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1.
An Acad Bras Cienc ; 95(suppl 2): e20220917, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38055560

RESUMO

In the present study, a taxonomic review was conducted on representatives of the genus Tetmemorus (Desmidiaceae, Zygnematophyceae) documented within Brazilian territory. This review involved compiling data from the literature and analyzing samples collected throughout the Bahia State, updating our knowledge about this genus in Brazil. For each identified taxon, we provided information such as description, distribution across biomes and states, watersheds, ecological aspects (including habitat and community types), a list of examined (and excluded) materials, and taxonomic comments. Additionally, a taxonomic key for all species reported in Brazil was provided. Through this comprehensive review, we identified a total of eight Tetmemorus taxa occurring in Brazilian territory, comprising five species (T. brebissonii, T. furcatus, T. granulatus, T. laevis, T. planctonicus) and three non-typical varieties (T. brebissonii var. minor, T. laevis var. borgei, T. laevis var. minutus).


Assuntos
Clorófitas , Ecossistema , Dispersão Vegetal , Brasil , Clorófitas/classificação , Clorófitas/genética
3.
J Anim Sci ; 94(8): 3420-3430, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27695807

RESUMO

Previous in vitro data showed that was inhibited by limonene. We further evaluated effects of limonene on growth of in vitro as well as on ruminal concentrations of in vivo. With in vitro cultivation in anaerobic brain-heart infusion broth, limonene decreased growth of . Thymol also reduced growth of , but it was less effective than limonene. Tylosin effectively reduced growth of in vitro. Although the response over fermentation times and concentrations of antimicrobials differed somewhat between tylosin and limonene, the 2 antimicrobial agents yielded similar inhibitory effects on growth of at concentrations ranging from 6 to 24 mg/L. The effects of limonene on ruminal concentration in vivo were tested in 7 ruminally cannulated heifers (225 kg initial BW) used in a 7 × 4 Youden square design. Treatments included: 1) control, 2) limonene at 10 mg/kg diet DM, 3) limonene at 20 mg/kg diet DM, 4) limonene at 40 mg/kg diet DM, 5) limonene at 80 mg/kg diet DM, 6) CRINA-L (a blend of essential oil components) at 180 mg/kg diet DM, and 7) tylosin at 12 mg/kg diet DM. Each period included 11 d with 10 d washouts between periods. Samples of ruminal contents were collected before treatment initiation and after 4, 7, and 10 d of treatment for measuring by the most probable number method using selective culture medium. Limonene linearly decreased ( = 0.03) ruminal concentration, with the lowest concentration achieved with 40 mg of limonene/kg dietary DM. Limonene tended ( ≤ 0.07) to linearly reduce ruminal molar proportions of propionate and valerate while tending to linearly increase ( ≤ 0.10) those of butyrate and 2-methyl butyrate. Limonene did not affect ruminal NH concentrations or degradation rates of lysine. Neither CRINA-L ( = 0.52) nor tylosin ( = 0.19) affected ruminal concentrations. CRINA-L significantly decreased ruminal concentrations of NH and molar proportions of 3-methyl butyrate, whereas tylosin significantly decreased molar proportions of propionate while increasing those of butyrate and tending to increase those of acetate. Limonene supplementation reduced ruminal concentrations of suggesting that it may have the potential to reduce the prevalence of liver abscesses, although further research is needed to assess the effect of limonene in feedlot cattle.


Assuntos
Bovinos/fisiologia , Cicloexenos/farmacologia , Suplementos Nutricionais , Fusobacterium/efeitos dos fármacos , Lisina/metabolismo , Rúmen/microbiologia , Terpenos/farmacologia , Ração Animal/análise , Animais , Butiratos/metabolismo , Dieta/veterinária , Digestão/fisiologia , Feminino , Fermentação , Concentração de Íons de Hidrogênio , Limoneno , Óleos Voláteis/administração & dosagem , Óleos Voláteis/farmacologia , Propionatos/farmacologia , Timol/farmacologia , Tilosina/farmacologia
4.
Adv Appl Microbiol ; 95: 179-204, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27261784

RESUMO

Bacterial enteric pathogens are responsible for a tremendous amount of foodborne illnesses every year through the consumption of contaminated food products. During their transit from contaminated food sources to the host gastrointestinal tract, these pathogens are exposed and must adapt to fluctuating oxygen levels to successfully colonize the host and cause diseases. However, the majority of enteric infection research has been conducted under aerobic conditions. To raise awareness of the importance in understanding the impact of oxygen, or lack of oxygen, on enteric pathogenesis, we describe in this review the metabolic and physiological responses of nine bacterial enteric pathogens exposed to environments with different oxygen levels. We further discuss the effects of oxygen levels on virulence regulation to establish potential connections between metabolic adaptations and bacterial pathogenesis. While not providing an exhaustive list of all bacterial pathogens, we highlight key differences and similarities among nine facultative anaerobic and microaerobic pathogens in this review to argue for a more in-depth understanding of the diverse impact oxygen levels have on enteric pathogenesis.


