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1.
Addiction ; 118(8): 1507-1516, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-36898848

RESUMEN

DESIGN: This was a prospective observational study. BACKGROUND AND AIMS: The characteristics of cannabis-involved motor vehicle collisions are poorly understood. This study of injured drivers identifies demographic and collision characteristics associated with high tetrahydrocannabinol (THC) concentrations. SETTING: The study was conducted in 15 Canadian trauma centres between January 2018 and December 2021. CASES: The cases (n = 6956) comprised injured drivers who required blood testing as part of routine trauma care. MEASUREMENTS: We quantified whole blood THC and blood alcohol concentration (BAC) and recorded driver sex, age and postal code, time of crash, crash type and injury severity. We defined three driver groups: high THC (THC ≥ 5 ng/ml and BAC = 0), high alcohol (BAC ≥ 0.08% and THC = 0) and THC/BAC-negative (THC = 0 = BAC). We used logistic regression techniques to identify factors associated with group membership. FINDINGS: Most injured drivers (70.2%) were THC/BAC-negative; 1274 (18.3%) had THC > 0, including 186 (2.7%) in the high THC group; 1161 (16.7%) had BAC > 0, including 606 (8.7%) in the high BAC group. Males and drivers aged less than 45 years had higher adjusted odds of being in the high THC group (versus the THC/BAC-negative group). Importantly, 4.6% of drivers aged less than 19 years had THC ≥ 5 ng/ml, and drivers aged less than 19 years had higher unadjusted odds of being in the high THC group than drivers aged 45-54 years. Males, drivers aged 19-44 years, rural drivers, seriously injured drivers and drivers injured in single-vehicle, night-time or weekend collisions had higher adjusted odds ratios (aORs) for being in the high alcohol group (versus THC/BAC-negative). Drivers aged less than 35 or more than 65 years and drivers involved in multi-vehicle, daytime or weekday collisions had higher adjusted odds for being in the high THC group (versus the high BAC group). CONCLUSIONS: In Canada, risk factors for cannabis-related motor vehicle collisions appear to differ from those for alcohol-related motor vehicle collisions. The collision factors associated with alcohol (single-vehicle, night-time, weekend, rural, serious injury) are not associated with cannabis-related collisions. Demographic factors (young drivers, male drivers) are associated with both alcohol and cannabis-related collisions, but are more strongly associated with cannabis-related collisions.


Asunto(s)
Accidentes de Tránsito , Consumo de Bebidas Alcohólicas , Dronabinol , Fumar Marihuana , Heridas y Lesiones , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Accidentes de Tránsito/estadística & datos numéricos , Factores de Edad , Consumo de Bebidas Alcohólicas/sangre , Dronabinol/sangre , Fumar Marihuana/sangre , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Heridas y Lesiones/epidemiología
2.
Trials ; 24(1): 84, 2023 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-36747305

RESUMEN

BACKGROUND: Advanced practice physiotherapy (APP) models of care where physiotherapists are primary contact emergency department (ED) providers are promising models of care to improve access, alleviate physicians' burden, and offer efficient centered patient care for patients with minor musculoskeletal disorders (MSKD). OBJECTIVES: To compare the effectiveness of an advanced practice physiotherapist (APPT)-led model of care with usual ED physician care for persons presenting with a minor MSKD, in terms of patient-related outcomes, health care resources utilization, and health care costs. METHODS: This trial is a multicenter stepped-wedge cluster randomized controlled trial (RCT) with a cost analysis. Six Canadian EDs (clusters) will be randomized to a treatment sequence where patients will either be managed by an ED APPT or receive usual ED physician care. Seven hundred forty-four adults with a minor MSKD will be recruited. The main outcome measure will be the Brief Pain Inventory Questionnaire. Secondary measures will include validated self-reported disability questionnaires, the EQ-5D-5L, and other health care utilization outcomes such as prescription of imaging tests and medication. Adverse events and re-visits to the ED for the same complaint will also be monitored. Health care costs will be measured from the perspective of the public health care system using time-driven activity-based costing. Outcomes will be collected at inclusion, at ED discharge, and at 4, 12, and 26 weeks following the initial ED visit. Per-protocol and intention-to-treat analyses will be performed using linear mixed models with a random effect for cluster and fixed effect for time. DISCUSSION: MSKD have a significant impact on health care systems. By providing innovative efficient pathways to access care, APP models of care could help relieve pressure in EDs while providing efficient care for adults with MSKD. TRIAL REGISTRATION: ClinicalTrials.gov NCT05545917 . Registered on September 19, 2022.


