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High-dose inhaled Nitric Oxide (iNO) has been shown to have anti-inflammatory, vasodilator, and antimicrobial properties, resulting in improved arterial oxygenation as well as a beneficial therapeutic effect on lower respiratory tract infections. This study evaluated the safety and efficacy of 150-ppm intermittent iNO administered with a novel iNO-generator, for treating adults hospitalised for viral pneumonia. In this prospective, open-label, multicenter study, subjects aged 18-80, diagnosed with viral pneumonia received either standard supportive treatment alone (Control-Group) or combined with iNO for 40 min, 4 times per day up to 7 days (Treatment-Group). Out of 40 recruited subjects, 35 were included in the intention-to-treat population (34 with COVID-19). Adverse Events rate was similar between the groups (56.3% vs. 42.1%; respectively). No treatment-related adverse events were reported, while 2 serious adverse events were accounted for by underlying pre-existing conditions. Among the Treatment-Group, oxygen support duration was reduced by 2.7 days (Hazard Ratio = 2.8; p = 0.0339), a greater number of subjects reached oxygen saturation ≥ 93% within hospitalisation period (Hazard Ratio = 5.4; p = 0.049), and a trend for earlier discharge was demonstrated. Intermittent 150-ppm iNO-treatment is well-tolerated, safe, and beneficial compared to usual care for spontaneously breathing hospitalised adults diagnosed with COVID-19 viral pneumonia.
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Tratamento Farmacológico da COVID-19 , COVID-19 , Óxido Nítrico , Humanos , Óxido Nítrico/administração & dosagem , Masculino , Feminino , Administração por Inalação , Pessoa de Meia-Idade , Idoso , Adulto , Estudos Prospectivos , SARS-CoV-2 , Idoso de 80 Anos ou mais , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Resultado do Tratamento , Adulto Jovem , AdolescenteRESUMO
Cell fusion is involved in the development of some adult organs, is implicated in the pathogenesis of specific types of cancer, and is known to participate in repair/regeneration processes mediated by bone-marrow-derived cells (BMDCs). Endometriosis is a disease characterized by growth of functional endometrial tissue outside of the uterine cavity. Endometriosis shares some molecular properties with cancer and BMDCs home to endometriosis lesions in a mouse model. Our objective was to determine if cell fusion can occur in endometriosis and establish whether bone-marrow-derived cells participate in cell fusion events in lesions. We employed a Cre-Lox system to identify cell fusion events in a mouse model of endometriosis. Fused cells were detected in endometriotic lesions, albeit at a low frequency (â¼1 in 400 cells), localized to the stromal compartment, and displayed restricted proliferation. Using 5-fluorouracil-based nongonadotoxic bone marrow transplantation model, we demonstrate that bone marrow cells represent a principal cell source for fusion events in lesions. Cell fusion progeny uniformly lacked expression of selected markers of hematopoietic, endothelial, and epithelial markers, though they expressed the mesenchymal/stromal markers Sca-1 and CD29. This study is the first to describe the phenomenon of cell fusion in endometriosis and points to a mesenchymal population derived from cell fusion events with limited proliferative activity, properties previously attributed to endometrial stem cells. Their putative role in the pathogenesis of the disease remains to be elucidated.
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Fusão Celular , Endometriose/patologia , Animais , Modelos Animais de Doenças , Endométrio/citologia , Feminino , Citometria de Fluxo , Camundongos , MutaçãoRESUMO
Electromagnetic pulse propagation in the slow light regime and near a zero group velocity point is relevant to a plethora of potential applications, and has analogies in numerous other wave systems. Unfortunately, the standard frequency-based formulation for pulse propagation is unsuitable for describing the dynamics in such regimes, due to the divergence of the dispersion coefficients. Moreover, in the presence of absorption, it is not clear how to interpret the propagation dynamics due to the drastic change induced by absorption upon the dispersion curves. As a remedy, we present an alternative momentum-based formulation, which is rapidly converging in these regimes, and naturally suitable for lossy and nonlinear media. It is specialized to a waveguide geometry which provides a significant simplification with respect to existing momentum-based schemes. Doing so, we provide a somewhat alternative, yet intuitive picture of the seeming enhanced absorption and nonlinear response in these regimes, and show that light-matter interactions are not enhanced in the slow/stopped light regimes.
