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1.
Integr Org Biol ; 5(1): obad026, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37545740

RESUMEN

Jumping is a rapid locomotory mode widespread in terrestrial organisms. However, it is a rare specialization in ants. Forward jumping has been reported within four distantly related ant genera: Gigantiops, Harpegnathos, Myrmecia, and Odontomachus. The temporal engagement of legs/body parts during jump, however, varies across these genera. It is unknown what morphological adaptations underlie such behaviors and whether jumping in ants is solely driven directly by muscle contraction or additionally relies on elastic recoil mechanism. We investigated the morphological adaptations for jumping behavior by comparing differences in the locomotory musculature between jumping and non-jumping relatives using X-ray micro-CT and 3D morphometrics. We found that the size-specific volumes of the trochanter depressor muscle (scm6) of the middle and hind legs are 3-5 times larger in jumping ants, and that one coxal remotor muscle (scm2) is reduced in volume in the middle and/or hind legs. Notably, the enlargement in the volume of other muscle groups is directly linked to the legs or body parts engaged during the jump. Furthermore, a direct comparison of the muscle architecture revealed two significant differences between jumping vs. non-jumping ants: First, the relative Physiological Cross-Sectional Area (PCSA) of the trochanter depressor muscles of all three legs were larger in jumping ants, except in the front legs of Odontomachus rixosus and Myrmecia nigrocincta; second, the relative muscle fiber length was shorter in jumping ants compared to non-jumping counterparts, except in the front legs of O. rixosus and M. nigrocincta. These results suggest that the difference in relative muscle volume in jumping ants is largely invested in the area (PCSA), and not in fiber length. There was no clear difference in the pennation angle between jumping and non-jumping ants. Additionally, we report that the hind leg length relative to body length was longer in jumping ants. Based on direct comparison of the observed vs. possible work and power output during jumps, we surmise that direct muscle contractions suffice to explain jumping performance in three species, except for O. rixosus, where the lack of data on jumping performance prevents us from drawing definitive conclusions for this particular species. We suggest that increased investment in jumping-relevant musculature is a primary morphological adaptation that separates jumping from non-jumping ants. These results elucidate the common and idiosyncratic morphological changes underlying this rare adaptation in ants. まとぅみ (Okinawan language-Uchinaaguchi) (Japanese) РЕЗЮМЕ (Kazakh) ZUSAMMENFASSUNG (German).

2.
Community Ment Health J ; 59(8): 1610-1618, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37318671

RESUMEN

Autistic people may have difficulties in finding and keeping a job. Studies highlight that only 34% of autistic people are employed compared to 54% of people with disability. 58% of people with ASD have never had a job. Social cognition and cognitive strains may also have a significant impact on working life. The primary goal of our project is supporting autistic people through a training program focused on neuropsychological and social skills training to improve participant' job skills. Through an Individual Placement and Support model the project involved various Partners to guide, identify skills and interests, provide cognitive and psychological support for autistic people. Results highlighted neuropsychological training efficacy, especially in inhibitory control and good rate of employment status at the end of the project. Findings are encouraging and underline the importance of a multidisciplinary approach to support autistic people in their work life considering their expectations, needs and inclinations.


Asunto(s)
Trastorno Autístico , Humanos , Adulto , Trastorno Autístico/psicología , Habilidades Sociales , Entrenamiento Cognitivo , Proyectos Piloto , Empleo/psicología
3.
Eur J Radiol ; 163: 110834, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37080059

RESUMEN

PURPOSE: To assess the role of current imaging-based resectability criteria and the degree of radiological downsizing in locally advanced pancreatic adenocarcinoma (LAPC) after multiagent induction chemotherapy (ICT) in multicentre, open-label, randomized phase 2 trial. METHOD: LAPC patients were prospectively treated with multiagent ICT followed by surgical exploration within the NEOLAP trial. All patients underwent CT scan at baseline and after ICT to assess resectability status according to national comprehensive cancer network guidelines (NCCN) criteria and response evaluation criteria in solid tumors (RECIST) at the local study center and retrospectively in a central review. Imaging results were compared in terms of local and central staging, downsizing and pathological resection status. RESULTS: 83 patients were evaluable for central review of baseline and restaging imaging results. Downstaging by central review was rarely seen after multiagent ICT (7.7%), whereas tumor downsizing was documented frequently (any downsizing 90.4%, downsizing to partial response (PR) according to RECIST: 26.5%). Patients with any downsizing showed no significant different R0 resection rate (37.3%) as patients that fulfilled the criteria of PR (40.9%). The sensitivity of any downsizing for predicting R0 resection was 97% with a negative predictive value (NPV) of 0.88. ROC-analysis revealed that tumor downsizing was a predictor of R0 resection (AUC 0.647, p = 0.028) with a best cut-off value of 22.5% downsizing yielding a sensitivity of 65% and a specificity of 61%. CONCLUSIONS: Imaging-based tumor downsizing and not downstaging can guide the selection of patients with a realistic chance of R0-resection in LAPC after multi-agent ICT.


