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1.
Biochem J ; 480(16): 1365-1377, 2023 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-37589484

RESUMO

High temperatures in the field hinder bread wheat high-yield production, mainly because of the adverse effects of heat over photosynthesis. The Yaqui Valley, the main wheat producer region in Mexico, is a zone prone to have temperatures over 30°C. The aim of this work was to test the flag leaf photosynthetic performance in 10 bread wheat genotypes grown under high temperatures in the field. The study took place during two seasons (2019-2020 and 2020-2021). In each season, control seeds were sown in December, while heat-stressed were sown in late January to subject wheat to heat stress (HS) during the grain-filling stage. HS reduced Grain yield from 20 to 58% in the first season. HS did not reduce chlorophyll content and light-dependent reactions were unaffected in any of the tested genotypes. Rubisco, chloroplast fructose 1,6-biphosphatase (FBPase), and sucrose phosphate synthase (SPS) activities were measured spectrophotometrically. Rubisco activity did not decrease under HS in any of the genotypes. FBPase activity was reduced by HS indicating that triose phosphate flux to starch synthesis was reduced, while SPS was not affected, and thus, sucrose synthesis was maintained. HS reduced aerial biomass in the 10 chosen genotypes. Genotypes SOKWB.1, SOKWB.3, and BORLAUG100 maintained their yield under HS, pointing to a potential success in their introduction in this region for breeding heat-tolerant bread wheat.


Assuntos
Ribulose-Bifosfato Carboxilase , Triticum , Triticum/genética , Temperatura , Fosfatos , Trioses
2.
Sensors (Basel) ; 23(22)2023 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-38005430

RESUMO

Small, low-power, and inexpensive marine depth sensors are of interest for a myriad of applications from maritime security to environmental monitoring. Recently, laser-induced graphene (LIG) piezoresistive pressure sensors have been proposed given their rapid fabrication and large dynamic range. In this work, the practicality of LIG integration into fieldable deep ocean (1 km) depth sensors in bulk is explored. Initially, a design of experiments (DOEs) approach evaluated laser engraver fabrication parameters such as line length, line width, laser speed, and laser power on resultant resistances of LIG traces. Next, uniaxial compression and thermal testing at relevant ocean pressures up to 10.3 MPa and temperatures between 0 and 25 °C evaluated the piezoresistive response of replicate sensors and determined the individual characterization of each, which is necessary. Additionally, bare LIG sensors showed larger resistance changes with temperature (ΔR ≈ 30 kΩ) than pressure (ΔR ≈ 1-15 kΩ), indicating that conformal coatings are required to both thermally insulate and electrically isolate traces from surrounding seawater. Sensors encapsulated with two dip-coated layers of 5 wt% polydimethylsiloxane (PDMS) silicone and submerged in water baths from 0 to 25 °C showed significant thermal dampening (ΔR ≈ 0.3 kΩ), indicating a path forward for the continued development of LIG/PDMS composite structures. This work presents both the promises and limitations of LIG piezoresistive depth sensors and recommends further research to validate this platform for global deployment.

3.
Int J Mol Sci ; 24(19)2023 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-37834190

RESUMO

Mice are commonly used to study mandibular dynamics due to their similarity in chewing cycle patterns with humans. Adult mice treated unilaterally with botulinum toxin type A (BoNTA) in the masseter exhibit atrophy of this muscle characterized by an increase in the gene expression of atrophy-related molecular markers, and a reduction in both muscle fiber diameter and muscle mass at 14d. However, the impact of this muscle imbalance on the non-treated masticatory muscles remains unexplored. Here, we hypothesize that the unilateral masseter hypofunction leads to molecular and 3D morphometric signs of atrophy of the masseter and its agonist masticatory muscles in adult mice. Twenty-three 8-week-old male BALB/c mice received a single injection of BoNTA in the right masseter, whereas the left masseter received the same volume of saline solution (control side). Animals were euthanized at 2d, 7d, and 14d, and the masticatory muscles were analyzed for mRNA expression. Five heads were harvested at 14d, fixed, stained with a contrast-enhanced agent, and scanned using X-ray microtomography. The three-dimensional morphometric parameters (the volume and thickness) from muscles in situ were obtained. Atrogin-1/MAFbx, MuRF-1, and Myogenin mRNA gene expression were significantly increased at 2 and 7d for both the masseter and temporalis from the BoNTA side. For medial pterygoid, increased mRNA gene expression was found at 7d for Atrogin-1/MAFbx and at 2d-7d for Myogenin. Both the volume and thickness of the masseter, temporalis, and medial pterygoid muscles from the BoNTA side were significantly reduced at 14d. In contrast, the lateral pterygoid from the BoNTA side showed a significant increase in volume at 14d. Therefore, the unilateral hypofunction of the masseter leads to molecular and morphological signs of atrophy in both the BoNTA-injected muscle and its agonistic non-injected masticatory muscles. The generalized effect on the mouse masticatory apparatus when one of its components is intervened suggests the need for more clinical studies to determine the safety of BoNTA usage in clinical dentistry.


