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1.
Science ; 384(6702): 1330-1335, 2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-38900867

RESUMEN

Extreme weather events radically alter ecosystems. When ecological damage persists, selective pressures on individuals can change, leading to phenotypic adjustments. For group-living animals, social relationships may be a mechanism enabling adaptation to ecosystem disturbance. Yet whether such events alter selection on sociality and whether group-living animals can, as a result, adaptively change their social relationships remain untested. We leveraged 10 years of data collected on rhesus macaques before and after a category 4 hurricane caused persistent deforestation, exacerbating monkeys' exposure to intense heat. In response, macaques demonstrated persistently increased tolerance and decreased aggression toward other monkeys, facilitating access to scarce shade critical for thermoregulation. Social tolerance predicted individual survival after the hurricane, but not before it, revealing a shift in the adaptive function of sociality.


Asunto(s)
Adaptación Psicológica , Agresión , Regulación de la Temperatura Corporal , Calor Extremo , Macaca mulatta , Animales , Femenino , Masculino , Tormentas Ciclónicas , Ecosistema , Macaca mulatta/fisiología , Macaca mulatta/psicología , Clima
2.
bioRxiv ; 2024 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-37503170

RESUMEN

Weather-related disasters can radically alter ecosystems. When disaster-driven ecological damage persists, the selective pressures exerted on individuals can change, eventually leading to phenotypic adjustments. For group-living animals, social relationships are believed to help individuals cope with environmental challenges and may be a critical mechanism enabling adaptation to ecosystems degraded by disasters. Yet, whether natural disasters alter selective pressures on patterns of social interactions and whether group-living animals can, as a result, adaptively change their social relationships remains untested. Here, we leveraged unique data collected on rhesus macaques from 5 years before to 5 years after a category 4 hurricane, leading to persistent deforestation which exacerbated monkeys' exposure to intense heat. In response, macaques increased tolerance for and decreased aggression toward other monkeys, facilitating access to scarce shade critical for thermoregulation. Social tolerance predicted individual survival for 5 years after the hurricane, but not before it, revealing a clear shift in the adaptive function of social relationships in this population. We demonstrate that an extreme climatic event altered selection on sociality and triggered substantial and persistent changes in the social structure of a primate species. Our findings unveil the function and adaptive flexibility of social relationships in degraded ecosystems and identify natural disasters as potential evolutionary drivers of sociality. One-Sentence Summary: Testard et al. show that a natural disaster altered selection on sociality in group-living primates triggering persistent changes in their social structure.

3.
Exp Mech ; 61(1): 229-235, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33776073

RESUMEN

BACKGROUND: Hemolysis in sickle cell disease (SCD) releases cell free hemoglobin, which scavenges nitric oxide (NO), leading to pulmonary vascular vasoconstriction, increased pulmonary vascular resistance (PVR), and the development of PH. However, PVR is only one component of right ventricular (RV) afterload. Whether sickled red blood cells increase the total RV afterload, including compliance and wave reflections, is unclear. OBJECTIVE: Patients with SCD and pulmonary hypertension (PH) have a significantly increased risk of sudden death compared to patients with SCD alone. Sickled red blood cells (RBCs) are fragile and lyse easily. Here, we sought to determine the acute effects of SCD RBCs and increased cell free hemoglobin on RV afterload. METHODS: Main pulmonary artery pressures and flows were measured in C57BL6 mice before and after exchanges of whole blood (~200 uL, Hct=45%) with an equal volume of SCD RBCs in plasma (Hct=45%) or cell free hemoglobin (Hb+) in solution. After transfusions, animals were additionally stressed with acute hypoxia (AH; 10% O2). RESULTS: SCD RBCs increased PVR only compared to control RBCs; cell free hemoglobin increased PVR and wave reflections. These increases in RV afterload increased further with AH. CONCLUSIONS: The release of cell free hemoglobin from fragile SCD RBCs in vivo increases the total RV afterload and may impair RV function more than the SCD RBCs themselves.

