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1.
Fam Process ; 2024 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-38462780

RESUMO

BACKGROUND: Data from a two-arm randomized controlled trial of emotionally focused therapy (EFT) compared to usual care were used to examine whether baseline emotion regulation influences relationship satisfaction for female and male partners. This is clinically relevant as clinicians have debated whether clients' initial emotion regulation skills predict positive outcomes in EFT. METHODS: Dyadic multilevel modeling was used to determine whether baseline emotion regulation predicted both initial levels and change in relationship satisfaction and whether that relationship differed by treatment group (i.e., EFT or usual care). RESULTS: Baseline emotion regulation difficulties were associated with lower initial relationship satisfaction. However, baseline emotion regulation difficulties were not associated with change in relationship satisfaction over the course of treatment and this relationship did not differ by treatment group. CONCLUSIONS: Results demonstrate that partners with diverse presentations of emotion regulation at baseline may benefit from couple therapy.

2.
J Zoo Wildl Med ; 55(2): 453-461, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38875202

RESUMO

Chytridiomycosis caused by Batrachochytrium dendrobatidis (Bd) has been documented in greater sirens (Siren lacertina) in the wild and in the pet trade. This study evaluated the use of terbinafine-impregnated implants for chytridiomycosis prophylaxis in greater sirens exposed to Bd. Implants were placed intracoelomically in both control (blank implant, n = 4) and treatment (24.5 mg of terbinafine implant, n = 4) groups. Sirens were exposed to Bd zoospores via 24-h immersion bath at 1 and 2 mon postimplant placement. Blood was collected monthly for plasma terbinafine levels, and skin swabs were collected weekly for Bd quantitative PCR. Animals with terbinafine implants had detectable concentrations of plasma terbinafine ranging from 17 to 102 ng/ml. Only one terbinafine-implanted animal had a peak concentration above the published minimum inhibitory concentration for terbinafine against Bd zoospores (63 ng/ml); however, it is unknown how plasma terbinafine concentrations relate to concentrations in the skin. There was no difference between the two treatment groups in clinical signs or Bd clearance rate, and no adverse effects from implants were observed. These findings indicate using intracoelomic drug implants for drug delivery in amphibians is safe; however, terbinafine efficacy in preventing Bd chytridiomycosis in sirens remains unclear. Further investigation of the use of intracoelomic implants and identification of effective drugs and doses in other amphibian species against Bd and other infectious diseases is warranted, as this may provide a practical method for long-term drug delivery in wildlife.


Assuntos
Antifúngicos , Terbinafina , Terbinafina/administração & dosagem , Terbinafina/uso terapêutico , Terbinafina/farmacologia , Animais , Projetos Piloto , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Antifúngicos/farmacocinética , Implantes de Medicamento , Batrachochytrium/efeitos dos fármacos , Masculino , Micoses/veterinária , Micoses/tratamento farmacológico , Anfíbios
3.
Emerg Infect Dis ; 29(10): 1-7, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37735750

RESUMO

The world's reptiles and amphibians are experiencing dramatic and ongoing losses in biodiversity, changes that can have substantial effects on ecosystems and human health. In 2022, the first Global Amphibian and Reptile Disease Conference was held, using One Health as a guiding principle. The conference showcased knowledge on numerous reptile and amphibian pathogens from several standpoints, including epidemiology, host immune defenses, wild population effects, and mitigation. The conference also provided field experts the opportunity to discuss and identify the most urgent herpetofaunal disease research directions necessary to address current and future threats to reptile and amphibian biodiversity.


Assuntos
Ecossistema , Saúde Única , Humanos , Animais , Anfíbios , Répteis , Biodiversidade
4.
PLoS Pathog ; 17(2): e1009234, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33600433

RESUMO

Environmental temperature is a key factor driving various biological processes, including immune defenses and host-pathogen interactions. Here, we evaluated the effects of environmental temperature on the pathogenicity of the emerging fungal pathogen, Batrachochytrium salamandrivorans (Bsal), using controlled laboratory experiments, and measured components of host immune defense to identify regulating mechanisms. We found that adult and juvenile Notophthalmus viridescens died faster due to Bsal chytridiomycosis at 14°C than at 6 and 22°C. Pathogen replication rates, total available proteins on the skin, and microbiome composition likely drove these relationships. Temperature-dependent skin microbiome composition in our laboratory experiments matched seasonal trends in wild N. viridescens, adding validity to these results. We also found that hydrophobic peptide production after two months post-exposure to Bsal was reduced in infected animals compared to controls, perhaps due to peptide release earlier in infection or impaired granular gland function in diseased animals. Using our temperature-dependent susceptibility results, we performed a geographic analysis that revealed N. viridescens populations in the northeastern United States and southeastern Canada are at greatest risk for Bsal invasion, which shifted risk north compared to previous assessments. Our results indicate that environmental temperature will play a key role in the epidemiology of Bsal and provide evidence that temperature manipulations may be a viable disease management strategy.