Asunto(s)
Enfermedades Musculoesqueléticas , Adulto , Humanos , Canadá , Enfermedades Musculoesqueléticas/diagnóstico , Enfermedades Musculoesqueléticas/terapia , Costos de la Atención en Salud , Modalidades de Fisioterapia , Servicio de Urgencia en Hospital
3.
Rev Med Liege ; 76(12): 868-874, 2021 Dec.
Artículo en Francés | MEDLINE | ID: mdl-34881830

RESUMEN

OBJECTIVE: To determine whether grip strength and fear of falling are associated with functional decline at 3 or 6 months after a minor trauma assessed in the emergency department. METHOD: Prospective multicenter cohort study of patient's aged 65 years and older, independent for activities of daily living, consulting the emergency department for minor trauma. Functional status, fear of falling, and grip strength measurements were collected. Functional decline was measured at 3 and 6 months. STATISTICS: Two groups were compared : one with functional decline, the other without. A ROC curve explored the predictive power of grip strength and initial fear of falling on the occurrence of functional decline. RESULTS: Participants were 74.7 years old, 52 % men. Initial peak grip strengths were identical (p superior to 0.05). Grip strength and fear of falling were not predictive of functional decline (p = 0.55 and p = 0.53). However, fear of falling was associated with functional decline (OR: 1.141 95 % CI [1.032-1.261]; p = 0.009). CONCLUSION: In the autonomous elder with minor trauma in the emergency department, grip strength is not associated with subsequent functional decline. But fear of falling is associated with decline at 6 months.


Objectif : Déterminer si la force de préhension et la peur de tomber sont associées au déclin fonctionnel à 3 ou 6 mois d'un traumatisme mineur évalué aux urgences. Méthode : Étude prospective de cohorte multicentrique des patients de 65 ans et plus, autonomes pour les activités de la vie quotidienne, consultant aux urgences pour traumatismes mineurs. Le statut fonctionnel, la peur de tomber, et la mesure de la force de préhension ont été recueillis. Le déclin fonctionnel a été mesuré à 3 et 6 mois. Statistiques : Deux groupes sont comparés : un avec déclin fonctionnel, l'autre sans. Une courbe ROC a exploré la puissance prédictive de la force de préhension et de la peur de tomber initiale sur l'apparition du déclin fonctionnel. Résultats : Les participants avaient 74 ± 7 ans, 52 % d'hommes. Les forces de préhension maximales initiales étaient identiques (p sup�rieur a 0,05). La force de préhension et la peur de tomber ne sont pas prédictives du déclin fonctionnel (p = 0,55 et p = 0,53). Cependant, la peur de tomber est associée au déclin fonctionnel (OR: 1,141 IC95 % [1,032-1,261]; p = 0,009). Conclusion : Chez l'aîné autonome avec un traumatisme mineur aux urgences, la force de préhension n'est pas associée au déclin fonctionnel ultérieur. Mais la peur de tomber est associée à un déclin à 6 mois.


Asunto(s)
Accidentes por Caídas , Actividades Cotidianas , Anciano , Canadá , Estudios de Cohortes , Servicio de Urgencia en Hospital , Miedo , Femenino , Fuerza de la Mano , Humanos , Masculino , Estudios Multicéntricos como Asunto , Estudios Prospectivos
4.
Brain Inj ; 35(9): 1028-1034, 2021 07 29.
Artículo en Inglés | MEDLINE | ID: mdl-34224275

RESUMEN

Objectives: To compare post-concussion symptoms (PCS) and return to normal activities between mild Traumatic Brain Injury (mTBI) patients with or without concomitant injuries at 7-and 90 days post-mTBI.Methods: Design: Sub-analysis of a multicentre prospective cohort study. PARTICIPANTS AND SETTING: patients with mTBI from 7 Canadian Emergency Departments. PROCEDURE: Research assistants conducted telephone follow-ups using the Rivermead Postconcussion Symptoms Questionnaire (RPQ) at 7-, 30- and 90 days post-mTBI. MAIN OUTCOME: Presence of PCS (RPQ: ≥3 symptoms) at 90 days. SECONDARY OUTCOMES: RPQ score ≥21, prevalence of individual RPQ symptoms and patients' return to normal activities, at 7- and 90-days. Adjusted risk ratios (RR) were calculated.Results: 1725 mTBI patients were included and 1055 (61.1%) had concomitant injuries. Patients with concomitant injuries were at higher risk of having ≥3 symptoms on the RPQ (RR:1.26 [95% CI 1.01-1.58]) at 90 days. They were also at higher risk of experiencing specific symptoms (dizziness, fatigue, headaches and taking longer to think) and of non-return to their normal activities (RR:2.11 [95% CI 1.30-3.45]).Conclusion: Patients with concomitant injuries have slightly more PCS and seemed to be at higher risk of non-return to their normal activities 90 days, compared to patients without concomitant injuries.