4.
Health Qual Life Outcomes ; 18(1): 214, 2020 Jul 06.
Artículo en Inglés | MEDLINE | ID: mdl-32631444

RESUMEN

BACKGROUND: People living with HIV experience burdensome multidimensional symptoms and concerns requiring person-centred care. Routine use of patient reported outcome measures can improve outcomes. There is no brief patient reported outcome measure (PROM) that currently reflects the breadth of concerns for people living with HIV. This study aimed to develop and cognitively test a brief novel patient reported outcome measure for use within routine adult HIV care- the "Positive Outcomes" HIV PROM. METHODS: Development followed the COSMIN taxonomy and guidance for relevance and comprehensiveness, and Rothrock guidance on development of valid patient reported outcome measures. The Positive Outcomes HIV PROM was developed by a steering group (people living with HIV, HIV professionals and health services researchers) using findings from a previously reported qualitative study of priority outcomes for people living with HIV. The prototype measure was cognitively tested with a purposive sample of people living with HIV. RESULTS: The Positive Outcomes HIV PROM consists of 23 questions (22 structured, and one open question) informed by the priorities of key stakeholders (n = 28 people living with HIV, n = 21 HIV professionals and n = 8 HIV commissioners) to ensure face and content validity, and refined through cognitive testing (n = 6 people living with HIV). Cognitive testing demonstrated high levels of acceptability and accessibility. CONCLUSIONS: The Positive Outcomes HIV PROM is the first brief patient reported outcome measure reflecting the diverse needs of people living with HIV designed specifically for use in the clinical setting to support patient assessment and care, and drive service quality improvement. It is derived from primary data on the priority outcomes for people living with HIV and is comprehensive and acceptable. Further psychometric testing is required to ensure reliability and responsiveness.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Cognición/efectos de los fármacos , Infecciones por VIH/tratamiento farmacológico , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Medición de Resultados Informados por el Paciente , Atención Dirigida al Paciente/métodos , Calidad de Vida/psicología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría/métodos , Investigación Cualitativa , Reproducibilidad de los Resultados
5.
Nanoscale ; 12(1): 262-270, 2020 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-31815999

RESUMEN

The discovery and characterisation of nanomaterials represents a multidisciplinary problem. Their properties and applications within biological, physical and medicinal sciences depend on their size, shape, concentration and surface charge. No single technology can currently measure all characteristics. Here we combine resistive pulse sensing with predictive logistic regression models, termed RPS-LRM, to rapidly characterise a nanomaterial's size, aspect ratio, shape and concentration when mixtures of nanorods and nanospheres are present in the same solution. We demonstrate that RPS-LRM can be applied to the characterisation of nanoparticles over a wide size range, and varying aspect ratios, and can distinguish between nanorods over nanospheres when they possess an aspect ratio grater then two. The RPS-LRM can rapidly measure the ratios of nanospheres to nanorods in solution within mixtures, regardless of their relative sizes and ratios i.e. many large nanospherical particles do not interfere with the characterisation of smaller nanorods. This was done with a 91% correct classification of nanospherical particles and 72% correct classification of nanorods even when the fraction of nanorods in solution is as low as 20%. The methodology here will enable the classification of nanomedicines, new nanomaterials and biological analytes in solution.