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BACKGROUND AND PURPOSE: Schizophrenia is well-known to be associated with hippocampal structural abnormalities. We used 1H-MR spectroscopy to test the hypothesis that these abnormalities are accompanied by NAA deficits, reflecting neuronal dysfunction, in patients compared with healthy controls. MATERIALS AND METHODS: Nineteen patients with schizophrenia (11 men; mean age, 40.6 ± 10.1 years; mean disease duration, 19.5 ± 10.5 years) and 11 matched healthy controls (5 men; mean age, 33.7 ± 10.1 years) underwent MR imaging and multivoxel point-resolved spectroscopy (TE/TR, 35/1400 ms) 1H-MRS at 3T to obtain their hippocampal GM absolute NAA, Cr, Cho, and mIns concentrations. Unequal variance t tests and ANCOVA were used to compare patients with controls. Bilateral volumes from manually outlined hippocampal masks were compared by using unequal variance t tests. RESULTS: Patients' average hippocampal GM Cr concentrations were 19% higher than that of controls, 8.7 ± 2.2 versus 7.4 ± 1.2 mmol/L (P < .05); showing no differences, concentrations in NAA were 8.8 ± 1.6 versus 8.7 ± 1.2 mmol/L; in Cho, 2.3 ± 0.7 versus 2.1 ± 0.3 mmol/L; and in mIns, 6.1 ± 1.5 versus 5.2 ± 0.9 (all P > .1). There was a positive correlation between mIns and Cr in patients (r = 0.57, P = .05) but not in controls. The mean bilateral hippocampal volume was â¼10% lower in patients: 7.5 ± 0.9 versus 8.4 ± 0.7 cm3 (P < .05). CONCLUSIONS: These findings suggest that the hippocampal volume deficit in schizophrenia is not due to net loss of neurons, in agreement with histopathology studies but not with prior 1H-MR spectroscopy reports. Elevated Cr is consistent with hippocampal hypermetabolism, and its correlation with mIns may also suggest an inflammatory process affecting some cases; these findings may suggest treatment targets and markers to monitor them.
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Hipocampo/diagnóstico por imagem , Imageamento Tridimensional/métodos , Neuroimagem/métodos , Espectroscopia de Prótons por Ressonância Magnética/métodos , Esquizofrenia/metabolismo , Adulto , Ácido Aspártico/metabolismo , Colina/metabolismo , Creatina/metabolismo , Feminino , Hipocampo/metabolismo , Hipocampo/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/patologiaRESUMO
Genome-wide chromatin studies identified the tumor suppressor p53 as both a promoter and an enhancer-binding transcription factor. As an enhancer factor, p53 can induce local production of enhancer RNAs, as well as transcriptional activation of distal neighboring genes. Beyond the regulation of protein-coding genes, p53 has the capacity to regulate long intergenic noncoding RNA molecules (lincRNAs); however, their importance to the p53 tumor suppressive function remains poorly characterized. Here, we identified and characterized a novel p53-bound intronic enhancer that controls the expression of its host, the lincRNA00475 (linc-475). We demonstrate the requirement of linc-475 for the proper induction of a p53-dependent cell cycle inhibitory response. We further confirm the functional importance of linc-475 in the maintenance of CDKN1A/p21 levels, a cell cycle inhibitor and a major p53 target gene, following p53 activation. Interestingly, loss of linc-475 reduced the binding of both p53 and RNA polymerase II (RNAPII) to the promoter of p21, attenuating its transcription rate following p53 activation. Altogether, our data suggest a direct role of p53-bound enhancer domains in the activation of lincRNAs required for an efficient p53 transcriptional response.