Asunto(s)
Conmoción Encefálica , Síndrome Posconmocional , Conmoción Encefálica/complicaciones , Conmoción Encefálica/epidemiología , Canadá/epidemiología , Servicio de Urgencia en Hospital , Humanos , Síndrome Posconmocional/epidemiología , Síndrome Posconmocional/etiología , Estudios Prospectivos
5.
J Nutr Health Aging ; 22(1): 16-25, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29300417

RESUMEN

CONTEXT: Several studies have demonstrated that physical activity can help limit decline in functional capacities of older adults. Nevertheless, many adults aged 65 and over are inactive. OBJECTIVE: To explore the feasibility, the acceptability and the effects of a home-based exercise program (HEP) using a motion capture gerontechnology in independent community-living older adults at risk of function decline. DESIGN: Interventionnal clinical trial. PARTICIPANTS: Sixteen previously independent individuals aged 65 and older recruited at the Emergency Department after being treated for a minor injury and discharged home were assigned to a home-based exercise program group (HEP=8) or to a control group (CONTR=8). Twelve participants completed the study, 6 in each group Setting: Canadian Community-dwelling in Montreal area. INTERVENTION: The HEP group engaged in a twelve-week physical activity intervention using a gerontechnology while the CONTR group continued with discharge plan from ED. MEASUREMENTS: Participants were evaluated for functional status using validated questionnaires and objective physical measures at baseline, three and six months later. Feasibility and acceptability of the HEP was assessed using data reports from the gerontechnology and from self-reported assessments. RESULTS: There was no differences between groups at baseline except for the fallrelated self-efficacy: HEP=8.33/28±1.51 vs CONTR=7/28±0 p=0.022. The HEP was found to be feasible and acceptable (adherence rate at 86% and average quality of movements at 87.5%). Significant improvement in walking speed on 4m was observed three months after baseline for HEP vs CONTR group (+0.25 vs +0.05 m/sec, p=0.025). Effects remained at follow-up. Only CONTR group resulted in a significant increase in SF-36 global score. CONCLUSION: This twelve-week HEP intervention using the Jintronix® gerontechnology is feasible, acceptable and safe for community-living older adults who sustained a minor injury. This intervention could increase walking speed, the most important predictor of adverse events in the elderly population, and that the improvement could be maintained over time.


Asunto(s)
Terapia por Ejercicio/métodos , Servicios de Atención de Salud a Domicilio , Vida Independiente , Accidentes por Caídas/prevención & control , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Canadá , Servicio de Urgencia en Hospital , Ejercicio Físico , Estudios de Factibilidad , Femenino , Humanos , Masculino , Modalidades de Fisioterapia , Proyectos Piloto , Encuestas y Cuestionarios , Caminata , Heridas y Lesiones/rehabilitación
6.
Clin Microbiol Infect ; 23(1): 47.e1-47.e10, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27615723

RESUMEN

OBJECTIVES: To identify important pathogen recognition receptor (PRR) pathways regulating innate immune responses and outcome in Staphylococcus aureus sepsis. METHODS: We analysed whether candidate PRR pathway genetic variants were associated with killed S. aureus-induced cytokine responses ex vivo and performed follow-up in vitro studies. We tested the association of our top-ranked variant with cytokine responses and clinical outcomes in a prospective multicentre cohort of patients with staphylococcal sepsis. RESULTS: An intronic TLR4 polymorphism and expression quantitative trait locus, rs1927907, was highly associated with cytokine release induced by stimulation of blood from healthy Thai subjects with S. aureus ex vivo. S. aureus did not induce TLR4-dependent NF-κB activation in transfected HEK293 cells. In monocytes, tumor necrosis factor (TNF)-α release induced by S. aureus was not blunted by a TLR4/MD-2 neutralizing antibody, but in a monocyte cell line, TNF-α was reduced by knockdown of TLR4. In Thai patients with staphylococcal sepsis, rs1927907 was associated with higher interleukin (IL)-6 and IL-8 levels as well as with respiratory failure. S. aureus-induced responses in blood were most highly correlated with responses to Gram-negative stimulants whole blood. CONCLUSIONS: A genetic variant in TLR4 is associated with cytokine responses to S. aureus ex vivo and plasma cytokine levels and respiratory failure in staphylococcal sepsis. While S. aureus does not express lipopolysaccharide or activate TLR4 directly, the innate immune response to S. aureus does appear to be modulated by TLR4 and shares significant commonality with that induced by Gram-negative pathogens and lipopolysaccharide.


