Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 638
Filtrar
1.
Resuscitation ; 203: 110389, 2024 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-39245405

RESUMEN

BACKGROUND: There is an increasing prevalence of durable mechanical circulatory supported patients in both the in-and-out of hospital communities. The scientific literature regarding the approach to patients supported by durable mechanical circulatory devices who suffer acutely impaired perfusion has not been well explored. METHODS: The International Liaison Committee on Resuscitation Advanced, Basic, and Pediatric Life Support Task Forces conducted a scoping review of the literature using a population, context, and concept framework. RESULTS: A total of 32 publications that included patients who were receiving durable mechanical circulatory support and required acute resuscitation were identified. Most of the identified studies were case reports or small case series. Of these, 11 (34.4%) included patients who received chest compressions. A number of studies reported upon delays in the application of chest compressions resulting from complexity due to the expected pulselessness in some patients with continuous flow left-ventricular assist devices as well as from concern regarding potential dislodgement of the mechanical circulatory support device. Three observational studies identified worse outcomes in durable mechanical circulatory support receiving patients with cardiac arrest and acutely impaired perfusion who received chest compressions as compared to those who did not, however those studies were at high risk of bias. Of 226 patients across 11 studies and two published scientific abstracts who sustained cardiac arrest while supported by durable MCS and underwent chest compressions, there were no reported instances of device dislodgement and 71 (31.4%) patients had favorable outcomes. CONCLUSIONS: There is a scarcity of evidence to inform the resuscitation of patients with durable mechanical circulatory support (MCS) experiencing acute impairment in perfusion and cardiac arrest. Reports indicate that delays in resuscitation often stem from rescuers' uncertainty about the safety of administering chest compressions. Notably, no instances of device dislodgement have been documented following chest compressions, suggesting that the risk of harm from timely CPR in these patients is minimal.

2.
Lung ; 2024 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-39325187

RESUMEN

PURPOSE: Poor functional status is associated with pediatric lung transplant (LTx) waitlist mortality. We investigate how pre-transplant functional status affects post-LTx survival. METHODS: A retrospective analysis was performed using The United Network for Organ Sharing (UNOS) Registry data. Pediatric first-time lung transplant candidates between ages 1 and 18 years with reported Lansky Play-Performance Scores (LPPS) at the time of waitlist and/or transplant were included from 2005 and 2021. Functional status by the LPPS scores is defined as severe limitation for LPPS score 10-40, mild limitation for LPPS score 50-70, and normal activity for LPPS score 80-100. Univariate analyses, multivariable Cox regression, and Kaplan-Meier plots were used to assess the impact of functional status on 1-year post-LTx survival. RESULTS: There were 913 and 610 patients at the time of LTx listing and transplant with LPPS scores, respectively. Poor functional status as determined by the LPPS score at the time of LTx, but not at the time of waitlist, was associated with worse 1-year post-LTx outcome (p value 0.0025 vs. 0.071). Multivariable survival analysis using Cox proportional hazards regression identified that a severely limited functional status at the time of LTx was the most profound risk factor for worse 1-year post-LTx survival outcomes when compared to a normal functional status (HR 2.16; 95% CI 1.15-4.07, p value 0.017). CONCLUSIONS: Children with severely limited functional status at the time of LTx have worse 1-year post-LTx outcome. It is important to develop strategies to optimize the functional status of children for improved post-LTx outcomes.

3.
ASAIO J ; 2024 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-39330959

RESUMEN

Adverse events (AEs) experienced by children and adults with congenital heart disease (CHD) on ventricular assist devices (VADs) are sometimes unique to these populations. The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) and the Academic Research Consortium (ARC) aimed to harmonize definitions of pediatric and CHD AEs for use in clinical trials, registries, and regulatory evaluation. Data from the ACTION registry and adjudication committee were used to adapt general mechanical circulatory support ARC definitions. This ACTION-ARC international expert panel of trialists, clinicians, patients, families, statisticians, biomedical engineers, device developers, and regulatory agencies drafted and iterated definitions harmonized to ACTION data and existing literature during sessions conducted between December 2022 and May 2023, followed by dissemination across clinical/research audiences and professional organizations and further revision. Both email-linked, internet-based surveys and in-person discussions were used as a modified Delphi process. Nineteen AE types were identified and defined, including seven new event types and six event types that were deleted and will no longer be collected, achieving consensus. ACTION-ARC paired rigorous development with methodical stakeholder involvement and dissemination to define pediatric VAD AEs to facilitate assimilation of data across future clinical trials and evaluation of devices for VAD-supported children and adults with CHD.