Assuntos
Toxinas Botulínicas Tipo A , Músculos da Mastigação , Adulto , Humanos , Camundongos , Masculino , Animais , Miogenina , Músculo Masseter/patologia , Músculo Masseter/fisiologia , Atrofia Muscular/patologia , RNA Mensageiro
4.
J Prosthet Dent ; 129(4): 644-649, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34303523

RESUMO

STATEMENT OF PROBLEM: Translucent zirconias have been developed with better esthetics than high-strength zirconias by reducing opacity. However, studies on their translucency and strength are sparse. PURPOSE: The purpose of this in vitro study was to compare the relationship between translucency and biaxial flexural strength of recently developed high-translucency zirconia, high-strength zirconia, and lithium disilicate ceramics. MATERIAL AND METHODS: Disks (n=12) were fabricated for 5 ceramic materials: high-strength zirconia (BruxZir 16 shaded), translucent zirconia (BruxZir Anterior shaded, Katana UTML, Katana STML), and lithium disilicate (IPS e.max, Press HT, and LT). A standard tessellation language (STL) file was designed, and the specimen milled, finished, and glazed according to manufacturer's instructions for each material. The translucency parameter was calculated against black and white backgrounds and white and stump shade with ND4 background by using a spectrophotometer. Biaxial flexural strength was calculated by using the 3-ball test. The load was applied at a crosshead speed of 0.5 mm/min with a 49-N load cell until failure occurred. Translucency parameter and biaxial flexural strength data were analyzed with 1-way analysis of variance (ANOVA). A Tukey honest significant difference multiple comparison test was used to determine significant differences (α=.05). RESULTS: The IPS e.max HT was more translucent against both backgrounds (32.85 for black/white and 15.34 for white/stump), while BruxZir 16 was the least translucent (19.78 for B/W and 8.83 for W/S). All groups tested differed in translucency (P<.001) except for BruxZir Anterior and Katana STML, which were not significantly different (P=.052). For biaxial flexural strength, BruxZir 16 had the highest strength (995.44 MPa) and e.max HT, the lowest (186.75 MPa). No significant differences were found between BruxZir anterior and Katana STML, Katana UTML and IPS e.max LT, or IPS e.max LT and IPS e.max HT (P>.05). Translucency parameter values using both backgrounds were strongly correlated (r=0.99). However, biaxial flexural strength values were inversely related to translucency parameter values when using black/white and white/stump shade but with high correlation (r=-0.777 and -0.756 respectively). CONCLUSIONS: Lithium disilicate was the most translucent and yet the weakest material, whereas high-strength zirconia was the most opaque ceramic and the strongest. Katana UTML had the highest translucency but was weakest among translucent and high-strength zirconia materials. Overall, translucency was negatively correlated with biaxial flexural strength.


Assuntos
Estética Dentária , Resistência à Flexão , Cerâmica , Análise de Variância
5.
Clin Gastroenterol Hepatol ; 20(9): 1947-1970.e7, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-34481951

RESUMO

BACKGROUND & AIMS: Inflammatory bowel disease (IBD) care and outcomes exhibit substantial variability, suggesting quality gaps. We aimed to identify interventions to narrow these gaps. METHODS: We performed a systematic review of Medline, Embase, and Web of Science through May 2021 to find manuscripts and abstracts reporting quality improvement (QI) interventions in IBD. We included studies with interventions that addressed acute care utilization, vaccination, or Crohn's and Colitis Foundation quality indicators for care processes, including pre-therapy testing, tobacco cessation, colorectal cancer surveillance, Clostridium difficile infection screening in flares, sigmoidoscopy in patients hospitalized with ulcerative colitis, and use of steroid-sparing therapy. The primary objective was to identify successful QI interventions. Risk of bias assessment was conducted using the Joanna Briggs Institute critical appraisal checklist. RESULTS: Twenty-three manuscripts and 23 meeting abstracts met inclusion criteria. Influenza and pneumococcal vaccination were the most studied indicators (24 references), followed by emergency room and/or hospital utilization, tobacco cessation, and pre-therapy testing (17, 11, and 10 references, respectively). Electronic medical record-based interventions were the most frequent, whereas other initiatives used strategies that included changes to care structure or delivery, vaccination protocols, or physician and patient education. Successful interventions matched the complexity of the metric to the intervention including making changes to care structure or delivery, empowered non-physician staff, and used electronic medical record changes to prompt clinicians. CONCLUSIONS: The quality of IBD care can be improved with diverse interventions that range from simple to complex. However, these interventions are not universally successful. Clinicians should emulate successful interventions and design new initiatives to narrow gaps in care quality.