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Elementos Facilitadores Genéticos/fisiologia , RNA Longo não Codificante/fisiologia , Proteína Supressora de Tumor p53/fisiologia , Inibidor de Quinase Dependente de Ciclina p21/genética , Pontos de Checagem da Fase G1 do Ciclo Celular , Humanos , Regiões Promotoras Genéticas , RNA Polimerase II/metabolismoRESUMO
OBJECTIVES: As â¼40% of HIV-infected individuals experience neurocognitive decline, we investigated whether proton magnetic resonance spectroscopic imaging ((1) H-MRSI) detects early metabolic abnormalities in the cerebral cortex of a simian immunodeficiency virus (SIV)-infected rhesus monkey model of neuroAIDS. METHODS: The brains of five rhesus monkeys before and 4 or 6 weeks after SIV infection (with CD8(+) T-cell depletion) were assessed with T2 -weighted quantitative magnetic resonance imaging (MRI) and 16×16×4 multivoxel (1) H-MRSI (echo time/repetition time = 33/1440 ms). Grey matter and white matter masks were segmented from the animal MRIs and used to produce cortical masks co-registered to (1) H-MRSI data to yield cortical metabolite concentrations of the glial markers myo-inositol (mI), creatine (Cr) and choline (Cho), and of the neuronal marker N-acetylaspartate (NAA). The cortex volume within the large, 28 cm(3) (â¼35% of total monkey brain) volume of interest was also calculated for each animal pre- and post-infection. Mean metabolite concentrations and cortex volumes were compared pre- and post-infection using paired sample t-tests. RESULTS: The mean (± standard deviation) pre-infection concentrations of the glial markers mI, Cr and Cho were 5.8 ± 0.9, 7.2 ± 0.4 and 0.9 ± 0.1 mM, respectively; these concentrations increased 28% (p ≈ 0.06), 15% and 10% (both p < 0.05), respectively, post-infection. The mean concentration of neuronal marker NAA remained unchanged (7.0 ± 0.6 mM pre-infection vs. 7.3 ± 0.8 mM post-infection; p ≈ 0.37). The mean cortex volume was also unchanged (8.1 ± 1.1 cm(3) pre-infection vs. 8.3 ± 0.5 cm(3) post-infection; p ≈ 0.76). CONCLUSIONS: These results support the hypothesis that early cortical glial activation occurs after SIV infection prior to the onset of neurodegeneration. This suggests HIV therapeutic interventions should potentially target early glial activation in the cerebral cortex.
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Córtex Cerebral/patologia , Síndrome de Imunodeficiência Adquirida dos Símios , Animais , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Biomarcadores/metabolismo , Doenças do Sistema Nervoso Central/etiologia , Córtex Cerebral/metabolismo , Colina/metabolismo , Creatina/metabolismo , Modelos Animais de Doenças , Feminino , Macaca mulatta , Masculino , Espectroscopia de Prótons por Ressonância Magnética , Síndrome de Imunodeficiência Adquirida dos Símios/complicações , Síndrome de Imunodeficiência Adquirida dos Símios/patologia , Vírus da Imunodeficiência SímiaRESUMO
BACKGROUND: Infants with hypoplastic left heart syndrome (HLHS) are susceptible to pre-Norwood comorbidities (PCs) and complications. This study aimed to describe the effect of PCs on timing and survival of Norwood palliation (NP). METHODS: A single-center, retrospective review of infants with HLHS who underwent initial NP between 2003 and 2010 was performed. PCs included intact atrial septum, ≥ moderate atrioventricular regurgitation (AVVR), no antenatal diagnosis, mitral stenosis/aortic atresia subtype, genetic abnormality, and prematurity. Complications included pre-NP mechanical ventilation, inotropic support, infection, arrhythmia, and end-organ injury. The primary outcome measure was survival after NP. RESULTS: 113 patients were included with 78 (69%) patients having at least one PC and 61 (78%) of those patients having at least one complication. Patients with PCs underwent NP later than those without PCs (7 vs 6 days, P = .036) as well as when associated with a complication (8 vs 5 days, P < .001). Patients with PCs had similar post-Norwood hospital length of stay (P = .116) except when the PC occurred in conjunction with a complication (28 vs 21 days; P = .015). In-hospital mortality post-NP was 10% and interstage mortality was 15%. On multivariable analysis, ≥ moderate AVVR was associated with increased overall mortality (OR 2.8, 95% CI 1.3-6.2). Age at NP was not associated with mortality (P = .638). CONCLUSIONS: Although PCs are common in infants with HLHS, only ≥ moderate AVVR was associated with increased mortality in this single-center experience. Older age at NP was not a significant risk factor for interstage mortality.