5.
Neuro Oncol ; 2024 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-39248287

RESUMEN

BACKGROUND: Co-amplification of EGFR and EGFRvIII, a tumor-specific truncation mutant of EGFR, represent hallmark genetic lesions in glioblastoma. METHODS: We used phospho-proteomics, RNA-sequencing, TCGA data and glioblastoma cell culture and mouse models to study the signal transduction mediated by EGFR and EGFRvIII. RESULTS: We report that EGFR and EGFRvIII stimulate the innate immune defense receptor Toll-like Receptor 2 (TLR2); and that knockout of TLR2 dramatically improved survival in orthotopic glioblastoma xenografts. EGFR and EGFRvIII activated TLR2 in a ligand-independent manner, promoting tumor growth and immune evasion. We show that EGFR and EGFRvIII cooperate to activate the Rho-associated protein kinase ROCK2, which modulated malignant progression both by activating TLR2 and WNT signaling, and through remodeling the tumor microenvironment. CONCLUSION: Together, our findings show that EGFR and EGFRvIII cooperate to drive tumor progression through ROCK2 and downstream WNT-ß-catenin/TLR2 signaling pathways.

6.
World J Pediatr Congenit Heart Surg ; : 21501351241269881, 2024 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-39252613

RESUMEN

Background: With significant advancements in fetal cardiac imaging, patients with complex congenital heart disease (CHD) carrying a high risk for postnatal demise are now being diagnosed earlier. We sought to assess an interdisciplinary strategy for delivering these children in an operating room (OR) adjacent to a cardiac OR for immediate surgery or stabilization. Methods: All children prenatally diagnosed with CHD at risk for immediate postnatal hemodynamic instability and cardiogenic shock who were delivered in the operating room (OR) between 2012 and 2023 in which the senior author was consulted were included. Results: Eight patients were identified. Six (75%) patients were operated on day-of-life zero, all requiring obstructed total anomalous pulmonary venous return (TAPVR) repair. Of these six patients, 2 (33%) required a simultaneous Norwood procedure, 2 (33%) required pulmonary artery unifocalization and modified Blalock-Taussig-Thomas shunt, and 2 (33%) patients had repair of obstructed mixed TAPVR. The remaining 2 patients potentially planned for immediate surgery had nonimmune hydrops fetalis and went into cardiogenic shock at 12 and 72 hours postnatally, requiring a novel Norwood procedure with left-ventricular exclusion for severe aortic/mitral valve insufficiency. The median ventilation and inpatient durations were 19 [IQR: 11-26] days and 41 [IQR: 32-128] days, respectively. Three(38%) patients required one or more in-hospital reoperations. Subsequent staged procedures included Glenn (n = 5), Fontan (n = 3), biventricular repair (n = 2), ventricular assist device placement (n = 1), and heart transplant (n = 1). Median follow-up was 5.7 [IQR:1.3-7.8] years. The five-year postoperative survival was 88% (n = 7/8). Conclusion: While children with these diagnoses have historically had poor survival, the strategy of birth in the OR adjacent to a cardiac OR where emergent surgery is planned is a potentially promising strategy with excellent clinical outcomes. However, this is a high-resource strategy whose feasibility in any program requires thoughtful assessment.