Asunto(s)
Adenocarcinoma , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Pancreáticas/cirugía , Estudios Prospectivos , Estudios Retrospectivos , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/cirugía , Terapia Neoadyuvante , Tomografía Computarizada por Rayos X/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Estadificación de Neoplasias
4.
Epidemiol Psychiatr Sci ; 31: e67, 2022 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-36148868

RESUMEN

AIM: In this study, we have compared 229 Wechsler Adults Intelligence Scale - Fourth Edition (WAIS-IV) cognitive profiles of different severity adults with autism spectrum disorder to verify the impact of several variables including sex, age, level of education and autism severity level in an Italian sample. Moreover, we wanted to find out the optimal cut points for the major intelligence quotients in order to discriminate autism severity levels. METHODS: Participants were recruited from two National Health System Center in two different Italian regions and were assessed with gold-standard instruments as a part of their clinical evaluation. According to DSM-5, cognitive domains were also measured with multi-componential tests. We used the Italian adaptation of WAIS-IV. We checked our hypotheses using linear regression models and receiver operating characteristics (ROC) curves. RESULTS: Our results showed that age and level of education have a strong impact on Verbal Comprehension (VCI) and Working Memory Indexes (WMI). Gender differences are relevant when considering the VCI and Processing Speed index (PSI) in which women obtained the best performance. These differences are still relevant when considering cut points of ROC because 69 resulted to be the optimal cut point for women, 65 for men. CONCLUSIONS: Few conclusions can be assumed only examining Full Scale Intelligence Quotient (FSIQ) scores as it includes many different information about broader cognitive abilities. Looking deeper at main indexes and their subtests findings are consistent with previous research on the disorder (moderate correlations of FSIQ, Perceptual Reasoning index, WMI and PSI with the participants' age), while other results are unforeseen (no effect of sex found on FSIQ score) or novel (significant effect of education on VCI and WMI). Using an algorithm predicting optimal cut point for discriminating through autism severity levels can help clinicians to better label and quantify the required help a person may need, a test cannot replace diagnostic and clinical evaluation by experienced clinicians.


Asunto(s)
Trastorno del Espectro Autista , Adulto , Trastorno del Espectro Autista/diagnóstico , Cognición , Femenino , Humanos , Pruebas de Inteligencia , Masculino , Memoria a Corto Plazo , Escalas de Wechsler
5.
ESMO Open ; 7(4): 100552, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35970013

RESUMEN

BACKGROUND: The prognostic and predictive value of carbohydrate antigen 19-9 (CA 19-9) in locally advanced pancreatic cancer (LAPC) has not yet been defined from prospective randomized controlled trials (RCTs). PATIENTS AND METHODS: A total of 165 LAPC patients were treated within the NEOLAP RCT for 16 weeks with multiagent induction chemotherapy [ICT; either nab-paclitaxel/gemcitabine alone or nab-paclitaxel/gemcitabine followed by FOLFIRINOX (combination of fluorouracil, leucovorin, irinotecan, and oxaliplatin)] followed by surgical exploration of all patients without evidence of disease progression. CA 19-9 was determined at baseline and after ICT and correlated with overall survival (OS) and secondary R0 resection rate. RESULTS: From the NEOLAP study population (N = 165) 133 patients (81%) were evaluable for CA 19-9 at baseline and 81/88 patients (92%) for post-ICT CA 19-9 response. Median OS (mOS) in the CA 19-9 cohort (n = 133) was 16.2 months [95% confidence interval (CI) 13.0-19.4] and R0 resection (n = 31; 23%) was associated with a significant survival benefit [40.8 months (95% CI 21.7-59.8)], while R1 resected patients (n = 14; 11%) had no survival benefit [14.0 (95% CI 11.7-16.3) months, hazard ratio (HR) 0.27; P = 0.001]. After ICT most patients showed a CA 19-9 response (median change from baseline: -82%; relative decrease ≥55%: 83%; absolute decrease to ≤50 U/ml: 43%). Robust CA 19-9 response (decrease to ≤50U/ml) was significantly associated with mOS [27.8 (95% CI 18.4-37.2) versus 16.5 (95% CI 11.7-21.2) months, HR 0.49; P = 0.013], whereas CA 19-9 baseline levels were not prognostic for OS. Multivariate analysis demonstrated that a robust CA 19-9 response was an independent predictive factor for R0 resection. Using a CA 19-9 decrease to ≤61 U/ml as optimal cut-off (by receiver operating characteristic analysis) yielded 72% sensitivity and 62% specificity for successful R0 resection, whereas CA 19-9 nonresponders (<20% decrease or increase) had no chance for successful R0 resection. CONCLUSIONS: CA 19-9 response after multiagent ICT provides relevant prognostic and predictive information and is useful in selecting LAPC patients for explorative surgery. CLINICAL TRIAL NUMBER: ClinicalTrials.govNCT02125136; https://clinicaltrials.gov/ct2/show/NCT02125136; EudraCT 2013-004796-12; https://www.clinicaltrialsregister.eu/ctr-search/trial/2013-004796-12/results.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Antígeno CA-19-9 , Neoplasias Pancreáticas , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Antígeno CA-19-9/uso terapéutico , Humanos , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Pancreáticas/patología , Pronóstico , Estudios Prospectivos
6.
Schweiz Arch Tierheilkd ; 163(4): 281-290, 2021 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-33821800

