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1.
Braz. j. biol ; 83: e246514, 2023. tab, graf
Artigo em Inglês | LILACS-Express | MEDLINE, LILACSEXPRESS | ID: biblio-1285640

RESUMO

Abstract The poultry sector in Pakistan is contributing mainly in bridging gap between demand and supply for protein. Mycoplasma gallisepticum is an emerging bacterium causing serious problems in poultry industry of Pakistan. A cross-sectional study was conducted to evaluate the M. gallisepticum load in poultry populated regions of Pakistan. Total 600 serum and 600 swab samples were collected, 200 from each broiler, layers and breeders poultry in Rawalpindi and Abbottabad districts. Serum samples were analyzed through ELISA for seroprevalence. Swabs were cultured on Frey's medium followed by PCR and partial mgc2 gene sequencing. Results of seroprevalence of M. gallisepticum showed that layers (75%, n=150) are more positive as compared to breeders (70%, n=140) and broilers (50%, n=100). Typical colonies of the M. gallisepticum were observed in breeder (26.5%), followed by layer (21%) and broilers (9%). A total of 37.1% (n=42) samples were identified positive through PCR out of total 113 cultured based positive samples. A total of six M. gallisepticum isolates of current study showed 98-99 percent similarity with previously reported isolates on the basis of mgc2 gene partial sequencing. The M. gallisepticum was found highly prevalent in different poultry breads. Results of this study would add into basic data and provide a direction for livestock sector to strengthen a control strategy for mycoplasmosis in poultry farms.


Resumo O setor avícola do Paquistão está contribuindo principalmente para preencher a lacuna entre a demanda e a oferta de proteína. Mycoplasma gallisepticum é uma bactéria emergente que causa sérios problemas na indústria avícola do Paquistão. Um estudo transversal foi conduzido para avaliar a carga de M. gallisepticum em regiões de avicultura do Paquistão. Um total de 600 amostras de soro e 600 amostras de esfregaço foi coletado, 200 de cada frango de corte, poedeiras e aves reprodutoras nos distritos de Rawalpindi e Abbottabad. Amostras de soro foram analisadas por ELISA para soroprevalência. As zaragatoas foram cultivadas em meio Frey, seguido de PCR e sequenciação parcial do gene mgc2. Os resultados da soroprevalência de M. gallisepticum mostraram que as poedeiras (75%, n = 150) são mais positivas em comparação com matrizes (70%, n = 140) e frangos de corte (50%, n = 100). Colônias típicas de M. gallisepticum foram observadas em reprodutoras (26,5%), seguidas de poedeiras (21%) e frangos de corte (9%). Um total de 37,1% (n = 42) das amostras foi identificado como positivas por PCR de um total de 113 amostras positivas baseadas em cultura. Um total de seis isolados de M. gallisepticum do estudo atual mostrou 98-99% de similaridade com isolados relatados anteriormente com base no sequenciamento parcial do gene mgc2. O M. gallisepticum foi encontrado com alta prevalência em diferentes pães de aves. Os resultados deste estudo acrescentariam dados básicos e forneceriam orientação para o setor pecuário fortalecer uma estratégia de controle da micoplasmose em granjas avícolas.

2.
Trop Biomed ; 38(3): 353-359, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34508343

RESUMO

Curcumin is a potent antimicrobial herb used traditionally as a spice in culinary. This study was designed to evaluate the antiviral effects of curcuma longa extract against H9 influenza virus. A total of 60 embryonated eggs were equally divided into 5 groups with 12 eggs in each group. Group 1 (G1) served as uninfected negative control. Whereas Group 2 (G2) was kept as positive control infected with known virus @ 0.2 ml with 10-9.3 EID50. Group 3 (G3) was offered Curcuma longa @ 0.2 mg/0.2 ml and H9N2 virus (@ 0.2 ml with 10-9.3 EID50. Similarly, Group 4 (G4) was inoculated with extract of Curcuma longa @ 0.2 mg/0.2 ml per egg, whereas Group 5 (G5) was given Ribazole @ 0.2 ml/ egg. The crude extract and virus were administered on the 15th day of incubation and were checked after every 24 hours up to 96th hour post inoculation by random selection of 3 eggs. Death and survival rate were noted in all groups. Gross and histopathological lesions were also observed. Results revealed that Curcuma longa extract had significantly (p<0.05) reduced the mortality rate of embryos infected with H9N2 virus. In G3, increased lymphocytes and mild fatty changes were seen in liver. Whereas, mature RBCs, plasma cells and some lymphoblast's were observed in Spleen. Similarly, the bursa follicles were with lymphocytic aggregation. The G4 (Curcuma longa) and G5 (Ribazole) were with maximum embryo survival after 48 and 72 h post inoculation. This study revealed potential antiviral activity of Curcuma longa against H9N2 influenza viruses and can be opted as alternative to antibiotics and antiviral drugs to minimize the antimicrobial resistance in human and animal population.

3.
Braz J Biol ; 83: e247701, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34468529

RESUMO

Staphylococcus aureus is an important foodborne pathogen associated to food intoxication and other multiple infections in human being. Its presence in salted food is a serious issue due to its salt tolerance potential. A study was conducted to analyze the presence of enterotoxins producing drug resistance S. aureus in salted sea fish from Gwadar. Freshly persevered samples (n=50) of salted fish were subjected to analyze the presence of S. aureus using 16S rRNA and Nuc genes primers. The isolates were then evaluated for drug resistance and enterotoxins producing potential using specific primers for MecA (methicillin resistance gene), (SEA) staphylococcal enterotoxin A and (SEB) staphylococcal enterotoxin B genes. Total 13/50 (26%) of the samples were found positive for the presence of S. aureus, preliminary confirmed with biochemical profiling and finally with the help of target genes presence. The isolates were found showing 100% resistant to methicillin, which were molecularly confirmed by the presence of MecA gene present in genome. The isolates 5/13 (38%) were positive for SEA and 3/13 (23%) for SEB genes, whereas 2/13 (15%) were confirmed having both SEA and SEB genes in its genome. It was also confirmed that all the isolates were capable to form biofilm over the glass surfaces. It was concluded that the study confirmed the presence of enterotoxigenic methicillin resistance Staphylococcus aurous (MRSA) in salted fish product, that poses gross food safety concern. Preventive and control measures are necessary to handle this serious food safety concern.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Animais , Produtos Pesqueiros , Humanos , Staphylococcus aureus Resistente à Meticilina/genética , RNA Ribossômico 16S , Staphylococcus aureus/genética
4.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-21261729

RESUMO

PurposeTo develop a reliable tool that predicts which patients are most likely to be COVID-19 positive and which ones have an increased risk of hospitalization. MethodsFrom February 2020 to April 2021, trained nurses recorded age, gender, and symptoms in an outpatient COVID-19 testing center. All positive patients were followed up by phone for 14 days or until symptom-free. We calculated the symptoms odds ratio for positive results and hospitalization and proposed a "random forest" machine-learning model to predict positive testing. ResultsA total of 8,998 patients over 16 years old underwent COVID-19 RT-PCR, with 1,914 (21.3%) positives. Fifty patients needed hospitalization (2.6% of positives), and three died (0.15%). Most common symptoms were: cough, headache, sore throat, coryza, fever, myalgia (57%, 51%, 44%, 36%, 35%, 27%, respectively). Cough, fever, and myalgia predicted positive COVID-19 test, while others behaved as protective factors. The best predictors of positivity were fever plus anosmia/ageusia (OR=6.31), and cough plus anosmia/ageusia (OR=5.82), both p<0.0001. Our random forest model had an ROC-AUC of 0.72 (specificity=0.70, sensitivity=0.61, PPV=0.38, NPV=0.86). Having steady fever during the first days of infection and persistent dyspnea increased the risk of hospitalization (OR=6.66, p<0.0001 and OR=3.13, p=0.003, respectively), while anosmia-ageusia (OR=0.36, p=0.009) and coryza (OR=0.31, p=0.014) were protective. ConclusionPresent study and algorithm may help identify patients at higher risk of having SARS-COV-2 (online calculator http://wdchealth.covid-map.com/shiny/calculator/), and also disease severity and hospitalization based on symptoms presence, pattern, and duration, which can help physicians and health care providers.

5.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-21261433

RESUMO

IntroductionHeath care workers with direct (HCW-D) or indirect (HCW-A) patient contact represent 4.2% to 17.8% of COVID-19 cases. We evaluate the temporal COVID-19 infection behavior among HCW-D, HCW-A, and non-HCW. MethodsFrom February 2020 to April 2021, trained nurses recorded age, gender, occupation, and symptoms in a COVID-19 testing outpatient health center. We allocated data into weekly time fractals and calculated the proportion of COVID-19 positive among HCW vs. non-HCW and incorporated an ARFIMA model (traditionally used in weather forecast) to predict future cases of COVID-19. ResultsAmong 8,998 COVID-19 RT-PCR tests, 3,462 (42%) patients were HCW-D, and 933 (11%) were HCW-A. Overall, 1,914 (21.3%) returned positive, representing 27%, 25% and 19% of HCW-D, HCW-A and non-HCW, respectively. HCW-D or HCW-A were significantly more likely to test positive for COVID-19 than non-HCW (OR=1.5, p<0.0001). The percentage of positive to negative test results remained steady over time. In the positive cases, the percentage of HCW to non-HCW declined significantly over time (Mann-Kendal trend test: tau=-0.58, p<0.0001). Our ARFIMA model showed a long-memory infection pattern in the occurrence of new COVID-19 cases lasting for months. Average error was 1.9 cases per week comparing predicted to actual values three months later (May-July 2021). ConclusionHCW have a sustained 50% higher risk of COVID-19 positivity in the pandemic. Time-series analysis showed a long-memory infection pattern with virus spread mainly among HCWs before the general population. The tool http://wdchealth.covid-map.com/shiny/covid-map/ will be updated according to population previous infection and vaccination impact.

6.
Braz J Biol ; 83: e246514, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34378682

RESUMO

The poultry sector in Pakistan is contributing mainly in bridging gap between demand and supply for protein. Mycoplasma gallisepticum is an emerging bacterium causing serious problems in poultry industry of Pakistan. A cross-sectional study was conducted to evaluate the M. gallisepticum load in poultry populated regions of Pakistan. Total 600 serum and 600 swab samples were collected, 200 from each broiler, layers and breeders poultry in Rawalpindi and Abbottabad districts. Serum samples were analyzed through ELISA for seroprevalence. Swabs were cultured on Frey's medium followed by PCR and partial mgc2 gene sequencing. Results of seroprevalence of M. gallisepticum showed that layers (75%, n=150) are more positive as compared to breeders (70%, n=140) and broilers (50%, n=100). Typical colonies of the M. gallisepticum were observed in breeder (26.5%), followed by layer (21%) and broilers (9%). A total of 37.1% (n=42) samples were identified positive through PCR out of total 113 cultured based positive samples. A total of six M. gallisepticum isolates of current study showed 98-99 percent similarity with previously reported isolates on the basis of mgc2 gene partial sequencing. The M. gallisepticum was found highly prevalent in different poultry breads. Results of this study would add into basic data and provide a direction for livestock sector to strengthen a control strategy for mycoplasmosis in poultry farms.


Assuntos
Mycoplasma gallisepticum , Doenças das Aves Domésticas , Animais , Galinhas , Estudos Transversais , Mycoplasma gallisepticum/genética , Paquistão/epidemiologia , Aves Domésticas , Doenças das Aves Domésticas/epidemiologia , Estudos Soroepidemiológicos
7.
J Headache Pain ; 22(1): 78, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34289806

RESUMO

In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the "patient journey") with perplexing obstacles.High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary.The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded.It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.


Assuntos
Transtornos da Cefaleia , Cefaleia , Atenção à Saúde , Cefaleia/terapia , Humanos , Atenção Primária à Saúde
8.
Artigo em Inglês | MEDLINE | ID: mdl-34146210

RESUMO

Electrokinetic remediation is a process in which a direct electric current is applied across a section of contaminated soil to remove metals. To improve the electrokinetic remediation in this study, a conductive membrane was fabricated via in situ chemical polymerization employing pyrrole and copper oxide nanoparticles. The fabricated membrane was placed in an electric field as part of the electrode structure. A physical model was constructed and filled with copper-contaminated kaolinite in the concentration of 200 mg/kg. To control the pH, 0.1 M citric acid and 0.01 M potassium chloride were used as the electrolyte solutions. Experimental parameters such as voltage, current, pH, EC, drained flow, and copper concentration were measured. The results showed that the minimum surface resistivity of the fabricated membrane under a maximum pressure of 8.2 kPa was 2.55 kΩ/m2. The experimental results demonstrated that the use of citric acid as an electrolyte was more useful to desorb the copper due to the formation of the copper-citrate complex. When employing the fabricated membrane, the copper removal increased from 13% (in CT-2) to 63% (in GM-2), while the removal of copper using potassium chloride electrolyte increased from 42% (in CT-1) to 52% (in GM-1). The highest power consumption was obtained in experiments using citric acid. Due to the higher removal efficiency of copper in GM-2, the energy utilization efficiency (ß) increased and reached 29.9 near ß value of GM-1 with the lowest power consumption.

10.
Sci Total Environ ; 769: 145051, 2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-33736233

RESUMO

Recent natural gas development by means of hydraulic fracturing requires a detailed risk analysis to eliminate or mitigate damage to the natural environment. Such geo-energy related subsurface activities involve complex engineering processes and uncertain data, making comprehensive, quantitative risk assessments a challenge to develop. This research seeks to develop a risk framework utilising data for quantitative numerical analysis and expert knowledge for qualitative analysis in the form of fuzzy logic, focusing on hydraulically fractured wells during the well stimulation stage applied to scenarios in the UK and Canada. New fault trees are developed for assessing cement failure in the vertical and horizontal directions, resulting in probabilities of failure of 3.42% and 0.84%, respectively. An overall probability of migration to groundwater during the well injection stage was determined as 0.0006%, compared with a Canadian case study which considered 0.13% of wells failed during any stage of the wells life cycle. It incorporates various data types to represent the complexity of hydraulic fracturing, encouraging a more complete and accurate analysis of risk failures which engineers can directly apply to old and new hydraulic fracturing sites without the necessity for extensive historic and probabilistic data. This framework can be extended to assess risk across all stages of well development, which would lead to a gap in the modelled and actual probabilities narrowing. The framework developed has relevance to other geo-energy related subsurface activities such as CO2 sequestration, geothermal, and waste fluid injection disposal.

11.
Br J Oral Maxillofac Surg ; 58(9): e33-e37, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32507642

RESUMO

The purpose of this study was to identify thrombin-activatable fibrinolysis inhibitor (TAFI) in saliva and to investigate the correlation between TAFI levels in saliva and plasma. Subjects included were healthy adults without diseases or medication that could affect coagulation. Samples of stimulated saliva and blood samples were obtained from 33 subjects. Levels of TAFI in saliva and plasma were analysed. The association between levels of TAFI in saliva and plasma was calculated using linear regression. Low levels of TAFIa/TAFIai were found in most saliva samples but only one sample had levels that were above the lower limit of detection of the assay used. TAFI (proenzyme) was not found in saliva, so no correlations could be calculated. In this study there was no indication that there is TAFI present in secreted saliva. Either TAFIa/TAFIai in saliva were much lower than in plasma and under the detection limit of the assay used, or there was no TAFIa/TAFIai in the saliva tested.


Assuntos
Carboxipeptidase B2 , Adulto , Coagulação Sanguínea , Fibrinólise , Humanos , Saliva , Trombina
12.
Sci Rep ; 10(1): 6218, 2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-32265468

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

13.
Sci Rep ; 10(1): 3650, 2020 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-32107456

RESUMO

Schistosomiasis is a severe neglected tropical disease caused by trematodes and transmitted by freshwater snails. Snails are known to be highly tolerant to agricultural pesticides. However, little attention has been paid to the ecological consequences of pesticide pollution in areas endemic for schistosomiasis, where people live in close contact with non-sanitized freshwaters. In complementary laboratory and field studies on Kenyan inland areas along Lake Victoria, we show that pesticide pollution is a major driver in increasing the occurrence of host snails and thus the risk of schistosomiasis transmission. In the laboratory, snails showed higher insecticide tolerance to commonly found pesticides than associated invertebrates, in particular to the neonicotinoid Imidacloprid and the organophosphate Diazinon. In the field, we demonstrated at 48 sites that snails were present exclusively in habitats characterized by pesticide pollution and eutrophication. Our analysis revealed that insensitive snails dominated over their less tolerant competitors. The study shows for the first time that in the field, pesticide concentrations considered "safe" in environmental risk assessment have indirect effects on human health. Thus we conclude there is a need for rethinking the environmental risk of low pesticide concentrations and of integrating agricultural mitigation measures in the control of schistosomiasis.


Assuntos
Lagos , Praguicidas/toxicidade , Esquistossomose/transmissão , Caramujos/parasitologia , Poluição da Água , Animais , Humanos , Quênia , Esquistossomose/epidemiologia
14.
Indian Dermatol Online J ; 11(1): 68-71, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32055513

RESUMO

Perforating dermatoses are characterized by transepidermal elimination of altered dermal components or foreign particles. Owing to their common clinical presentation as umbilicated papules with a keratotic plug, histopathology and special staining play a very crucial role in the diagnosis. Perforating calcific elastosis, (periumbilical perforating pseudoxanthoma elasticum), an uncommon acquired localized cutaneous dermatoses, is characterized by transepidermal elimination of modified elastic fibres. It is usually seen in middle-aged obese multiparous women as well-defined periumbilical hyperpigmented atrophic plaques. We report a case of a 66-year-old female who presented with a mildly pruritic hyperpigmented periumbilical plaque of 2 years duration. Histopathology studies revealed multiple fragmented, thick, short, and curly eosinophilic fibers; along with granular basophilic material in the dermis, which stained positive for calcium and elastin, thus clinching the diagnosis of perforating calcific elastosis. There were no features of hereditary pseudoxanthoma elasticum. We report this case for its rarity.

15.
J Am Chem Soc ; 141(43): 17331-17336, 2019 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-31573193

RESUMO

In this work, a new phosphonium-containing cationic polyelectrolyte (PE1) has been rationally designed and developed via a facile click-chemistry type postfunctionalization, which can form complexes with highly polarizable anionic cyanines to significantly reduce the strong and random cyanine-cyanine interactions (i.e., aggregation) in the solid-state. This material design strategy enables an efficient translation of the favorable molecular properties of cyanines into macroscopic material properties. One of such complexes exhibits a very large third-order susceptibility over 10-10 esu with low nonlinear optical loss suitable for all optical signal processing.

16.
New Microbes New Infect ; 30: 100560, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31193267

RESUMO

Consumer demand for natural pathogen-control agents for substitution of synthetic food preservatives and traditional antibiotics is increasing. This study aimed to reveal the distribution of lactic acid bacteria (LAB) in raw camel milk and to characterize their antimicrobial traits. The genetic identification by 16S rRNA sequencing of 58 LAB isolates showed the predominance of Enterococcus (24.2%), Lactococcus (22.4%) and Pediococcus (20.7%) genera in raw camel milk. These genera exhibited inhibitory activity against a broad spectrum of Gram-positive and Gram-negative bacteria including multidrug-resistant Salmonella. Among these LAB, two isolates-identified as Pediococcus pentosaceus CM16 and Lactobacillus brevis CM22-were selected for their strong bacteriocinogenic anti-listerial activity estimated at 1600 and 800 AU/mL, respectively. The bacteriocins produced were partially purified by ammonium sulphate precipitation and gel filtration and then biochemically characterized. The proteinaceous nature of bacteriocins was confirmed by the susceptibility to enzymes. These bacteriocins showed significant technological characteristics such as heat-resistance, and stability over a wide range of pH (2.0-10.0). In conclusion, these results indicated that Pediococcus pentosaceus CM16 and Lactobacillus brevis CM22 could be useful as potential probiotics. Moreover, their partially purified bacteriocins may play an important role as food preservatives and feed additives. To our knowledge, this is the first report describing the distribution of LAB population in raw camel milk and the characterization of their bacteriocins from the Arabian Peninsula of western Asia.

17.
Eur Arch Paediatr Dent ; 20(1): 53-61, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30413972

RESUMO

AIM: To evaluate and compare the perceptions and concerns of dental and medical practitioners towards water fluoridation as a caries preventive measure. METHODS: A self-administered questionnaire comprising 21 questions was designed and validated to assess general knowledge and concerns of fluoride and community water fluoridation (CWF) as a dental caries preventive measure. The questions examined participant's perception regarding effectiveness, advantages, adverse effects, cost-benefit, and concerns pertinent to CWF. Dentists, general physicians and paediatricians were randomly recruited from public medical/dental centres, university clinics, and the private sector to complete the questionnaire. RESULTS: A total of 474 participants (74% response rate) completed the questionnaire (294 dentists and 180 medical practitioners). About 86% of the dentists and 78% of the medical practitioners agreed that CWF has a role in caries prevention. However, only a few of those would advise their patients to drink fluoridated water. There were some concerns about CWF, and the main concern in both groups was dental fluorosis. The level of awareness regarding CWF status in Kuwait amongst the two groups was low. However, the majority in both groups (77%) believed that the water supply should be optimally fluoridated. CONCLUSION: Dental and medical health care professionals agreed that water fluoridation can benefit the oral health of the individuals in the community, however, general knowledge about fluoride benefits, safety, risks and status of public water fluoridation was low.


Assuntos
Atitude do Pessoal de Saúde , Cárie Dentária/prevenção & controle , Odontólogos , Fluoretação , Conhecimentos, Atitudes e Prática em Saúde , Médicos , Fluoretação/efeitos adversos , Humanos , Kuweit , Pediatras , Inquéritos e Questionários
18.
Clin Exp Immunol ; 194(1): 79-92, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30030847

RESUMO

The in-depth understanding of skin resident memory CD8+ T lymphocytes (TRM ) may help to uncover strategies for their manipulation during disease. We investigated isolated TRM from healthy human skin, which expressed the residence marker CD69, and compared them to circulating CD8+ T cell populations from the same donors. There were significantly increased proportions of CD8+ CD45RA- CD27- T cells in the skin that expressed low levels of killer cell lectin-like receptor G1 (KLRG1), CD57, perforin and granzyme B. The CD8+ TRM in skin were therefore phenotypically distinct from circulating CD8+ CD45RA- CD27- T cells that expressed high levels of all these molecules. Nevertheless, the activation of CD8+ TRM with T cell receptor (TCR)/CD28 or interleukin (IL)-2 or IL-15 in vitro induced the expression of granzyme B. Blocking signalling through the inhibitory receptor programmed cell death 1 (PD)-1 further boosted granzyme B expression. A unique feature of some CD8+ TRM cells was their ability to secrete high levels of tumour necrosis factor (TNF)-α and IL-2, a cytokine combination that was not seen frequently in circulating CD8+ T cells. The cutaneous CD8+ TRM are therefore diverse, and appear to be phenotypically and functionally distinct from circulating cells. Indeed, the surface receptors used to distinguish differentiation stages of blood T cells cannot be applied to T cells in the skin. Furthermore, the function of cutaneous TRM appears to be stringently controlled by environmental signals in situ.


Assuntos
Memória Imunológica/imunologia , Pele/citologia , Pele/imunologia , Linfócitos T Citotóxicos/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos CD/metabolismo , Antígenos de Diferenciação de Linfócitos T/metabolismo , Antígenos CD28/imunologia , Antígenos CD57/metabolismo , Células Cultivadas , Feminino , Granzimas/metabolismo , Humanos , Interleucina-15/imunologia , Interleucina-2/imunologia , Lectinas Tipo C/metabolismo , Antígenos Comuns de Leucócito/metabolismo , Masculino , Pessoa de Meia-Idade , Perforina/metabolismo , Receptores Imunológicos , Transativadores/metabolismo , Membro 7 da Superfamília de Receptores de Fatores de Necrose Tumoral/metabolismo , Fator de Necrose Tumoral alfa/imunologia , Adulto Jovem
19.
Colorectal Dis ; 20(9): 804-812, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29603863

RESUMO

AIM: A longstanding disparity exists between the approaches to restorative surgery after colectomy for patients with ulcerative colitis (UC) in England and Sweden. This study aims to compare rates of colectomy and restorative surgery in comparable national cohorts. METHOD: The English Hospital Episode Statistics (HES) and Swedish National Patient Register (NPR) were interrogated between 2002 and April 2012. Patients with two diagnostic episodes for UC (age ≥ 15 years) were included. Patients were excluded if they had an episode of inflammatory bowel disease or colectomy before 2002. The cumulative incidences of colectomy and restorative surgery were calculated using the Kaplan-Meier method. RESULTS: A total of 98 691 patients were included in the study, 76 129 in England and 22 562 in Sweden. The 5-year cumulative incidence of all restorative surgery after colectomy in England was 33% vs 46% in Sweden (P-value < 0.001). Of the patients undergoing restorative surgery, 92.3% of English patients had a pouch vs 38.8% in Sweden and 7.7% vs 59.1% respectively had an ileorectal anastomosis (IRA). The 5-year cumulative incidence of colectomy in this study cohort was 13% in England and 6% in Sweden (P-value < 0.001). CONCLUSION: Following colectomy for UC only one-third of English patients and half of Swedish patients underwent restorative surgery. In England nearly all these patients underwent pouches, in Sweden a less significant majority underwent IRAs. It is surprising to demonstrate this discrepancy in a comparable cohort of patients from similar healthcare systems. The causes and consequences of this international variation in management are not fully understood and require further investigation.


Assuntos
Colectomia/estatística & dados numéricos , Colite Ulcerativa/cirurgia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Proctocolectomia Restauradora/estatística & dados numéricos , Sistema de Registros , Adolescente , Adulto , Estudos de Coortes , Colectomia/métodos , Colite Ulcerativa/diagnóstico , Inglaterra , Feminino , Humanos , Internacionalidade , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Proctocolectomia Restauradora/métodos , Prognóstico , Estudos Retrospectivos , Suécia , Resultado do Tratamento , Adulto Jovem
20.
J Med Eng Technol ; 42(7): 546-552, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30875263

RESUMO

A three-dimensional hip model was created from the MRI scans of one human subject based on constructing the entire pelvis and femur. The ball and socket joint was modelled between the hip's acetabulum and the femoral head to analyse the multiaxial loads applied in the hip joint. The three key ligaments that reinforce the external surface of the hip to help to stabilise the joint were also modelled which are the iliofemoral, the pubofemoral and ischiofemoral ligaments. Each of these ligaments wraps around the joint connection to form a seal over the synovial membrane, a line of attachment around the head of the femur. This model was tested for different loading and boundary conditions to analyse their sensitivities on the cortical and cancellous tissues of the human hip bones. The outcomes of a one-legged stance finite element analysis revealed that the maximum of 0.056 mm displacement occurred. The stress distribution varied across the model which the majority occurring in the cortical femur and dissipating through the cartilage. The maximum stress value occurring in the joint was 110.1 MPa, which appeared at the free end of the proximal femur. This developed finite element model was validated against the literature data to be used as an asset for further research in investigating new methods of total hip arthroplasty, to minimise the recurrence of dislocations and discomfort in the hip joint, as well as increasing the range of movement available to a patient after surgery.


Assuntos
Análise de Elementos Finitos , Quadril/fisiologia , Modelos Biológicos , Fêmur/fisiologia , Articulação do Quadril/fisiologia , Humanos , Estresse Mecânico
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