7.
Acad Med ; 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39265094

RESUMEN

ABSTRACT: Discrimination toward trainees is a pervasive problem, with surveys showing it is often perpetrated by patients. For several years, residents and faculty in an internal medicine residency have participated in a workshop offering a framework for responding to discriminatory behavior by patients. As part of a larger effort to reinforce this teaching and promote an inclusive environment, the authors pursued a multi-pronged simulation curriculum that could be incorporated into graduate medical education programs across their institution. First, the authors conducted trainee and faculty focus groups to better understand their experiences. Qualitative data was collected, including recommendations for responding to discrimination, characteristics of the most common experiences, and trainees' own ideas for worthwhile simulation scenarios. Trainees and faculty were then brought together in a collaborative process to co-develop simulation cases that were later implemented in curricula across multiple learner levels, specialties, and contexts. Participants in these simulations reported improved comfort in responding to discrimination in the moment and/or in the wake of such incidents. Through trainee-faculty collaboration, the project yielded authentic and impactful simulation experiences for learners, while also giving trainees an opportunity to turn previous trauma into constructive learning opportunities that promote an inclusive environment.

8.
Materials (Basel) ; 17(18)2024 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-39336406

RESUMEN

This study focuses on the feasibility of using ground Acanthocardia tuberculate seashells as fine aggregates for self-compacting mortar production. The obtained results show a promising future for coastal industries as their use eliminates waste products and improves the durability of these materials. The use of Acanthocardia tuberculate recycled aggregate, in terms of durability, improves the performance of all mixes made with seashells compared to those made with natural sand, although it decreases workability and slightly reduces mechanical strength. Proper mix design has beneficial effects, as it improves compressive strength, especially when the powder/sand ratio is 0.7. Three replacement ratios based on the volume (0%, 50%, and 100%) of natural limestone sand with recycled fine aggregate from Acanthocardia tuberculate seashells, and three different dosages modifying the powder/sand ratio (0.6, 0.7, and 0.8), were tested. The fresh-state properties of each self-compacting mixture were evaluated based on workability. The mineralogical phases of the hardened mixtures were characterised using X-ray diffraction, thermogravimetry, and differential analyses. Subsequently, the mechanical and durability properties were evaluated based on the compressive and flexural strengths, dry bulk density, accessible porosity for water and water absorption, drying shrinkage, mercury intrusion porosimetry, and water absorption by capillarity. Therefore, the use of Acanthocardia tuberculate seashells in cement-based systems contributes to circular economy.

9.
Ann Thorac Surg ; 2024 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-39102932

RESUMEN

BACKGROUND: Children who undergo cardiac surgery may require post-cardiotomy extracorporeal membrane oxygenation (ECMO). Although morbidities are considerable, our understanding of outcome determinants is limited. We evaluated associations between patient and peri-operative factors with outcomes. METHODS: The STS Congenital Heart Surgery Database was queried for patients <18yo who underwent post-cardiotomy ECMO from 1/2016-6/2021. PRIMARY OUTCOME: survival to hospital discharge. SECONDARY OUTCOME: survival without neurologic injury. Logistic regression for binary outcomes and competing risk analysis for survival were used to identify the most important predictors. Variables were selected by stepwise procedure using entry level p=0.35. Those with p≤0.1 were kept in the final model. RESULTS: A total of 3,181 patients were supported with post-cardiotomy ECMO during the same hospitalization as cardiac surgery: (A) intra-operative initiation of ECMO, n=1206; (B) early post-operative (≤48 hours), n=936; (C) late post-operative (>48 hours), n=1039. Most common primary procedure of index operation was the Norwood procedure. 57% intra-op survived to discharge, versus 59% early post-op and 42% late post-op group (χ2 (2) = 64, p<0.0001, V = 0.14). In all groups, post-op septicemia, cardiac arrest, and new neurologic injury had the strongest association with mortality, while post-operative reintubation and unplanned non-cardiac reoperation were associated with higher survival. CONCLUSIONS: Multiple risk factors impact survival in children who undergo cardiac surgery and post-cardiotomy ECMO. ECMO initiated >48 hours after surgery is associated with the poorest outcomes. This is the first step in creating a predictive tool to educate clinicians and families regarding expectations in this high-risk population.