Asunto(s)
Inflamación/genética , Sepsis/microbiología , Infecciones Estafilocócicas/genética , Infecciones Estafilocócicas/microbiología , Receptor Toll-Like 4/metabolismo , Adulto , Citocinas/genética , Citocinas/metabolismo , Femenino , Regulación de la Expresión Génica , Técnicas de Silenciamiento del Gen , Predisposición Genética a la Enfermedad , Variación Genética , Humanos , Inflamación/patología , Masculino , Persona de Mediana Edad , Tailandia , Receptor Toll-Like 4/genética
8.
Neuroscience ; 286: 87-96, 2015 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-25463516

RESUMEN

The calsyntenins are atypical members of the cadherin superfamily that have been implicated in learning in Caenorhabditis elegans and memory formation in humans. As members of the cadherin superfamily, they could mediate cell-cell adhesion, although their adhesive properties have not been investigated. As an initial step in characterizing the calsyntenins, we have cloned clstn1, clstn2 and clstn3 from the zebrafish and determined their expression in the developing zebrafish nervous system. The three genes each have broad, yet distinct, expression patterns in the zebrafish brain. Each of the ectodomains mediates homophilic interactions through two, amino-terminal cadherin repeats. In bead sorting assays, the calsyntenin ectodomains do not exhibit homophilic preferences. These data support the idea that calsyntenins could either act as adhesion molecules or as diffusible, homophilic or heterophilic ligands in the vertebrate nervous system.


Asunto(s)
Encéfalo/metabolismo , Cadherinas/genética , Cadherinas/metabolismo , Adhesión Celular/genética , Proteínas de Pez Cebra/genética , Proteínas de Pez Cebra/metabolismo , Animales , Encéfalo/embriología , Embrión no Mamífero/metabolismo , Expresión Génica , Pez Cebra
9.
Genes Immun ; 15(2): 63-71, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24285178

RESUMEN

Melioidosis is a severe infection caused by the flagellated bacterium Burkholderia pseudomallei. The nonsense polymorphism TLR51174C>T is associated with improved outcome in Thais with melioidosis. We hypothesized that other TLR5 variants may modulate the host response and determine outcome in melioidosis. We genotyped 12 TLR5 variants selected de novo from the HapMap database and examined the association of each with cytokines induced by flagellin stimulation of whole blood from healthy Thai subjects. We found a blunted cytokine response for three related markers that were in linkage disequilibrium (LD) with a non-synonymous variant, TLR51846T>C. Carriers of TLR51846T>C had broadly impaired cytokine responses induced by flagellin. TLR51846T>C was associated with protection against death in melioidosis patients (odds ratio: 0.62, 95% confidence interval: 0.42-0.93, P=0.021). We observed no impairment in TLR51846C-dependent nuclear factor κB activation, however, suggesting an alternative mechanism for the effect. We found that TLR51846T>C was in strong LD with TLR51174C>T. Many of the blunted cytokine responses observed and the association of TLR51846T>C with survival in melioidosis patients may be attributable to TLR51174C>T, but we could not exclude an independent effect of TLR51846T>C. These data identify novel associations for TLR51846T>C, enhance our understanding of TLR5 genetic architecture in Thais and highlight the role of TLR5 in melioidosis.


Asunto(s)
Flagelina/inmunología , Melioidosis/mortalidad , Receptor Toll-Like 5/genética , Receptor Toll-Like 5/inmunología , Adulto , Burkholderia pseudomallei/inmunología , Línea Celular , Citocinas/sangre , Femenino , Genotipo , Células HEK293 , Humanos , Inmunidad Innata , Desequilibrio de Ligamiento , Masculino , Melioidosis/sangre , Melioidosis/inmunología , FN-kappa B/sangre , Polimorfismo de Nucleótido Simple , Salmonella typhimurium/inmunología , Transducción de Señal/genética , Transducción de Señal/inmunología , Receptor Toll-Like 5/sangre , Resultado del Tratamiento , Adulto Joven
10.
Neuroscience ; 219: 280-9, 2012 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-22659564