Assuntos
Infecções por Enterobacteriaceae/microbiologia , Enterobacteriaceae/metabolismo , Oxigênio/metabolismo , Animais , Enterobacteriaceae/genética , Enterobacteriaceae/isolamento & purificação , Enterobacteriaceae/patogenicidade , Humanos , Virulência
5.
Ultrasonics ; 63: 31-8, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26152887

RESUMO

When ultrasound contrast agent microbubbles are nested within a liposome, damage to the liposome membrane caused by both stable and inertial cavitation of the microbubble allows for release of the aqueous core of the liposome. Triggered release was not accomplished unless microbubbles were present within the liposome. Leakage was tested using fluorescence assays developed specifically for this drug delivery vehicle and qualitative measurements using an optical microscope. These studies were done using a 1 MHz focused ultrasound transducer while varying parameters including peak negative ultrasound pressure, average liposome diameter, and microbubble concentration. Two regimes exist for membrane disruption caused by cavitating microbubbles. A faster release rate, as well as permanent membrane damage are seen for samples exposed to high pressure (2.1-3.7 MPa). A slower release rate and dilation/temporary poration are characteristic of stable cavitation for low pressure studies (0.54-1.7 MPa).


Assuntos
Sistemas de Liberação de Medicamentos/métodos , Lipossomos/química , Fluoresceínas/farmacologia , Corantes Fluorescentes/farmacologia , Microbolhas , Espectrofotometria , Ultrassom
6.
Ultrasonics ; 58: 67-74, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25620709

RESUMO

Cavitation of ultrasound contrast agents (UCAs) promotes both beneficial and detrimental bioeffects in vivo (Radhakrishnan et al., 2013) [1]. The ability to determine the inertial cavitation threshold of UCA microbubbles has potential application in contrast imaging, development of therapeutic agents, and evaluation of localized effects on the body (Ammi et al., 2006) [2]. This study evaluates a novel UCA and its inertial cavitation behavior as determined by a home built cavitation detection system. Two 2.25 MHz transducers are placed at a 90° angle to one another where one transducer is driven by a high voltage pulser and the other transducer receives the signal from the oscillating microbubble. The sample chamber is placed in the overlap of the focal region of the two transducers where the microbubbles are exposed to a pulser signal consisting of 600 pulse trains per experiment at a pulse repetition frequency of 5 Hz where each train has four pulses of four cycles. The formulation being analyzed is comprised of an SF6 microbubble coated by a DSPC PEG-3000 monolayer nested within a poly-lactic acid (PLA) spherical shell. The effect of varying shell diameters and microbubble concentration on cavitation threshold profile for peak negative pressures ranging from 50 kPa to 2 MPa are presented and discussed in this paper. The nesting shell decreases inertial cavitation events from 97.96% for an un-nested microbubble to 19.09% for the same microbubbles nested within a 2.53 µm shell. As shell diameter decreases, the percentage of inertially cavitating microbubbles also decreases. For nesting formulations with average outer capsule diameters of 20.52, 14.95, 9.95, 5.55, 2.53, and 1.95 µm, the percentage of sample destroyed at 1 MPa was 51.02, 38.94, 33.25, 25.27, 19.09, and 5.37% respectively.