RESUMEN

INTRODUCTION: One of the varied tasks of the Large Animal Rescue Service Switzerland and Liechtenstein (GTRD CH/FL)® is the recovery of animals from manure and cesspools. The aim of the present retrospective study was the evaluation of the rescue protocols of the GTRD CH/FL from such operations and the documentation of a rescue procedure. In the past 25 years, a total of 176 animals have been rescued from manure and cesspools. These included 113 cattle, 51 horses and 12 pigs. All animals could be safely rescued with the animal rescue and transport net (TBTN) or the large animal vertical rescue set (GTVBS). The TBTN is used when the opening of the cesspool is large enough to recover the animal in a horizontal position. The GTVBS is particularly suitable for narrow openings, as the recovery in a -vertical position does not require any constructional modification or the enlargement of the cesspool opening. Both rescue harnesses are characterized by reliable handling and allow gentle recovery.


INTRODUCTION: L'une des multiples tâches du Service de sauvetage des grands animaux de Suisse et du Liechtenstein (GTRD CH/FL)® est de sortir des animaux de fosses à fumier ou à lisier. Le but de la présente étude rétrospective était l'évaluation des protocoles de sauvetage du GTRD CH/FL sur la base de ces opérations et la documentation d'un processus de sauvetage. Au cours des 25 dernières années, 176 animaux au total ont été tirés de fosses à fumier ou à lisier. Il s'agissait de 113 bovins, 51 chevaux et 12 porcs. Tous les animaux ont pu être secourus en toute sécurité grâce au filet de sauvetage et de transport des animaux (TBTN) ou à l'équipement de sauvetage vertical pour grands animaux (GTVBS). Le TBTN est utilisé lorsque l'ouverture de la fosse à lisier est suffisamment grande pour récupérer l'animal en position horizontale. Le GTVBS est particulièrement adapté aux ouvertures étroites, car la récupération en position verticale permet de ne pas devoir ou modifier modifiées par d'autres mesures structurelles les ouvertures des fosses. Les deux harnais de sauvetage se caractérisent par une manipulation fiable et permettent une récupération en douceur.


Asunto(s)
Servicios Médicos de Urgencia/estadística & datos numéricos , Estiércol , Camillas/veterinaria , Animales , Bovinos , Urgencias Médicas/veterinaria , Caballos , Liechtenstein , Porcinos , Suiza
7.
Ultrasound Obstet Gynecol ; 57(3): 386-391, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-32068925

RESUMEN

OBJECTIVES: Congenital diaphragmatic hernia (CDH) can cause a significant mass effect in the fetal thorax, displacing the heart into the opposite hemithorax. In left-sided CDH (L-CDH), this is associated with smaller left-sided cardiac structures and reduced left-ventricular cardiac output (LVCO). The effect of these physiologic changes on cerebral blood flow is not well understood. We sought to describe the middle cerebral artery (MCA) pulsatility index (PI), a measure of cerebrovascular impedance, in fetuses with L-CDH and those with right-sided CDH (R-CDH) compared with unaffected fetuses, and the relationship between MCA-PI and LVCO. We hypothesized that MCA-PI would be lower in fetuses with L-CDH and similar in those with R-CDH compared to controls, and that MCA-PI would be correlated with LVCO. METHODS: We identified all fetuses with CDH evaluated at The University of California San Francisco, San Francisco, CA, USA from 2011 to 2018. Fetal echocardiograms and ultrasound scans were reviewed. Umbilical artery and MCA Doppler examinations were assessed to calculate pulsatility indices. Ventricular outputs were calculated using Doppler-derived stroke volume and fetal heart rate. Lung-to-head ratio (LHR), estimated fetal weight, biparietal diameter (BPD) and head circumference (HC) were obtained from fetal sonograms. Measurements in fetuses with CDH, according to the side of the defect, were compared with those in unaffected, gestational age-matched controls. A subset of CDH survivors had available data on neurodevelopmental outcome, as assessed using the Bayley Scales of Infant Development, 3rd edition. RESULTS: A total of 64 fetuses with CDH (L-CDH, n = 53; R-CDH, n = 11) comprised the study groups, with 27 unaffected fetuses serving as controls. Mean gestational age at evaluation was similar between the three groups. Compared to controls, fetuses with L-CDH had significantly lower LVCO expressed as a percentage of combined cardiac output (CCO) (32%; 95% CI, 29-35% vs 38%; 95% CI, 33-42%; P = 0.04) and lower MCA-PI Z-score (-1.3; 95% CI, -1.7 to -1.0 vs 0.08; 95% CI, -0.5 to 0.6; P < 0.001), while they did not differ between the R-CDH group and controls. There was a strong positive association between LVCO as a percentage of CCO and MCA-PI Z-score in the overall cohort of CDH and control fetuses (P = 0.01). BPD and HC were similar between the three groups. At neurodevelopmental follow-up, mean cognitive, motor and language scores in the CDH group were within 1 SD of those in the general population. CONCLUSION: MCA-PI values are significantly lower in fetuses with L-CDH as compared to controls, and lower LVCO was correlated with lower MCA vascular impedance. The neurodevelopmental effect of changes in MCA-PI in response to decreased LVCO is unknown, although, on average, CDH survivors had neurodevelopmental scores in the normal range. This may reflect a fetal compensatory mechanism in response to diminished antegrade cerebral blood flow. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.