RESUMEN

The clustered protocadherin genes encode a diverse collection of neuronal cell surface receptors. These genes have been proposed to play roles in axon targeting, synaptic development and neuronal survival, although their specific cellular roles remain poorly defined. In zebrafish there are four clustered protocadherin genes, two pcdhα clusters and two pcdhγ clusters, that give rise to over 100 distinct proteins, each with a distinct ectodomain (EC). The zebrafish is an excellent model in which to address the function of protocadherins during neural development, as the embryos are transparent, develop rapidly, and are amenable to experimental manipulation. As a first step to investigating the clustered protocadherins during zebrafish development, we have generated antibodies against the common cytodomains of zebrafish Pcdhγ. We compare the distribution of Pcdhγ with Pcdhα and find a similar pan-neuronal pattern, with strong labeling of neurons within all major regions of the central nervous system. Pcdhα and Pcdhγ are particularly enriched in the developing visual system, with strong labeling found in the synaptic layers of the retina, as well as the optic tectum. Consistent with studies in mouse, we find that Pcdhα and Pcdhγ are present in a complex, as they can be co-immunoprecipitated from zebrafish larval extracts. This interaction is direct and occurs through the ECs of these proteins. Using standard bead aggregation assays, we find no evidence for intrinsic adhesive ability by either Pcdhγ or Pcdhα, suggesting that they do not function as cell adhesion molecules.


Asunto(s)
Encéfalo/metabolismo , Cadherinas/metabolismo , Retina/metabolismo , Proteínas de Pez Cebra/metabolismo , Pez Cebra/metabolismo , Animales , Western Blotting , Embrión no Mamífero , Células HEK293 , Humanos , Inmunohistoquímica , Inmunoprecipitación , Neurogénesis/fisiología , Transfección , Pez Cebra/crecimiento & desarrollo
11.
Genes Immun ; 13(1): 38-46, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21776015

RESUMEN

Melioidosis is a tropical infection caused by the Gram-negative soil saprophyte Burkholderia pseudomallei. Despite broad exposure of northeastern Thais, disease develops in only a small proportion of individuals. Although diabetes is a risk factor, the mechanisms of host susceptibility to melioidosis are still poorly understood. We postulated that Toll-like receptors (TLRs) regulate host susceptibility to disease, and that genetic variation in TLRs is associated with melioidosis. We analyzed the frequency of eight previously described TLR pathway polymorphisms in 490 cases compared with 950 non-hospitalized controls or 458 hospitalized controls. Based on these results, we then analyzed the frequency of additional TLR4 or TLR6-1-10 region polymorphisms in cases and controls. We found that the TLR4(1196C>T) variant was associated with protection from melioidosis when compared with non-hospitalized controls. The TLR1(742A>G) and TLR1(-7202A>G) variants were associated with melioidosis when compared with hospitalized controls. In further analyses, we found that two additional TLR4 region polymorphisms were associated with disease. In diabetics, three other TLR6-1-10 region polymorphisms were associated with disease when compared with hospitalized controls. We conclude that TLR genetic variants may modulate host susceptibility to melioidosis. Confirmation of these findings and further investigation of the mechanisms are required.


Asunto(s)
Predisposición Genética a la Enfermedad , Melioidosis/genética , Receptor Toll-Like 4/genética , Adulto , Anciano , Alelos , Estudios de Casos y Controles , Femenino , Estudios de Asociación Genética , Genotipo , Humanos , Desequilibrio de Ligamiento , Masculino , Melioidosis/metabolismo , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Transducción de Señal , Receptor Toll-Like 1/genética , Receptor Toll-Like 4/metabolismo , Receptor Toll-Like 6/genética
12.
Neuroscience ; 199: 523-34, 2011 Dec 29.
Artículo en Inglés | MEDLINE | ID: mdl-22001682

RESUMEN

Protocadherins comprise the largest family within the cadherin superfamily of cell surface receptors. Here, we characterize the δ1-protocadherin subfamily during the development of the zebrafish nervous system. In zebrafish, there are five δ1-protocadherins: pcdh1a, pcdh1b, pcdh7a, pcdh7b, andpcdh9. Each protocadherin gene is highly homologous to its human ortholog. While the expression pattern in the developing CNS is similar for each δ1-protocadherin, with labeling observed in all major subdivisions, the detailed patterns are distinct. In addition, we provide evidence for alternative splicing of the pcdh7b and pcdh9 genes, resulting in variation in their respective cytoplasmic domains. As protocadherins are widely regarded to act as cell adhesion molecules, we used in vitro assays of δ1-pcdh ectodomains to directly test their adhesive properties. We found no evidence for calcium-dependent, homophilic adhesion, contrasting sharply with the behavior of classical cadherins.