Assuntos
Meios de Contraste , Microbolhas , Cápsulas , Transdutores , Ultrassom
7.
Ultrasonics ; 54(8): 2099-108, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25041980

RESUMO

This study aims to bridge the gap between transport mechanisms of an improved ultrasound contrast agent (UCA) and its resulting behavior in a clinical imaging study. Phospholipid-shelled microbubbles nested within the aqueous core of a polymer microcapsule are examined for their use and feasibility as an improved UCA. The nested formulation provides contrast comparable to traditional formulations, specifically an SF6 microbubble coated by a DSPC PEG-3000 monolayer, with the advantage that contrast persists at least nine times longer in a mock clinical, in vitro setting. The effectiveness of the sample was measured using a contrast ratio in units of decibels (dB) which compares the brightness of the nested microbubbles to a reference value of a phantom tissue mimic. During a 40min imaging study, six nesting formulations with average outer capsule diameters of 1.95, 2.53, 5.55, 9.95, 14.95, and 20.51µm reached final contrast ratio values of 0.25, 2.35, 3.68, 4.51, 5.93, and 8.00dB, respectively. The starting contrast ratio in each case was approximately 8dB and accounts for the brightness attributed to the nesting shell. As compared with empty microcapsules (no microbubbles nested within), enhancement of the initial contrast ratio increased systematically with decreasing microcapsule size. The time required to reach a steady state in the temporal contrast ratio profile also varied with microcapsule diameter and was found to be 420s for each of the four smallest shell diameters and 210s and 150s, respectively, for the largest two shell diameters. All nested formulations were longer-lived and gave higher final contrast ratios than a control sample comprising un-nested, but otherwise equivalent, microbubbles. Specifically, the contrast ratio of the un-nested microbubbles decreased to a negative value after 4min of continuous ultrasound exposure with complete disappearance of the microbubbles after 15min whereas all nested formulations maintained positive contrast ratio values for the duration of the 40min trial. The results are consistent with two distinct stages of gas transport: in the first stage, passive diffusion occurs under ambient conditions across the microbubble monolayer within the first few minutes after formulation until the aqueous interior of the microcapsule is saturated with gas; in the second stage ultrasound drives additional gas dissolution even further due to pressure modulation. It is important to understand the chemistry and transport mechanisms of this contrast agent under the influence of ultrasound to attain better perspicacity for enhanced applications in imaging. Results from this study will facilitate future preclinical studies and clinical applications of nested microbubbles for therapeutic and diagnostic imaging.


Assuntos
Meios de Contraste/química , Microbolhas , Fosfatidiletanolaminas/química , Ultrassom , Imagens de Fantasmas , Polímeros/química , Transdutores
8.
Genes Brain Behav ; 12(8): 749-59, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24102798

RESUMO

The norepinephrine (NE) transporter (NET) regulates synaptic NE availability for noradrenergic signaling in the brain and sympathetic nervous system. Although genetic variation leading to a loss of NET expression has been implicated in psychiatric and cardiovascular disorders, complete NET deficiency has not been found in people, limiting the utility of NET knockout mice as a model for genetically driven NET dysfunction. Here, we investigate NET expression in NET heterozygous knockout male mice (NET(+/-) ), demonstrating that they display an approximately 50% reduction in NET protein levels. Surprisingly, these mice display no significant deficit in NET activity assessed in hippocampal and cortical synaptosomes. We found that this compensation in NET activity was due to enhanced activity of surface-resident transporters, as opposed to surface recruitment of NET protein or compensation through other transport mechanisms, including serotonin, dopamine or organic cation transporters. We hypothesize that loss of NET protein in the NET(+/-) mouse establishes an activated state of existing surface NET proteins. The NET(+/-) mice exhibit increased anxiety in the open field and light-dark box and display deficits in reversal learning in the Morris water maze. These data suggest that recovery of near basal activity in NET(+/-) mice appears to be insufficient to limit anxiety responses or support cognitive performance that might involve noradrenergic neurotransmission. The NET(+/-) mice represent a unique model to study the loss and resultant compensatory changes in NET that may be relevant to behavior and physiology in human NET deficiency disorders.


Assuntos
Ansiedade/genética , Permeabilidade da Membrana Celular , Aprendizagem em Labirinto , Proteínas da Membrana Plasmática de Transporte de Norepinefrina/genética , Animais , Ansiedade/metabolismo , Córtex Cerebral/metabolismo , Córtex Cerebral/fisiologia , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Hipocampo/metabolismo , Hipocampo/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteínas da Membrana Plasmática de Transporte de Norepinefrina/metabolismo , Proteínas de Transporte de Cátions Orgânicos/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina/metabolismo , Sinaptossomos/metabolismo
9.
Br J Pharmacol ; 167(5): 1111-25, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22671931