Assuntos
Batrachochytrium/patogenicidade , Micoses/imunologia , Notophthalmus viridescens/imunologia , Estações do Ano , Pele/imunologia , Animais , Micoses/epidemiologia , Micoses/microbiologia , Notophthalmus viridescens/microbiologia , Pele/microbiologia , Temperatura
5.
Fam Process ; 62(3): 880-898, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37086013

RESUMO

Including diverse participants in couple intervention studies is critical for developing an evidence base that informs best practices for all potential clients. Research has shown that subgroups of clients respond differently to different interventions and that interventions that have been adapted to fit the needs of a given population are more effective than non-adapted interventions. Unfortunately, couple intervention samples often exclude participants with marginalized identities and culturally adapted couple intervention research is limited. The lack of information about best practices for diverse client subgroups perpetuates mental and relational health disparities. We conducted a systematic review to examine recruitment strategies and sampling characteristics of diverse races/ethnicities, incomes, ages, and sexual identities. We reviewed articles published between January 2015 and December 2020. Articles were eligible for inclusion in our review if they implemented an intervention with couples in the United States. Of 4054 articles identified, 54 articles were eligible for our review. Findings suggest that couple intervention studies lack diversity across multiple identity domains (i.e., races/ethnicities, incomes, ages, and sexual identities). Further, descriptions of recruitment strategies are often vague, limiting opportunities to better understand methods used to recruit diverse samples.


Assuntos
Terapia de Casal , Seleção de Pacientes , Humanos , Estados Unidos
6.
Vet Pathol ; 58(2): 396-400, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33327886

RESUMO

A 13-year-old castrated male Maine coon cat with a 5-year history of atypical mycobacteriosis was euthanized and submitted for necropsy. The cat had been kept in clinical remission since diagnosis using a combination of the antimycobacterial drug clofazimine and additional multimodal antimicrobial therapy. Grossly, tissues were diffusely discolored red-brown to yellow. Histologically, the myocardial interstitum was expanded by numerous, often multinucleated cells, which were distended by uniformly shaped acicular cytoplasmic spaces. These cells were immunopositive for CD18 and immunonegative for desmin, suggesting a histiocytic rather than muscular origin. Macrophages in other tissues contained similar acicular spaces. Ultrastructurally, the spaces were surrounded by 2 lipid membranes, resembling an autophagosome. Based on the clinical history and histologic, immunohistochemical, and ultrastructural data, we diagnosed clofazimine crystal storage. To our knowledge, this is the first report of clofazimine storage in a cat or within myocardial interstitial macrophages.


Assuntos
Clofazimina , Preparações Farmacêuticas , Animais , Antibacterianos , Macrófagos , Masculino
7.
Prev Sci ; 22(3): 288-298, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33099717

RESUMO

Empirically determining the components of evidence-based interventions contributing to positive change is a crucial, yet understudied area of research. In support of this aim, we describe the development and evaluation of an observational rating system for measuring fidelity to specific components of the evidence-based GenerationPMTO parenting intervention. A five-step process was employed to systematically develop the rating system, which included consultation with the intervention developer and input from additional GenerationPMTO experts. The rating system was then tested using 247 h of video data from 184 parenting group intervention sessions. Study findings support the psychometric properties of the new measure with regard to item performance, reliability (i.e., inter-rater reliability of items, dimensionality of components, internal consistency of component scales), and validity (i.e., content validity, convergent validity, discriminant validity, and predictive validity of the component scales) for seven of the eight scales evaluated. The seven components include clear directions, skill encouragement, emotion regulation, limit setting, effective communication, problem solving, and monitoring. Data did not support the psychometric properties of the positive involvement scale. Overall, the ability to assess component-specific fidelity allows for a more nuanced examination of change processes, with meaningful implications for research and practice.