Asunto(s)
Moléculas de Adhesión Celular/genética , Adhesión Celular/genética , Perfilación de la Expresión Génica , Proteínas de Pez Cebra/genética , Empalme Alternativo , Secuencia de Aminoácidos , Animales , Moléculas de Adhesión Celular/biosíntesis , Expresión Génica , Humanos , Hibridación in Situ , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Pez Cebra , Proteínas de Pez Cebra/biosíntesis
13.
Pediatr Pulmonol ; 44(11): 1107-17, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19824046

RESUMEN

BACKGROUND: In order to establish a valid surrogate outcome measure, it must be shown that the outcome measure (chest HRCT scores in cystic fibrosis [CF] patients) demonstrates strong statistical association with established endpoints of disease, such as Pseudomonas aeruginosa (Pa) airway acquisition, acute exacerbations, or mortality. METHODS: We estimated and tested the association between Pa infection status (Pa+ vs. Pa-) and baseline chest HRCT scores in 25 children with mild-to-moderate CF lung disease. For comparison, we estimated the association between Pa status and pulmonary function tests (PFTs), chest X-rays (CXR) scores, and BMI. Pa acquisition was determined from respiratory culture results and systematic review of clinic notes. RESULTS: All subjects had respiratory cultures performed prior to or at baseline with a median of 19 months of retrospective culture observation (SD = 15.7 months, range: 0-52.5 months). The difference between age-adjusted mean total HRCT score for Pa+ versus Pa- was highly significant (P < 0.00001) with a near-perfect separation between scores in Pa+ versus Pa- patients. Similar results were found for several HRCT sub-scores. Among PFTs, only residual volume-to-total lung capacity (RV/TLC) had a significant difference between group means (P = 0.03), but the overlap between groups in RV/TLC measurements was large. CONCLUSIONS: CF HRCT scores correlate highly with Pa acquisition, a clinically meaningful measure of progressing CF lung disease. HRCT scores are highly sensitive at predicting Pa acquisition status, while most PFT measures, chest radiograph (CXR) scores, and body mass index are not. These results provide further evidence that HRCT is appropriate for use in patient care and as an outcome measure in clinical trials.


Asunto(s)
Fibrosis Quística/diagnóstico por imagen , Fibrosis Quística/microbiología , Infecciones por Pseudomonas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adolescente , Índice de Masa Corporal , Niño , Estudios Transversales , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Curva ROC
14.
Acad Radiol ; 16(9): 1134-41, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19467609

RESUMEN

RATIONALE AND OBJECTIVES: The purpose of this study was to demonstrate the use of a phantom to standardize low-dose chest computed tomographic (CT) protocols in children with cystic fibrosis. MATERIALS AND METHODS: Spiral chest CT scans of a Plexiglas phantom simulating airway sizes (internal diameter, 1.1-16.4 mm; wall thickness, 0.4-4.6 mm) in children with cystic fibrosis were obtained using two multidetector CT (MDCT) scanners (GE VCT and Siemens Sensation 64). Quantitative airway measurements from both scanners were compared with micro-CT airway measurements over a range of doses (0.2-1.8 mSv) to evaluate bias and variance of measurements. The effective doses for CT protocols were estimated using the ImPACT CT Patient Dosimetry Calculator. RESULTS: Both MDCT scanners were able to accurately measure airway sizes down to 3 mm internal diameter and 1.3 mm airway wall thickness, with errors of <3.5%. ImPACT estimates of effective dose were different for the MDCT scanners for a given peak tube voltage and product of tube current and exposure time. Accuracy and precision were not found to be associated with dose parameters for either machine. Bias in all measurements was strongly associated with airway diameter (P values < .00001), but the magnitude of bias was small (mean, 0.07 mm; maximum, 0.21 mm). Differences between machines in error components were on the order of a few micrometers. CONCLUSIONS: The use of a standard airway phantom confirms that different MDCT scanners have similar results within dose ranges planned for potential future clinical trials. Standardized protocols can be developed that adjust for differences in radiation exposure for different MDCT scanners.


Asunto(s)
Pulmón/diagnóstico por imagen , Estudios Multicéntricos como Asunto/normas , Fantasmas de Imagen/normas , Radiografía Torácica/instrumentación , Radiografía Torácica/normas , Tomografía Computarizada por Rayos X/instrumentación , Tomografía Computarizada por Rayos X/normas , Diseño de Equipo , Humanos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Estados Unidos
15.
J Gerontol A Biol Sci Med Sci ; 63(8): 813-22, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18772469

RESUMEN

We describe the effects of mitochondrially targeted catalase (MCAT) expression on end-of-life pathology in mice using detailed semiquantitative histopathological evaluation. We previously reported that the median and maximum life spans of MCAT mice were extended relative to those of wild-type littermates. We now report that MCAT expression is associated with reduced malignant nonhematopoietic tumor burden, reduced cardiac lesions, and a trend toward reduced systemic inflammation, with no effect on hematopoietic neoplasia or glomerulonephropathy. Combined disease burden and comorbidity are also reduced, and MCAT expression is not associated with any detrimental clinical effects. The results suggest that oxidative damage is involved in aging of C57BL/6J mice via modulation of a subset of age-associated lesions. Antioxidant interventions targeting mitochondria may therefore be a viable strategy for prevention or postponement of some age-associated diseases. The variability of the MCAT effect across tissues, however, illustrates the importance of developing semiquantitative histopathology for assessment of comorbidity in life-span studies.