RESUMO

BACKGROUND & PURPOSE: Loperamide is a selective µ opioid receptor agonist acting locally in the gastrointestinal (GI) tract as an effective anti-diarrhoeal but can cause constipation. We tested whether modulating µ opioid receptor agonism with δ opioid receptor antagonism, by combining reference compounds or using a novel compound ('MuDelta'), could normalize GI motility without constipation. EXPERIMENTAL APPROACH: MuDelta was characterized in vitro as a potent µ opioid receptor agonist and high-affinity δ opioid receptor antagonist. Reference compounds, MuDelta and loperamide were assessed in the following ex vivo and in vivo experiments: guinea pig intestinal smooth muscle contractility, mouse intestinal epithelial ion transport and upper GI tract transit, entire GI transit or faecal output in novel environment stressed mice, or four weeks after intracolonic mustard oil (post-inflammatory). Colonic δ opioid receptor immunoreactivity was quantified. KEY RESULTS: δ Opioid receptor antagonism opposed µ opioid receptor agonist inhibition of intestinal contractility and motility. MuDelta reduced intestinal contractility and inhibited neurogenically-mediated secretion. Very low plasma levels of MuDelta were detected after oral administration. Stress up-regulated δ opioid receptor expression in colonic epithelial cells. In stressed mice, MuDelta normalized GI transit and faecal output to control levels over a wide dose range, whereas loperamide had a narrow dose range. MuDelta and loperamide reduced upper GI transit in the post-inflammatory model. CONCLUSIONS AND IMPLICATIONS: MuDelta normalizes, but does not prevent, perturbed GI transit over a wide dose-range in mice. These data support the subsequent assessment of MuDelta in a clinical phase II trial in patients with diarrhoea-predominant irritable bowel syndrome.


Assuntos
Motilidade Gastrointestinal/fisiologia , Receptores Opioides mu/fisiologia , Analgésicos Opioides/farmacologia , Animais , Feminino , Motilidade Gastrointestinal/efeitos dos fármacos , Cobaias , Células HEK293 , Humanos , Macaca fascicularis , Masculino , Camundongos , Antagonistas de Entorpecentes/farmacologia , Ratos , Ratos Sprague-Dawley , Ratos Wistar , Receptores Opioides mu/agonistas , Receptores Opioides mu/antagonistas & inibidores
10.
Neurogastroenterol Motil ; 19(5): 390-400, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17509021

RESUMO

Oil of mustard (OM), administered intracolonically, produces severe colitis in mice that is maximized within 3 days. The purpose of this study was to characterize the cytokine response, and to establish expression patterns of enteric neuronal mediators and neuronal receptors affected during active colitis. We measured the changes in the mRNA levels for neuronal receptors and mediators by real-time PCR, and cytokine and chemokine protein levels in the affected tissue. Significant increases in neuronal receptors, such as transient receptor potential A1 (TRPA1), cannabinoid type 1 receptor, neurokinin 1 receptor (NK1R) and delta-opioid receptor; prokineticin-1 receptor; and soluble mediators, such as prodynorphin, proenkephalin1, NK1, prokineticin-1 and secretory leukocyte protease inhibitor, occurred. Significant increases in cytokines, such as interleukin (IL)-1beta, IL-6 and granulocyte macrophage colony stimulating factor (GM-CSF), and in chemokines, such as macrophage chemotactic protein 1 (MCP-1), macrophage inflammatory protein 1 (MIP-1alpha) and Kupffer cell derived chemokine (KC), were detected, with no changes in T-cell-derived cytokines. Furthermore, immunodeficient C57Bl/6 RAG2(-/-) mice exhibited OM colitis of equal severity as seen in wt C57Bl/6 and CD-1 mice. The results demonstrate rapidly increased levels of mRNA for neuronal receptors and soluble mediators associated with pain and inflammation, and increases in cytokines associated with macrophage and neutrophil activation and recruitment. Collectively, the data support a neurogenic component in OM colitis coupled with a myeloid cell-related, T- and B-cell-independent inflammatory component.