Assuntos
Colite Ulcerativa , Doença de Crohn , Doenças Inflamatórias Intestinais , Adulto , Doença Crônica , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Qualidade da Assistência à Saúde
6.
Int J Mol Sci ; 23(17)2022 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36077493

RESUMO

A loss of neuroplastic control on nucleus accumbens (NAc) neuronal activity exerted by the medial prefrontal cortex (mPFC) through long-term depression (LTD) is involved in triggering drug-seeking behavior and relapse on several substances of abuse due to impaired glutamate homeostasis in tripartite synapses of the nucleus accumbens (NAc) core. To test whether this maladaptive neuroplastic mechanism underlies the addiction-like behavior induced in young mice by a high-fat diet (HFD), we utilized 28-days-old male mice fed HFD ad-libitum over 2 weeks, followed by 5 days of HFD abstinence. Control groups were fed a regular diet. HFD fed mice showed increased ΔFosB levels in the NAc core region, whereas LTD triggered from the mPFC became suppressed. Interestingly, LTD suppression was prevented by an i.p. injection of 100 mg/kg N-acetylcysteine 2.5 h before inducing LTD from the mPFC. In addition, excessive weight gain due to HFD feeding was diminished by adding 2mg/mL N-acetylcysteine in drinking water. Those results show a loss of neuroplastic mPFC control over NAc core activity induced by HFD consumption in young subjects. In conclusion, ad libitum consumption of HFD can lead to neuroplastic changes an addiction-like behavior that can be prevented by N-acetylcysteine, helping to decrease the rate of excessive weight gain.


Assuntos
Dieta Hiperlipídica , Núcleo Accumbens , Acetilcisteína/farmacologia , Animais , Dieta Hiperlipídica/efeitos adversos , Humanos , Masculino , Camundongos , Obesidade/tratamento farmacológico , Obesidade/etiologia , Obesidade/prevenção & controle , Córtex Pré-Frontal , Aumento de Peso
7.
J Clin Immunol ; 41(2): 285-293, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33392852

RESUMO

POLA1 encodes the catalytic unit of DNA polymerase α, which together with the Primase complex launches the DNA replication process. While complete deficiency of this essential gene is presumed to be lethal, at least two conditions due to partial POLA1 deficiency have been described. The first genetic syndrome to be mapped to POLA1 was X-linked reticulate pigmentary disorder (XLPDR, MIM #301220), a rare syndrome characterized by skin hyperpigmentation, sterile multiorgan inflammation, recurrent infections, and distinct facial features. XLPDR has been shown to be accompanied by profound activation of type I interferon signaling, but unlike other interferonopathies, it is not associated with autoantibodies or classical autoimmunity. Rather, it is accompanied by marked Natural Killer (NK) cell dysfunction, which may explain the recurrent infections seen in this syndrome. To date, all XLPDR cases are caused by the same recurrent intronic mutation, which results in gene missplicing. Several hypomorphic mutations in POLA1, distinct from the XLPDR intronic mutation, have been recently reported and these mutations associate with a separate condition, van Esch-O'Driscoll syndrome (VEODS, MIM #301030). This condition results in growth retardation, microcephaly, hypogonadism, and in some cases, overlapping immunological features to those seen in XLPDR. This review summarizes our current understanding of the clinical manifestations of POLA1 gene mutations with an emphasis on its immunological consequences, as well as recent advances in understanding of its pathophysiologic basis and potential therapeutic options.