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Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Procedimentos de Norwood/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Fatores Etários , Insuficiência da Valva Aórtica/mortalidade , Distribuição de Qui-Quadrado , Comorbidade , Feminino , Mortalidade Hospitalar , Humanos , Síndrome do Coração Esquerdo Hipoplásico/mortalidade , Mortalidade Infantil , Recém-Nascido , Estimativa de Kaplan-Meier , Tempo de Internação , Masculino , Análise Multivariada , Procedimentos de Norwood/mortalidade , Razão de Chances , Cuidados Paliativos , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/terapia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária , Texas/epidemiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
INTRODUCTION: As throughout sub-Saharan Africa, the use of skin-lightening (or brightening or bleaching) products is widespread in Senegal (67%). Although the medical and social determinants of this phenomenon have been documented, its cost is poorly defined. Thus, this work aims to evaluate the economic effects of skin bleaching on women's income. METHODOLOGY: A cross-sectional, quantitative, and descriptive survey was conducted in 2010 (October 7 to November 8) among women consulting for outpatient care at a reference dermatology clinic for complications related to use of skin-lightening products. We calculated the direct costs (products) and indirect costs (transportation costs, medical fees, dermatological treatment of complications). The social damage (pain and suffering and esthetics) was assessed. RESULTS: This study included 65 women; their mean age was 33 years and 26% had not attended school. In all, 52% were merchants, 29% housewives, 9% civil servants, and 5% students. The average duration of product use was 9 years, and the mean age at onset of use, 23 years. Most (80%) had a low income (<100,000 FCFA or US $204). The total monthly income of the 65 women in the study was 5,675,000 CFA (US $ 11,582). The total monthly cost of skin lightening for them was 1081,658 CFA (US $ 2207), that is, 19% of their total income. The esthetic harm was categorized as moderate by 20% and high by 22%. CONCLUSION: This study opens perspectives for further studies of the intangible costs of skin bleaching and for increasing awareness of the complications and social damage induced.
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Indústria da Beleza , Renda , Preparações Clareadoras de Pele/efeitos adversos , Preparações Clareadoras de Pele/economia , Adulto , África Subsaariana , Estudos Transversais , Estética , Feminino , Humanos , Ambulatório Hospitalar , Dermatopatias/induzido quimicamente , Preparações Clareadoras de Pele/administração & dosagem , Inquéritos e Questionários , Adulto JovemRESUMO
The concentration of the toxic elements Ag, As, Cd, Co, Mn, Mo, Pb, Se, and U and the elements Al, Mg, Cu, Fe, and Zn in human hair samples of population living in the north of the Negev Desert in Israel was determined. The study population consisted of three subgroups: Jewish urban population, Bedouin urban population, and Bedouins living in unrecognized villages (the "dispersion"). The main focus is on the differences between these subgroups in an attempt to explore factors responsible for the variation in trace metal contents in hair samples. The results show that the level of several elements, particularly Ag, Mn, and Pb, in the female Bedouin group significantly differed from the other groups in the study. Exploring the reasons for these differences, we concluded that the lifestyle of those women is the main cause. The female Bedouin subgroup is exposed to heavy metals from kitchen utensils, jewelry, and makeup. Therefore, differences in the heavy metal concentration in the hair samples of this group were attributed to the traditional unique lifestyle and social behavior of the females in the Bedouin society.
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Exposição Ambiental/análise , Monitoramento Ambiental , Cabelo/química , Metais Pesados/análise , Feminino , Humanos , Israel , MasculinoRESUMO
INTRODUCTION: The aim of this study was to evaluate the outcome of through-the-scope (TTS) implanted self-expanding metal stent (SEMS) comparing left-sided vs. proximal placement with regard to complications and outcome in palliation of malignant colorectal obstruction. MATERIAL AND METHODS: All patients were consecutively retrospectively enrolled to this study between January 2009 and February 2012 due to impending or prevalent complete malignant colorectal obstruction. TTS applicable uncovered nitinol SEMS with unique flexible properties were used (Taewoong Medical, South Korea). Left-sided obstruction (aboral from the left flexure) was compared to proximal (from the ileo-cecal valve to the left flexure) localization. All patients have been discussed in the interdisciplinary tumor conference and the recommendation to treat by endoscopic stent placement was given in consensus. RESULTS: A total of 15 patients was enrolled to this study (10 male and 5 female; mean age 68.3 ± 15.4 years, range 48 - 94), five patients with obstructions located in the proximal hemicolon whereas ten patients had a left-sided malignancy. Technical success was achieved in all cases and there was no early complication noticed. Three late complications included tumor overgrowth (n = 1), stent occlusion (1), and dislocation (1). Stent-in-stent insertion achieved, again, clinical success. The site of SEMS implantation (proximal vs. left colon) had no impact on patient outcome or complication rate. SEMS patency duration was 269.8 ± 175.2 days (range 30 - 570) and mean survival of the patients was 305.1 ± 279.3 days (range 16 - 990). CONCLUSION: TTS application of flexible, non-covered SEMS seems to be safe and effective for palliation of malignant colorectal obstruction independent of localization of the tumor in the colon.