Asunto(s)
Circulación Cerebrovascular , Feto/irrigación sanguínea , Hernias Diafragmáticas Congénitas/embriología , Arteria Cerebral Media/embriología , Ultrasonografía Prenatal/métodos , Adaptación Fisiológica , Cardiografía de Impedancia/métodos , Estudios de Casos y Controles , Ecocardiografía/métodos , Impedancia Eléctrica , Femenino , Desarrollo Fetal/fisiología , Lateralidad Funcional , Edad Gestacional , Hernias Diafragmáticas Congénitas/diagnóstico por imagen , Humanos , Arteria Cerebral Media/diagnóstico por imagen , Trastornos del Neurodesarrollo/etiología , Embarazo , Flujo Pulsátil , Arterias Umbilicales/diagnóstico por imagen , Arterias Umbilicales/fisiopatología
8.
Psychiatry Res ; 272: 609-617, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30616131

RESUMEN

Numerous studies have examined mindreading in borderline personality disorder (BPD). However, the empirical data obtained to date have not facilitated the development of a clear clinical profile of mindreading impairment in BPD due to a lack of consistency or incongruence across studies. One possible explanation for these inconsistencies and divergences in the current literature may lie in the multidimensional character of the mindreading construct; moreover, the heterogeneity of the experimental measures used to assess individuals with BPD mindreading skills may also need to be taken into account. The aim of the present study is to investigate mindreading skills and impairments in patients with BPD through direct comparison of a wide range of mindreading dimensions using a comprehensive semistructured interview, the Theory of Mind Assessment Scale (Th.o.m.a.s.) (Bosco et al., 2009). Our results show that the performance of patients with BPD differs from that of healthy controls only in certain specific dimensions of mindreading. The difficulties encountered by the patients with BPD typically emerge when mindreading tasks require them to disentangle their own subjective mindreading from that of another person, in other words, when they were required to assume an allocentric perspective.


Asunto(s)
Trastorno de Personalidad Limítrofe/diagnóstico , Trastorno de Personalidad Limítrofe/psicología , Relaciones Metafisicas Mente-Cuerpo/fisiología , Teoría de la Mente/fisiología , Adulto , Trastorno de Personalidad Limítrofe/epidemiología , Servicios Comunitarios de Salud Mental/tendencias , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Adulto Joven
9.
Int J Colorectal Dis ; 34(4): 649-655, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30671634

RESUMEN

INTRODUCTION: The aim of this study was to evaluate the effectiveness of initially conservative therapy compared to immediate appendectomy for acute appendicitis with abscess in terms of medical and economic outcomes. METHODS: Of all the patients treated for appendicitis from January 2009 to December 2017 in five German hospitals, 240 were included in the study. Fifty-three patients received conservative (CON) and 195 patients received surgical (SUR) therapy as initial treatment. RESULTS: Length of stay was similar (12.5 days in CON vs. 13.3 days in SUR, p = 0.530). Readmission rate was higher in the conservative group (54.7% vs. 6.2%, p < 0.001). The majority (53.7%) of the 41 operations in CON group were appendectomies (22 procedures), 1 (4.5%) of them was in the first hospital stay because of persisting symptoms, 21 (95.5%) after a recovery interval. Seven (33.3%) of the recovery appendectomies were performed due to persisting or recurrent symptoms and 14 (66.7%) due to the request of patient. Twenty-one patients (39.6%) in the CON group did not need surgery. The rates of complication-related operations per patient (0.04 versus 0.58, p < 0.001), conversions of surgical technique (1.9% vs. 34.9%, p = 0.0287), and extended resections (1.9% vs. 31.3%, p < 0.001) were higher in SUR group. Furthermore, morbidity, hospital costs, and loss in quality of life were significantly higher in the surgical group (17.0% vs. 66.2%, p < 0.001; € 5044 vs. € 8457, p < 0.001, and 4.3 days vs. 7.5 days, p < 0.001, CON vs. SUR). CONCLUSION: Initially, conservative treatment for acute appendicitis with abscess is preferable to immediate surgical treatment in reduction of morbidity, hospital costs, and loss in quality of life.