Asunto(s)
Envejecimiento/patología , Catalasa/metabolismo , Mitocondrias/metabolismo , Envejecimiento/fisiología , Animales , Comorbilidad , Modelos Animales de Enfermedad , Longevidad , Ratones , Ratones Transgénicos , Estrés Oxidativo/fisiología , Especies Reactivas de Oxígeno
16.
Vision Res ; 46(18): 2914-25, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16647740

RESUMEN

Ring-billed gulls (Larus delawarensis) and gray gulls (Larus modestus) are two species active both by day and night. We have investigated the retinal adaptations that allow the diurnal and nocturnal behaviours of these two species. Electroretinograms and histological analyses show that both species have a duplex retina in which cones outnumber rods, but the number of rods appears sufficient to provide vision at night. Their retinas respond over the same scotopic dynamic range of 3.4logcdm(-2), which encompasses all of the light levels occurring at night in their photic environment. The amplitudes of the scotopic saturated a- and b-wave responses as well as the photopic saturated b-wave response and the photopic sensitivity parameter S are however higher in ring-billed gulls than in gray gulls. Moreover, the process of dark adaptation is about 30min faster in gray gulls than in ring-billed gulls. Our results suggest that both species have acquired in the course of their evolution functional adaptations that can be related to their specific photic environment.


Asunto(s)
Charadriiformes/fisiología , Adaptación a la Oscuridad/fisiología , Retina/fisiología , Adaptación Ocular/fisiología , Animales , Charadriiformes/anatomía & histología , Electrorretinografía , Microscopía Electrónica , Epitelio Pigmentado Ocular/ultraestructura , Retina/ultraestructura , Células Fotorreceptoras Retinianas Conos/anatomía & histología , Células Fotorreceptoras Retinianas Bastones/anatomía & histología , Especificidad de la Especie
17.
Am J Physiol Regul Integr Comp Physiol ; 289(2): R473-R477, 2005 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-15860644

RESUMEN

Leptin amplifies feeding inhibition and neural activation produced by either cholecystokinin or intragastric preloads, suggesting that leptin may increase the efficacy of gastrointestinal meal-related signals. To determine whether leptin would similarly potentiate the feeding inhibitory actions of another putative satiety peptide, we evaluated the effects of third ventricular leptin administration on food intake and c-Fos activation in response to systemically administered bombesin (BN). Leptin (3.5 microg) was administered 1 h before either 0.9% saline or BN (0.32 and 1.0 nmol/kg) followed by 30-min access to Ensure liquid diet. Although neither leptin nor 0.32 nmol/kg BN alone suppressed Ensure intake, the combination reduced intake by 28%. The higher BN dose (1.0 nmol/kg) produced a significant suppression by itself but was further enhanced in the presence of leptin. Consistent with the behavioral results, c-Fos activation in the nucleus of the solitary tract was increased by combined dosages of leptin and 0.32 nmol/kg BN beyond the individual response to either peptide. In the presence of leptin, BN produced a 3.4- to 5.2-fold increase in the number of c-Fos-positive cells in the nucleus of the solitary tract compared with when BN was given alone. These data provide further support for the hypothesis that the effect of leptin on food intake may be mediated, in part, by modulating meal-related satiety signals.


Asunto(s)
Bombesina/farmacología , Ingestión de Alimentos/efectos de los fármacos , Leptina/farmacología , Proteínas Proto-Oncogénicas c-fos/metabolismo , Rombencéfalo/efectos de los fármacos , Rombencéfalo/metabolismo , Animales , Área Postrema/metabolismo , Sinergismo Farmacológico , Inyecciones Intraperitoneales , Inyecciones Intraventriculares , Leptina/administración & dosificación , Masculino , Ratas , Ratas Sprague-Dawley , Respuesta de Saciedad/efectos de los fármacos , Núcleo Solitario/metabolismo
18.
Behav Pharmacol ; 15(2): 133-9, 2004 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15096913

RESUMEN

Nimodipine, a dihydropyridine L-type voltage-gated calcium-channel blocker, was examined for its potential effect on the acquisition of a complex-arm sequence task in an automated radial maze. Young (60-day-old) male Wistar rats were injected with saline or nimodipine (5 mg/kg) 15 min prior to radial maze training, or immediately following the radial maze testing. The results of the learning task (over 7 days of testing) showed that rats injected with nimodipine each training session acquired the task more quickly and more efficiently compared to saline-treated animals. There were no significant differences for rats that were pre-/post-treated with nimodipine during the maze-learning task. The number of incorrect arm entries and number of additional lever presses in the same arm were found to be significantly lower in rats treated with nimodipine compared to saline-injected controls. The beneficial effect of nimodipine treatment occurred only in rats that were acquiring the task, and not in rats that had already learned the arm sequence paradigm. There were no potential non-specific influences on locomotor activity or appetite caused by chronic nimodipine treatments. These results strongly suggest that nimodipine can facilitate the acquisition of a complex learning task.


