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1.
J Small Anim Pract ; 64(9): 581-589, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37382056

RESUMEN

OBJECTIVES: This study evaluated success rates of surgical treatment of head and neck abscesses and draining tracts for suspected migrating vegetal foreign body and oropharyngeal penetrating injuries, and compared the outcomes according to whether a vegetal foreign body was identified in preoperative computed tomography (CT) examination. MATERIALS AND METHODS: This retrospective study involved 39 dogs that underwent CT and subsequent surgical exploration of abscesses and/or draining tracts in the head and neck, in a single institution between 2010 and 2021. Recorded data included signalment, history, physical examination, CT and surgical findings. The postoperative follow-up period was at least 8 months. Cases were classified according to whether a foreign body was identified on CT or was only suspected because of the presence of cavities and/or draining tracts on CT. RESULTS: A vegetal foreign body was identified on CT in 11 of 39 cases and later confirmed at surgery in 10 cases. In 28 of 39 cases, a vegetal foreign body was not identified on CT, but in seven of these 28 cases it was found at surgery. Resolution of clinical signs was achieved in 11 of 11 cases when a vegetal foreign body was identified on CT and in 26 of 28 cases without a foreign body identified on CT. Two cases of recurrence were observed in animals in which no foreign body was detected. CLINICAL SIGNIFICANCE: In this population of dogs undergoing surgery after preoperative CT scan, we observed resolution of clinical signs after a single surgical procedure in 95% of the cases. All animals in which a foreign body was identified were cured.


Asunto(s)
Enfermedades de los Perros , Cuerpos Extraños , Heridas Penetrantes , Perros , Animales , Absceso/complicaciones , Absceso/veterinaria , Estudios Retrospectivos , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Cuerpos Extraños/veterinaria , Tomografía Computarizada por Rayos X/veterinaria , Heridas Penetrantes/diagnóstico por imagen , Heridas Penetrantes/cirugía , Heridas Penetrantes/veterinaria , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/cirugía , Enfermedades de los Perros/etiología
2.
N Z Vet J ; 71(3): 152-158, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36786654

RESUMEN

CASE HISTORY: Dogs (n = 15) that were presented to a single veterinary teaching hospital with elbow dysplasia-associated lameness between September 2021 and May 2022, and were determined to require arthroscopy based on imaging results, were prospectively recruited into the study. The median duration of lameness was 4 (min 1, max 24) months. CLINICAL FINDINGS: Various breeds were represented with a median body weight of 31.6 (min 15, max 46.4) kg and median age at presentation of 14 (min 8, max 83) months. Results of imaging modalities (CT) were consistent with medial coronoid disease with fissured or fragmented medial coronoid process in all dogs. ARTHROSCOPIC FINDINGS: Feasibility of the needle arthroscopy (NA) procedure was firstly assessed in a preliminary cadaveric study in forelimbs (n = 10) collected from 10 adult dogs euthanised for reasons unrelated to the study. Elbow exploration was performed through a medial approach beginning with NA (1.9 mm 0° angle scope) followed by standard arthroscopy (SA; 2.4 mm 30° angle scope). The quality and extent of visualisation (scored through the number of anatomical structures visualised) were recorded and statistically compared. As the cadaver study indicated that NA allowed safe inspection of all structures in medial/caudal compartments, this procedure was then used in the dogs requiring treatment. In the clinical setting, elbow exploration was successful in all dogs and the treatment (removal of osteochondral fragments) was performed without requiring conversion into SA. One month after surgery, all dogs had an improvement in their lameness score (0-5) and 12/15 dogs were no longer lame. There was a reduction in Canine Orthopaedic Index scores measured a median of 99 (min 47, max 180) days after surgery (24 (IQR 19.5-31.5)) compared to the pre-operative period (49 (IQR 46.5-57); p < 0.001). CLINICAL RELEVANCE: Needle arthroscopy-assisted removal of osteochondral fragments was performed in all dogs with satisfactory short-term clinical outcome. NA is a feasible technique for diagnosis and lesion assessment in dogs with a fissured or fragmented coronoid process. Larger clinical studies with longer follow-up are necessary to validate the NanoScope operative arthroscopy system as an alternative strategy to SA for video-assisted treatment of medial coronoid disease.