6.
HIV Med ; 20(8): 542-554, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31162817

RESUMEN

OBJECTIVES: People living with HIV (PLWH) have multidimensional concerns requiring person-centred care. Routine use of patient-reported outcome measures (PROMs) improves outcomes. No brief PROM currently reflects the breadth of concerns for PLWH. This study sought to identify priority outcomes for PLWH, model current practice, explore views on introducing PROMs into routine care, and devise a model for person-centred care incorporating the PROM. METHODS: A cross-national multi-centre study (London, Brighton and Dublin) was carried out. Semi-structured qualitative interviews with adult PLWH, HIV health care professionals and HIV commissioners (responsible for planning and commissioning services) were performed. Interviews were analysed using thematic and framework analysis. RESULTS: PLWH (n = 28), professionals (n = 21) and commissioners (n = 8) described concerns related to living with HIV across six domains: physical (e.g. pain and gastrointestinal symptoms), cognitive (e.g. memory and sleep), psychological (e.g. anxiety and depression), social (e.g. isolation and intimacy), welfare (e.g. finances and fears regarding change of immigration status), and information (e.g. long-term outcomes) needs. Themes were highly inter-related, impacting across domains of need (e.g. physical and cognitive problems impacting on psychological and social wellbeing). Perceived benefits of using PROMs in routine HIV care included improved person-centredness, patient empowerment, fewer missed concerns, increased engagement with services, and informed planning of services. Potential challenges included heterogeneity of PLWH, literacy, and utility for those who struggle to engage with care. CONCLUSIONS: This study presents a novel model of person-centred care incorporating an HIV-specific PROM. The model reflects priorities of key stakeholders. Explicit use of PROMs in routine HIV care could afford benefits for PLWH, clinical teams and commissioners.


Asunto(s)
Infecciones por VIH/terapia , Medición de Resultados Informados por el Paciente , Atención Dirigida al Paciente/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Infecciones por VIH/psicología , Personal de Salud , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Reino Unido , Adulto Joven
7.
Sci Rep ; 7(1): 17791, 2017 12 19.
Artículo en Inglés | MEDLINE | ID: mdl-29259240

RESUMEN

Individuals who are well integrated into society have greater access to resources and tend to live longer. Why some individuals are socially isolated and others are not is therefore puzzling from an evolutionary perspective. Answering this question requires establishing the mix of intrinsic and contextual factors that contribute to social isolation. Using social network data spanning up to half of the median adult lifespan in a gregarious primate, we found that some measures of social isolation were modestly repeatable within individuals, consistent with a trait. By contrast, social isolation was not explained by the identity of an animal's mother or the group into which it was born. Nevertheless, age, sex and social status each played a role, as did kin dynamics and familiarity. Females with fewer close relatives were more isolated, and the more time males spent in a new group the less isolated they became, independent of their social status. These results show that social isolation results from a combination of intrinsic and environmental factors. From an evolutionary perspective, these findings suggest that social isolation could be adaptive in some contexts and partly maintained by selection.


Asunto(s)
Madres/psicología , Aislamiento Social/psicología , Adolescente , Adulto , Animales , Niño , Femenino , Humanos , Masculino , Primates/psicología , Medio Social , Adulto Joven
9.
Bone Joint J ; 99-B(8): 1102-1108, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28768789

RESUMEN

AIMS: It is well established that there is a strong association between Perthes' disease and worsening socioeconomic deprivation. It has been suggested that the primary determinant driving this association is exposure to tobacco smoke. This study aimed to examine this hypothesis. PATIENTS AND METHODS: A hospital case-control study (n = 149/146) examined the association between tobacco smoke exposure and Perthes' disease, adjusting for area-level socioeconomic deprivation. Tobacco smoke exposure was assessed by parental questionnaire of smoking habits during pregnancy, and by quantitative assay of current exposure using the urinary cotinine-creatinine ratio, which is a widely used and validated measure of tobacco smoke exposure. RESULTS: The odds of Perthes' disease significantly increased with reported in utero exposure after adjustment for socioeconomic deprivation (maternal smoking odds ratio (OR) 2.06, 95% confidence interval (CI) 1.17 to 3.63; paternal smoking OR 2.09, 95% CI 1.26 to 3.46). The cotinine-creatinine ratio was significantly greater in cases, OR 1.63 (95% CI 1.09 to 2.43), suggesting a greater 'dose' of current tobacco exposure. CONCLUSION: An association exists between tobacco smoke exposure and Perthes' disease but we remain unable to disentangle the association with socioeconomic deprivation. Cite this article: Bone Joint J 2017;99-B:1102-8.