Assuntos
DNA Polimerase I/deficiência , DNA Polimerase I/genética , Doenças do Sistema Imunitário/genética , Deficiência Intelectual/genética , Malformações do Sistema Nervoso/genética , Animais , Genes Ligados ao Cromossomo X/genética , Humanos , Mutação/genética
8.
Adm Policy Ment Health ; 48(6): 937-941, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33580393

RESUMO

The development and implementation of clinical practice guidelines has flourished over the past two decades. Unfortunately, many studies have found that the quality of such guidelines is highly variable (Alonso-Coello et al. in Qual Safe Health Care 19:e58, 2010; MacQueen et al. in Can J Psychiatry 62:11-23, 2016); research suggests that some of the guidelines used in psychology have been developed using poor methods for guideline development (Bennett et al. in Depress Anxiety 35:330-340, 2018; Trepanier et al. in: Can Psychol 58: 211-217, 2017). While there remains a dearth of research in this area, typically, it is guidelines themselves that are examined by researchers, while too little attention is paid to the developers, and more specifically to how the guideline development groups are composed and the nature of the expertise of those involved in developing the guidelines. Given the importance of grounding guidelines in science, it is key that guideline development groups be comprised of research experts that will help ensure that this essential aspect be respected. In this brief paper, we provide findings from a recent study in which group composition as well as the expertise of guideline development committee members at the Order of Psychologists of Quebec (OPQ) was examined, as defined by academic research productivity. As results highlighted a clear imbalance between clinical and research expertise in these specific committees, with only a small percentage of researchers being represented, we conclude that major improvements need to be made for research to properly reach practitioners and make recommendations to facilitate this.


Assuntos
Medicina Baseada em Evidências , Guias de Prática Clínica como Assunto/normas , Humanos , Quebeque
9.
Behav Sci Law ; 35(1): 18-36, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27757984

RESUMO

Some innocent suspects rely on the memory of strangers to corroborate their alibis. However, no research has examined whether such potential alibi corroborators can accurately recognize an innocent suspect with whom they previously interacted. We developed a novel alibi corroboration paradigm in which undergraduate students (representing innocent suspects who would later provide an alibi) interacted with naïve university employees (representing potential alibi corroborators). Each student briefly interacted with a different naïve university employee (n = 60), and were also each yoked to a different employee with whom they did not interact (n = 60). Employees were presented 24 hours later with either a single photograph of the student or a six-person array containing a photograph of the student and were asked if they recognized anyone. The majority of employees failed to make a correct recognition of the student. False recognitions, however, were rare. Students exhibited overconfidence that they would be recognized. Findings imply that innocent suspects who rely on strangers to corroborate their alibis may be at risk. Copyright © 2016 John Wiley & Sons, Ltd.


Assuntos
Crime/psicologia , Reconhecimento Facial/fisiologia , Adulto , Direito Penal/métodos , Feminino , Humanos , Masculino , Memória/fisiologia , Distribuição Aleatória , Reprodutibilidade dos Testes , Estudantes , Revelação da Verdade , Adulto Jovem
10.
J Clin Psychol ; 73(9): 1076-1090, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28195649

RESUMO

BACKGROUND: Depressive disorders are frequently under diagnosed in resource-limited settings because of lack of access to mental health care or the inability of healthcare providers to recognize them. The Patient Health Questionnaire (PHQ)-2 and the PHQ-9 have been widely used for screening and diagnosis of depression in primary care settings; however, the validity of their use in rural, Spanish-speaking populations is unknown. METHOD: We used a cross-sectional design to assess the psychometric properties of the PHQ-9 for depression diagnosis and estimated the sensitivity and specificity of the PHQ-2 for depression screening. Data were collected from 223 adults in a rural community of Chiapas, Mexico, using the PHQ-2, the PHQ-9, and the World Health Organization Quality of Life BREF Scale (WHOQOL- BREF). RESULTS: Confirmatory factor analysis suggested that the 1-factor structure fit reasonably well. The internal consistency of the PHQ-9 was good (Cronbach's alpha > = 0.8) overall and for subgroups defined by gender, literacy, and age. The PHQ-9 demonstrated good predictive validity: Participants with a PHQ-9 diagnosis of depression had lower quality of life scores on the overall WHOQOL-BREF Scale and each of its domains. Using the PHQ-9 results as a gold standard, the optimal PHQ-2 cutoff score for screening of depression was 3 (sensitivity 80.00%, specificity 86.88%, area under receiver operating characteristic curve = 0.89; 95% confidence interval [0.84, 0.94]). CONCLUSION: The PHQ-2 and PHQ-9 demonstrated good psychometric properties, suggesting their potential benefit as tools for depression screening and diagnosis in rural, Spanish-speaking populations.