Asunto(s)
Enfermedades de los Perros , Artropatías , Perros , Animales , Proyectos Piloto , Artroscopios , Cojera Animal/diagnóstico , Cojera Animal/cirugía , Hospitales Veterinarios , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/cirugía , Hospitales de Enseñanza , Artropatías/diagnóstico , Artropatías/cirugía , Artropatías/veterinaria , Miembro Anterior/cirugía
3.
J Neuroradiol ; 50(3): 281-287, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-35385772

RESUMEN

BACKGROUND AND PURPOSE: Classification of deep (D), superficial (S) MCA territories and their junctional vascular area (the internal border zone, IBZ) can help to identify patients most likely to benefit from aggressive reperfusion therapy after stroke. We tested the prognostic value of an IBZ injury compared to DWI-ASPECTS and infarct volume. MATERIALS AND METHODS: DW lesions of 168 patients with acute (4.2±6.5 h) MCA strokes were retrospectively examined and manually delineated. Patients with haemorrhagic transformation or other neurological diseases were excluded. Clinical data were recorded within 24 h following symptom onset and 48 h for patients who benefited from reperfusion therapy. The occurrence of an IBZ injury was determined using a standardized stereotaxic atlas. Performance to predict a good outcome (mRS<3 at 3 months) was estimated through ROC curves for DWI-ASPECTS≤6, lesion volume≥100 mL and IBZ injury. Logistic regression models were performed to estimate independent outcomes for infarct volume and IBZ injury. RESULTS: Infarcts involving the IBZ were larger (94.9±98.8 mL vs. 30.2±31.3 mL), had higher NIHSS (13.8±7.2 vs. 7.2±5.7), more frequent MCA occlusions (64.9% vs. 28.3%), and worse outcomes (mRS 3.0±1.8 vs. 1.9±1.7), and were less responsive to IVtPA (34±47% vs. 55±48% of NIHSS improvement). The area under the ROC curves was comparable between the occurrence of IBZ injury (0.651), ASPECTS≤6 (0.657) and volume≥100 mL (0.629). Logistic regression analyses showed an independent effect of an IBZ injury, especially for superficial MCA strokes and for patients who benefited from reperfusion therapy. CONCLUSION: An IBZ injury is an early and independent marker of stroke severity, functional prognosis and treatment responsiveness.


Asunto(s)
Infarto de la Arteria Cerebral Media , Accidente Cerebrovascular , Humanos , Infarto de la Arteria Cerebral Media/patología , Estudios Retrospectivos , Imagen de Difusión por Resonancia Magnética , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/patología , Pronóstico , Resultado del Tratamiento
4.
J Geophys Res Space Phys ; 127(5): e2021JA030147, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35865127

RESUMEN

The Martian interaction with the solar wind leads to the formation of a bow shock upstream of the planet. The shock dynamics appear complex, due to the combined influence of external and internal drivers. The extreme ultraviolet fluxes and magnetosonic Mach number are known major drivers of the shock location, while the influence of other possible drivers is less constrained or unknown such as crustal magnetic fields, solar wind dynamic pressure, or the Interplanetary Magnetic Field (IMF) intensity, and orientation. In this study, we compare the influence of the main drivers of the Martian shock location, based on several methods and published datasets from Mars Express (MEX) and Mars Atmosphere Volatile EvolutioN (MAVEN) missions. We include here the influence of the crustal fields, extreme ultraviolet fluxes, solar wind dynamic pressure, as well as (for MAVEN, thanks to magnetic field measurements) magnetosonic Mach number and Interplanetary Magnetic Field parameters (intensity and orientation angles). The bias due to the cross-correlations among the possible drivers is investigated with a partial correlations analysis. Several model selection methods (Akaike Information Criterion and Least Absolute Shrinkage Selection Operator regression) are also used to rank the relative importance of the physical parameters. We conclude that the major drivers of the shock location are extreme ultraviolet fluxes and magnetosonic Mach number, while crustal fields and solar wind dynamic pressure are secondary drivers at a similar level. The IMF orientation also plays a significant role, with larger distances for perpendicular shocks rather than parallel shocks.