Assuntos
Colite/induzido quimicamente , Citocinas/metabolismo , Mostardeira/toxicidade , Neuropeptídeos/metabolismo , Óleos de Plantas/toxicidade , Células Receptoras Sensoriais/metabolismo , Animais , Colite/patologia , Colo/metabolismo , Colo/patologia , Citocinas/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout/genética , Camundongos Knockout/metabolismo , Neuropeptídeos/genética , Óleos de Plantas/administração & dosagem , Canal de Cátion TRPA1 , Canais de Cátion TRPV/genética , Canais de Cátion TRPV/metabolismo , Canais de Potencial de Receptor Transitório/genética , Canais de Potencial de Receptor Transitório/metabolismo
11.
Neurogastroenterol Motil ; 16(6): 811-8, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15601431

RESUMO

Neurogenic mechanisms have been implicated in the induction of inflammatory bowel disease (IBD). Vanilloid receptor type 1 (TRPV1) has been visualized on nerve terminals of intrinsic and extrinsic afferent neurones innervating the gastrointestinal tract and local administration of a TRPV1 antagonist, capsazepine, reduces the severity of dextran sulphate sodium (DSS)-induced colitis in rats (Gut 2003; 52: 713-9(1)). Our aim was to test whether systemically or orally administered TRPV1 antagonists attenuate experimental colitis induced by 5% DSS in Balb/c mice. Intraperitoneal capsazepine (2.5 mg kg(-1), bid), significantly reduced the overall macroscopic damage severity compared with vehicle-treated animals (80% inhibition, P < 0.05); however, there was no effect on myeloperoxidase (MPO) levels. An experimental TRPV1 antagonist given orally was tested against DSS-induced colitis, and shown to reverse the macroscopic damage score at doses of 0.5 and 5.0 mg kg(-1). Epithelial damage assessed microscopically was significantly reduced. MPO levels were attenuated by approximately 50%, and diarrhoea scores were reduced by as much as 70%. These results suggest that pharmacological modulation of TRPV1 attenuates indices of experimental colitis in mice, and that development of orally active TRPV1 antagonists might have therapeutic potential for the treatment of IBD.


Assuntos
Capsaicina/análogos & derivados , Colite/prevenção & controle , Canais Iônicos/antagonistas & inibidores , Animais , Anticoagulantes/farmacologia , Capsaicina/farmacologia , Colite/induzido quimicamente , Colite/patologia , Sulfato de Dextrana/farmacologia , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Feminino , Doenças Inflamatórias Intestinais/patologia , Doenças Inflamatórias Intestinais/prevenção & controle , Canais Iônicos/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos BALB C , Peroxidase/efeitos dos fármacos , Peroxidase/metabolismo , Canais de Cátion TRPV
12.
Perfusion ; 18 Suppl 1: 23-31, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12708762

RESUMO

Cardiopulmonary bypass (CPB) precipitates inflammation that causes marked pulmonary dysfunction. Leukocyte filtration has been proposed to reduce these deleterious effects. Other studies show an improvement with aprotinin. We proposed that a combination of these two therapies would synergistically improve pulmonary outcomes. Two hundred and twenty-five patients participated in a randomized prospective study comparing pulmonary microvascular function and pulmonary shunt fraction postcoronary artery bypass grafting (CABG). The study group underwent leukocyte depletion with aprotinin during the procedure. Pulmonary microvascular function was assessed by pulmonary microvascular pressure (PMVP), a measure of pulmonary capillary edema, and pulmonary function was evaluated by comparing pulmonary shunt fractions. Elevated PMVP and increased pulmonary shunting compromise pulmonary performance. The leukocyte-depleted group had significantly reduced PMVP and pulmonary shunt fraction for at least the first 24 hours postbypass. The combination of strategic leukocyte filtration and aprotinin therapy can effectively reduce postoperative decline in pulmonary function. Cardiopulmonary bypass precipitates a variety of inflammatory effects that can cause marked pulmonary dysfunction to the point of respiratory failure, necessitating prolonged mechanical ventilation. Leukocyte filtration has been investigated previously and appears to be beneficial in improving pulmonary outcome by preventing direct neutrophil-induced inflammatory injury. Recent studies of leukocyte reduction profiles suggest that leukoreduction via leukofiltration is short lived with filter saturation occurring 30-45 minutes after onset of filtration. This phenomenon may explain the limited utility observed with higher risk patients. These patients typically require longer pump runs, so leukocyte reduction capability is suboptimal at the time of pulmonary vascular reperfusion. To more effectively protect the lung from reperfusion injury, leukocyte filtration can be delayed so that reduction of activated neutrophils is maximal at the time of pulmonary vascular reperfusion. It is, thus, conceivable that a timely use of arterial line leukoreducing filters may improve, more substantially, pulmonary function postbypass. Two hundred and twenty-five isolated coronary revascularization patients participated in this prospective, randomized trial. The patients received moderately hypothermic CBP alone (control group: n = 110) or combined with leukocyte depletion, initiated 30 minutes before crossclamp release, with filters placed in the bypass circuit (study group: n = 115). All patients also received full Hammersmith aprotinin dosing during the operation. Pulmonary microvascular pressures were lower in the study group at three hours postbypass, and continued to fall until 24 hours postbypass. In contrast, the control group measured a rise in PMVP and a continued plateau throughout 24 hours postbypass (p < 0.028). The calculated pulmonary shunt fraction also was reduced significantly throughout the study interval, with the greatest reduction occurring approximately three to six hours post-CPB (p < 0.002). Shunt fractions eventually converged at 24 hours postbypass. Outcome measures included hospital charges and length of stay, which were also markedly reduced in the treatment group. Increasing PMVPs are a direct reflection of pulmonary capillary edema, which, in conjunction with increased pulmonary shunt ratio, lead to an overall worsening of pulmonary function. Intraoperative strategic leukocyte filtration combined with aprotinin treatment improves post-CPB lung performance by reducing significantly the reperfusion inflammatory response and its sequelae. These benefits are manifested by reductions in ventilator times, hospital stay and patient morbidity.