Assuntos
Transtorno Depressivo/diagnóstico , Questionário de Saúde do Paciente/normas , Psicometria/instrumentação , População Rural , Populações Vulneráveis/psicologia , Adulto , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
11.
Am J Physiol Heart Circ Physiol ; 310(6): H667-80, 2016 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-26747502

RESUMO

Mitochondrial dysfunction has been implicated as a cause of energy deprivation in heart failure (HF). Herein, we tested individual and combined effects of two pathogenic factors of nonischemic HF, inhibition of nitric oxide synthesis [with l-N(G)-nitroarginine methyl ester (l-NAME)] and hypertension [with angiotensin II (AngII)], on myocardial mitochondrial function, oxidative stress, and metabolic gene expression. l-NAME and AngII were administered individually and in combination to mice for 5 wk. Although all treatments increased blood pressure and reduced cardiac contractile function, the l-NAME + AngII group was associated with the most severe HF, as characterized by edema, hypertrophy, oxidative stress, increased expression of Nppa and Nppb, and decreased expression of Atp2a2 and Camk2b. l-NAME + AngII-treated mice exhibited robust deterioration of cardiac mitochondrial function, as observed by reduced respiratory control ratios in subsarcolemmal mitochondria and reduced state 3 levels in interfibrillar mitochondria for complex I but not for complex II substrates. Cardiac myofibrils showed reduced ADP-supported and oligomycin-inhibited oxygen consumption. Mitochondrial functional impairment was accompanied by reduced mitochondrial DNA content and activities of pyruvate dehydrogenase and complex I but increased H2O2 production and tissue protein carbonyls in hearts from AngII and l-NAME + AngII groups. Microarray analyses revealed the majority of the gene changes attributed to the l-NAME + AngII group. Pathway analyses indicated significant changes in metabolic pathways, such as oxidative phosphorylation, mitochondrial function, cardiac hypertrophy, and fatty acid metabolism in l-NAME + AngII hearts. We conclude that l-NAME + AngII is associated with impaired mitochondrial respiratory function and increased oxidative stress compared with either l-NAME or AngII alone, resulting in nonischemic HF.


Assuntos
Angiotensina II/farmacologia , Inibidores Enzimáticos/farmacologia , Insuficiência Cardíaca/etiologia , Mitocôndrias Cardíacas/efeitos dos fármacos , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Vasoconstritores/farmacologia , Animais , Fator Natriurético Atrial , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/efeitos dos fármacos , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/genética , Cardiomegalia , DNA Mitocondrial/efeitos dos fármacos , DNA Mitocondrial/metabolismo , Complexo I de Transporte de Elétrons/efeitos dos fármacos , Complexo I de Transporte de Elétrons/metabolismo , Complexo II de Transporte de Elétrons/efeitos dos fármacos , Complexo II de Transporte de Elétrons/metabolismo , Expressão Gênica/efeitos dos fármacos , Coração/efeitos dos fármacos , Peróxido de Hidrogênio/metabolismo , Camundongos , Mitocôndrias Cardíacas/metabolismo , Miocárdio/metabolismo , Miocárdio/patologia , Peptídeo Natriurético Encefálico/efeitos dos fármacos , Peptídeo Natriurético Encefálico/genética , Peptídeo Natriurético Tipo C/efeitos dos fármacos , Peptídeo Natriurético Tipo C/genética , Precursores de Proteínas/efeitos dos fármacos , Precursores de Proteínas/genética , Complexo Piruvato Desidrogenase/efeitos dos fármacos , Complexo Piruvato Desidrogenase/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , ATPases Transportadoras de Cálcio do Retículo Sarcoplasmático/efeitos dos fármacos , ATPases Transportadoras de Cálcio do Retículo Sarcoplasmático/genética
12.
J Card Fail ; 22(1): 73-81, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26370778

RESUMO

OBJECTIVES: Right ventricular failure is the primary reason for mortality in pulmonary hypertension (PH), but little is understood about the energetics of the failing right myocardium. Our aim was to examine mitochondrial function and proteomic signatures in paired remodeled right (RM-RV) and non-remodeled left (NRM-LV) ventricular tissue samples procured during heart-lung transplantation. METHODS AND RESULTS: Contractile dysfunction in RM-RV and preserved contractile function in NRM-LV were determined clinically and by echocardiography. Mitochondria were isolated from fresh paired RV and LV wall specimens of explanted hearts. Respiratory states in response to 4 substrates and an uncoupler were analyzed. Proteomic analysis on the mitochondrial isolates was performed with the use of liquid chromatography-mass spectrometry. The RM-RV mitochondria exhibited higher succinate state 4 levels with lower respiratory control ratio (RCR) compared with state 4 levels for pyruvate-malate (PM) and glutamate-malate (GM). RM-RV mitochondria also exhibited lower state 3 for palmitoyl-carnitine (PC) and state 4 for all complex I substrates compared with NRM-LV. The mean RCR were greater in RM-RVs than in NRM-LVs for PM and GM, which is consistent with tight coupling (low state 4 rates, higher RCRs); however, low RM-RV state 3 rates suggest concurrent substrate-dependent impairment in respiratory capacity. Mitochondrial proteomics revealed greater levels of mitochondrial ADP-ATP translocase and proteins of ATP synthesis, mitochondrial pyruvate and short branched chain acyl-CoA metabolism in RM-RV. CONCLUSIONS: The mitochondrial respiration and proteomics in RM-RV are different from NRM-LV. These results have important implications in expanding our understanding of RV metabolism and future management of RV failure.