5.
N Z Vet J ; 70(5): 287-296, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35703056

RESUMEN

CASE HISTORY: Dogs (n = 6) suffering from elbow-associated lameness for a median of 3.5 (min 2, max 12) months duration requiring arthroscopic exploration according to imaging results were prospectively included in this study. CLINICAL FINDINGS: Dogs that met the inclusion criteria were of various breeds with a median body weight of 18 (min 13.2, max 34.5) kg and median age at presentation of 11 (min 6, max 96) months. Results of imaging modalities (radiographs and/or computed tomography (CT)) were consistent with developmental elbow disease in all of the dogs. ARTHROSCOPIC FINDINGS: Feasibility of the needle arthroscopy procedure was first assessed in a preliminary cadaveric study. Disease-free cadaveric forelimbs (n = 12) were collected from adult dogs (n = 6) euthanised for reasons unrelated to the present study. Elbow exploration was performed, beginning with needle arthroscopy (1 mm, 0° angle scope) followed by standard arthroscopy (2.4 mm, 30° angle scope) through a medial approach. The ease of introduction, range of motion and the quality of visualisation were assessed subjectively and the presence of iatrogenic introduction lesions and extent of field of vision (assessed by the number of anatomical structures visualised) were scored and statistically compared. Needle arthroscopy allowed inspection of all structures at risk for medial/caudal compartment disease in all joints considering the occasional need for multiple portals. In the clinical setting, elbow exploration was found to be similar to that in cadaver joints in 4/6 dogs. The lower quality of vision provided by needle arthroscopy was a limitation of the technique, and 2/6 clinical cases required conversion to standard arthroscopy for full visualisation of the joint. No introduction lesions were noted with needle arthroscopy in either the cadaveric or clinical studies. CONCLUSIONS AND CLINICAL RELEVANCE: Needle arthroscopy allowed safe visualisation of all of the structures of the medial and caudal compartment in disease-free cadaveric elbows, suggesting that needle arthroscopy is an appropriate technique for diagnosis and assessment of lesions of developmental elbow disease. However, the low quality of vision provided by the 1 mm scope, and the small diameter of the sleeve, which limited fluid inflow, combined with fragility of the device were major drawbacks that prevented consistent full exploration of the joint and detailed lesion assessment in clinical situations. Improvement of the device is thus necessary before use of the technique in clinical practice can be recommended. ABBREVIATIONS: CCD: Caudal compartment disease; CT: Computed tomography; DED: Developmental elbow disease; DJD: Degenerative joint disease; LCL: Lateral collateral ligament; LCP: Lateral coronoid process; LHC: Lateral part of the humeral condyle; MCD: Medial compartment disease; MCL: Medial collateral ligament; MCP: Medial coronoid process; MHC: Medial part of the humeral condyle; MRI: Magnetic resonance imaging.


Asunto(s)
Enfermedades de los Perros , Articulación del Codo , Artropatías , Animales , Artroscopía/métodos , Artroscopía/veterinaria , Cadáver , Enfermedades de los Perros/cirugía , Perros , Miembro Anterior/patología , Miembro Anterior/cirugía , Humanos , Artropatías/cirugía , Artropatías/veterinaria
6.
J Small Anim Pract ; 62(12): 1122-1126, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33650679

RESUMEN

A 1.5-year-old MC Cardigan Welsh Corgi was presented for a right oral fistula associated with left tonsil enlargement that responded to medical treatment. A first computed tomography scan was performed and showed no signs of a foreign body. Medical treatment was continued for 2 additional weeks and the dog was free of clinical signs for 3 months. The dog was presented again for a 3-day history of anorexia and marked pain when opening the jaw. The repeat computed tomography scan revealed a migrating foreign body near the optic canal of the right eye, and surgical exploration confirmed that it was trapped within the intraconal part of the retrobulbar space, abutting the optic nerve. The foreign body was surgically removed through an osteotomy of the zygomatic bone. The dog fully recovered with no vision loss. Based on the literature search, this is the first published report describing a migrating grass awn located in the intraconal part of the retrobulbar space, abutting the optic nerve.


Asunto(s)
Enfermedades de los Perros , Cuerpos Extraños , Animales , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/cirugía , Perros , Cuerpos Extraños/veterinaria , Poaceae , Tomografía Computarizada por Rayos X/veterinaria
8.
Psychol Med ; 50(16): 2702-2710, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-31637990

RESUMEN

BACKGROUND: Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years. METHODS: The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis. RESULTS: At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (-10.215 to -0.337) and (-4.731 to -0.605) respectively). CONCLUSIONS: Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.