Assuntos
Poder Familiar , Avaliação de Programas e Projetos de Saúde , Humanos , Psicometria , Reprodutibilidade dos Testes
8.
Fam Process ; 60(2): 424-440, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33434313

RESUMO

Disparities in mental health care among marginalized populations have been well-documented. Without research designed to study interventions for diverse populations, disparities in the quality of services will persist. A systematic review of articles evaluating couple and family therapy (CFT) interventions was conducted to evaluate the representation of diverse populations. More specifically, researchers sought to examine race/ethnicity, sexual orientation, income level, and age of sample participants. One hundred ninety-six studies evaluating CFT interventions in the United States in ten journals were included in the analysis. Findings indicate that family therapy research is more representative of racial minority and low-income participants compared with studies of couple interventions. Couple therapy research is often still conducted with predominately white, middle- to high-income samples. Following whites, African Americans and Hispanic/Latinos were the most common racial/ethnic groups included in both couple therapy research and family therapy research. Participants in same-sex relationships were absent from family intervention research and under-researched in couple intervention studies. Only one couple therapy study recruited a sample in which the average age was late adulthood. These findings are cause for concern given the widening mental health disparities in the United States.


Las desigualdades en la atención para la salud mental entre poblaciones marginadas están muy bien documentadas. Si no se diseñan investigaciones para estudiar intervenciones orientadas a poblaciones diversas, las desigualdades en la calidad de los servicios y en los resultados de los tratamientos seguirán existiendo. Se realizó un análisis sistemático de artículos que evaluaban las intervenciones de la terapia familiar y de pareja para evaluar la representación de poblaciones diversas. Más específicamente, los investigadores intentaron analizar la raza/etnia, la orientación sexual, el nivel de ingresos y la edad de los participantes de la muestra. Se incluyeron en el análisis ciento noventa y seis estudios que evaluaban las intervenciones de la terapia familiar y de pareja en los Estados Unidos en diez revistas médicas. Los resultados indican que la investigación sobre terapia familiar es más representativa de la minoría racial y de los participantes de bajos recursos en comparación con los estudios de intervenciones para las parejas. La investigación sobre terapia de pareja generalmente se sigue realizando con muestras predominantemente blancas, de ingresos medios y altos. Después de los blancos, los afroestadounidenses y los hispanos/latinos fueron los grupos raciales/étnicos más comunes incluidos tanto en la investigación sobre terapia familiar como en la de pareja. Los participantes de relaciones del mismo sexo estuvieron ausentes en las investigaciones sobre intervenciones familiares y se investigaron poco en los estudios sobre intervenciones para parejas. Solo un estudio sobre terapia de pareja reunió una muestra en la cual la edad promedio fue la edad adulta tardía. Estos resultados son motivo de preocupación teniendo en cuenta las desigualdades crecientes en el ámbito de la salud mental en los Estados Unidos.


Assuntos
Etnicidade , Terapia Familiar , Adulto , Negro ou Afro-Americano , Feminino , Hispânico ou Latino , Humanos , Masculino , Comportamento Sexual , Estados Unidos
9.
J Aquat Anim Health ; 33(1): 24-32, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33590581

RESUMO

Populations of the eastern hellbender Cryptobranchus alleganiensis alleganiensis have been declining for decades, and emerging pathogens and pesticides are hypothesized to be contributing factors. However, few empirical studies have attempted to test the potential effects of these factors on hellbenders. We simultaneously exposed subadult hellbenders to environmentally relevant concentrations of either Batrachochytrium dendrobatidis (Bd) or a frog virus 3-like ranavirus (RV), a combination of the pathogens, or each pathogen following exposure to a glyphosate herbicide (Roundup). Additionally, we measured the ability of the skin mucosome to inactivate Bd and RV in growth assays. We found that mucosome significantly inactivated RV by an average of 40% but had no negative effects on Bd growth. All treatments that included RV exposure experienced reduced survival compared to controls, and the combination of RV and herbicide resulted in 100% mortality. Histopathology verified RV as the cause of mortality in all RV-exposed treatments. No animals were infected with Bd or died in the Bd-only treatment. Our results suggest that RV exposure may be a significant threat to the survival of subadult hellbenders and that Roundup exposure may potentially exacerbate this threat.