Assuntos
Insuficiência Cardíaca/fisiopatologia , Ventrículos do Coração/fisiopatologia , Hipertensão Pulmonar/complicações , Mitocôndrias Cardíacas/metabolismo , Disfunção Ventricular Direita/fisiopatologia , Remodelação Ventricular , Adolescente , Idoso , Ecocardiografia , Complexo I de Transporte de Elétrons/metabolismo , Feminino , Insuficiência Cardíaca/etiologia , Humanos , Pessoa de Meia-Idade , Mitocôndrias Cardíacas/enzimologia , Translocases Mitocondriais de ADP e ATP/metabolismo , Proteômica , Disfunção Ventricular Direita/etiologia
13.
J Card Fail ; 22(7): 501-11, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26762651

RESUMO

BACKGROUND: Thrombotic events in patients with continuous flow left ventricular assist devices (CF-LVADs) are associated with significant morbidity and mortality. The objective of this study was to delineate the frequency, clinical characteristics, and outcomes of patients with hypercoagulable states who undergo CF-LVAD implantation. METHODS: We performed a retrospective review of 168 consecutive patients who underwent CF-LVAD implantation between 2010 and 2013. Chart and laboratory data were reviewed for the presence of a hereditary and/or acquired hypercoagulable state. Adverse outcomes were defined as death, confirmed pump thrombosis, aortic root clot, stroke, deep vein thrombosis, and pulmonary embolism. Fisher's exact test and Kaplan-Meier estimate were used to analyze frequency of adverse outcomes and event free survival, respectively. RESULTS: A hypercoagulable state was identified in 20 patients (11.9%). There were 18 patients with acquired, 1 with a congenital, and 1 with both congenital and acquired hypercoagulable states. The median follow-up was 429 days and 475 days in patients with and without hypercoagulable states, respectively. During the study period, 15% (3/20) of the patients with a hypercoagulable state had a diagnosis of deep vein thrombosis vs 3% (4/148) of the patients without a hypercoagulable state (P = .030). Only patients with a hypercoagulable state had a subarachnoid hemorrhage (3/20 vs 0/148; P < .01). The event-free survival was lower in the patients with hypercoagulable states (P = .005). CONCLUSION: Hypercoagulable states are not uncommon in patients with CF-LVADs and may be associated with increased morbidity. Prospective studies are needed to more accurately identify the incidence, prevalence, and significance of hypercoagulable states in patients being considered for CF-LVAD.


Assuntos
Insuficiência Cardíaca/cirurgia , Coração Auxiliar/efeitos adversos , Trombofilia/etiologia , Trombose/etiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Trombofilia/congênito , Trombofilia/diagnóstico
15.
J Card Fail ; 21(2): 119-25, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25463739

RESUMO

BACKGROUND: Common adverse events in patients supported with Continuous-flow left ventricular assist devices (CF-LVAD) include infections and cerebrovascular accidents (CVA). Some studies have suggested a possible association between blood stream infection (BSI) and CVA. METHODS AND RESULTS: Medical records of patients who received Heartmate II (HMII) CF-LVADs in 2008-2012 at a single center were reviewed. CVA was categorized as either hemorrhagic (HCVA) or ischemic (ICVA). BSI was divided into persistent (pBSI) and nonpersistent (non-pBSI). pBSI was defined as BSI with the same organism on repeated blood culture >72 hours from initial blood culture despite antibiotics. Univariate and multivariate analyses were performed to determine predictors. A total of 149 patients had HMII implanted; 76% were male, and the overall mean age was 55.4 ± 13 years. There were a total of 19 (13%) patients who had CVA (7 HCVA and 12 ICVA) at a median of 295 days (range 5-1,096 days) after implantation. There were a total of 28 (19%) patients with pBSI and 17 (11%) patients with non-pBSI. Patients with pBSI had a trend toward greater BMI (31 kg/m(2) vs 27 kg/m(2); P = .09), and longer duration of support (1,019 d vs 371 d; P < .001) compared with those with non-pBSI. Persistent BSI was associated with an increased risk of mortality and with all-cause CVA on multivariate analysis (odds ratio [OR] 5.97; P = .003) as well as persistent Pseudomonas aeruginosa infection (OR 4.54; P = .048). CONCLUSIONS: Persistent BSI is not uncommon in patients supported by CF-LVAD and is highly associated with all-cause CVA and increased all-cause mortality.