Asunto(s)
Reserva Cognitiva , Funcionamiento Psicosocial , Trastornos Psicóticos/psicología , Cognición Social , Adolescente , Adulto , Femenino , Humanos , Modelos Lineales , Masculino , Análisis de Mediación , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Trastornos Psicóticos/diagnóstico , Adulto Joven
9.
Pract Lab Med ; 11: 10-18, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30202779

RESUMEN

A recently released kit (PerFix EXPOSE) was reported to improve the measurement of the degree of phosphorylation of proteins in leukocytes by flow cytometry. We tested its adaptation for platelets to monitor vasodilator-stimulated phosphoprotein (VASP) phosphorylation, which is the basis of a currently used test for the assessment of the pharmacological response to P2Y12 antagonists (PLT VASP/P2Y12). The PerFix EXPOSE kit was compared to the PLT VASP/P2Y12 kit by using blood samples drawn at 24 h post clopidogrel dose from 19 patients hospitalized for a non-cardio-embolic ischemic stroke and treated with clopidogrel monotherapy for at least five days in an observational study. The platelet PerFix method was based on adaptation of the volume of the sample, the centrifugation speed and the incubation temperature. Poor agreement between prevention by adenosine diphosphate (ADP) of PGE1-induced cAMP-mediated VASP phosphorylation and ADP induced aggregation assessed by Light Transmittance Aggregometry was found. We found a significant correlation between the PLT VASP/P2Y12 kit and the PerFix EXPOSE kit. The PerFix EXPOSE kit may also be helpful to monitor adverse effects of second-generation tyrosine kinase inhibitors on platelets.

10.
J Nutr Health Aging ; 21(4): 429-439, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28346570

RESUMEN

OBJECTIVES: To assess the tolerance and potential nutritional consequences of long-term repeated doses of PEG 4000 (10 to 30 g/day) in elderly patients with chronic constipation as compared to lactulose (10-30 g/day). DESIGN: Single blind, randomised, multicentre, parallel group comparative study. SETTING: Community-dwelling patients and nursing homes residents aged 70 years and older with a history of chronic constipation. Treatment intervention: PEG 4000 (10-30 g/day) or lactulose (10-30 g/day) for six months. ASSESSMENTS: Clinical nutritional status (Mini Nutritional Assessment), blood and stool samples were taken at baseline and after three and six months for assay of nutritional and absorption parameters. A patient diary documented digestive symptoms and adverse events were recorded. Information on efficacy (stool frequency and consistency) was collected as a secondary outcome measure. RESULTS: Of the 316 patients screened, 245 eligible patients constituted the ITT population (PEG 4000: N = 118; lactulose group: N = 127). The proportion of patients receiving PEG 4000 with abnormal levels of electrolytes, nutritional markers or vitamins did not significantly change in the six months after initiating laxative treatment and do not differ between the two groups. After a D-xylose challenge test, the proportion of patients with abnormally low xylosaemia (suggesting malabsorption) varied from 24.6% at baseline to 35.8% after six months in the PEG 4000 group and from 29.1% to 42.4% in the lactulose group, with no significant between-group or within-group differences. The proportion of patients with poor nutritional status (MNA score <17) varied from 8.5% at baseline to 9.8% after 6 months in the PEG 4000 group and from 3.9% to 5.0% in the lactulose group. No changes in stool fat or total or soluble stool nitrogen were observed in the minority of patients for whom stool analysis was performed. A significantly higher stool frequency (p <0.05) and improved stool consistency (p <0.05) was observed in the PEG 4000 group compared to the lactulose group at each monthly evaluation period. CONCLUSIONS: After six months of treatment with PEG 4000, no clinically relevant changes in biochemical and nutritional parameters and no unanticipated treatment-related adverse events were detected, demonstrating the good clinical tolerance of PEG 4000 in this population of elderly constipated patients. This tolerance was associated with a better clinical efficacy of PEG 4000 compared to lactulose.