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Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Stents , Adulto , Idoso , Neoplasias do Colo/diagnóstico , Feminino , Humanos , Obstrução Intestinal/diagnóstico , Masculino , Metais , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Resultado do TratamentoRESUMO
STUDY QUESTION: Is thin endometrium unresponsive to standard treatments expandable by intrauterine perfusion with granulocyte colony-stimulating factor (G-CSF)? SUMMARY ANSWER: This cohort study is supportive of the effectiveness of G-CSF in expanding chronically unresponsive endometria. WHAT IS KNOWN ALREADY: In a previous small case series, we reported the successful off-label use of G-CSF in four consecutive patients, who had previously failed to expand their endometria beyond 6.9 mm with the use of standard treatments. STUDY DESIGN, SIZE AND DURATION: In a prospective observational cohort pilot study over 18 months, we described 21 consecutive infertile women with endometria <7 mm on the day of hCG administration in their first IVF cycles at our center. All previous cycles using traditional treatments with estradiol, sildenafil citrate (Viagra™) and/or beta-blockers had been unsuccessful. G-CSF (Nupogen™) was administered per intrauterine catheter by slow infusion before noon on the day of hCG administration. If the endometrium had not reached at least a 7-mm within 48h, a second infusion was given following oocyte retrieval. Primary and secondary main outcomes were an increase in endometrial thickness and clinical pregnancy, respectively. Endometrial thickness was assessed by vaginal ultrasound at the most expanded area of the endometrial stripe. PARTICIPANTS/MATERIALS, SETTINGS AND METHOD: This study was uncontrolled, each patient serving as her own control in a prospective evaluation of endometrial thickness. The mean ± SD age of the cohort was 40.5 ± 6.6 years, gravidity was 1.8 ± 2.1 (range 0-7) and parity was 0.4 ± 1.1 (range 0-4); 76.2% of women had, based on age-specific FSH and anti-Müllerian hormone, an objective diagnosis of diminished ovarian reserve and had failed 2.0 ± 2.1 prior IVF cycles elsewhere. MAIN RESULTS AND THE ROLE OF CHANCE: With 5.2 ± 1.9 days between G-CSF perfusions and embryo transfers, endometrial thickness increased from 6.4 ± 1.4 to 9.3 ± 2.1 mm (P < 0.001). The Δ in change was 2.9 ± 2.0 mm, and did not vary between conception and non-conception cycles. A 19.1% ongoing clinical pregnancy rate was observed, excluding one ectopic pregnancy. LIMITATIONS AND REASONS FOR CAUTION: Small sample size (but a highly selected patient population) in an uncontrolled cohort study and in unselected first IVF cycles at our center. WIDER IMPLICATIONS OF THE FINDINGS: This pilot study supports the utility of G-CSF in the treatment of chronically thin endometrium and suggests that such treatment will, in very adversely affected patients, result in low but very reasonable clinical pregnancy rates. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the Foundation for Reproductive Medicine, New York, New York, USA, a not-for-profit research foundation and intramural grants from the Center for Human Reproduction (CHR)-New York. N.G. and D.H.B. are members of the board of the Foundation for Reproductive Medicine. N.G. is owner of CHR-New York, where the study was conducted. N.G. and D.H.B. have been recipients of research awards, travel grants and speaker honoraria from various pharmaceutical and medical device companies. None of these companies was, however, in any way associated with the materials and the manuscript presented here. N.G. and D.H.B. are listed as co-inventors on a number of awarded and still pending U.S. patents, none related to the materials presented here. N.G. is on the board of a medically related company, not in any way associated with the data presented here.
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Resistência a Medicamentos , Endométrio/efeitos dos fármacos , Fármacos para a Fertilidade Feminina/uso terapêutico , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Infertilidade Feminina/etiologia , Doenças Uterinas/tratamento farmacológico , Administração Intravaginal , Adulto , Estudos de Coortes , Monitoramento de Medicamentos , Endométrio/patologia , Feminino , Fármacos para a Fertilidade Feminina/administração & dosagem , Fertilização in vitro , Filgrastim , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Humanos , Infertilidade Feminina/terapia , Infusões Parenterais , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Indução da Ovulação , Projetos Piloto , Gravidez , Taxa de Gravidez , Insuficiência Ovariana Primária/complicações , Estudos Prospectivos , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/uso terapêutico , Doenças Uterinas/complicações , Doenças Uterinas/patologia , Doenças Uterinas/fisiopatologiaRESUMO
We report a case of congenital midaortic syndrome with bilateral renal artery atresia in a premature female neonate born by way of caesarean section secondary to acute onset of decreased fetal movement and polyhydramnios. The infant required cardiopulmonary resuscitation at birth, and initial echocardiogram exhibited normal intracardiac anatomy and mildly depressed left-ventricular systolic function. Within 24 h, the neonate developed severe systemic arterial hypertension and acute renal failure. Ultrasound demonstrated hyperechoic kidneys and a hypoplastic abdominal aorta. Angiography revealed severe suprarenal hypoplasia of the abdominal aorta with bilateral renal artery atresia. Medical support was withdrawn, and the patient died shortly thereafter.
