differences in gene dosage. This requires selective recruitment of regulatory factors to the modulated chromosome. How these factors are localized to a chromosome with requisite accuracy is poorly understood. Drosophila melanogaster males increase expression from their single X chromosome. Identification of this chromosome involves cooperation between different classes of X-identity elements. The chromatin entry sites (CES) recruit a chromatin-modifying complex that spreads into nearby genes and increases expression. In addition, a family of satellite repeats that is enriched on the X chromosome, the 1.688X repeats, promotes recruitment of the complex to nearby genes. The 1.688X repeats and CES are dissimilar, and appear to operate through different mechanisms. Interestingly, the siRNA pathway and siRNA from a 1.688X repeat also promote X recognition. We postulate that siRNA-dependent modification of 1.688X chromatin contributes to recognition of nearby genes. In accord with this, we found enrichment of the siRNA effector Argonaute2 (Ago2) at some 1.688X repeats. Mutations in several proteins that physically interact with Ago2, including the histone methyltransferase Su(var)3-9, enhance the lethality of males with defective X recognition. Su(var)3-9 deposits H3K9me2 on some 1.688X repeats, and this mark is disrupted upon ectopic expression of 1.688X siRNA. Furthermore, integration of 1.688X DNA on an autosome induces local H3K9me2 deposition, but enhances expression of nearby genes in a siRNA-dependent manner. Our findings are consistent with a model in which siRNA-directed modification of 1.688X chromatin contributes to recognition of the male X chromosome for dosage compensation.


Asunto(s)
Proteínas Argonautas/metabolismo , Cromatina/metabolismo , Compensación de Dosificación (Genética) , Proteínas de Drosophila/metabolismo , Drosophila melanogaster/genética , ARN Interferente Pequeño/genética , Animales , Proteínas Argonautas/genética , Proteínas de Drosophila/genética , Redes Reguladoras de Genes , Genes Letales , Histonas/metabolismo , Elementos de Nucleótido Esparcido Largo , Masculino , Mutación , Proteínas Represoras/genética , Cromosomas Sexuales/genética
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