Asunto(s)
Estreñimiento/tratamiento farmacológico , Lactulosa/uso terapéutico , Laxativos/uso terapéutico , Polietilenglicoles/uso terapéutico , Anciano , Anciano de 80 o más Años , Electrólitos/análisis , Heces/química , Femenino , Francia , Humanos , Lactulosa/efectos adversos , Laxativos/efectos adversos , Masculino , Casas de Salud , Estado Nutricional/fisiología , Polietilenglicoles/efectos adversos , Método Simple Ciego , Resultado del Tratamiento , Xilosa/sangre
11.
Acta Physiol (Oxf) ; 219(4): 790-802, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-27364224

RESUMEN

AIM: Evidence that brain-derived neurotrophic factor (BDNF), a neurotrophin largely involved in cognition, is expressed by cerebral endothelial cells led us to explore in rats the contribution of the cerebral microvasculature to BDNF found in brain tissue and the link between cerebrovascular nitric oxide (NO) and BDNF production. METHODS: Brain BDNF protein levels were measured before and after in situ removal of the cerebral endothelium that was achieved by brain perfusion with a 0.2% CHAPS (3-[(3-cholamidopropyl) dimethylammonio]-1-propane sulphonate) solution. BDNF protein and mRNA levels as well as levels of endothelial NO synthase phosphorylated at serine 1177 (P-eNOSser1177 ) were measured in cerebral microvessel-enriched fractions. These fractions were also exposed to glycerol trinitrate. Hypertension (spontaneously hypertensive rats) and physical exercise training were used as experimental approaches to modulate cerebrovascular endothelial NO production. RESULTS: CHAPS perfusion resulted in a marked decrease in brain BDNF levels. Hypertension decreased and exercise increased P-eNOSser1177 and BDNF protein levels. However, BDNF mRNA levels that were increased by exercise did not change after hypertension. Finally, in vitro exposure of cerebral microvessel-enriched fractions to glycerol trinitrate enhanced BDNF production. CONCLUSION: These data reveal that BDNF levels measured in brain homogenates correspond for a large part to BDNF present in cerebral endothelial cells and that cerebrovascular BDNF production is dependent on cerebrovascular endothelial eNOS activity. They provide a paradigm shift in the cellular source of brain BDNF and suggest a new approach to improve our understanding of the link between endothelial function and cognition.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo/metabolismo , Encéfalo/metabolismo , Células Endoteliales/metabolismo , Microvasos/metabolismo , Animales , Western Blotting , Encéfalo/irrigación sanguínea , Inmunohistoquímica , Óxido Nítrico/metabolismo , Reacción en Cadena de la Polimerasa , Ratas , Ratas Endogámicas SHR , Ratas Wistar
12.
Rev Stomatol Chir Maxillofac Chir Orale ; 117(6): 458-462, 2016 Dec.
Artículo en Francés | MEDLINE | ID: mdl-27836443

RESUMEN

Tinnitus has been described in temporomandibular joint dysfunction for a long time. Yet, other disorders, such as hearing loss, stress, anxiety and depression, play a major role in the pathophysiology of tinnitus. Temporomandibular joint dysfunctions seem to increase the risk of tinnitus in patients with other predisposing factors. Especially somatosensory tinnitus, which is characterized by sound modulations with neck or mandible movements, is frequently associated with temporomandibular joint dysfunction, but it is not pathognomonic of such a disorder. In such cases, functional therapy of the temporomandibular joint should be part of the multidisciplinary rehabilitation of patients with tinnitus.


Asunto(s)
Trastornos de la Articulación Temporomandibular/terapia , Síndrome de la Disfunción de Articulación Temporomandibular/terapia , Articulación Temporomandibular/fisiología , Acúfeno/etiología , Acúfeno/rehabilitación , Humanos , Comunicación Interdisciplinaria , Grupo de Atención al Paciente/organización & administración , Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/rehabilitación , Síndrome de la Disfunción de Articulación Temporomandibular/complicaciones , Síndrome de la Disfunción de Articulación Temporomandibular/rehabilitación
13.
J Nutr Health Aging ; 19(10): 1009-11, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26624212