Asunto(s)
Absceso/complicaciones , Apendicitis/complicaciones , Apendicitis/cirugía , Tratamiento Conservador , Hospitales , Enfermedad Aguda , Apendicitis/economía , Apendicitis/mortalidad , Economía Hospitalaria , Alemania , Humanos , Tiempo de Internación/economía , Morbilidad , Complicaciones Posoperatorias/etiología , Calidad de Vida
10.
Musculoskelet Surg ; 103(1): 55-61, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30361837

RESUMEN

PURPOSE: Advances in anterior cruciate ligament (ACL) reconstruction have allowed for many progressions in postoperative management. However, there is no standardized protocol for immediate postoperative management or return to play. Our objective was to evaluate current trends in immediate postoperative and return to sport practices after ACL reconstruction. LEVEL OF EVIDENCE: Cross sectional study, Level IV. METHODS: Surveys were obtained from four large sports fellowship alumni networks. Demographics included years of practice and ACLs performed per year. Postoperative questions included weight bearing status, brace use and continuous passive motion (CPM) use. Return to play included time for return, brace use and metrics used for clearance to sport. RESULTS: A total of 143 surveys were completed (32% response rate). Average years in practice were 15.1 years. Average ACL reconstructions performed per year was 20-50 in 44% and 50-100 in 29%. 26% used CPM in all patients, 8% if concomitant meniscal repair and 66% never. Bracing after surgery was used in 84% and 48% after return to play. Return to play was allowed at 6-9 months in 67% and overall 94% from 6 to 12 months. No consensus on return to play metrics was used, with the hop test being most important followed by specific time point after surgery. CONCLUSION: Immediate weight bearing after surgery is commonplace with intermittent CPM use. Bracing is common postoperatively and half the time with return to play. Return to play is typically allowed after at least 6 months with no consensus on return to sport metrics. Years after fellowship and ACLs performed yearly had no correlation with postoperative practices.


Asunto(s)
Reconstrucción del Ligamento Cruzado Anterior/métodos , Tirantes/estadística & datos numéricos , Volver al Deporte/tendencias , Medicina Deportiva/estadística & datos numéricos , Soporte de Peso , Reconstrucción del Ligamento Cruzado Anterior/estadística & datos numéricos , Reconstrucción del Ligamento Cruzado Anterior/tendencias , Estudios Transversales , Becas , Humanos , Terapia Pasiva Continua de Movimiento/estadística & datos numéricos , Cuidados Posoperatorios , Volver al Deporte/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Factores de Tiempo
11.
Dalton Trans ; 47(4): 1337-1346, 2018 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-29303180

RESUMEN

The fluorescent ligand 1,1'-((1E,1'E)-(1,2-phenylenebis(azanylylidene))bis(methanylylidene)) bis(naphthalen-2-ol) (H2L) was used to prepare lanthanide(iii) metal complexes. These were found to self-assemble as triple decker sandwich complexes of the type (Ln2L3), where Ln = Pr(iii), Nd(iii), Sm(iii), Eu(iii), Gd(iii), Tb(iii), Dy(iii), Ho(iii), Er(iii), Yb(iii), or Lu(iii). The structures of the complexes Nd2L3, Gd2L3, Tb2L3, Dy2L3, Ho2L3, Yb2L3, and Lu2L3 are structurally characterized by single crystal X-ray diffraction. In the Nd2L3 complex, both metals are 8 coordinate. Yb2L3, Tb2L3, Dy2L3, and Lu2L3 are isostructural. In these, as in the Gd2L3 and Ho2L3 complexes, one metal is 8 coordinate, one 7 coordinate. The ligand was found to have tunable emission in the solid state across the lanthanide series with a maximum at 556 nm for the Sm2L3 complex to 617 nm for Er2L3. Of these, most demonstrate only ligand-centered fluorescence at room temperature. The ligand was found to have much greater fluorescence in the complex Lu2L3. Here, we describe these distinctive triple decker complexes and their absorption and emission properties as both solids and solutions.