Asunto(s)
Biomarcadores/metabolismo , Enfermedad de Legg-Calve-Perthes/etiología , Nicotiana/efectos adversos , Fumar/efectos adversos , Contaminación por Humo de Tabaco/efectos adversos , Adolescente , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Enfermedad de Legg-Calve-Perthes/epidemiología , Enfermedad de Legg-Calve-Perthes/metabolismo , Embarazo , Estudios Retrospectivos , Factores de Riesgo , Factores Socioeconómicos , Factores de Tiempo , Reino Unido/epidemiología
10.
Proc Biol Sci ; 284(1854)2017 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-28515205

RESUMEN

Two decades of research suggest social relationships have a common evolutionary basis in humans and other gregarious mammals. Critical to the support of this idea is growing evidence that mortality is influenced by social integration, but when these effects emerge and how long they last is mostly unknown. Here, we report in adult female macaques that the impact of number of close adult female relatives, a proxy for social integration, on survival is not experienced uniformly across the life course; prime-aged females with a greater number of relatives had better survival outcomes compared with prime-aged females with fewer relatives, whereas no such effect was found in older females. Group size and dominance rank did not influence this result. Older females were less frequent targets of aggression, suggesting enhanced experience navigating the social landscape may obviate the need for social relationships in old age. Only one study of humans has found age-based dependency in the association between social integration and survival. Using the largest dataset for any non-human animal to date, our study extends support for the idea that sociality promotes survival and suggests strategies employed across the life course change along with experience of the social world.


Asunto(s)
Conducta Animal , Macaca , Conducta Social , Agresión , Animales , Evolución Biológica , Femenino , Predominio Social
11.
Neuropsychopharmacology ; 42(10): 1931-1939, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28553839

RESUMEN

Foraging is a fundamental behavior, and many types of animals appear to have solved foraging problems using a shared set of mechanisms. Perhaps the most common foraging problem is the choice between exploiting a familiar option for a known reward and exploring unfamiliar options for unknown rewards-the so-called explore/exploit trade-off. This trade-off has been studied extensively in behavioral ecology and computational neuroscience, but is relatively new to the field of psychiatry. Explore/exploit paradigms can offer psychiatry research a new approach to studying motivation, outcome valuation, and effort-related processes, which are disrupted in many mental and emotional disorders. In addition, the explore/exploit trade-off encompasses elements of risk-taking and impulsivity-common behaviors in psychiatric disorders-and provides a novel framework for understanding these behaviors within an ecological context. Here we explain relevant concepts and some common paradigms used to measure explore/exploit decisions in the laboratory, review clinically relevant research on the neurobiology and neuroanatomy of explore/exploit decision making, and discuss how computational psychiatry can benefit from foraging theory.


Asunto(s)
Conducta Apetitiva/fisiología , Encéfalo/fisiopatología , Toma de Decisiones/fisiología , Conducta Exploratoria/fisiología , Trastornos Mentales/fisiopatología , Animales , Investigación Biomédica/métodos , Encéfalo/fisiología , Humanos , Psiquiatría/métodos
12.
Nanoscale ; 8(45): 19139-19147, 2016 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-27827506

RESUMEN

A tunable resistive pulse sensor, utilising a polyurethane nanopore, has been used to characterise nanoparticles as they traverse the pore opening. Herein we demonstrate that the translocation speed, conductive and resistive pulse magnitude, can be used to infer the surface charge of a nanoparticle, and act as a specific transduction signal for the binding of metal ions to ligands on the particle surface. Surfaces of silica nanoparticles were modified with a ligand to demonstrate the concept, and used to extract copper(ii) ions (Cu2+) from solution. By tuning the pH and ionic strength of the solution, a biphasic pulse, a conductive followed by a resistive pulse is recorded. Biphasic pulses are becoming a powerful means to characterise materials, and provide insight into the translocation mechanism, and herein we present their first use to detect the presence of metal ions in solution. We demonstrate how combinations of translocation speed and/or biphasic pulse behaviour are used to detect Cu2+ with quantitative responses across a range of pH and ionic strengths. Using a generic ligand this assay allows a clear signal for Cu2+ as low as 1 ppm with a short 5-minute incubation time, and is capable of measuring 10 ppm Cu2+ in the presence of 5 other ions. The method has potential for monitoring heavy metals in biological and environmental samples.