10.
J Am Coll Cardiol ; 84(7): 633-634, 2024 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-39111969
11.
Dalton Trans ; 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39171661

RESUMEN

π-π stacking interactions are versatile because they are involved in many processes, such as protein folding, DNA stacking, and drug recognition. However, from the point of view of crystal engineering, there is an incipient knowledge of its exploitation. A comparison of these interactions with hydrogen bonds shows a huge difference in their employment as a reliable non-covalent interaction. And different reasons can be listed to explain why hydrogen bonding can be considered a more robust interaction than π-π stacking. For instance, hydrogen bonds encompass a wide energy range (25-40 kJ mol-1). From this, these interactions can be classified as strong, moderate, and weak. Hence, the first two can be considered highly to moderately directional to be exploited in crystal engineering. This aspect is relevant for them to be used in a relatively reliably way in this area of supramolecular chemistry. On the other hand, in the case of π-π stacking, the energy range is 0-10 kJ mol-1, thus implying that hydrogen bonds or any other energetically more robust contact would predominate in the competition for establishing packing interactions in a given arrangement. In this sense, if stacking is pretended to be exploited from the point of view of crystal engineering, one of the points that must be ensured is that this interaction will be the one energetically predominant. However, although there are other factors to consider, it seems that energetics is the dominant one. In this line, our research group has obtained and studied many single-crystalline structures of coordination and organometallic compounds containing fluorinated thiolates. This being particularly true in the case of the thiolate 2,3,5,6-S(C6F4H-4) bound to different metals, where it has been observed that they preferentially tend to establish πF-πF stacking interactions, results that have been reported in several papers. Thus, from this perspective, we have explored, using ConQuest (CCDC) a number of structures to observe how feasible is to find stacking in coordination and organometallic compounds containing the thiolate 2,3,5,6-S(C6F4H-4).

12.
J Intensive Care Med ; : 8850666241268655, 2024 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-39094610

RESUMEN

BACKGROUND: Elevated renin has been shown to predict poor response to standard vasoactive therapies and is associated with poor outcomes in adults. Similarly, elevated renin was associated with mortality in children with septic shock. Renin concentration profiles after pediatric cardiac surgery are unknown. The purpose of this study was to characterize renin kinetics after pediatric cardiac surgery. METHODS: Single-center retrospective study of infants who underwent cardiac surgery with cardiopulmonary bypass (CPB) utilizing serum samples obtained in the perioperative period to measure plasma renin concentrations (pg/mL). Time points included pre-bypass and 1, 4, and 24 h after initiation of CPB. RESULTS: Fifty patients (65% male) with a median age 5 months (interquartile range (IQR) 3.5, 6.5) were included. Renin concentrations peaked 4 h after CPB. There was a significant difference in preoperative and 4 h post-CPB renin concentration (4 h post-CPB vs preoperative: mean difference 100.6, 95% confidence interval (CI) 48.9-152.4, P < .001). Median renin concentration at 24 h after CPB was lower than the preoperative baseline. CONCLUSIONS: We describe renin kinetics in infants after CPB. Future studies based on these data can now be performed to evaluate the associations of elevated renin concentrations with adverse outcomes.

13.
Lung ; 202(4): 459-464, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38971847

RESUMEN

Data on concomitant cardiac surgery (CCS) performed during pediatric lung transplantation (LTx) is limited. Therefore, we conducted a multi-institutional analysis to identify the incidence and outcomes of CCS in pediatric (< 18 years) LTx recipients by merging data (2004-2023) from the United Network for Organ Sharing (UNOS) and Pediatric Health Information System (PHIS) databases. Of the total of 596 pediatric LTx recipients, 87 (15%) underwent CCS. The majority of these cardiac surgeries were atrial septal defect (ASD) closure (90%) followed by aortic arch/descending aortic repair (3%), atrial repair (3%), ventricular septal defect closure (2%), patent ductus arteriosus ligation (2%), and tricuspid valve repair (2%). The median age at LTx was 3 years (IQR: 0-12). Pulmonary hypertension (PHT) was the predominant indication for LTx (54%). Survival to discharge was 94% and 5-years survival was 64%. Our findings indicate CCS in children undergoing LTx has acceptable outcomes.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Trasplante de Pulmón , Humanos , Trasplante de Pulmón/estadística & datos numéricos , Niño , Masculino , Estados Unidos/epidemiología , Femenino , Preescolar , Procedimientos Quirúrgicos Cardíacos/métodos , Lactante , Adolescente , Recién Nacido , Estudios Retrospectivos , Hipertensión Pulmonar/cirugía , Resultado del Tratamiento , Cardiopatías Congénitas/cirugía , Cardiopatías Congénitas/complicaciones , Tasa de Supervivencia , Bases de Datos Factuales , Incidencia
14.
Artículo en Inglés | MEDLINE | ID: mdl-38971401