Assuntos
Ponte Cardiopulmonar , Leucaférese/métodos , Pulmão/irrigação sanguínea , Circulação Pulmonar/fisiologia , Idoso , Pressão Sanguínea/fisiologia , Transfusão de Sangue/métodos , Feminino , Humanos , Contagem de Leucócitos , Pulmão/fisiologia , Masculino , Microcirculação/fisiologia , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Artéria Pulmonar/fisiologia , Pressão Propulsora Pulmonar/fisiologia , Fatores de Tempo
13.
Perfusion ; 17 Suppl: 35-9, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-12009084

RESUMO

PURPOSE: Postcardiopulmonary bypass atrial fibrillation remains a constant complication associated with coronary revascularization, the incidence of which occurs from 20% to 35%. Previous studies have addressed this problem in the postoperative setting utilizing pharmacological agents, but the results have been variable. The purpose of this study was to evaluate a novel intraoperative strategy to reduce the incidence of postcardiopulmonary bypass atrial fibrillation. We theorized that leukocyte depletion by filtration with the addition of aprotinin would reduce the systemic inflammatory effects of bypass and reduce the incidence of atrial fibrillation. METHODS: One hundred and twenty-two patients participated in this randomized study. Only isolated primary coronary revascularization procedures on cardiopulmonary bypass were included. The control group (n=55) received standard moderate hypothermic blood cardioplegia cardiopulmonary bypass. The treatment group (n=65) received similar cardiopulmonary bypass with the addition of strategic leukocyte depletion with Pall Biomedical Products (East Hills, NY) leukodepletion filters and full-dose aprotinin. RESULTS: The intraoperative addition of leukocyte depletion by filtration with aprotinin reduced the incidence of postcardiopulmonary bypass atrial fibrillation by 72%. The incidence.of atrial fibrillation in the control group was 27% (15 of 55). In contrast, the occurrence of atrial fibrillation in the treated group was only 7.6% (5 of 65) (p<0.025). CONCLUSIONS: This novel intraoperative treatment strategy of both mechanical (leukocyte filtration) and pharmacological (aprotinin) intervention appears to markedly reduce the incidence of postcardiopulmonary bypass atrial fibrillation. To our knowledge, this is the first study to combine these two treatment strategies. A previous study has noted a decline in atrial fibrillation with aprotinin in the animal model, but not to the extent observed in our study. The beneficial effects of the reduction of atrial fibrillation include reduced risk of emboli formation and the incidence of ischemia in the heart, lung and brain. In addition, a decrease in length of hospital stay, recovery time and overall cost occurred.


Assuntos
Aprotinina/uso terapêutico , Fibrilação Atrial/etiologia , Fibrilação Atrial/prevenção & controle , Ponte de Artéria Coronária/efeitos adversos , Hemofiltração , Hemostáticos/uso terapêutico , Cuidados Intraoperatórios , Leucaférese/métodos , Humanos , Resultado do Tratamento
14.
J Behav Health Serv Res ; 27(4): 437-45, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11070637

RESUMO

Two consortia of community mental health centers in Colorado varied in their administrative readiness for changing to a capitated system and, ultimately, implemented capitation using different organizational arrangements. The objective was to assess the impact of this natural experiment on administrative change, costs, and utilization of services during the first two years postcapitation. Prior to capitation, one was rated as having greater "readiness" than the other and received a capitation contract from the state, while the other did not. A private, for-profit managed behavioral health organization was awarded a contract and formed a joint venture with the less "ready" consortium, providing managed care expertise to complement the consortium's expertise in delivering mental health services. Two years later, these consortia do not look different either administratively or in their patterns of service utilization and costs. These findings suggest alternative ways of successfully implementing a capitated public mental health system.