13.
Anim Behav ; 103: 267-275, 2015 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-26034313

RESUMEN

An ethological approach to attention predicts that organisms orient preferentially to valuable sources of information in the environment. For many gregarious species, orienting to other individuals provides valuable social information but competes with food acquisition, water consumption and predator avoidance. Individual variation in vigilance behaviour in humans spans a continuum from inattentive to pathological levels of interest in others. To assess the comparative biology of this behavioural variation, we probed vigilance rates in free-ranging macaques during water drinking, a behaviour incompatible with the gaze and postural demands of vigilance. Males were significantly more vigilant than females. Moreover, vigilance showed a clear genetic component, with an estimated heritability of 12%. Monkeys carrying a relatively infrequent 'long' allele of TPH2, a regulatory gene that influences serotonin production in the brain, were significantly less vigilant compared to monkeys that did not carry the allele. These findings resonate with the hypothesis that the serotonin pathway regulates vigilance in primates and by extension provoke the idea that individual variation in vigilance and its underlying biology may be adaptive rather than pathological.

15.
Public Health ; 128(5): 399-403, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24794180

RESUMEN

Preterm birth is defined as birth before 37 completed weeks gestation, and it is estimated that each day, across the world over 41,000 infants are born before this gestational age. The risk of adverse consequences declines with increasing gestational age. While this paper focuses on the consequences of preterm birth, the adverse consequences for infants born at 38 and 39 weeks gestation are also of a higher risk than those for infants born at 40 weeks gestation, with the neonatal mortality risk increasing again in infants born beyond the 42nd week of gestation.


Asunto(s)
Edad Gestacional , Mortalidad Infantil/tendencias , Enfermedades del Prematuro/epidemiología , Resultado del Embarazo , Nacimiento Prematuro/epidemiología , Parto Obstétrico/efectos adversos , Países Desarrollados/estadística & datos numéricos , Inglaterra/epidemiología , Femenino , Política de Salud , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro/mortalidad , Complicaciones del Trabajo de Parto/etiología , Complicaciones del Trabajo de Parto/prevención & control , Embarazo , Nacimiento Prematuro/etiología , Nacimiento Prematuro/mortalidad , Factores de Riesgo , Factores Socioeconómicos , Tasa de Supervivencia , Gales/epidemiología
17.
Neuroscience ; 248: 585-93, 2013 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-23831424

RESUMEN

Developmental dyslexia, the most common childhood learning disorder, is highly heritable, and recent studies have identified KIAA0319-Like (KIAA0319L) as a candidate dyslexia susceptibility gene at the 1p36-34 (DYX8) locus. In this experiment, we investigated the anatomical effects of knocking down this gene during rat corticogenesis. Cortical progenitor cells were transfected using in utero electroporation on embryonic day (E) 15.5 with plasmids encoding either: (1) Kiaa0319l small hairpin RNA (shRNA), (2) an expression construct for human KIAA0319L, (3) Kiaa0319l shRNA+KIAA0319L expression construct (rescue), or (4) controls (scrambled Kiaa0319l shRNA or empty expression vector). Mothers were injected with 5-bromo-2-deoxyuridine (BrdU) at either E13.5, E15.5, or E17.5. Disruption of Kiaa0319l function (by knockdown, overexpression, or rescue) resulted in the formation of large nodular periventricular heterotopia in approximately 25% of the rats, which can be seen as early as postnatal day 1. Only a small subset of heterotopic neurons had been transfected, indicating non-cell autonomous effects of the transfection. Most heterotopic neurons were generated in mid- to late-gestation, and laminar markers suggest that they were destined for upper cortical laminae. Finally, we found that transfected neurons in the cerebral cortex were located in their expected laminae. These results indicate that KIAA0319L is the fourth of four candidate dyslexia susceptibility genes that is involved in neuronal migration, which supports the association of abnormal neuronal migration with developmental dyslexia.