RESUMEN

OBJECTIVES: For neonates and infants with aortic valve pathology, the Ross procedure historically has been associated with high rates of morbidity and mortality. Data regarding long-term durability are lacking. METHODS: The international, multi-institutional Ross Collaborative included 6 tertiary care centers. Infants who underwent a Ross operation between 1996 and 2016 (allowing a minimum 5 years of follow-up) were retrospectively identified. Serial echocardiograms were examined to study evolution in neoaortic size and function. RESULTS: Primary diagnoses for the 133 patients (n = 30 neonates) included isolated aortic stenosis (14%, n = 19), Shone complex (14%, n = 19), and aortic stenosis plus other (excluding Shone complex; n = 95, 71%), including arch obstruction (n = 55), left ventricular hypoplasia (n = 9), and mitral disease (moderate or greater stenosis or regurgitation, n = 31). At the time of the Ross procedure, median age was 96 days (interquartile range, 36-186), and median weight was 4.4 kg (3.6-6.5). In-hospital mortality occurred in 13 of 133 patients (10%) (4/30 [13%] neonates). Postdischarge mortality occurred in 10 of 120 patients (8%) at a median of 298 days post-Ross. Post-Ross neoaortic dilatation occurred, peaking at 4 to 5 SDs above normal at 2 to 3 years before returning to near-baseline z-score at a median follow-up of 11.5 [6.4-17.4] years. Autograft/left ventricular outflow tract reintervention was required in 5 of 120 patients (4%) at a median of 10.3 [4.1-12.8] years. Freedom from moderate or greater neoaortic regurgitation was 86% at 15 years. CONCLUSIONS: Neonates and infants experience excellent postdischarge survival and long-term freedom from autograft reintervention and aortic regurgitation after the Ross. Neoaortic dilatation normalizes in this population in the long-term. Increased consideration should be given to Ross in neonates and infants with aortic valve disease.

15.
JTCVS Open ; 19: 275-295, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39015443

RESUMEN

Objective: The study objective was to determine if intraoperative peritoneal catheter placement is associated with improved outcomes in neonates undergoing high-risk cardiac surgery with cardiopulmonary bypass. Methods: This propensity score-matched retrospective study used data from 22 academic pediatric cardiac intensive care units. Consecutive neonates undergoing Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery category 3 to 5 cardiac surgery with cardiopulmonary bypass at centers participating in the NEonatal and Pediatric Heart Renal Outcomes Network collaborative were studied to determine the association of the use of an intraoperative placed peritoneal catheter for dialysis or passive drainage with clinical outcomes, including the duration of mechanical ventilation. Results: Among 1490 eligible neonates in the NEonatal and Pediatric Heart Renal Outcomes Network dataset, a propensity-matched analysis was used to compare 395 patients with peritoneal catheter placement with 628 patients without peritoneal catheter placement. Time to extubation and most clinical outcomes were similar. Postoperative length of stay was 5 days longer in the peritoneal catheter placement cohort (17 vs 22 days, P = .001). There was a 50% higher incidence of moderate to severe acute kidney injury in the no-peritoneal catheter cohort (12% vs 18%, P = .02). Subgroup analyses between specific treatments and in highest risk patients yielded similar associations. Conclusions: This study does not demonstrate improved outcomes among neonates with placement of a peritoneal catheter during cardiac surgery. Outcomes were similar apart from longer hospital stay in the peritoneal catheter cohort. The no-peritoneal catheter cohort had a 50% higher incidence of moderate to severe acute kidney injury (12% vs 18%). This analysis does not support indiscriminate peritoneal catheter use, although it may support the utility for postoperative fluid removal among neonates at risk for acute kidney injury. A multicenter controlled trial may better elucidate peritoneal catheter effects.