12.
Musculoskelet Surg ; 102(2): 159-163, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29027640

RESUMEN

PURPOSE: The purpose of our study is to report the outcomes and complications in patients who underwent distal biceps tendon repair with the use of Botulinum toxin A (BoNT-A) as an adjunct to surgery. METHODS: A retrospective review of 14 patients who underwent 15 distal biceps tendon repairs was performed. All repaired tendons had their correlating muscle bellies injected intraoperatively with a mixture of 100U of BoNT-A and 10 ml of normal saline. Each patient was evaluated for surgical and post-operative complications and followed with Disabilities of the Arm, Shoulder and Hand (DASH) Disability Scores. RESULTS: The cohort was exclusively male, 14/14 (100%). The mean age at procedure was 52.1 years (range: 29-65 years). Types of injuries repaired included: 12 acute biceps tendon ruptures, one chronic partial (> 50% of tendon) biceps tear, and two chronic biceps ruptures. Average final follow-up was 32.9 months (SD: 19.6; range: 7.07-61.72). Average time to repair of chronic injury was 5.75 months (range: 2-12 months). There were no intraoperative complications, and all patients were discharged home on the day of surgery. Average DASH score at latest follow-up was 4.9 (range: 0.0-12.5). All patients had return of function of paralyzed muscle prior to final follow-up. One patient required an incision and drainage for a deep infection 1 week post-operatively, without any further complications. Another patient required operative removal of heterotopic ossification located around the tendon fixation site, which was the result of a superficial infection treated with antibiotics 2 weeks post-operatively. This patient later healed with improvement in supination/pronation range-of-motion and no further complications. CONCLUSIONS: Injection of BoNT-A is safe and effective to protect distal biceps tendon repair during the early phases of bone-tendon healing. CLINICAL RELEVANCE: BoNT-A may is safe and effective to protect distal biceps tendon repair. The utility of BoNT-A as an adjunct to surgical repair may be applicable to acute or chronic tears as well as repairs in the non-compliant patient without decreases in functional scores after return of function of the biceps muscle. LEVEL OF EVIDENCE: Level 4.


Asunto(s)
Toxinas Botulínicas Tipo A/uso terapéutico , Traumatismos de los Tendones/tratamiento farmacológico , Adulto , Quimioterapia Adyuvante , Terapia Combinada , Desbridamiento , Evaluación de la Discapacidad , Evaluación de Medicamentos , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Rotura/cirugía , Anclas para Sutura , Traumatismos de los Tendones/cirugía , Trasplante Autólogo , Resultado del Tratamiento
13.
Clin Genet ; 92(4): 415-422, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28295210

RESUMEN

BACKGROUND: Array-comparative genomic hybridization (array-CGH) is a widely used technique to detect copy number variants (CNVs) associated with developmental delay/intellectual disability (DD/ID). AIMS: Identification of genomic disorders in DD/ID. MATERIALS AND METHODS: We performed a comprehensive array-CGH investigation of 1,015 consecutive cases with DD/ID and combined literature mining, genetic evidence, evolutionary constraint scores, and functional information in order to assess the pathogenicity of the CNVs. RESULTS: We identified non-benign CNVs in 29% of patients. Amongst the pathogenic variants (11%), detected with a yield consistent with the literature, we found rare genomic disorders and CNVs spanning known disease genes. We further identified and discussed 51 cases with likely pathogenic CNVs spanning novel candidate genes, including genes encoding synaptic components and/or proteins involved in corticogenesis. Additionally, we identified two deletions spanning potential Topological Associated Domain (TAD) boundaries probably affecting the regulatory landscape. DISCUSSION AND CONCLUSION: We show how phenotypic and genetic analyses of array-CGH data allow unraveling complex cases, identifying rare disease genes, and revealing unexpected position effects.


Asunto(s)
Variaciones en el Número de Copia de ADN/genética , Proteínas de Unión al ADN/genética , Discapacidades del Desarrollo/genética , Discapacidad Intelectual/genética , Adolescente , Adulto , Niño , Preescolar , Efectos de la Posición Cromosómica/genética , Aberraciones Cromosómicas , Hibridación Genómica Comparativa , Discapacidades del Desarrollo/patología , Femenino , Estudios de Asociación Genética , Genómica , Humanos , Lactante , Discapacidad Intelectual/patología , Masculino , Linaje , Fenotipo , Eliminación de Secuencia/genética , Adulto Joven
14.
Appl Phys Lett ; 109(4)2016 07 25.
Artículo en Inglés | MEDLINE | ID: mdl-27746481

RESUMEN

The response time of an atomic force microscopy (AFM) cantilever can be decreased by reducing cantilever size; however, the fastest AFM cantilevers are currently nearing the smallest size that can be detected with the conventional optical lever approach. Here, we demonstrate an electron beam detection scheme for measuring AFM cantilever oscillations. The oscillating AFM tip is positioned perpendicular to and in the path of a stationary focused nanometer sized electron beam. As the tip oscillates, the thickness of the material under the electron beam changes, causing a fluctuation in the number of scattered transmitted electrons that are detected. We demonstrate detection of sub-nanometer vibration amplitudes with an electron beam, providing a pathway for dynamic AFM with cantilevers that are orders of magnitude smaller and faster than the current state of the art.