Asunto(s)
Corteza Cerebral/crecimiento & desarrollo , Dislexia/genética , Regulación del Desarrollo de la Expresión Génica , Malformaciones del Desarrollo Cortical del Grupo II/genética , Células-Madre Neurales/metabolismo , Proteínas Nucleares/metabolismo , Animales , Animales Recién Nacidos , Susceptibilidad a Enfermedades , Electroporación , Humanos , Neurogénesis/genética , Proteínas Nucleares/genética , ARN Interferente Pequeño , Ratas , Ratas Transgénicas , Receptores de Superficie Celular , Transfección
18.
Neuroscience ; 247: 273-9, 2013 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-23735753

RESUMEN

The kinin-B2 receptor (B2BKR) activated by its endogenous ligand bradykinin participates in various metabolic processes including the control of arterial pressure and inflammation. Recently, functions for this receptor in brain development and protection against glutamate-provoked excitotoxicity have been proposed. Here, we report neuroprotective properties for bradykinin against organophosphate poisoning using acute hippocampal slices as an in vitro model. Following slice perfusion for 10min with diisopropylfluorophosphate (DFP) to initiate the noxious stimulus, responses of pyramidal neurons upon an electric impulse were reduced to less than 30% of control amplitudes. Effects on synaptic-elicited population spikes were reverted when preparations had been exposed to bradykinin 30min after challenging with DFP. Accordingly, bradykinin-induced population spike recovery was abolished by HOE-140, a B2BKR antagonist. However, the kinin-B1 receptor (B1BKR) agonist Lys-des-Arg(9)-bradykinin, inducing the phosphorylation of mitogen-activated protein kinase (MEK/MAPK) and cell death, abolished bradykinin-mediated neuroprotection, an effect, which was reverted by the ERK inhibitor PD98059. In agreement with pivotal B1BKR functions in this process, antagonism of endogenous B1BKR activity alone was enough for restoring population spike activity. On the other hand pralidoxime, an oxime, reactivating acetylcholinesterase (AChE) after organophosphate poisoning, induced population spike recovery after DFP exposure in the presence of bradykinin and Lys-des-Arg(9)-bradykinin. Lys-des-Arg(9)-bradykinin did not revert protection exerted by pralidoxime, however when instead bradykinin and Ly-des-Arg(9)-bradykinin were superfused together, recovery of population spikes diminished. These findings again confirm the neuroprotective feature of bradykinin, which is, diminished by its endogenous metabolites, stimulating the B1BKR, providing a novel understanding of the physiological roles of these receptors.


Asunto(s)
Isoflurofato/toxicidad , Neuronas/efectos de los fármacos , Fármacos Neuroprotectores/farmacología , Receptor de Bradiquinina B2/fisiología , Potenciales de Acción/efectos de los fármacos , Potenciales de Acción/fisiología , Animales , Bradiquinina/análogos & derivados , Bradiquinina/farmacología , Antagonistas del Receptor de Bradiquinina B2 , Hipocampo/efectos de los fármacos , Hipocampo/patología , Hipocampo/fisiología , Masculino , Neuronas/patología , Neuronas/fisiología , Técnicas de Cultivo de Órganos , Ratas Sprague-Dawley , Receptor de Bradiquinina B2/agonistas
19.
J Bone Joint Surg Br ; 94(12): 1684-9, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23188912