16.
Chem Biodivers ; : e202400995, 2024 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-39001660

RESUMEN

A series of three Ni(II)-POCOP complexes para-functionalized with an acetoxyl fragment were synthesized. All complexes (2 a-c) were fully characterized through standard analytical techniques. The molecular structure of complex 2 b was unambiguously determined by single-crystal X-ray diffraction, revealing that the metal center is situated in a slightly distorted square-planar environment. Additionally, the acetoxy fragment at the para-position of the phenyl ring was found to be present. The in vitro cytotoxic activity of all complexes was assessed on six human cancer cell lines. Notably, complex 2 b exhibited selective activity against K-562 (chronic myelogenous leukemia) and MCF-7 (mammary adenocarcinoma) with IC50 values of 7.32±0.60 µM and 14.36±0.02 µM, respectively. Furthermore, this compound showed negligible activity on the healthy cell line COS-7, highlighting the potential therapeutic application of 2 b. The cytotoxic evaluations were further complemented with molecular docking calculations to explore the potential biological targets of complex 2 b, revealing interactions with cluster differentiation protein 1a (CD1A, PDB: 1xz0) for K-562 and with the progesterone receptor for MCF-7.

17.
J Am Soc Mass Spectrom ; 35(8): 1875-1882, 2024 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-38918936

RESUMEN

Mass spectrometry is a powerful technique for analyzing molecules in complex biological samples. However, inter- and intralaboratory variability and bias can affect the data due to various factors, including sample handling and preparation, instrument calibration and performance, and data acquisition and processing. To address this issue, the Quality Control (QC) working group of the Human Proteome Organization's Proteomics Standards Initiative has established the standard mzQC file format for reporting and exchanging information relating to data quality. mzQC is based on the JavaScript Object Notation (JSON) format and provides a lightweight yet versatile file format that can be easily implemented in software. Here, we present open-source software libraries to process mzQC data in three programming languages: Python, using pymzqc; R, using rmzqc; and Java, using jmzqc. The libraries follow a common data model and provide shared functionalities, including the (de)serialization and validation of mzQC files. We demonstrate use of the software libraries in a workflow for extracting, analyzing, and visualizing QC metrics from different sources. Additionally, we show how these libraries can be integrated with each other, with existing software tools, and in automated workflows for the QC of mass spectrometry data. All software libraries are available as open source under the MS-Quality-Hub organization on GitHub (https://github.com/MS-Quality-Hub).


Asunto(s)
Espectrometría de Masas , Lenguajes de Programación , Proteómica , Control de Calidad , Programas Informáticos , Espectrometría de Masas/métodos , Espectrometría de Masas/normas , Humanos , Proteómica/métodos , Proteómica/normas , Flujo de Trabajo
18.
Reumatol Clin (Engl Ed) ; 20(5): 249-253, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38880553

RESUMEN

INTRODUCTION/AIM: Older people with rheumatic diseases tend to have a greater number of associated comorbidities, which will require the use of more drugs, increasing the risk of hospitalizations, complications, and drug interactions. In Mexico, there has been an estimated prevalence of polypharmacy of up to 55%, however there are scarce reports on the topic in our elderly population with rheumatic diseases. We aimed to determine the prevalence of polypharmacy and the association of drug interactions in patients treated for rheumatic disease. METHODS: A retrospective observational study was conducted on patients undergoing treatment for rheumatic diseases who were treated in geriatrics and rheumatology clinics from January to December 2021. The presence of polypharmacy and drug interactions was evaluated using the BOT Plus Pharmacological Surveillance System. The prevalence of polypharmacy and the association of drug interactions were estimated. RESULTS: We evaluated 320 patients, with a mean age of 67.05±5.8 years, predominantly female (85%). The prevalence of polypharmacy was 68.1% (n=218), of which 214 (98.1%) patients had related drug interactions; 27.1% were severe and 53.2% as moderate interactions. Factors related with increased risk of drug interactions were being exposed to hypertension increased the risk of drug interactions (POR 1.75, 95% CI 1.44-2.14; P<0.001), having osteoarthritis (POR 1.21, 95% CI 1.04-1.42; P=0.032) and thyroid disease (POR 1.45, 95% CI 1.28-1.65; P=0.001). The most prevalent serious interactions were leflunomide-methotrexate in 27 (46.5%) patients and buprenorphine-tramadol in 8 (13.7%). CONCLUSIONS: A high prevalence of polypharmacy and drug interactions was observed in elderly patients with rheumatic diseases. The main associated factors were comorbidities, particularly high blood pressure, osteoarthritis and thyroid diseases.