15.
J Appl Microbiol ; 118(6): 1357-69, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25809524

RESUMEN

AIMS: The characterization of the antitumour activity and chemical identification of the compounds obtained after the isolation of extracellular metabolites of bacteria Raoultella ornithinolytica. METHODS AND RESULTS: The fraction with anticancer activity against the HeLa cell line, T47D and TOV-112D was obtained from the supernatants of R. ornithinolytica culture using ion-exchange chromatography, and separated by Sephadex G-50 medium gel filtration into two subfractions. The obtained compounds were analysed using Fourier Transform-Infrared Spectroscopy, Raman spectroscopy and matrix-assisted laser desorption/ionization MS/MS spectrometry. The antitumour activity of the two subfractions was analysed using 5-bromo-2-deoxy-uridine kit. The subfraction with the highest activity against HeLa cells was identified as Tris-peptide complex. The amino acid sequence of the peptide from the complex was found to be TDAPSFSDIPN and molecular weight was estimated at 1430·6576 Da. Cytotoxic, cytopathic and apoptotic effects in HeLa cells treated with the active complex were observed; however, the cytotoxic effect against normal human skin fibroblasts was minimal. CONCLUSIONS: The Tris-peptide complex from R. ornithinolytica showed selective antitumour activity against the HeLa cell line. SIGNIFICANCE AND IMPACT OF THE STUDY: The Tris-peptide complex due to the high selectivity can be used in biomedicine, and its derivatives may contribute to the development of new anticancer compounds.


Asunto(s)
Antineoplásicos/farmacología , Apoptosis/efectos de los fármacos , Enterobacteriaceae/química , Péptidos/farmacología , Secuencia de Aminoácidos , Antineoplásicos/química , Antineoplásicos/aislamiento & purificación , Línea Celular Tumoral , Cromatografía en Gel , Enterobacteriaceae/aislamiento & purificación , Enterobacteriaceae/metabolismo , Fibroblastos/citología , Fibroblastos/efectos de los fármacos , Células HeLa , Humanos , Datos de Secuencia Molecular , Peso Molecular , Péptidos/química , Péptidos/aislamiento & purificación , Espectroscopía Infrarroja por Transformada de Fourier , Espectrometría de Masas en Tándem
16.
Ultrasound Obstet Gynecol ; 46(6): 688-94, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25597867

RESUMEN

OBJECTIVES: To assess whether severity of congenital diaphragmatic hernia (CDH) correlates with the degree of left heart hypoplasia and left ventricle (LV) output, and to determine if factors leading to abnormal fetal hemodynamics, such as compression and reduced LV preload, contribute to left heart hypoplasia. METHODS: This was a retrospective cross-sectional study of fetuses at 16-37 weeks' gestation that were diagnosed with CDH between 2000 and 2010. Lung-to-head ratio (LHR), liver position and side of the hernia were determined from stored ultrasound images. CDH severity was dichotomized based on LHR and liver position. The dimensions of mitral (MV) and aortic (AV) valves and LV were measured, and right and left ventricular outputs were recorded. RESULTS: In total, 188 fetuses with CDH were included in the study, 171 with left CDH and 17 with right CDH. Fetuses with severe left CDH had a smaller MV (Z = -2.24 ± 1.3 vs -1.33 ± 1.08), AV (Z = -1.39 ± 1.21 vs -0.51 ± 1.05) and LV volume (Z = -4.23 ± -2.71 vs -2.08 ± 3.15) and had lower LV output (26 ± 10% vs 32 ± 10%) than those with mild CDH. MV and AV in fetuses with right CDH (MV, Z = -0.83 ± 1.19 and AV, Z = -0.71 ± 1.07) were larger than those in fetuses with left CDH, but LV outputs were similarly diminished, regardless of hernia side. Severe dextroposition and abnormal liver position were associated independently with smaller left heart, while LHR was not. CONCLUSION: The severity of left heart hypoplasia correlates with the severity of CDH. Altered fetal hemodynamics, leading to decreased LV output, occurs in both right- and left-sided CDH, but the additional compressive effect on the left heart is seen only when the hernia is left-sided. Improved knowledge of the physiology of this disease may lead to advances in therapy and better risk assessment for use in counseling affected families.