Assuntos
Capitação , Serviços Comunitários de Saúde Mental/organização & administração , Programas de Assistência Gerenciada/organização & administração , Medicaid , Colorado , Serviços Comunitários de Saúde Mental/economia , Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Análise Custo-Benefício , Humanos , Modelos Organizacionais , Programas Médicos Regionais/organização & administração , Estados Unidos , Revisão da Utilização de Recursos de Saúde
15.
Inquiry ; 37(2): 121-33, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-10985107

RESUMO

This paper identifies the impact of "program realignment," a 1991 California state policy that significantly enhanced local governments' financial risk and programmatic authority for public mental health services, on treatment costs per user, and on the mix of inpatient and outpatient service costs. The study employs a natural pre-realignment and post-realignment design using the 59 California local mental health authorities (LMHAs) as the unit of analysis over a seven-year period spanning policy implementation. Total treatment and inpatient cost per user decreases and outpatient cost per user increases after program realignment. Higher levels of contracting with private providers tend to enhance this trend, while risk for institutional services reduces user costs uniformly. Financial and programmatic decentralization can enhance cost efficiency in treatment, while promoting substitution of outpatient services for inpatient services. Local conditions such as risk and contracting determine the extent of the policy response.


Assuntos
Custos de Cuidados de Saúde/tendências , Serviços de Saúde Mental/economia , Administração em Saúde Pública/economia , Participação no Risco Financeiro/organização & administração , Adolescente , Adulto , Assistência Ambulatorial/economia , California , Controle de Custos , Custos de Cuidados de Saúde/estatística & dados numéricos , Hospitalização/economia , Humanos , Governo Local , Serviços de Saúde Mental/organização & administração , Pessoa de Meia-Idade , Modelos Econométricos , Formulação de Políticas , Política , Análise de Regressão , Responsabilidade Social
16.
Am J Vet Res ; 60(9): 1061-5, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10490072

RESUMO

OBJECTIVE: To determine effects of tylosin on ruminal concentrations of Fusobacterium necrophorum and fermentation products in cattle during rapid adaptation to a high-concentrate diet. ANIMALS: 6 steers fitted with ruminal cannulas. PROCEDURE: Steers were assigned randomly to 2 treatment groups and switched from a 0 to an 85% concentrate diet during a 4-day period. Cattle received this diet, with or without tylosin (90 mg/steer/d), for 4 weeks. Samples of ruminal contents were collected daily beginning 2 days before the treatment protocol and in the first week of concentrate feeding. Four subsequent samples were collected at weekly intervals. Concentration of F. necrophorum in samples was determined, using the most-probable-number technique. Ruminal pH and concentrations of volatile fatty acids (VFA), lactate, and ammonia also were determined. All steers received both treatments separated by 4 weeks (cross-over design), during which time they were fed alfalfa hay only. RESULTS: In control steers, concentration of F. necrophorum increased in response to the high-concentrate diet. Tylosin-fed steers had lower concentrations of F. necrophorum than control steers at all times during concentrate feeding. However, ruminal pH and concentrations of lactate, VFA, and ammonia did not differ between treatment groups. CONCLUSIONS AND CLINICAL RELEVANCE: Tylosin caused a significant reduction in ruminal concentrations of F. necrophorum during rapid adaptation to a high-concentrate diet but had no effect on fermentation products. The reduction in ruminal concentration of F. necrophorum helps explain the reduction in prevalence of hepatic abscesses reported in tylosin-fed feedlot cattle.