Assuntos
Infecções por Vírus de DNA/veterinária , Glicina/análogos & derivados , Herbicidas/administração & dosagem , Imunidade Inata , Micoses/veterinária , Urodelos/imunologia , Animais , Batrachochytrium/fisiologia , Infecções por Vírus de DNA/virologia , Glicina/administração & dosagem , Micoses/microbiologia , Ranavirus/fisiologia , Glifosato
10.
J Zoo Wildl Med ; 52(1): 300-305, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33827189

RESUMO

Batrachochytrium dendrobatidis (Bd) is an important fungal pathogen present in wild hellbender (Cryptobranchus alleganiensis) populations that appears to cause disease during novel exposure and acute stress. Hellbender repatriation efforts are ongoing to combat declining populations, but mortality by chytridiomycosis (disease from Bd) after release has been reported. The goal was to determine whether a safe antifungal agent could be administered and provide prolonged plasma concentrations without repeated handling. A subcutaneous implant impregnated with 24.5 mg of terbinafine was tested in three juvenile eastern hellbenders (C. a. alleganiensis) raised in human care, and plasma terbinafine concentrations were recorded from weekly to biweekly for 141 days. Plasma concentrations were variable, with peak plasma concentrations of 1,610, 112, and 66 ng/ml between 28 and 56 days postimplant. Although all hellbenders achieved plasma concentrations above the published minimum inhibitory concentration for terbinafine against Bd zoospores (63 ng/ml) at several time points, only one individual remained above this threshold for more than two consecutive time intervals. Results show the potential for these implants as a prophylaxis for chytridiomycosis in captive-to-wild hellbender releases. However, further investigation will be needed to determine the plasma concentrations required to achieve prophylaxis in vivo and implant reliability.


Assuntos
Antifúngicos/uso terapêutico , Batrachochytrium , Micoses/veterinária , Terbinafina/uso terapêutico , Urodelos , Animais , Antifúngicos/administração & dosagem , Antifúngicos/sangue , Implantes de Medicamento , Micoses/prevenção & controle , Absorção Subcutânea , Terbinafina/administração & dosagem , Terbinafina/sangue
11.
Dis Aquat Organ ; 127(1): 65-69, 2017 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-29256429

RESUMO

Toxoplasma gondii is a feline protozoan reported to cause morbidity and mortality in manatees and other marine mammals. Given the herbivorous nature of manatees, ingestion of oocysts from contaminated water or seagrass is presumed to be their primary mode of infection. The objectives of this study were to investigate oocyst contamination of seagrass beds in Puerto Rico and determine the seroprevalence of T. gondii in Antillean (Trichechus manatus manatus) and Florida (T. m. latirostris) manatees. Sera or plasma from Antillean (n = 5) and Florida (n = 351) manatees were tested for T. gondii antibodies using the modified agglutination test. No T. gondii DNA was detected via PCR in seagrass samples (n = 33) collected from Puerto Rico. Seroprevalence was 0%, suggesting a lower prevalence of T. gondii in these manatee populations than previously reported. This was the first study to investigate the potential oocyst contamination of the manatee diet, and similar studies are important for understanding the epidemiology of T. gondii in herbivorous marine mammals.


Assuntos
Plantas/parasitologia , Toxoplasma , Toxoplasmose Animal/transmissão , Trichechus manatus/parasitologia , Animais , Animais Selvagens , Florida/epidemiologia , Porto Rico/epidemiologia , Toxoplasmose Animal/sangue , Toxoplasmose Animal/parasitologia , Trichechus manatus/sangue
12.
N Engl J Med ; 369(11): 999-1010, 2013 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-23991622