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Coartação Aórtica/diagnóstico por imagem , Artéria Renal/anormalidades , Reanimação Cardiopulmonar , Diagnóstico Diferencial , Ecocardiografia Doppler , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , SíndromeRESUMO
We conducted a theoretical study of the physiological significance of respiratory sinus arrhythmia (RSA), a phenomenon used as an index of cardiac vagal tone and wellbeing, whereby the heart rate (HR) increases during inspiration and decreases during expiration. We first tested the hypothesis that RSA improves gas exchange efficiency but found that although gas exchange efficiency improved with slow and deep breathing and with increased mean heart rate, this was unrelated to RSA. We then formulated and tested a new hypothesis: that RSA minimizes the work done by the heart while maintaining physiological levels of arterial carbon dioxide. We tested the new hypothesis using two methods. First, the HR for which the work is minimized was calculated using techniques from optimal control theory. This calculation was done on simplified models that we derived from a previously published model of gas exchange in mammals. We found that the calculated HR was remarkably similar to RSA and that this became more profound under slow and deep breathing. Second, the HR was prescribed and the work done by the heart was calculated by conducting a series of numerical experiments on the previously published gas exchange model. We found that cardiac work was minimized for RSA-like HR functions, most profoundly under slow and deep breathing. These findings provide novel insights into potential reasons for and benefits of RSA under physiological conditions.
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Arritmia Sinusal/fisiopatologia , Coração/fisiopatologia , Modelos Cardiovasculares , Mecânica Respiratória/fisiologia , Animais , Arritmia Sinusal/metabolismo , Dióxido de Carbono/metabolismo , Frequência Cardíaca/fisiologia , Humanos , Modelos Teóricos , Perfusão , Troca Gasosa Pulmonar/fisiologia , Ventilação PulmonarRESUMO
OBJECTIVE: Fibrin glue is used as a haemostatic agent or as a sealant. The aim of this study is to objectively evaluate the efficacy of the use of fibrin glue Quixil - a human surgical sealer - in tonsillectomy, for the reduction of post-operative inflammatory response. STUDY DESIGN: A prospective randomized single-blind study. METHODS: The study was performed on 40 consecutive patients undergoing adenotonsillectomy (T&A). Patients were randomly assigned to one of two sub-groups: a study group and a control group. The tonsillar beds of patients in the study group were coated with fibrin glue (Quixil, OMRIX biopharmaceuticals) at the end of the operation; the patients in the control group were treated for hemostasis without the use of fibrin glue. Complete blood counts and circulating pro-inflammatory cytokines (assayed by specific immunoassay - ELISA) were assessed in samples drawn pre- and 16 h post-tonsillectomy. RESULTS: Forty patients (aged 5.8 ± 2.4 years) were consecutively enrolled; 45% (18) of the patients were treated with fibrin glue, 55% (22) were not. Compared to controls, Quixil-treated patients demonstrated a reduction in post-tonsillectomy circulating leukocytes (29.2% vs. 45.4%, p<0.05), neutrophiles (28.3% vs. 42.1%, p<0.05), IL-6 (+1% vs. +42%, p<0.05), and TNF-alpha (+8% vs. +26%, p<0.05. CONCLUSIONS: Intra-operative fibrin glue therapy is associated with decreased immediate inflammatory response following T&A. Further studies are warranted to assess long-term outcome. LEVEL OF EVIDENCE: 1B.