RESUMEN

Perthes' disease is an osteonecrosis of the juvenile hip, the aetiology of which is unknown. A number of comorbid associations have been suggested that may offer insights into aetiology, yet the strength and validity of these are unclear. This study explored such associations through a case control study using the United Kingdom General Practice Research database. Associations investigated were those previously suggested within the literature. A total of 619 cases of Perthes' disease were included, as were 2544 controls. The risk of Perthes' disease was significantly increased with the presence of congenital anomalies of the genitourinary and inguinal region, such as hypospadias (odds ratio (OR) 4.04 (95% confidence interval (CI) 1.41 to 11.58)), undescended testis (OR 1.83 (95% CI 1.12 to 3.00)) and inguinal herniae (OR 1.79 (95% CI 1.02 to 3.16)). Attention deficit hyperactivity disorder was not associated with Perthes' disease (OR 1.01 (95% CI 0.48 to 2.12)), although a generalised behavioural disorder was (OR 1.55 (95% CI 1.10 to 2.17)). Asthma significantly increased the risk of Perthes' disease (OR 1.44 (95% CI 1.17 to 1.76)), which remained after adjusting for oral/parenteral steroid use. Perthes' disease has a significant association with congenital genitourinary and inguinal anomalies, suggesting that intra-uterine factors may be critical to causation. Other comorbid associations may offer insight to support or refute theories of pathogenesis.


Asunto(s)
Enfermedad de Legg-Calve-Perthes/etiología , Adolescente , Estudios de Casos y Controles , Niño , Preescolar , Comorbilidad , Femenino , Medicina General , Humanos , Lactante , Recién Nacido , Enfermedad de Legg-Calve-Perthes/epidemiología , Masculino , Medición de Riesgo , Factores de Riesgo , Reino Unido
20.
J Urol ; 186(5): 2056-60, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21944104

RESUMEN

PURPOSE: We describe the prevalence, associated anomalies, prenatal diagnosis and survival of patients with bladder exstrophy-epispadias complex. MATERIALS AND METHODS: Data were extracted from the Northern Congenital Abnormality Survey for patients delivered during 1985 to 2008. This survey collects data on congenital anomalies in fetuses, stillbirths and live-born infants of mothers residing in Northern England (Northumberland, North Cumbria, Tyne and Wear Durham, Darlington and Teesside). RESULTS: A total of 43 cases were identified from 824,368 registered births for a total prevalence of 5.22 per 100,000 (95% CI 3.77-7.03). Excluding 1 twin with cloacal exstrophy, 42 cases occurred in singleton pregnancies. A total of 29 cases (69%) were isolated and 13 (31%) were associated with other anomalies, of which 11 (26%) were other structural and 2 (5%) were chromosomal. Male-to-female ratio was 2.2:1 for all singleton cases and 1.4:1 for isolated cases. Total prevalence of bladder exstrophy-epispadias complex singleton cases was 5.10 per 100,000 registered births (95% CI 3.67-6.89) and overall live birth prevalence was 4.63 per 100,000 live births (95% CI 3.28-6.36). Total prevalence of isolated cases of bladder exstrophy-epispadias complex was 3.52 per 100,000 births (95% CI 2.36-5.05) and live birth prevalence was 3.29 per 100,000 (95% CI 2.17-4.79). Accuracy of prenatal diagnosis was low, with 4 cases (10%) being detected prenatally by routine ultrasound (bladder exstrophy in 3, cloacal exstrophy in 1). Overall survival of all infants at 1 year was 95%. CONCLUSIONS: This population based study demonstrates a prevalence rate similar to other studies, a low prenatal diagnosis rate and high survival.


Asunto(s)
Extrofia de la Vejiga/epidemiología , Epispadias/epidemiología , Ano Imperforado/epidemiología , Extrofia de la Vejiga/diagnóstico por imagen , Inglaterra/epidemiología , Epispadias/diagnóstico por imagen , Femenino , Humanos , Recién Nacido , Masculino , Prevalencia , Sistema de Registros , Ultrasonografía Prenatal
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