Assuntos
Bacteriemia/diagnóstico , Contaminação de Equipamentos , Coração Auxiliar/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Pseudomonas aeruginosa/isolamento & purificação , Acidente Vascular Cerebral/diagnóstico , Adulto , Idoso , Bacteriemia/mortalidade , Feminino , Coração Auxiliar/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Complicações Pós-Operatórias/microbiologia , Complicações Pós-Operatórias/mortalidade , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/microbiologia , Acidente Vascular Cerebral/mortalidade
16.
Eur Heart J ; 35(16): 1061-8, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24375073

RESUMO

AIMS: Various reports have raised the possibility of humoral immune responses as contributors for the progression of heart failure. Previous studies, however, have focused on the analysis of serum and documented circulating antibodies against a variety of cardiac proteins. However, there is little evidence on whether anti-cardiac antibodies are deposited in end-stage failing myocardium. Our objective was to determine whether or not there was evidence of deposition of anti-cardiac antibodies and/or activated complement components in end-stage failing human myocardium. METHODS AND RESULTS: Myocardial samples were obtained from 100 end-stage heart failure patients and 40 donor control biopsies. Sections were cut and stained using standard fluorescent immunohistochemistry techniques with anti-human immunoglobulin G (IgG), IgG3, and C3c. Gel electrophoresis and protein identification by mass spectrometry were used to confirm the presence of IgG and its antigen. Immunoglobulin G was localized to the sarcolemma in 71% of patients, 48% of those being positive for the subtype IgG3. The proportion of patients with ischaemic heart disease that was positive for IgG was 65% and among those with non-ischaemic aetiologies was 76%. In a subgroup analysis, the presence of IgG and its subunits were confirmed by mass spectrometry and adenosine triphosphate synthase ß subunit identified as an antigen. Complement was activated in 31% of all patients. The presence of IgG, IgG3, and C3c was directly correlated with the length of disease (r = 0.451, P = 0.006). CONCLUSION: Evidence of anti-cardiac antibodies and complement activation was found in a large number of patients with end-stage cardiomyopathy regardless of the aetiology. Adenosine triphosphate synthase appears to be a new prominent antigenic stimulus; but more interestingly, the simultaneous co-existence of activated complement components suggests that this humoral mechanism may participate in disease progression.


Assuntos
Anticorpos/metabolismo , Insuficiência Cardíaca/imunologia , Miocárdio/imunologia , Adenosina Trifosfatases/imunologia , Antígenos/metabolismo , Estudos de Casos e Controles , Progressão da Doença , Feminino , Humanos , Imunidade Humoral/imunologia , Imunoglobulina G/metabolismo , Masculino , Pessoa de Meia-Idade
17.
Rev Gastroenterol Peru ; 35(4): 295-305, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-26802882

RESUMO

OBJECTIVE: This study seeks to identify, through a survey, how Peruvian gastroenterologists deal with Helicobacter pylori infection. MATERIAL AND METHODS: Gastroenterologists answered a survey concerning diagnosis and treatment of Helicobacter pylori infection. RESULTS: 177 valid answers were obtained (29.6% of the population). Within the main results, 77.4% use endoscopy + biopsy (histology) for diagnosis, 95.5% choose proton pump inhibitor + clarithromycin + amoxicillin as first line treatment and 50.0% check for eradication 4-6 weeks after treatment. CONCLUSIONS: Most gastroenterologists in Peru deal adequately with Helicobacter pylori infection, although follow-up aspects could be improved.


Assuntos
Gastroenterologistas , Infecções por Helicobacter , Padrões de Prática Médica/estatística & dados numéricos , Assistência ao Convalescente/métodos , Assistência ao Convalescente/estatística & dados numéricos , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Biópsia/estatística & dados numéricos , Claritromicina/uso terapêutico , Quimioterapia Combinada , Endoscopia Gastrointestinal/estatística & dados numéricos , Feminino , Pesquisas sobre Atenção à Saúde , Infecções por Helicobacter/diagnóstico por imagem , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/patologia , Humanos , Masculino , Peru , Inibidores da Bomba de Prótons/uso terapêutico
18.
J Mol Cell Cardiol ; 68: 98-105, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24412531