RESUMO

BACKGROUND: Although P2Y12 antagonists are effective in patients with non-ST-segment elevation (NSTE) acute coronary syndromes, the effect of the timing of administration--before or after coronary angiography--is not known. We evaluated the effect of administering the P2Y12 antagonist prasugrel at the time of diagnosis versus administering it after the coronary angiography if percutaneous coronary intervention (PCI) was indicated. METHODS: We enrolled 4033 patients with NSTE acute coronary syndromes and a positive troponin level who were scheduled to undergo coronary angiography within 2 to 48 hours after randomization. Patients were randomly assigned to receive prasugrel (a 30-mg loading dose) before the angiography (pretreatment group) or placebo (control group). When PCI was indicated, an additional 30 mg of prasugrel was given in the pretreatment group at the time of PCI and 60 mg of prasugrel was given in the control group. RESULTS: The rate of the primary efficacy end point, a composite of death from cardiovascular causes, myocardial infarction, stroke, urgent revascularization, or glycoprotein IIb/IIIa inhibitor rescue therapy (glycoprotein IIb/IIIa bailout) through day 7, did not differ significantly between the two groups (hazard ratio with pretreatment, 1.02; 95% confidence interval [CI], 0.84 to 1.25; P=0.81). The rate of the key safety end point of all Thrombolysis in Myocardial Infarction (TIMI) major bleeding episodes, whether related or not related to coronary-artery bypass grafting (CABG), through day 7 was increased with pretreatment (hazard ratio, 1.90; 95% CI, 1.19 to 3.02; P=0.006). The rates of TIMI major bleeding and life-threatening bleeding not related to CABG were increased by a factor of 3 and 6, respectively. Pretreatment did not reduce the rate of the primary outcome among patients undergoing PCI (69% of the patients) but increased the rate of TIMI major bleeding at 7 days. All the results were confirmed at 30 days and in prespecified subgroups. CONCLUSIONS: Among patients with NSTE acute coronary syndromes who were scheduled to undergo catheterization, pretreatment with prasugrel did not reduce the rate of major ischemic events up to 30 days but increased the rate of major bleeding complications. (Funded by Daiichi Sankyo and Eli Lilly; ACCOAST ClinicalTrials.gov number, NCT01015287.).


Assuntos
Síndrome Coronariana Aguda/tratamento farmacológico , Angiografia Coronária , Piperazinas/administração & dosagem , Pré-Medicação , Antagonistas do Receptor Purinérgico P2Y/administração & dosagem , Tiofenos/administração & dosagem , Síndrome Coronariana Aguda/terapia , Idoso , Ponte de Artéria Coronária , Método Duplo-Cego , Feminino , Hemorragia/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/tratamento farmacológico , Intervenção Coronária Percutânea , Piperazinas/efeitos adversos , Cloridrato de Prasugrel , Antagonistas do Receptor Purinérgico P2Y/efeitos adversos , Tiofenos/efeitos adversos
13.
Oecologia ; 182(2): 611-23, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27344151

RESUMO

There is growing evidence that pathogens play a role in population declines and species extinctions. For small populations, disease-induced extinction may be especially probable. We estimated the susceptibility of two amphibian species of conservation concern (the dusky gopher frog [Lithobates sevosus] and boreal toad [Anaxyrus boreas boreas]) to an emerging pathogen (ranavirus) using laboratory challenge experiments, and combined these data with published demographic parameter estimates to simulate the potential effects of ranavirus exposure on extinction risk. We included effects of life stage during pathogen exposure, pathogen exposure interval, hydroperiod of breeding habitat, population carrying capacity, and immigration in simulations. We found that both species were highly susceptible to ranavirus when exposed to the pathogen in water at environmentally relevant concentrations. Dusky gopher frogs experienced 100 % mortality in four of six life stages tested. Boreal toads experienced 100 % mortality when exposed as tadpoles or metamorphs, which were the only life stages tested. Simulations showed population declines, greater extinction probability, and faster times to extinction with ranavirus exposure. These effects were more evident with more frequent pathogen exposure intervals and lower carrying capacity. Immigration at natural rates did little to mitigate effects of ranavirus exposure unless immigration occurred every 2 years. Our results demonstrate that disease-induced extinction by emerging pathogens, such as ranavirus, is possible, and that threat may be especially high for species with small population sizes. For the species in this study, conservation organizations should incorporate ranavirus surveillance into monitoring programs and devise intervention strategies in the event that disease outbreaks occur.


Assuntos
Infecções por Vírus de DNA , Ranavirus , Animais , Suscetibilidade a Doenças , Larva , Ranidae
14.
Dis Aquat Organ ; 118(2): 113-27, 2016 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-26912042

RESUMO

Long-term monitoring of amphibians is needed to clarify population-level effects of ranaviruses (Rv) and the fungal pathogen Batrachochytrium dendrobatidis (Bd). We investigated disease dynamics of co-occurring amphibian species and potential demographic consequences of Rv and Bd infections at a montane site in the Southern Appalachians, Georgia, USA. Our 3-yr study was unique in combining disease surveillance with intensive population monitoring at a site where both pathogens are present. We detected sub-clinical Bd infections in larval and adult red-spotted newts Notophthalmus viridescens viridescens, but found no effect of Bd on body condition of adult newts. Bd infections also occurred in larvae of 5 anuran species that bred in our fishless study pond, and we detected co-infections with Bd and Rv in adult newts and larval green frogs Lithobates clamitans. However, all mortality and clinical signs in adult newts and larval anurans were most consistent with ranaviral disease, including a die-off of larval wood frogs Lithobates sylvaticus in small fish ponds located near our main study pond. During 2 yr of drift fence monitoring, we documented high juvenile production in newts, green frogs and American bullfrogs L. catesbeianus, but saw no evidence of juvenile recruitment in wood frogs. Larvae of this susceptible species may have suffered high mortality in the presence of both Rv and predators. Our findings were generally consistent with results of Rv-exposure experiments and support the purported role of red-spotted newts, green frogs, and American bullfrogs as common reservoirs for Bd and/or Rv in permanent and semi-permanent wetlands.