Asunto(s)
Desarrollo Fetal , Enfermedades Fetales/diagnóstico por imagen , Corazón Fetal/diagnóstico por imagen , Hernias Diafragmáticas Congénitas/embriología , Síndrome del Corazón Izquierdo Hipoplásico/embriología , Estudios Transversales , Ecocardiografía/métodos , Femenino , Corazón Fetal/anatomía & histología , Edad Gestacional , Cabeza/diagnóstico por imagen , Cabeza/embriología , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/embriología , Hernias Diafragmáticas Congénitas/complicaciones , Hernias Diafragmáticas Congénitas/diagnóstico por imagen , Humanos , Síndrome del Corazón Izquierdo Hipoplásico/diagnóstico por imagen , Hígado/diagnóstico por imagen , Hígado/embriología , Pulmón/diagnóstico por imagen , Pulmón/embriología , Tamaño de los Órganos , Embarazo , Estudios Retrospectivos , Ultrasonografía Prenatal/métodos
17.
Neurocase ; 21(4): 438-47, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-24837443

RESUMEN

Reduced awareness of illness is a well-known phenomenon that has been understudied in remitted patients with bipolar disorder. In particular, the relationship between reduced awareness and executive dysfunction is an intriguing question that has yet to be resolved. The aim of the current study is to analyze the link between reduced awareness, brain dysfunction, and concomitant cognitive-behavioral disturbances from a neurocognitive perspective. In previous studies, we demonstrated the role of the anterior cingulate cortex (ACC) in the unawareness of distinct pathologies that exhibit overlapping symptoms in the context of overlapping circuit-specific dysfunction. Given the clinical importance of the results obtained, the present study considers six aware and four unaware remitted bipolar disorder patients. Cingulate functionality was assessed with functional magnetic resonance imaging while patients performed a go/no-go task. Patients were also studied on an overall cognitive task battery and with behavioral assessment of mood changes in terms of apathy and disinhibited behavior. Unaware patients showed frontoparietal hypo-perfusion, with a significant reduction of task-sensitive activity in the bilateral superior and middle frontal gyrus, putamen, insular, and ACCs.


Asunto(s)
Concienciación/fisiología , Trastorno Bipolar/fisiopatología , Trastorno Bipolar/psicología , Giro del Cíngulo/fisiopatología , Adulto , Mapeo Encefálico , Servicios de Planificación Familiar , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas
19.
Transpl Infect Dis ; 16(2): 270-8, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24628809

RESUMEN

BACKGROUND: Dematiaceous, or dark-pigmented, fungi are known to cause infections such as phaeohyphomycosis, chromoblastomycosis, and mycetoma. These fungi are becoming increasingly important opportunistic pathogens in solid organ transplant recipients (SOTR). We present a retrospective chart review of 27 SOTR who developed phaeohyphomycosis infections post transplant from 1988 to 2009. METHODS: Cases were reviewed for fungal species isolated, date and source of culture, immunosuppressive and fungal therapy used, and outcome. The majority of isolates obtained were from the skin and soft tissue, with 3 pulmonary and brain abscesses. RESULTS: The time from transplantation to onset of infection ranged from 2 months to 11 years. The species isolated were Exophiala (11), Ochroconis (3), Alternaria (2), Phoma (2), Wangiella (1), Cladosporium (1), Aureobasidium (1), Chaetomium (1), Coniothyrium (1), and non-sporulating fungi (2). An additional 4 patients had infections confirmed by pathology, but no cultures were done. Most of the affected skin lesions were surgically debrided and treated with itraconazole; 2 patients were treated with voriconazole and 2 with amphotericin D. Death from fungal disease occurred only in patients with pulmonary and brain abscesses. CONCLUSIONS: As the number of SOTR increases, so does the incidence of fungal infections in that population. Surgery, along with antifungal therapy and a reduction in immunosuppression, are the cornerstones of treatment.


Asunto(s)
Absceso Encefálico/microbiología , Terapia de Inmunosupresión/efectos adversos , Absceso Pulmonar/microbiología , Infecciones Oportunistas/microbiología , Feohifomicosis/microbiología , Feohifomicosis/terapia , Adulto , Anciano , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Absceso Encefálico/tratamiento farmacológico , Desbridamiento , Femenino , Humanos , Itraconazol/uso terapéutico , Absceso Pulmonar/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Infecciones Oportunistas/terapia , Trasplante de Órganos/efectos adversos , Estudios Retrospectivos , Factores de Tiempo , Voriconazol/uso terapéutico , Adulto Joven
20.
J Microsc ; 254(3): 129-36, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24660836

RESUMEN

We report the effects of varying specimen thickness on the generation of transmission Kikuchi patterns in the scanning electron microscope. Diffraction patterns sufficient for automated indexing were observed from films spanning nearly three orders of magnitude in thickness in several materials, from 5 nm of hafnium dioxide to 3 µm of aluminum, corresponding to a mass-thickness range of ~5 to 810 µg cm(-2) . The scattering events that are most likely to be detected in transmission are shown to be very near the exit surface of the films. The energies, spatial distribution and trajectories of the electrons that are transmitted through the film and are collected by the detector are predicted using Monte Carlo simulations.

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