RESUMEN

Time-to-event analysis is frequently used in medical research to investigate potential disease-modifying treatments in neurodegenerative diseases. Potential treatment effects are generally evaluated using the logrank test, which has optimal power and sensitivity when the treatment effect (hazard ratio) is constant over time. However, there is generally no prior information as to how the hazard ratio for the event of interest actually evolves. In these cases, the logrank test is not necessarily the most appropriate to use. When the hazard ratio is expected to decrease or increase over time, alternative statistical tests such as the Fleming-Harrington test, provide a better sensitivity. An example of this comes from a large, five-year randomised, placebo-controlled prevention trial (GuidAge) in 2854 community-based subjects making spontaneous memory complaints to their family physicians, which evaluated whether treatment with EGb761 can modify the risk of developing AD. The primary outcome measure was the time to conversion from memory complaint to Alzheimer's type dementia. Although there was no significant difference in the hazard function of conversion between the two treatment groups according to the preplanned logrank test, a significant treatment-by-time interaction for the incidence of AD was observed in a protocol-specified subgroup analysis, suggesting that the hazard ratio is not constant over time. For this reason, additional post hoc analyses were performed using the Fleming-Harrington test to evaluate whether there was a signal of a late effect of EGb761. Applying the Fleming-Harrington test, the hazard function for conversion to dementia in the placebo group was significantly different from that in the EGb761 treatment group (p = 0.0054), suggesting a late effect of EGb761. Since this was a post hoc analysis, no definitive conclusions can be drawn as to the effectiveness of the treatment. This post hoc analysis illustrates the interest of performing another randomised clinical trial of EGb761 explicitly testing the hypothesis of a late treatment effect, as well as of using of better adapted statistical approaches for long term preventive trials when it is expected that prevention cannot have an immediate effect but rather a delayed effect that increases over time.


Asunto(s)
Enfermedad de Alzheimer/prevención & control , Trastornos de la Memoria , Memoria , Evaluación de Resultado en la Atención de Salud , Extractos Vegetales/uso terapéutico , Proyectos de Investigación , Anciano , Demencia/prevención & control , Femenino , Ginkgo biloba , Humanos , Masculino , Trastornos de la Memoria/tratamiento farmacológico , Modelos de Riesgos Proporcionales
14.
Br J Sports Med ; 48(10): 862-6, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24648438

RESUMEN

The introduction of the athlete's biological passport (ABP) has been a milestone in the fight against doping. The ABP is a collection of measurements of different biological parameters influenced by the administration of doping agents through the time and for each athlete. Two different modules have been developed and validated so far: the haematological module, which aims to identify enhancement of oxygen transport, including use of erythropoiesis-stimulating agents and any form of blood transfusion or manipulation, which became effective in 2010; and the steroidal module, which intends to detect the use of endogenous anabolic androgenic steroids when administered exogenously and other anabolic agents, which was introduced in 2014. Prior to the implementation of the haematological module, it is important to define an athlete's testing pool on whom to collect blood and/or urine in-competition and out-of-competition (for the steroidal module, this is irrelevant because all collected urine samples will be subjected to analysis for the steroidal variables) and to be compliant with the strict requirements of the World Anti-Doping Agency ABP Operating Guidelines. The established individual profile can be used either to target traditional antidoping tests (recombinant erythropoietins, or homologous blood transfusion tests for the haematological module; isotope ratio mass spectrometry (IRMS) for the steroidal module) or to support an antidoping rule violation due to the use of a forbidden substance or method. In this article, we present the experience of four major International Federations which have implemented an ABP programme, focusing on the haematological module. They constitute examples which could be followed by other antidoping organisations wishing to introduce this new, efficient and innovative antidoping tool.


Asunto(s)
Doping en los Deportes/prevención & control , Sustancias para Mejorar el Rendimiento/análisis , Deportes/ética , Detección de Abuso de Sustancias/métodos , Anabolizantes/análisis , Atletas , Ciclismo , Transfusión de Sangre Autóloga , Eritropoyetina/administración & dosificación , Eritropoyetina/análisis , Humanos , Agencias Internacionales , Fútbol , Esteroides/análisis , Natación
15.
Environ Sci Pollut Res Int ; 21(4): 2761-76, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24132521