Assuntos
Notophthalmus/microbiologia , Notophthalmus/virologia , Lagoas , Comportamento Predatório , Rana clamitans/microbiologia , Rana clamitans/virologia , Animais , Quitridiomicetos/imunologia , Infecções por Vírus de DNA/epidemiologia , Infecções por Vírus de DNA/veterinária , Infecções por Vírus de DNA/virologia , Georgia , Larva/microbiologia , Larva/virologia , Micoses/microbiologia , Micoses/transmissão , Micoses/veterinária , Rana clamitans/fisiologia , Ranavirus/isolamento & purificação , Estações do Ano , Fatores de Tempo
15.
Am Heart J ; 170(5): 1025-1032.e2, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26542513

RESUMO

OBJECTIVES: We evaluated impact of timing of coronary artery bypass grafting (CABG) and prasugrel pretreatment in patients with non-ST-segment elevation myocardial infarction undergoing CABG in the ACCOAST study. METHODS: Of 4033 enrolled patients, 314 (7.8%) underwent isolated CABG through 30 days. Primary efficacy end point for this analysis was any cardiovascular death, myocardial infarction, stroke, urgent revascularization, or glycoprotein IIb/IIIa inhibitor bailout through 30 days. RESULTS: More CABG versus percutaneous coronary intervention or medically managed patients were men, diabetic, or had peripheral arterial disease. Per randomization, 157 of 314 patients received a 30-mg prasugrel loading dose before CABG, and 157 of 314 received placebo. Patients were stratified by tertile of time from randomization to CABG: <2.98 days (n = 104), ≥2.98 and <6.95 days (n = 106), and ≥6.95 days (n = 104). Primary end point occurred in 12.5%, 4.7%, and 4.8%, respectively (<2.98 days vs other tertiles, hazard ratio [HR] = 2.80; P = .011). Similarly, the rate of all TIMI major bleeding was highest in the lowest tertile (26.0% vs 10.4% and 4.8%; P < .001), but no difference in all-cause death was observed through 30 days (3.9% vs 1.9% and 1.9%; P = .30). Time from randomization to CABG (HR = 0.84 for each day delay), left main disease (HR = 1.76), region of enrollment (Non-Eastern Europe vs Eastern Europe; HR = 3.83), but not prasugrel pretreatment and baseline troponin ≥3× upper limit of normal, were independent predictors of combined 30-day end point of all-cause death/myocardial infarction/stroke/TIMI major bleeding. CONCLUSIONS: In ACCOAST, early (<2.98 days) surgical revascularization carried increased risk of bleeding and ischemic complications without affecting all-cause mortality through 30 days. Baseline troponin and prasugrel pretreatment did not impact ischemic clinical outcomes.


Assuntos
Ponte de Artéria Coronária/métodos , Eletrocardiografia , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/terapia , Intervenção Coronária Percutânea/métodos , Cloridrato de Prasugrel/administração & dosagem , Cuidados Pré-Operatórios/métodos , Idoso , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
16.
Br J Nutr ; 111(4): 653-61, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24274771