RESUMO

In heart failure mitochondrial dysfunction is thought to be responsible for energy depletion and contractile dysfunction. The difficulties in procuring fresh left ventricular (LV) myocardium from humans for assessment of mitochondrial function have resulted in the reliance on surrogate markers of mitochondrial function and limited our understanding of cardiac energetics. We isolated mitochondria from fresh LV wall tissue of patients with heart failure and reduced systolic function undergoing heart transplant or left ventricular assist device placement, and compared their function to mitochondria isolated from the non-failing LV (NFLV) wall tissue with normal systolic function from patients with pulmonary hypertension undergoing heart-lung transplant. We performed detailed mitochondrial functional analyses using 4 substrates: glutamate-malate (GM), pyruvate-malate (PM) palmitoyl carnitine-malate (PC) and succinate. NFLV mitochondria showed preserved respiratory control ratios and electron chain integrity with only few differences for the 4 substrates. In contrast, HF mitochondria had greater respiration with GM, PM and PC substrates and higher electron chain capacity for PM than for PC. Surprisingly, HF mitochondria had greater respiratory control ratios and lower ADP-independent state 4 rates than NFLV mitochondria for GM, PM and PC substrates demonstrating that HF mitochondria are capable of coupled respiration ex vivo. Gene expression studies revealed decreased expression of key genes in pathways for oxidation of both fatty acids and glucose. Our results suggest that mitochondria from the failing LV myocardium are capable of tightly coupled respiration when isolated and supplied with ample substrates. Thus energy starvation in the failing heart may be the result of dysregulation of metabolic pathways, impaired substrate supply or reduced mitochondrial number but not the result of reduced mitochondrial electron transport capacity.


Assuntos
Insuficiência Cardíaca/metabolismo , Mitocôndrias Cardíacas/metabolismo , Adulto , Antígenos CD36/genética , Antígenos CD36/metabolismo , Estudos de Casos e Controles , Respiração Celular , Complexo I de Transporte de Elétrons/metabolismo , Complexo II de Transporte de Elétrons/metabolismo , Feminino , Insuficiência Cardíaca/patologia , Ventrículos do Coração/metabolismo , Ventrículos do Coração/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Oxirredução , Oxigênio/metabolismo , Transcriptoma , Adulto Jovem
19.
Zool Stud ; 62: e57, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38628161

RESUMO

Understanding and preserving biodiversity in natural habitats is crucial due to their rapid degradation and destruction. The meiofauna of natural areas is less well known than the macroscopic life. Tardigrades are common in limno-terrestrial meiofauna and can indicate environmental conditions. In this study, we expand our understanding of the taxonomy and ecology of tardigrade communities in two natural reserves in Argentina by examining the environmental factors that can affect them and the species that could be used as indicators. In 2018, sampling occurred in the Parque Luro Provincial Reserve (province of La Pampa) and the Poligono A Municipal Ecological Reserve (province of Salta). Samples were taken from epiphytic communities that grow on the bark of trees. Various environmental and microhabitat factors were taken into account. In the province of La Pampa, there were 1326 specimens of five species, and in the province of Salta, there were 212 specimens of nine species. The tardigrade communities in Salta exhibited statistically higher diversity than those in La Pampa. Temperature and moisture affected the tardigrade community of Parque Luro Provincial Reserve, while the microhabitat thickness affected those of Poligono A Municipal Ecological Reserve. The species turnover shaped the community of Salta, while nesting shaped the community of La Pampa.

20.
J Eval Clin Pract ; 28(6): 1138-1146, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35599434

RESUMO

RATIONALE, AIMS AND OBJECTIVES: Clinical Practice Guidelines (CPGs) have been shown to improve healthcare services and clinical outcomes. However, they are useful resources only to the degree that they are developed according to the most rigorous standards. Multiple studies have demonstrated significant variability between CPGs with regard to specific indicators of quality. The Ordre des psychologues du Québec (OPQ), the College of psychologists of Quebec, has published several CPGs that are intended to provide empirically supported guidance for psychologists in the areas of assessment, diagnosis, general functioning, treatment and other decision-making support. The aim of this study was to evaluate the quality of these CPGs. METHODS: The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to assess the quality of the CPGs. RESULTS: Our results show that although there have been some modest improvements in quality of the CPGs over time, there are important methodological inadequacies in all CPGs evaluated. CONCLUSIONS: The findings of this study demonstrate the need for more methodological rigour in CPGs development as such, recommendations to improve CPG quality are discussed.


Assuntos
Prática Psicológica , Humanos , Quebeque
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