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Adesivo Tecidual de Fibrina/uso terapêutico , Hemostáticos/uso terapêutico , Interleucina-6/sangue , Tonsilectomia/efeitos adversos , Tonsilite/sangue , Fator de Necrose Tumoral alfa/sangue , Adenoidectomia/efeitos adversos , Criança , Pré-Escolar , Feminino , Humanos , Inflamação/sangue , Inflamação/etiologia , Inflamação/prevenção & controle , Masculino , Estudos Prospectivos , Método Simples-Cego , Apneia Obstrutiva do Sono/sangue , Apneia Obstrutiva do Sono/patologia , Apneia Obstrutiva do Sono/cirurgia , Tonsilite/patologia , Tonsilite/cirurgiaRESUMO
The aim of the present study was to estimate slow-wave activity (SWA), a marker of sleep homeostasis, in children with obstructive sleep apnoea (OSA) before and after adenotonsillectomy (AT) compared with untreated OSA children (comparison group). 14 children with OSA (mean ± sd age 6.4 ± 2.5 yrs; apnoea-hypopnoea index (AHI) 10.0 ± 10.3 events·h⻹) who underwent AT were consecutively recruited to the study. The comparison group comprised six retrospectively recruited children (age 5.4 ± 2.2 yrs; AHI 9.4 ± 7.6 events·h⻹) with OSA that did not undergo treatment. Electroencephalogram (derivation C3/A2) was analysed using spectral and waveform analysis to determine SWA energy and slow-wave slope. The same procedure was repeated 5.4 and 19 months later for the AT and comparison groups, respectively. AT improved respiration without a change in duration of sleep stages. Following AT, >50% elevation of SWA during the first two sleep cycles (p<0.01) and a more physiological decay of SWA across the night (p<0.0001) were noted. The slow-wave slope increased by >30% following AT (p<0.03). No significant changes were found in SWA in the comparison group. Sleep homeostasis is considerably impaired in pre-pubescent children with OSA. AT restores more physiological sleep homeostasis in children with OSA. SWA analysis may provide a useful addition to standard sleep-stage analyses in children with OSA.
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Adenoidectomia , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/cirurgia , Sono , Criança , Pré-Escolar , Eletroencefalografia , Feminino , Homeostase/fisiologia , Humanos , Masculino , Respiração , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Dietary application of dried Rosmarinus officinalis (rosemary) leaves as a treatment for streptococcal infection was studied in tilapia, Oreochromis sp. Feeding with dried rosemary leaves significantly reduced mortality following infection with Streptococcus iniae: 44% mortality in the group fed 8% rosemary, similar to oxytetracycline treatment (43% mortality), and significantly lower than the control (65%). Dietary administration of 16% rosemary significantly reduced mortality because of Streptococcus agalactiae infection in 44 g fish (62% and 76% in 16% rosemary and control, respectively), but not in a similar experiment conducted with 5.5 g fish. The antibacterial effect of rosemary on S. iniae was studied. Activity of rosemary cultivar Israel was reduced during the winter, but there was no significant change in cultivars Oranit and Star. Storage of powdered rosemary leaves at 50 degrees C resulted in fourfold and eightfold higher MIC(24 h) values after 3 and 4.5 months, respectively. Storage at -20 degrees C, 4 degrees C and 25 degrees C and autoclaving (120 degrees C) each resulted in a twofold increase in MIC(24 h). Repeated exposures of S. iniae to rosemary did not affect minimal inhibitory concentration, suggesting no development of resistance to rosemary.
Assuntos
Anti-Infecciosos/farmacologia , Doenças dos Peixes/tratamento farmacológico , Fitoterapia/veterinária , Rosmarinus , Infecções Estreptocócicas/veterinária , Tilápia , Animais , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Doenças dos Peixes/mortalidade , Folhas de Planta , Rosmarinus/fisiologia , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/mortalidade , Streptococcus/efeitos dos fármacos , Streptococcus/crescimento & desenvolvimento , Streptococcus agalactiae/efeitos dos fármacos , Temperatura , Fatores de TempoRESUMO
Single nucleotide polymorphisms (SNPs) are amenable to automation and therefore have become the marker of choice for DNA profiling. SNaPshot, a primer extension-based method, was used to multiplex 25 SNPs that have been previously validated as useful for identity control. Detection of extended products was based on four different fluorochromes and extension primers with oligonucleotide tails of differing lengths, thus controlling the concise length of the entire chromatogram to 81 bases. Allele frequencies for Holstein, Simmental, Limousin, Angus, Charolais and Tux Cattle were estimated and significant positive Pearson-correlation coefficients were obtained among the analysed breeds. The probability that two randomly unrelated individuals would share identical genotypes for all 25 loci varied from 10(-8) to 10(-10) for these breeds. For parentage control, the exclusion power was found to be 99.9% when the genotypes of both putative parents are known. A traceability test of duplicated samples indicated a high genotyping precision of >0.998. This was further corroborated by analysis of 60 cases of parent-sib pairs and trio families. The 25-plex SNaPshot assay is adapted for low- and high-throughput capacity and thus presents an alternative for DNA-based traceability in the major commercial cattle breeds.