Asunto(s)
Interacciones Farmacológicas , Polifarmacia , Enfermedades Reumáticas , Humanos , Femenino , Anciano , Masculino , Enfermedades Reumáticas/tratamiento farmacológico , Estudios Retrospectivos , Prevalencia , México/epidemiología , Persona de Mediana Edad , Comorbilidad , Anciano de 80 o más Años
19.
Nat Metab ; 6(5): 963-979, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38693320

RESUMEN

Subcutaneous white adipose tissue (scWAT) is a dynamic storage and secretory organ that regulates systemic homeostasis, yet the impact of endurance exercise training (ExT) and sex on its molecular landscape is not fully established. Utilizing an integrative multi-omics approach, and leveraging data generated by the Molecular Transducers of Physical Activity Consortium (MoTrPAC), we show profound sexual dimorphism in the scWAT of sedentary rats and in the dynamic response of this tissue to ExT. Specifically, the scWAT of sedentary females displays -omic signatures related to insulin signaling and adipogenesis, whereas the scWAT of sedentary males is enriched in terms related to aerobic metabolism. These sex-specific -omic signatures are preserved or amplified with ExT. Integration of multi-omic analyses with phenotypic measures identifies molecular hubs predicted to drive sexually distinct responses to training. Overall, this study underscores the powerful impact of sex on adipose tissue biology and provides a rich resource to investigate the scWAT response to ExT.


Asunto(s)
Tejido Adiposo Blanco , Condicionamiento Físico Animal , Caracteres Sexuales , Grasa Subcutánea , Animales , Masculino , Femenino , Ratas , Tejido Adiposo Blanco/metabolismo , Grasa Subcutánea/metabolismo , Adipogénesis , Ratas Sprague-Dawley , Multiómica
20.
Cell Metab ; 36(6): 1411-1429.e10, 2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38701776

RESUMEN

Mitochondria have diverse functions critical to whole-body metabolic homeostasis. Endurance training alters mitochondrial activity, but systematic characterization of these adaptations is lacking. Here, the Molecular Transducers of Physical Activity Consortium mapped the temporal, multi-omic changes in mitochondrial analytes across 19 tissues in male and female rats trained for 1, 2, 4, or 8 weeks. Training elicited substantial changes in the adrenal gland, brown adipose, colon, heart, and skeletal muscle. The colon showed non-linear response dynamics, whereas mitochondrial pathways were downregulated in brown adipose and adrenal tissues. Protein acetylation increased in the liver, with a shift in lipid metabolism, whereas oxidative proteins increased in striated muscles. Exercise-upregulated networks were downregulated in human diabetes and cirrhosis. Knockdown of the central network protein 17-beta-hydroxysteroid dehydrogenase 10 (HSD17B10) elevated oxygen consumption, indicative of metabolic stress. We provide a multi-omic, multi-tissue, temporal atlas of the mitochondrial response to exercise training and identify candidates linked to mitochondrial dysfunction.


Asunto(s)
Mitocondrias , Condicionamiento Físico Animal , Animales , Masculino , Femenino , Mitocondrias/metabolismo , Ratas , Músculo Esquelético/metabolismo , Humanos , Ratas Sprague-Dawley , Tejido Adiposo Pardo/metabolismo , Glándulas Suprarrenales/metabolismo , Multiómica
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA