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1.
Am J Kidney Dis ; 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34606933

RESUMO

Hepatorenal syndrome (HRS) is a form of acute kidney injury occurring in patients with advanced cirrhosis and is associated with significant morbidity and mortality. The pathophysiology underlying HRS begins with increasing portal pressures leading to the release of vasodilatory substances which result in pooling blood in the splanchnic system and a corresponding reduction in effective circulating volume. Compensatory activation of the sympathetic nervous system, renin-angiotensin-aldosterone system and release of arginine vasopressin serve to defend mean arterial pressure but at the cost of severe constriction of the renal vasculature, leading to a progressive, often fulminant form of AKI. While there are no approved treatments for HRS in the United States, multiple countries, including much of Europe, utilize terlipressin, a synthetic vasopressin analogue, as first-line therapy. The recently published CONFIRM trial, the third randomized trial based in North America evaluating terlipressin, met its primary endpoint, showing greater rates of HRS reversal in the terlipressin arm. However, due to concerns about apparent increased rates of respiratory adverse events and a lack of evidence for mortality benefit, terlipressin was not approved by the Food and Drug Administration (FDA). In this Perspective, we explore the history of regulatory approval for terlipressin in the United States, examine the results from CONFIRM and the concerns they raised and consider the future role of terlipressin in this critical clinical area of continued unmet need.

2.
J Anim Sci ; 99(9)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34468760

RESUMO

The main objective of this study was to evaluate the effect of peripartal administration of a commercially available nonspecific immune stimulant (mycobacterium cell wall fraction; MCWF [Amplimune, NovaVive Inc., Napanee, ON, Canada]) on the incidence of disease during early lactation and subsequent fertility of dairy cows. A second objective was to characterize the dynamics of circulating white blood cells (WBC) and metabolic markers following treatment administration. Cows in an United States Department of Agriculture (USDA) organic-certified dairy herd were blocked by parity and, based on sequential calving dates, randomly assigned to receive two injections (5 mL s.c.) of either a placebo (saline solution) as a control (CON; n = 71) or MCWF (n = 65) at enrollment (7 d before expected calving) and within 24 h after calving. Blood samples were collected from a subsample of the study population (MCWF = 16; CON = 18) for WBC count at enrollment, at day 2 post enrollment, and at days 1, 3, 7, and 14 after calving. Serum fatty acids, beta-hydroxybutyrate, and Ca concentrations were determined at days 1 and 7 postpartum (MCWF = 21; CON = 21). Main outcome variables included incidence risk of peripartal and early lactation health disorders and pregnancy at first artificial insemination (AI), at 100, and at 150 days in milk (DIM). In addition, the average daily milk yield up to 90 DIM and death and live culling before 305 DIM were compared. Treatment effects were assessed using multivariable logistic regression, time-to-event analyses, and repeated measures analysis of variance (ANOVA). A treatment effect on the incidence risk of some of the health disorders in the study was established. Incidence risk of metritis and clinical mastitis <28 DIM was smaller in MCWF than in CON cows (36.9% vs. 50.7% and 6.3% vs. 19.7%, respectively). On the contrary, the incidence risk of respiratory disease <28 DIM was smaller in CON (0%) than in MCWF (7.7%). Reproductive performance of multiparous cows was affected by MCWF administration: pregnancy at first AI and pregnancy at 100 and 150 DIM were greater in MCWF than in CON (35.6% vs. 19.2%; 51.1% vs. 25.0%; and 64.4% vs. 40.4%, respectively). Overall, median intervals from calving to pregnancy were 90 vs. 121 d in MCWF and CON cows, respectively. No treatment effects on the dynamics of circulating WBC or in postpartum metabolic status were established. No differences for milk yield or for the proportion of cows that survived up to 305 DIM were determined, although cows in MCWF left the herd earlier than cows in CON. In conclusion, incidence risks of metritis and mastitis in early lactation were smaller in cows receiving MCWF, whereas the incidence risk of respiratory disease was smaller in CON. Fertility significantly improved in MCWF compared with CON cows. As this study was performed in an organic-certified dairy, specific health and reproductive management practices may affect the external validity of the current findings.


Assuntos
Doenças dos Bovinos , Mycobacterium , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Parede Celular , Feminino , Fertilidade , Lactação , Leite , Período Pós-Parto , Gravidez , Reprodução
3.
Am J Trop Med Hyg ; 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34370699

RESUMO

This study aimed to analyze epidemiological indicators related to seroprevalent and seroincident cases of spotted fever group rickettsiae (SFGR) and to identify housing conditions related to tick infestation. A prospective study (2016-2018) was conducted to examine rickettsial seropositivity in humans, domestic animals, and wild mammals in the municipality of Uramita, Antioquia, Colombia, where a previous Rickettsia rickettsii outbreak was reported from 2014 to 2015. The seroprevalence and its associated factors were estimated at baseline, and the seroincidence and its risk factors for humans were estimated 20 months later. A cross-sectional analysis was performed to evaluate the housing conditions linked to tick infestation. The SFGR seroprevalence was 26.70% (95% confidence interval [CI], 20.79-31.37), and the factors associated with SFGR seropositivity were male sex (adjusted prevalence ratio [PRa], 1.67; 95% CI, 1.19-2.32), age (evaluated in 5-year increments) (PRa, 1.05; 95% CI, 1.01-1.09), and household proximity (PRascattered versus very near=3.87; 95% CI, 1.12-8.66). The overall seroincidence was 7.40% (95% CI, 4.71-11.06), and the factors associated with SFGR seroincident cases were the presence of wild animals (adjusted relative risk [RRa], 2.46; 95% CI, 1.06-4.72) and the presence of trees in the peri-domiciliary area (RRa, 0.47; 95% CI, 0.23-0.94). The prevalence of house tick infestation was 27.81% (95% CI, 21.93-34.80), and the factors associated with infestation were dirt floors (PRa, 5.88; 95% CI, 2.28-10.31), fiber cement roofs (PRa, 1.76; 95% CI, 1.07-2.83), and the presence of canines in peri-domiciliary or intra-domiciliary areas (PRa, 5.05; 95% CI, 3.31-7.19). Seropositivity rates for canines and opossums were 35.62% (26/73) and 100% (6/6), respectively. Identification of these factors will help to implement efficient surveillance programs in Colombia.

4.
J Am Chem Soc ; 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34355571

RESUMO

Iridium and ruthenium and their oxides/hydroxides are the best candidates for the oxygen evolution reaction under harsh acidic conditions owing to the low overpotentials observed for Ru- and Ir-based anodes and the high corrosion resistance of Ir-oxides. Herein, by means of cutting edge operando surface and bulk sensitive X-ray spectroscopy techniques, specifically designed electrode nanofabrication and ab initio DFT calculations, we were able to reveal the electronic structure of the active IrOx centers (i.e., oxidation state) during electrocatalytic oxidation of water in the surface and bulk of high-performance Ir-based catalysts. We found the oxygen evolution reaction is controlled by the formation of empty Ir 5d states in the surface ascribed to the formation of formally IrV species leading to the appearance of electron-deficient oxygen species bound to single iridium atoms (µ1-O and µ1-OH) that are responsible for water activation and oxidation. Oxygen bound to three iridium centers (µ3-O) remains the dominant species in the bulk but do not participate directly in the electrocatalytic reaction, suggesting bulk oxidation is limited. In addition a high coverage of a µ1-OO (peroxo) species during the OER is excluded. Moreover, we provide the first photoelectron spectroscopic evidence in bulk electrolyte that the higher surface-to-bulk ratio in thinner electrodes enhances the material usage involving the precipitation of a significant part of the electrode surface and near-surface active species.

5.
Kidney Blood Press Res ; : 1-5, 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34293749

RESUMO

INTRODUCTION: Oncogenic osteomalacia (Onc-Ost) is a paraneoplastic phenomenon characterized by hypophosphatemia due to elevated fibroblast growth factor-23 (FGF-23). Onc-Ost has been previously reported in patients with germ line mesenchymal tumors and solid organ malignancies. This is the first report of aggressive natural killer (NK) T-cell lymphoma presenting as Onc-Ost. CASE DESCRIPTION: A 33-year-old Vietnamese female with active hepatitis B and Mycobacterium avium complex, on ongoing therapy with tenofovir disoproxil, azithromycin, and ethambutol, presented with persistent fevers and developed refractory hypophosphatemia. Workup confirmed severe renal phosphate wasting. Tenofovir disoproxil was initially suspected; however, presence of isolated phosphaturia without Fanconi syndrome and persistence of hypophosphatemia despite discontinuation of medication led to clinical suspicion of Onc-Ost. Elevated FGF-23 warranted further workup, leading to a definitive diagnosis of clinically subtle NK T-cell lymphoma. Chemotherapy was initiated; however, patient continued to deteriorate clinically and expired. CONCLUSION: Along with commonly reported germ line mesenchymal tumors and solid malignancies, NK T-cell lymphoma can also present as Onc-Ost. Timely detection of associated tumors and subsequent antitumor therapy would likely reverse hypophosphatemia and improve clinical outcomes.

6.
Mol Cell Biol ; 41(8): e0023421, 2021 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-34096775

RESUMO

Fanconi anemia (FA) is a rare genetic disease characterized by increased risk for bone marrow failure and cancer. The FA proteins function together to repair damaged DNA. A central step in the activation of the FA pathway is the monoubiquitination of the FANCD2 and FANCI proteins, which occurs upon exposure to DNA-damaging agents and during the S phase of the cell cycle. The regulatory mechanisms governing S-phase monoubiquitination, in particular, are poorly understood. In this study, we have identified a cyclin-dependent kinase (CDK) regulatory phosphosite (S592) proximal to the site of FANCD2 monoubiquitination. FANCD2 S592 phosphorylation was detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and by immunoblotting with an S592 phospho-specific antibody. Mutation of S592 leads to abrogated monoubiquitination of FANCD2 during the S phase. Furthermore, FA-D2 (FANCD2-/-) patient cells expressing S592 mutants display reduced proliferation under conditions of replication stress and increased mitotic aberrations, including micronuclei and multinucleated cells. Our findings describe a novel cell cycle-specific regulatory mechanism for the FANCD2 protein that promotes mitotic fidelity.


Assuntos
Quinases Ciclina-Dependentes/metabolismo , Proteína do Grupo de Complementação D2 da Anemia de Fanconi/metabolismo , Anemia de Fanconi/genética , Fosforilação/fisiologia , Ciclo Celular/fisiologia , Quinases Ciclina-Dependentes/genética , Anemia de Fanconi/metabolismo , Proteína do Grupo de Complementação D2 da Anemia de Fanconi/genética , Proteínas de Grupos de Complementação da Anemia de Fanconi/química , Proteínas de Grupos de Complementação da Anemia de Fanconi/genética , Proteínas de Grupos de Complementação da Anemia de Fanconi/metabolismo , Humanos , Espectrometria de Massas em Tandem/métodos , Ubiquitinação/fisiologia
7.
Curr Opin Cardiol ; 36(4): 420-428, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34059610

RESUMO

PURPOSE OF REVIEW: Controlling hypertension to the desired target is commonly unsuccessful and requires multi-drug regimen, which can lead to undesirable side effects. Resistant hypertension (RH) is more cumbersome to deal with and has robust morbidity and mortality burden even with current multiple medical options. Herein, we review the literature for the potential role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) as a treatment option for hypertension and RH. RECENT FINDINGS: With more recent randomized controlled trials (RCTs), SGLT2i have gained more recognition for their renal and cardiovascular protection as well as mortality benefit that are believed to be medication class-related effects. Multiple RCTs have evaluated blood pressure (BP) lowering properties of SGLT2i, as a primary or secondary end point, in diabetic and nondiabetic patients, yet trials are scarce in studying SGLT2i as first-line antihypertensives, or as add-on agents for treating RH. SUMMARY: Finding the right medical therapy in treating hypertension, especially RH, is commonly onerous when it comes to achieving BP targets, avoiding medication side effects, and aiming for the best outcomes. Utilizing existing drugs like SGLT2i or exploring other novel agents with more RCTs for these purposes will be beneficial. The addition of SGLT2i to the therapeutic armamentarium in patients with RH should be considered as a target for upcoming RCTs.


Assuntos
Diabetes Mellitus Tipo 2 , Hipertensão , Inibidores do Transportador 2 de Sódio-Glicose , Diabetes Mellitus Tipo 2/tratamento farmacológico , Glucose , Humanos , Hipertensão/tratamento farmacológico , Sódio , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico
8.
ASAIO J ; 67(10): 1087-1096, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34191753

RESUMO

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has emerged into a worldwide pandemic of epic proportion. Beyond pulmonary involvement in coronavirus disease 2019 (COVID-19), a significant subset of patients experiences acute kidney injury. Patients who die from severe disease most notably show diffuse acute tubular injury on postmortem examination with a possible contribution of focal macro- and microvascular thrombi. Renal biopsies in patients with proteinuria and hematuria have demonstrated a glomerular dominant pattern of injury, most notably a collapsing glomerulopathy reminiscent of findings seen in human immunodeficiency virus (HIV) in individuals with apolipoprotein L-1 (APOL1) risk allele variants. Although various mechanisms have been proposed for the pathogenesis of acute kidney injury in SARS-CoV-2 infection, direct renal cell infection has not been definitively demonstrated and our understanding of the spectrum of renal involvement remains incomplete. Herein we discuss the biology, pathology, and pathogenesis of SARS-CoV-2 infection and associated renal involvement. We discuss the molecular biology, risk factors, and pathophysiology of renal injury associated with SARS-CoV-2 infection. We highlight the characteristics of specific renal pathologies based on native kidney biopsy and autopsy. Additionally, a brief discussion on ancillary studies and challenges in the diagnosis of SARS-CoV-2 is presented.


Assuntos
Injúria Renal Aguda , COVID-19/complicações , Rim/patologia , Injúria Renal Aguda/patologia , Injúria Renal Aguda/fisiopatologia , COVID-19/patologia , Humanos , Necrose Tubular Aguda/patologia , SARS-CoV-2
9.
Rev. colomb. biotecnol ; 23(1): 32-45, ene.-jun. 2021. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1289179

RESUMO

ABSTRACT During the most recent decades, advances have been made to reduce the environmental impact by anthropogenic activities that constantly release toxic components into the environment, generating instability and damage to the health of biological communities. Among the different pollutants, heavy metals are important by virtue of their properties, which hinder their degradation or transformation into other less toxic compounds. Chromium is one of the metals of greatest global interest due to its use in multiple industries. Conventional methods using chromed materials in their processes, not only throw considerable amounts of waste into the environment, but also give little account of the fraction of hexavalent chromium (Cr6+) present in certain ecosystems. Bioremediation has been proposed as an economically viable and environmentally sustainable alternative. This work aimed to evaluate the chromium reduction capacity by bacteria isolated from a biosolids matrix obtained at the San Fernando Wastewater Treatment Plant (WWTP), located in Medellín (Colombia). Biosolids samples were grown in a nutrient agar enriched with different concentrations of Cr6+. The strains presenting the greater tolerance to chromium were isolated to perform reduction tests by triplicate, monitoring the concentration of the metal over time. Seven different bacterial species were obtained, among which Staphylococcus saprophyticus, Ochrobactrum anthropic, and Bacillus cereus showed the greatest ability to reduce Cr6+ (29.0%, 61.1 and 100%, at 96 h) respectively.


RESUMEN En las últimas décadas se ha trabajado activamente para reducir el impacto ambiental generado por las actividades antrópicas que constantemente liberan componentes tóxicos al ambiente generando inestabilidad y daños en la salud de las comunidades biológicas. Entre los diferentes contaminantes, los metales pesados revisten importancia en virtud de sus propiedades, que dificultan su degradación o transformación en otros compuestos menos tóxicos. El cromo es uno de los metales de mayor interés a nivel global por su uso en múltiples industrias. Los métodos convencionales que utilizan materiales cromados en sus procesos, no sólo arrojan cantidades considerables de residuos al ambiente, sino que dan poca cuenta de la fracción de Cr6+ presente en determinados ecosistemas. La biorremediación se ha propuesto como una alternativa económicamente viable y ambientalmente sostenible. El propósito del presente trabajo fue evaluar la capacidad de reducción de cromo por bacterias, aisladas de una matriz de biosólidos de la Planta de tratamiento de aguas residuales (PTAR) San Fernando en la ciudad de Medellín-Colombia. Muestras de biosólidos se cultivaron en Agar Nutritivo enriquecido con diferentes concentraciones de Cr6+. Las cepas que presentaron mayor tolerancia al cromo fueron aisladas para realizar ensayos de reducción por triplicado, monitoreando la concentración del metal en el tiempo. Se obtuvieron siete especies bacterianas diferentes dentro de las cuales se destacaron Staphylococcus saprophyticus, Ochrobactrum anthropi y Bacillus cereus por la capacidad de reducir Cr6+ a 96 h con eficiencias de 29.0%, 61.1% y 100%, respectivamente.

10.
Clin Transl Gastroenterol ; 12(5): e00359, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33979307

RESUMO

INTRODUCTION: Urinary neutrophil gelatinase-associated lipocalin (NGAL) has shown promise in differentiating acute tubular necrosis (ATN) from other types of acute kidney injuries (AKIs) in cirrhosis, particularly hepatorenal syndrome (HRS). However, NGAL is not currently available in clinical practice in North America. METHODS: Urinary NGAL was measured in a prospective cohort of 213 US hospitalized patients with decompensated cirrhosis (161 with AKI and 52 reference patients without AKI). NGAL was assessed for its ability to discriminate ATN from non-ATN AKI and to predict 90-day outcomes. RESULTS: Among patients with AKI, 57 (35%) had prerenal AKI, 55 (34%) had HRS, and 49 (30%) had ATN, with a median serum creatinine of 2.0 (interquartile range 1.5, 3.0) mg/dL at enrollment. At an optimal cutpoint of 244 µg/g creatinine, NGAL distinguished ATN (344 [132, 1,429] µg/g creatinine) from prerenal AKI (45 [0, 154] µg/g) or HRS (110 [50, 393] µg/g; P < 0.001), with a C statistic of 0.762 (95% confidence interval 0.682, 0.842). By 90 days, 71 of 213 patients (33%) died. Higher median NGAL was associated with death (159 [50, 865] vs 58 [0, 191] µg/g; P < 0.001). In adjusted and unadjusted analysis, NGAL significantly predicted 90-day transplant-free survival (P < 0.05 for all Cox models) and outperformed Model for End-Stage Liver Disease score by C statistic (0.697 vs 0.686; P = 0.04), net reclassification index (37%; P = 0.008), and integrated discrimination increment (2.7%; P = 0.02). DISCUSSION: NGAL differentiates the type of AKI in cirrhosis and may improve prediction of mortality; therefore, it holds potential to affect management of AKI in cirrhosis.


Assuntos
Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/urina , Lipocalina-2/urina , Cirrose Hepática/complicações , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/mortalidade , Biomarcadores/urina , Diagnóstico Diferencial , Feminino , Síndrome Hepatorrenal/diagnóstico , Síndrome Hepatorrenal/urina , Humanos , Necrose Tubular Aguda/diagnóstico , Necrose Tubular Aguda/urina , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Reprodutibilidade dos Testes , Análise de Sobrevida , Estados Unidos/epidemiologia
11.
ACS Appl Mater Interfaces ; 13(20): 23675-23688, 2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-33974392

RESUMO

The electrochemical transformation of biomass-derived compounds (e.g., aldehyde electroreduction to alcohols) is gaining increasing interest due to the sustainability of this process that can be exploited to produce value-added products from biowastes and renewable electricity. In this framework, the electrochemical conversion of 5-hydroxymethylfurfural (HMF) to 2,5-bis(hydroxymethyl)furan (BHMF) is studied. Nanostructured Ag deposited on Cu is an active and selective electrocatalyst for the formation of BHMF in basic media. However, this catalyst deserves further research to elucidate the role of the morphology and size of the coated particles in its performance as well as the actual catalyst surface composition and its stability. Herein, Ag is coated on Cu open-cell foams by electrodeposition and galvanic displacement to generate different catalyst morphologies, deepening on the particle growth mechanism, and the samples are compared with bare Ag and Cu foams. The chemical-physical and electrochemical properties of the as-prepared and spent catalysts are correlated to the electroactivity in the HMF conversion and its selectivity toward the formation of BHMF during electroreduction. AgCu bimetallic nanoparticles or dendrites are formed on electrodeposited and displaced catalysts, respectively, whose surface is Cu-enriched along with electrochemical tests. Both types of bimetallic AgCu particles evidence a superior electroactive surface area as well as an enhanced charge and mass transfer in comparison with the bare Ag and Cu foams. These features together with a synergistic role between Ag and Cu superficial active sites could be related to the twofold enhanced selectivity of the Ag/Cu catalysts for the selective conversion of HMF to BHMF, that is, >80% selectivity and ∼ 100% conversion, and BHMF productivity values (0.206 and 0.280 mmol cm-2 h-1) ca. 1.5-3 times higher than those previously reported.

12.
Mar Pollut Bull ; 168: 112471, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34000707

RESUMO

Marine litter in mangroves comes mainly from poor waste management practices and its abundance is increased by natural catastrophes occurrence that affects coastal settlements, as occurred in November-2020, when two hurricanes (ETA and IOTA) destroyed homes and deposited litters in mangroves of the Providencia and Santa Catalina islands, in the Colombian Caribbean. This study aims to assess the litter pollution in mangrove forests of these islands after Hurricane IOTA. Litter pollution was high in mangroves near urban areas and low in mangroves with little urban influence. In three mangrove sectors with high pollution, litter densities of 0.4-1.4 items m-2 and masses of 0.1-1.2 kg m-2 were determined; the majority were megalitter (sizes >1 m). Plastics were the most abundant (>60%). Local community is aware of the litter pollution problem and their participation in scientific research and mangroves recovery is key to understanding the impacts of natural and anthropogenic events and for ecosystem conservation.


Assuntos
Tempestades Ciclônicas , Ecossistema , Região do Caribe , Colômbia , Monitoramento Ambiental , Ilhas , Plásticos , Providencia , Resíduos/análise , Áreas Alagadas
13.
BMC Vet Res ; 17(1): 178, 2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33926466

RESUMO

BACKGROUND: Hypocalcemia has detrimental effects on health and performance of dairy cows. As hypocalcemic cows show reduced feed intake, we hypothesized that cows with reduced combined rumination and eating time (CRET) may benefit from Ca supplementation. The objective was to evaluate the effect of postpartum oral Ca administration on metabolic status (Calcium [Ca], fatty acids [FA], and ß-Hydroxybutyrate [BHB] serum concentrations) and incidence of puerperal metritis (PM) in dairy cows with reduced postpartum CRET. Cows in an organic-certified dairy, diagnosed with reduced CRET (< 489 min/d; n = 88) during the first day postpartum were assigned into 1 of 2 treatments: i) Calcium administration (CA; n = 45) that received 1 Ca oral capsule (Bovikalc bolus, Boehringer Ingelheim, St. Joseph, MO) containing CaCl2 and CaSO4 (43 g of Ca) once per day, for 3 consecutive days, starting at d 1 postpartum; and ii) Control (CON; n = 43) that did not receive oral Ca. A convenience group consisting of cows with CRET ≥489 min/d was used for comparison and did not receive oral Ca (NOR; n = 96). RESULTS: At day 1 postpartum cows with reduced CRET had lower Ca serum concentrations (CA = 2.08 mmol/L; CON = 2.06 mmol/L) compared with NOR cows (2.17 mmol/L). Calcium concentrations at d 3, 5, and 12 postpartum were not different among the three groups. Serum FA concentrations at d 1, 3 and 5 postpartum were higher in both CA and CON cows compared with NOR. At d 12, only CA cows had higher FA concentrations than NOR cows. Serum BHB concentrations at d 3 were highest in CA, with no difference between CON and NOR. At d 5, BHB concentrations were higher in CA, followed by CON, and NOR. No effect was observed for Ca administration on incidence of PM and reproductive performance. CON cows had lower survival at 30 DIM (86.5%) than NOR cows (97.9%). CONCLUSIONS: The use of remote sensor technology identified cows with reduced rumination and eating time that had lower postpartum serum concentrations of calcium and altered metabolic status. However, oral calcium administration to cows with reduced CRET did not affect incidence of metabolic disorders nor reproductive health and subsequent pregnancy. Although survival at 30 days postpartum was lower for non-Ca supplemented cows, the identification of effective interventions in cows with reduced CRET requires further consideration.


Assuntos
Cálcio/administração & dosagem , Doenças dos Bovinos/dietoterapia , Doenças dos Bovinos/metabolismo , Período Pós-Parto/metabolismo , Ácido 3-Hidroxibutírico/sangue , Animais , Cálcio/sangue , Bovinos , Indústria de Laticínios , Suplementos Nutricionais , Endometrite/veterinária , Ácidos Graxos/sangue , Comportamento Alimentar , Feminino , Gravidez , Ruminação Digestiva
14.
Semin Dial ; 2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827146

RESUMO

With the evolution of standardized replacement fluids, newer machines, and high flux membranes, continuous renal replacement therapy (CRRT) has made remarkable progress in the field of extracorporeal therapies. CRRT is the preferred dialytic modality for patients in intensive care unit setting (ICU). Standardized protocols are implemented by many institutions to avoid errors and ensure patient safety. However, complications related to CRRT are not uncommon. Understanding CRRT operations is essential to analyze the complications and further assist in developing measures to mitigate the risk. Overview of CRRT complications and potential preventive strategies are discussed in the current review.

15.
Semin Dial ; 2021 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-33705575

RESUMO

Severe COVID-19 illness and the consequent cytokine storm and vasodilatory shock commonly lead to ischemic acute kidney injury (AKI). The need for renal replacement therapies (RRTs) in those with the most severe forms of AKI is considerable and risks overwhelming health-care systems at the peak of a surge. We detail the challenges and considerations involved in the preparation of a disaster response plan in situations such as the COVID-19 pandemic, which dramatically increase demand for nephrology services. Taking careful inventory of all aspects of an RRT program (personnel, consumables, and machines) before a surge in RRT arises and developing disaster contingency protocol anticoagulation and for shared RRT models when absolutely necessary are paramount to a successful response to such a disaster.

16.
Am J Transplant ; 21(8): 2895-2899, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33721396

RESUMO

Shortage of organs for liver transplantation (LT) and the availability of highly efficient pan-genotypic direct-acting antivirals (DAAs) against hepatitis C virus (HCV) have allowed the use of livers from HCV-positive antibody/negative nucleic acid test donors (dHCV Ab+/NAT-) into aviremic HCV recipients over the last few years. We report the case of a patient who received an LT from an HCV Ab+/NAT- donor and, after HCV viremic conversion, developed a nephrotic syndrome due to a focal proliferative glomerulonephritis early after LT. Patient's renal function and proteinuria resolved after successful treatment with DAAs. Renal and hepatic function remain normal over 24 months of follow-up. This case restates the success of LT using livers from dHCV Ab+/NAT- in aviremic recipients in the context of DAAs while illustrating the risk for potential complications associated with the HCV transmission and reinforcing the importance of early initiation of anti-HCV therapy.


Assuntos
Glomerulonefrite , Hepatite C Crônica , Hepatite C , Transplante de Fígado , Antivirais/uso terapêutico , Hepacivirus , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Hepatite C Crônica/tratamento farmacológico , Humanos , Doadores Vivos , Doadores de Tecidos
17.
Transfusion ; 61(7): 2019-2024, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33745158

RESUMO

Disparities are prevalent in numerous areas of healthcare. We sought to investigate whether there were racial/ethnic disparities among pregnant women with the most severe form of alloimmunization who require intrauterine transfusions (IUT). We reviewed patients who underwent IUT for alloimmunization at a single fetal treatment center between 2015 and 2020. This "IUT cohort" was compared to an "Alloimmunization cohort": patients seen at our institution with a diagnosis of alloimmunization during pregnancy, who did not receive IUT. We collected maternal demographics including self-identified race/ethnicity and primary language, transfusion, and antibody characteristics. The cohorts were compared using unpaired t-tests, Mann-Whitney tests, and Fischer's exact tests, as appropriate. The IUT cohort included 43 patients and the alloimmunization cohort included 1049 patients. Compared to the alloimmunization cohort, there were significantly more patients of Latina descent in the IUT cohort (23.3% vs. 3.4%, p < .0001), and more non-English speakers (18.6% vs. 4.6%, p = .001). Twenty-one percent (9/43) of patients had immigrated to the United States, all of whom had pregnancies or miscarriages in their country of origin. A third of patients had new antibodies identified on serial screens during the current pregnancy. Significantly more women of Latina ethnicity and non-English speakers required IUTs compared to the cohort of women with alloimmunization. Insufficient access to care prior to arriving in the United States and among racial and ethnic minorities in the United States may contribute to these findings. Providers should be cognizant of potential, racial, and ethnic inequalities among women receiving intrauterine transfusions.


Assuntos
Transfusão de Sangue Intrauterina/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Histocompatibilidade Materno-Fetal/imunologia , Troca Materno-Fetal/imunologia , Aborto Espontâneo/etnologia , Adulto , Estudos de Coortes , Grupos de Populações Continentais/estatística & dados numéricos , Conjuntos de Dados como Assunto , Emigrantes e Imigrantes/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Disparidades em Assistência à Saúde/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Humanos , Imunoglobulina G/imunologia , Isoanticorpos/sangue , Isoanticorpos/imunologia , Paridade , Gravidez , Imunoglobulina rho(D)/sangue , São Francisco , Classe Social
18.
Biomedica ; 41(1): 131-144, 2021 03 19.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33761196

RESUMO

INTRODUCTION: No equations to predict the body composition of athletes from Medellín expected to have high performance have been constructed and, thus, decisions regarding their training and nutrition plans lack support. OBJECTIVE: To calculate the concurrent validity of five prediction equations for fat percentage in a group of athletes from Medellín, Colombia, expected to yield high performance. MATERIALS AND METHODS: We conducted a cross-sectional analysis to validate diagnostic tests using secondary-source data of athletes under the age of 18 who were part of the "Medellín Team". The gold standard was dual-energy X-ray densitometry (DEXA). We analyzed the Slaughter, Durnin and Rahaman, Lohman, and Johnston prediction equations, as well as the five-component model. We used the intraclass correlation coefficient to assess the consistency of the methods and the Bland-Altman plot to calculate the average bias and agreement limits of each of the equations. RESULTS: We included 101 athletes (50,5 % of them women). The median age was 14,8 years (IR: 13,0 - 16,0). The concurrent validity was "good/excellent" for the Johnston and the Durnin and Rahaman equations and the five-components model. The Lohman equation overestimated the fat percentage in 12,7 points. All of the equations showed broad agreement limits. CONCLUSIONS: The Durnin and Rahaman and the Johnston equations, as well as the fivecomponent model, can be used to predict the FP in the study population as they showed a "good/excellent" concurrent validity and a low average bias. The equations analyzed have low accuracy, which hinders their use to diagnose the individual fat percentage within this population.

19.
Angew Chem Int Ed Engl ; 60(26): 14420-14428, 2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-33729669

RESUMO

Electronic metal-support interactions (EMSI) describe the electron flow between metal sites and a metal oxide support. It is generally used to follow the mechanism of redox reactions. In this study of CuO-CeO2 redox, an additional flow of electrons from metallic Cu to surface carbon species is observed via a combination of operando X-ray absorption spectroscopy, synchrotron X-ray powder diffraction, near ambient pressure near edge X-ray absorption fine structure spectroscopy, and diffuse reflectance infrared Fourier transform spectroscopy. An electronic metal-support-carbon interaction (EMSCI) is proposed to explain the reaction pathway of CO oxidation. The EMSCI provides a complete picture of the mass and electron flow, which will help predict and improve the catalytic performance in the selective activation of CO2 , carbonate, or carbonyl species in C1 chemistry.

20.
Neurol Sci ; 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33675003

RESUMO

PURPOSE: The present study aims to explore the association between the quality of life (QoL) score and the clinical and sociodemographic variables in patients with the PSEN1-E280A mutation. We also seek to evaluate the differences between the QoL reported by the patients (P-QoL) and the scores reported by the caregivers (C-QoL). METHODS: An analysis of 75 patients with the PSEN1-E280A mutation with mild cognitive impairment and dementia was performed. We used the Quality of Life in Alzheimer Disease (QoL-AD) survey to evaluate QoL as an outcome and evaluated its association with sociodemographic, lifestyle, clinical, and past medical history variables. RESULTS: The largest difference in the median of the QoL-AD score was in those who needed help to eat, those with moderate or severe dementia, those classified as frail or pre-frail, those with moderate social risk, and those with depression. Also, C-QoL was lower than the P-QoL, and the QoL-AD of individuals with severe dementia was lower than for milder forms of the disease. Not needing help to eat, not having a stressful situation in the past 3 months, and the years of education were positively correlated with QoL-AD in the linear model. CONCLUSION: As studies in similar populations with AD, factors with more impact on QoL are those related to loss of functionality and independence. These factors are also associated with variables related to the current literature with the burden of the disease for the caregivers.

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