RESUMO

The consumption of cocoa and dark chocolate is associated with a lower risk of CVD, and improvements in endothelial function may mediate this relationship. Less is known about the effects of cocoa/chocolate on the augmentation index (AI), a measure of vascular stiffness and vascular tone in the peripheral arterioles. We enrolled thirty middle-aged, overweight adults in a randomised, placebo-controlled, 4-week, cross-over study. During the active treatment (cocoa) period, the participants consumed 37 g/d of dark chocolate and a sugar-free cocoa beverage (total cocoa = 22 g/d, total flavanols (TF) = 814 mg/d). Colour-matched controls included a low-flavanol chocolate bar and a cocoa-free beverage with no added sugar (TF = 3 mg/d). Treatments were matched for total fat, saturated fat, carbohydrates and protein. The cocoa treatment significantly increased the basal diameter and peak diameter of the brachial artery by 6% (+2 mm) and basal blood flow volume by 22%. Substantial decreases in the AI, a measure of arterial stiffness, were observed in only women. Flow-mediated dilation and the reactive hyperaemia index remained unchanged. The consumption of cocoa had no effect on fasting blood measures, while the control treatment increased fasting insulin concentration and insulin resistance (P= 0·01). Fasting blood pressure (BP) remained unchanged, although the acute consumption of cocoa increased resting BP by 4 mmHg. In summary, the high-flavanol cocoa and dark chocolate treatment was associated with enhanced vasodilation in both conduit and resistance arteries and was accompanied by significant reductions in arterial stiffness in women.


Assuntos
Cacau/química , Doenças Cardiovasculares/fisiopatologia , Endotélio Vascular/efeitos dos fármacos , Flavonoides/farmacologia , Obesidade/fisiopatologia , Rigidez Vascular/efeitos dos fármacos , Vasodilatação/efeitos dos fármacos , Adulto , Pressão Sanguínea/efeitos dos fármacos , Artéria Braquial/efeitos dos fármacos , Artéria Braquial/patologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/prevenção & controle , Estudos Cross-Over , Método Duplo-Cego , Endotélio Vascular/fisiopatologia , Jejum , Feminino , Flavonoides/uso terapêutico , Humanos , Hiperemia , Insulina/sangue , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/tratamento farmacológico , Fitoterapia , Preparações de Plantas/farmacologia , Preparações de Plantas/uso terapêutico , Fatores Sexuais
17.
Dis Aquat Organ ; 112(1): 9-16, 2014 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-25392038

RESUMO

Amphibians are one of the most imperiled vertebrate groups, with pathogens playing a role in the decline of some species. Rare species are particularly vulnerable to extinction because populations are often isolated and exist at low abundance. The potential impact of pathogens on rare amphibian species has seldom been investigated. The dusky gopher frog Lithobates sevosus is one of the most endangered amphibian species in North America, with 100-200 individuals remaining in the wild. Our goal was to determine whether adult L. sevosus were susceptible to ranavirus, a pathogen responsible for amphibian die-offs worldwide. We tested the relative susceptibility of adult L. sevosus to ranavirus (103 plaque-forming units) isolated from a morbid bullfrog via 3 routes of exposure: intra-coelomic (IC) injection, oral (OR) inoculation, and water bath (WB) exposure. We observed 100% mortality of adult L. sevosus in the IC and WB treatments after 10 and 19 d, respectively. Ninety-five percent mortality occurred in the OR treatment over the 28 d evaluation period. No mortality was observed in the control treatment after 28 d. Our results indicate that L. sevosus is susceptible to ranavirus, and if adults in the wild are exposed to this pathogen, significant mortality could occur. Additionally, our study demonstrates that some adult amphibian species can be very susceptible to ranavirus, which has been often overlooked in North American studies. We recommend that conservation planners consider testing the susceptibility of rare amphibian species to ranavirus and that the adult age class is included in future challenge experiments.


Assuntos
Infecções por Vírus de DNA/veterinária , Espécies em Perigo de Extinção , Ranavirus/patogenicidade , Ranidae/virologia , Animais , Infecções por Vírus de DNA/virologia
18.
Dis Aquat Organ ; 111(3): 219-27, 2014 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-25320034

RESUMO

In 2009, juvenile pallid sturgeon Scaphirhynchus albus, reared at the Blind Pony State Fish Hatchery (Missouri, USA) to replenish dwindling wild stocks, experienced mass mortality. Histological examination revealed extensive necrosis of the haematopoietic tissues, and a virus was isolated from affected organs in cell culture and then observed by electron microscopy. Experimental infection studies revealed that the virus is highly pathogenic to juvenile pallid sturgeon, one of several species of sturgeon currently listed as Endangered. The DNA sequence of the full length major capsid protein gene of the virus was identical to that of the species Frog virus 3 (FV3), the type species for the genus Ranavirus, originally isolated from northern leopard frog Lithobates pipiens. Although FV3 infections and epizootics in amphibians and reptiles are well documented, there is only 1 prior report of a natural infection of FV3 in fish. Our results illustrate the broad potential host range for FV3, with the known potential to cause significant mortality in poikilothermic vertebrates across 3 taxonomic classes including bony fishes, anuran and caudate amphibians, and squamate and testudine reptiles.