Asunto(s)
Bloqueadores de los Canales de Calcio/farmacología , Canales de Calcio Tipo L/efectos de los fármacos , Aprendizaje por Laberinto/efectos de los fármacos , Nimodipina/farmacología , Aprendizaje Seriado/efectos de los fármacos , Animales , Bloqueadores de los Canales de Calcio/administración & dosificación , Esquema de Medicación , Conducta Alimentaria/efectos de los fármacos , Inyecciones Subcutáneas , Activación del Canal Iónico , Masculino , Actividad Motora/efectos de los fármacos , Nimodipina/administración & dosificación , Ratas , Ratas Wistar
19.
Exp Neurol ; 170(1): 129-39, 2001 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-11421590

RESUMEN

We previously showed that overexpressing the 70-kDa inducible heat shock protein in primary astrocyte cultures and in a rodent stroke model using viral vectors resulted in protection from ischemia and ischemia-like injury. However, viral transfection could potentially provoke a stress response itself; therefore, we examined whether transgenic mice constitutively expressing human heat shock protein 70 were protected from ischemic insults. Astrocyte cultures from brains of heat shock protein 70 transgenic mice were resistant to hydrogen peroxide injury in a dose-dependent fashion, but were less resistant to hypoglycemia and oxygen-glucose deprivation. Because hydrogen peroxide exposure and glucose deprivation are partially dependent on glutathione levels, we determined whether heat shock protein 70 transgenic cultures had altered glutathione levels under normal growth conditions. However, there was no significant difference in glutathione levels between heat shock protein 70 transgenic and wildtype astrocytes. Hippocampal, but not cortical neuron cultures from these same transgenic mice were also protected against oxygen-glucose deprivation and glutamate toxicity. In an in vivo model of permanent focal cerebral ischemia, there was no significant difference in infarct size assessed 24 h postinsult. These results suggest that heat shock protein 70 protects against some but not all kinds of central nervous system injury. The protective effects may be related to the nature and severity of the insults, as well as subpopulations of brain cells and dose-dependent effects of HSP70 overexpression.


Asunto(s)
Isquemia Encefálica/metabolismo , Proteínas HSP70 de Choque Térmico/biosíntesis , Animales , Astrocitos/citología , Astrocitos/efectos de los fármacos , Astrocitos/metabolismo , Células Cultivadas , Relación Dosis-Respuesta a Droga , Genotipo , Glucosa/deficiencia , Glucosa/metabolismo , Glutatión/metabolismo , Proteínas HSP70 de Choque Térmico/genética , Proteínas HSP70 de Choque Térmico/farmacología , Células HeLa , Hipocampo/metabolismo , Hipocampo/patología , Humanos , Peróxido de Hidrógeno/farmacología , Hipoglucemia/metabolismo , Hipoxia Encefálica/metabolismo , Masculino , Ratones , Ratones Transgénicos , Plasticidad Neuronal/genética , Oxidantes/farmacología , Reacción en Cadena de la Polimerasa
20.
Genes Dev ; 15(8): 933-8, 2001 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-11316787

RESUMEN

The chromosome 8p11-12 Werner syndrome (WRN ) locus encodes a RecQ helicase protein of unknown function that possesses both 3' --> 5' helicase and 3' --> 5' exonuclease activities. We show that WRN cell lines display a marked reduction in cell proliferation following mitotic recombination, and generate few viable gene conversion-type recombinants. These findings indicate that WRN plays a role in mitotic recombination, and that a loss of WRN function may promote genetic instability and disease via recombination-initiated mitotic arrest, cell death, or gene rearrangement.


Asunto(s)
ADN Helicasas/genética , ADN Helicasas/fisiología , Mitosis , Recombinación Genética , Síndrome de Werner/genética , Muerte Celular , División Celular , Línea Celular , Cromosomas Humanos Par 8 , Exodesoxirribonucleasas , Fibroblastos/metabolismo , Humanos , Modelos Biológicos , Modelos Genéticos , Fenotipo , Plásmidos/metabolismo , RecQ Helicasas , Helicasa del Síndrome de Werner
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