Assuntos
Antibacterianos/uso terapêutico , Doenças dos Bovinos/prevenção & controle , Infecções por Fusobacterium/veterinária , Fusobacterium necrophorum/efeitos dos fármacos , Rúmen/microbiologia , Tilosina/uso terapêutico , Amônia/análise , Ração Animal , Animais , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Bovinos , Doenças dos Bovinos/microbiologia , Estudos Cross-Over , Ácidos Graxos Voláteis/análise , Fermentação/efeitos dos fármacos , Infecções por Fusobacterium/microbiologia , Infecções por Fusobacterium/prevenção & controle , Fusobacterium necrophorum/crescimento & desenvolvimento , Concentração de Íons de Hidrogênio , Ácido Láctico/análise , Análise dos Mínimos Quadrados , Abscesso Hepático/microbiologia , Abscesso Hepático/prevenção & controle , Abscesso Hepático/veterinária , Masculino , Distribuição Aleatória , Rúmen/química , Gastropatias/complicações , Gastropatias/microbiologia , Gastropatias/prevenção & controle , Gastropatias/veterinária , Tilosina/administração & dosagem , Tilosina/farmacologia
17.
J Anim Sci ; 77(8): 2259-68, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10462007

RESUMO

The objective of Exp. 1 was to compare the effects of virginiamycin (VM; 0, 175, or 250 mg x animal(-1) x d(-1)) and monensin/tylosin (MT; 250/ 90 mg x animal(-1) x d(-1)) on ruminal fermentation products and microbial populations in cattle during adaptation to an all-concentrate diet. Four ruminally cannulated, Holstein steers were used in a 4x4 Williams square design with 21-d periods. Steers were stepped up to an all-concentrate diet fed at 2.5% of BW once daily. Ruminal pH, protozoal counts, and NH3-N and VFA concentrations generally were unaffected by VM or MT. Mean counts of Lactobacillus and Streptococcus bovis were lower (P<.05) for VM-treated compared with control or MT-treated steers. Both VM and MT prevented the increase in Fusobacterium necrophorum counts associated with increasing intake of the high-concentrate diet observed in the control. The objective of Exp. 2 was to compare the effects of VM and MT on ruminal pH, L(+) lactate and VFA concentrations, and F. necrophorum numbers during carbohydrate overload. Six ruminally cannulated Holstein steers were assigned randomly to either the control, VM (175 mg/d), or MT (250 + 90 mg/d) treatments. Acidosis was induced with intraruminal administration of a slurry of ground corn and corn starch. The VM and MT premixes were added directly to the slurry before administration. Carbohydrate challenge induced acute ruminal acidosis (pH was 4.36 and L (+) lactate was 19.4 mM) in controls by 36 h. Compared with the controls, steers receiving VM or MT had higher (P<.05) ruminal pH, and the VM group had a lower (P<.05) L (+) lactate concentration. Fusobacterium necrophorum numbers initially increased in VM- and MT-administered steers. In the control steers, F. necrophorum was undetectable by 36 h. Virginiamycin seemed to control the growth of ruminal lactic acid-producing bacteria and, therefore, has the potential to moderate ruminal fermentation in situations that could lead to rapid production of lactic acid.


Assuntos
Acidose/veterinária , Adaptação Fisiológica , Ração Animal , Antibacterianos/farmacologia , Bovinos/metabolismo , Fermentação/efeitos dos fármacos , Rúmen/efeitos dos fármacos , Virginiamicina/farmacologia , Animais , Fusobacterium/isolamento & purificação , Concentração de Íons de Hidrogênio , Masculino , Rúmen/microbiologia , Streptococcus bovis/isolamento & purificação
19.
Psychiatr Serv ; 49(8): 1067-71, 1998 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9712214

RESUMO

OBJECTIVE: This study examined the factors that determine whether mental health services provided under contracts with private providers are more cost-efficient than services provided directly by public mental health agencies. METHODS: Data on service costs for 1993 were obtained from the California Department of Mental Health cost reporting and data collection system and from a survey of local mental health departments. Ordinary least-squares regression was used to estimate the effect of contracting, local market conditions, and contracting procedures on unit costs of seven core mental health services: psychiatric inpatient care, rehabilitative day service, intensive day service, individual therapy, medication management, crisis intervention, and case management. RESULTS: Contracts with private providers significantly reduced costs for six core mental health services, but not for inpatient care. However, the extent of savings was affected by local market conditions, including the concentration of providers in an area, the provider organization's size, and the scope of services that the provider offered, as well as by contracting procedures-whether there was a formal contract review process and whether prices were negotiated with the majority of providers. CONCLUSIONS: The amount of cost savings that can be achieved from contracting with private providers is influenced by several factors, including competitive conditions in local markets. In some areas, direct provision of services by public mental health agencies may cost less. Contracting is a complex process that cannot be viewed as a panacea for improving cost-efficiency.


Assuntos
Serviços Contratados/economia , Serviços de Saúde Mental/economia , California , Redução de Custos , Custos e Análise de Custo , Programas de Assistência Gerenciada/economia
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