Assuntos
Infecções por Vírus de DNA/veterinária , Doenças dos Peixes/virologia , Ranavirus/isolamento & purificação , Animais , Infecções por Vírus de DNA/virologia , Peixes , Especificidade de Hospedeiro
19.
J Clin Psychopharmacol ; 33(4): 499-506, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23764688

RESUMO

Like caffeine, theobromine crosses the blood-brain barrier and binds to adenosine receptors, suggesting it might share caffeine's beneficial effects on mood and vigilance. Therefore, the purpose of this study was to assess the effect of theobromine doses commonly found in foods on mood and vigilance parameters sensitive to caffeine. Caffeine was tested as a positive control. Twenty-four men (age, 23 [3] years) completed 6 double-blind trials during which they consumed experimental beverages, assessed their mood using standardized self-report questionnaires, and completed a 2-hour visual vigilance task. Three experimental doses (100, 200, and 400 mg theobromine) were delivered in a cocoa-based beverage; 3 matched control treatments (0 mg theobromine, 400 mg theobromine, and 100 mg caffeine) were delivered in a non-cocoa beverage. Mean salivary concentrations of theobromine exhibited significant dose-dependent differences (400 mg trials > 200 mg trial > 100 mg trial > 0 mg trials; P < 0.005). At every dose tested, theobromine failed to consistently affect mood state or vigilance (P > 0.05), but 100-mg caffeine significantly decreased lethargy/fatigue and increased vigor (P = 0.006 and 0.011, respectively). These findings indicate theobromine does not influence mood and vigilance when administered in nutritionally relevant doses, despite sharing many of caffeine's structural characteristics.


Assuntos
Afeto/efeitos dos fármacos , Nível de Alerta/efeitos dos fármacos , Cafeína/farmacologia , Estimulantes do Sistema Nervoso Central/farmacologia , Teobromina/farmacologia , Administração Oral , Adulto , Análise de Variância , Atenção/efeitos dos fármacos , Bebidas , Cafeína/administração & dosagem , California , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estudos Cross-Over , Relação Dose-Resposta a Droga , Método Duplo-Cego , Humanos , Masculino , Estrutura Molecular , Testes Neuropsicológicos , Autorrelato , Relação Estrutura-Atividade , Teobromina/administração & dosagem , Fatores de Tempo , Adulto Jovem
20.
Dis Aquat Organ ; 107(1): 77-81, 2013 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-24270026

RESUMO

Use of disinfectants by biologists, veterinarians, and zoological facilities is a standard biosecurity procedure to prevent contamination and the spread of pathogens. We tested the efficacy of 5 disinfectants and 1 anti-fungal treatment, at 1 and 5 min contact durations, in inactivating Batrachochytrium dendrobatidis (Bd) grown on tryptone media. Our study focused on concentrations of disinfectants known to inactivate ranaviruses, which can be found at the same sites as Bd and can concurrently infect amphibians. Disinfectants tested were chlorhexidine gluconate (0.25, 0.75, and 2%), Pro-San (0.19, 0.35, and 0.47%), Virkon S (1%), household bleach (0.2, 1, and 3%), and Xtreme Mic (5%). The anti-fungal was terbinafine HCl at 0.005, 0.05, 0.1, and 1 mg ml-1. Inactivation of Bd was determined by microscopic evaluation of zoospore motility and growth of colony mass after 14 d. All disinfectants were effective at inactivating zoospore motility and colony growth of Bd at all concentrations and both contact times; however, terbinafine HCl inactivated Bd at only the highest concentration tested (1 mg ml-1) and 5 min duration. Thus, a minimum of 0.25% chlorhexidine gluconate, 0.19% Pro-San, 1% Virkon, 0.2% bleach, and 5% Xtreme Mic with 1 min contact was sufficient to inactivate Bd. Also, terbinafine HCl (1 mg ml-1) with a 5 min contact time might be effective in treating amphibians infected with Bd. Based on this study and previously published findings, 0.75% Nolvasan, 1% Virkon S, and 3% bleach with 1 min contact are sufficient to inactivate both Bd and ranaviruses.


Assuntos
Antifúngicos/farmacologia , Quitridiomicetos/efeitos dos fármacos , Desinfetantes/farmacologia , Naftalenos/farmacologia , Testes de Sensibilidade Microbiana , Terbinafina
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