RESUMEN

Composting has been demonstrated to be effective in degrading organic pollutants (OP) whose behaviour depends on the composting conditions, the microbial populations activated and interactions with organic matters. The fate of OP during composting involves complex mechanisms and models can be helpful tools for educational and scientific purposes, as well as for industrialists who want to optimise the composting process for OP elimination. A COP-Compost model, which couples an organic carbon (OC) module and an organic pollutant (OP) module and which simulates the changes of organic matter, organic pollutants and the microbial activities during the composting process, has been proposed and calibrated for a first set of OP in a previous study. The objectives of the present work were (1) to introduce the COP-Compost model from its convenient interface to a potential panel of users, (2) to show the variety of OP that could be simulated, including the possibility of choosing between degradation through co-metabolism or specific metabolism and (3) to show the effect of the initial characteristics of organic matter quality and its microbial biomass on the simulated results of the OP dynamic. In the model, we assumed that the pollutants can be adsorbed on organic matter according to the biochemical quality of the OC and that the microorganisms can degrade the pollutants at the same time as they degrade OC (by co-metabolism). A composting experiment describing two different (14)C-labelled organic pollutants, simazine and pyrene, were chosen from the literature because the four OP fractions simulated in the model were measured during the study (the mineralised, soluble, sorbed and non-extractable fractions). Except for the mineralised fraction of simazine, a good agreement was achieved between the simulated and experimental results describing the evolution of the different organic fractions. For simazine, a specific biomass had to be added. To assess the relative importance of organic matter dynamics on the organic pollutants' behaviour, a sensitivity analysis was conducted. The sensitivity analysis demonstrated that the parameters associated with organic matter dynamics and its initial microbial biomass greatly influenced the evolution of all the OP fractions, although the initial biochemical quality of the OC did not have a significant impact on the OP evolution.


Asunto(s)
Modelos Teóricos , Programas Informáticos , Microbiología del Suelo , Contaminantes del Suelo/metabolismo , Suelo , Carbono , Compuestos Orgánicos/metabolismo
16.
Respiration ; 86(6): 504-7, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24281247

RESUMEN

Air embolism following transbronchial needle aspiration (TBNA) is extremely rare. To date, only 1 case has been described (estimated incidence: 0.02-0.07%). Here, a 70-year-old patient developed a left upper-lobe alveolar syndrome with no response to well-conducted antibiotic treatments. Conventional bronchoscopy was normal, but virtual bronchoscopy showed that the tumor was contiguous to the left B3-B4 division. During a second bronchoscopy, a TBNA was performed without bleeding, and pathology later revealed primitive lung adenocarcinoma. Immediately after the puncture, an epileptic seizure occurred with right rotation of the head and a tonic seizure of the left arm followed by left hemiplegia. A brain CT scan performed almost immediately showed no abnormalities and a chest radiography did not show any pleural or mediastinal aeric image. A few hours later, clonic seizures occurred and brain MRI showed lesions compatible with air embolisms (right gyral cortical location). Several hyperbaric therapy sessions successfully cured the neurological deficit. Despite its rarity, each practitioner of TBNA has to be aware of this side effect and its early treatment. The mechanism of such accidents remains unclear, but probably involves high bronchial pressure and venous trauma. © 2013 S. Karger AG, Basel.


Asunto(s)
Biopsia con Aguja/efectos adversos , Encefalopatías/etiología , Encéfalo/patología , Broncoscopía/efectos adversos , Embolia Aérea/etiología , Adenocarcinoma/diagnóstico , Anciano , Biopsia con Aguja/métodos , Encefalopatías/patología , Encefalopatías/terapia , Broncoscopía/métodos , Embolia Aérea/patología , Embolia Aérea/terapia , Humanos , Oxigenoterapia Hiperbárica , Procesamiento de Imagen Asistido por Computador , Neoplasias Pulmonares/diagnóstico , Imagen por Resonancia Magnética , Masculino , Convulsiones/etiología , Tomografía Computarizada por Rayos X
17.
Gynecol Obstet Fertil ; 41(9): 499-504, 2013 Sep.
Artículo en Francés | MEDLINE | ID: mdl-23972921