Assuntos
Bovinos/genética , Polimorfismo de Nucleotídeo Único , Animais , DNA/química , DNA/genética , Feminino , Frequência do Gene , Variação Genética , Reação em Cadeia da Polimerase/veterináriaRESUMO
"Description. Face au vieillissement de la population et au developpement de la demence; il est necessaire de disposer d'outil de depistage valide et fiable qui soit adapte au contexte socio-culturel. Objectif.Valider le Test du Senegal; un instrument de depistage de la demence aupres de la population agee senegalaise. Methode .Le Test du Senegal est un instrument de depistage de la demence incluant des items en rapport avec l'orientation; la memoire; l'attention/calcul; la praxie et le langage avec un score de 0-39 points. Sa validation s'est deroulee en deux phases aupres de personnes agees de 55 ans et plus frequentant le Centre Medicosocial et Universitaire de l'IPRES (Institut de Prevoyance Retraite du Senegal) pour des soins : 1) etude transversale aupres de 872 patients interviewes avec le questionnaire ""Vieillir au Senegal"" pour identifier les cas selon les criteres DSM IV-R; 2) une etude cas-temoins avec 116 patients (58 sujets dements et 58 temoins apparies par le sexe) pour la validation proprement dite. Le Test du Senegal a ete administre lors de la premiere phase; re-administre une semaine puis deux semaines apres lors de la deuxieme phase. La validite de critere; la validite de construit et la fidelite du test ont ete estimees. L'effet de l'age et de l'instruction sur la performance du test pour depister la demence a ete etudie avec des analyses de regression logistique. Resultat. Le Test du Senegal identifiait les cas de demence avec les caracteristiques suivantes au point de coupure de 28/29 : sensibilite : 93;1; specificite : 89;6; valeur predictive positive : 93;1; valeur predictive negative : 92;8; surface sous la courbe caracteristique de performance: 0;967; kappa : 0;82; coefficient de correlation intraclasse variant entre 0;67 et 0;87. L'age et l'education n'avaient aucune influence sur la performance au Test du Senegal. Conclusion Le Test du Senegal est un instrument valide et fiable pour le depistage de la demence dans la population agee senegalaise. Il pourra etre utilise comme outil de depistage de la demence dans les services de sante."
Assuntos
Demência , Programas de Rastreamento , Pessoas com Deficiência AuditivaRESUMO
Environmentally sound management of the use of composts in agriculture relies on matching the rate of release of available N from compost-amended soils to the crop demand. To develop such management it is necessary to (i) characterize the properties of composts that control their rates of decomposition and release of N and (ii) determine the optimal amount of composts that should be applied annually to wheat (Triticum aestivum L.). Carbon and N mineralization were measured under controlled conditions to determine compost decomposition rate parameters, and the NCSOIL model was used to derive the organic wastes parameters that control the rates of N and C transformations in the soil. We also characterized the effect of a drying period to estimate the effects of the dry season on C and N dynamics in the soil. The optimized compost parameters were then used to predict mineral N concentration dynamics in a soil-wheat system after successive annual applications of compost. Sewage sludge compost (SSC) and cattle manure compost (CMC) mineralization characteristics showed similar partitioning into two components of differing ease of decomposition. The labile component accounted for 16 to 20% of total C and 11 to 14% of total N, and it decomposed at a rate of 2.4 x 10(-2) d(-1), whereas the resistant pool had a decomposition rate constant of 1.2 to 1.4 x 10(-4) d(-1). The main differences between the two composts resulted from their total C and N and inorganic N contents, which were determined analytically. The long-term effect of a drying period on C and N mineralization was negligible. Use of these optimization results in a simulation of compost mineralization under a wheat crop, with a modified plant-effect version of the NCSOIL model, enabled us to evaluate the effects of the following factors on the C and N dynamics in soil: (i) soil temperature, (ii) mineral N uptake by plants, and (iii) release of very labile organic C in root exudates. This labile organic C enhanced N immobilization following application, and so decreased the N available for uptake by plants.