RESUMEN

OBJECTIVE: To draw a parallel between the contraceptive methods prescribed in the post-natal ward and the contraceptive methods taken by patients during their postnatal visit. PATIENTS AND METHODS: This piece of work draws information from a prospective 10 weeks study at a University Teaching Hospital post-natal ward on the contraception that is prescribed upon leaving the maternity ward and also at the time of the post-natal visit. RESULTS: From the 600 cases studied, the analysis is about 129 patients reviewed in the post-natal visit. The percentage of loss was 78.5%. A hormonal contraceptive pill was prescribed to 73.5% of women (441 patients) after birth in which 63.5% had microprogestative pills. At the earliest, the IUD was given at about 5.4 weeks postpartum. At the time of the postnatal visit, compliance was bad for one third of women with either estrogen plus progestin methods, microprogestative or natural methods. Women who chose a barrier method were only 45.5% to follow this choice, the others left without contraception. DISCUSSION AND CONCLUSION: The prescription of postpartum contraception was followed by only 66.6% of women. In order to prescribe a more effective contraceptive method, we must improve the prescriber's timing in sharing contraceptive information and completeness of the contraceptive methods offered.


Asunto(s)
Anticoncepción/métodos , Atención Posnatal/métodos , Periodo Posparto , Adulto , Anticoncepción/estadística & datos numéricos , Conducta Anticonceptiva , Dispositivos Anticonceptivos Femeninos/estadística & datos numéricos , Anticonceptivos Hormonales Orales , Femenino , Hospitales de Enseñanza , Hospitales Universitarios , Humanos , Dispositivos Intrauterinos/estadística & datos numéricos , Cooperación del Paciente , Embarazo , Progestinas , Estudios Prospectivos
18.
J Environ Qual ; 42(2): 361-72, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23673828

RESUMEN

Organic pollutants (OPs) are potentially present in composts and the assessment of their content and bioaccessibility in these composts is of paramount importance. In this work, we proposed a model to simulate the behavior of OPs and the dynamic of organic C during composting. This model, named COP-Compost, includes two modules. An existing organic C module is based on the biochemical composition of the initial waste mixture and simulates the organic matter transformation during composting. An additional OP module simulates OP mineralization and the evolution of its bioaccessibility. Coupling hypotheses were proposed to describe the interactions between organic C and OP modules. The organic C module, evaluated using experimental data obtained from 4-L composting pilots, was independently tested. The COP-Compost model was evaluated during composting experiments containing four OPs representative of the major pollutants detected in compost and targeted by current and future regulations. These OPs included a polycyclic aromatic hydrocarbon (fluoranthene), two surfactants (4--nonylphenol and a linear alkylbenzene sulfonate), and an herbicide (glyphosate). Residues of C-labeled OP with different bioaccessibility were characterized by sequential extraction and quantified as soluble, sorbed, and nonextractable fractions. The model was calibrated and coupling the organic C and OP modules improved the simulation of the OP behavior and bioaccessibility during composting.


Asunto(s)
Compuestos Orgánicos , Suelo , Herbicidas , Modelos Teóricos , Compuestos Orgánicos/química , Hidrocarburos Policíclicos Aromáticos , Eliminación de Residuos , Suelo/química
20.
Rev Neurol (Paris) ; 169(2): 169-72, 2013 Feb.
Artículo en Francés | MEDLINE | ID: mdl-22763204

RESUMEN

Few vascular dementias are diagnosed in memory clinic consultations. One type, a rare etiology, Sneddon syndrome, can lead patients to consult for an isolated memory complaint. We report the cases of two patients, aged 63 and 66 years, who presented frontocortical cognitive profile and behavior disorders. Seronegative Sneddon syndrome, complicated with dementia, was diagnosed in each case by noticing an association between, on MRI, an atrophy and several ischemic cerebrovascular accident aftermaths, and a livedo racemosa. Management of vascular risks factors improves the prognosis.


Asunto(s)
Demencia Vascular/etiología , Síndrome de Sneddon/complicaciones , Anciano , Alcoholismo/complicaciones , Encéfalo/patología , Isquemia Encefálica/etiología , Humanos , Hipertensión/complicaciones , Trastornos del Lenguaje/etiología , Imagen por Resonancia Magnética , Masculino , Trastornos de la Memoria/etiología , Trastornos Mentales/etiología , Persona de Mediana Edad , Pruebas Neuropsicológicas , Síndrome de Sneddon/diagnóstico , Síndrome de Sneddon/tratamiento farmacológico , Trastornos de la Visión/etiología
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