ABSTRACT
BACKGROUND AND PURPOSE: The purpose of this study is to evaluate the feasibility of using 3-dimensional (3D) ultra-short echo time (UTE) radial imaging method for measurement of the permeability of the blood-brain barrier (BBB) to gadolinium-based contrast agent. In this study, we propose to use the golden-angle radial sparse parallel (GRASP) method with 3D center-out trajectories for UTE, hence named as 3D UTE-GRASP. We first examined the feasibility of using 3D UTE-GRASP dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) for differentiating subtle BBB disruptions induced by focused ultrasound (FUS). Then, we examined the BBB permeability changes in Alzheimer's disease (AD) pathology using Alzheimer's disease transgenic mice (5xFAD) at different ages. METHODS: For FUS experiments, we used four Sprague Dawley rats at similar ages where we compared BBB permeability of each rat receiving the FUS sonication with different acoustic power (0.4-1.0 MPa). For AD transgenic mice experiments, we included three 5xFAD mice (6, 12, and 16 months old) and three wild-type mice (4, 8, and 12 months old). RESULTS: The result from FUS experiments showed a progressive increase in BBB permeability with increase of acoustic power (p < .05), demonstrating the sensitivity of DCE-MRI method for detecting subtle changes in BBB disruption. Our AD transgenic mice experiments suggest an early BBB disruption in 5xFAD mice, which is further impaired with aging. CONCLUSION: The results in this study substantiate the feasibility of using the proposed 3D UTE-GRASP method for detecting subtle BBB permeability changes expected in neurodegenerative diseases, such as AD.
Subject(s)
Alzheimer Disease , Blood-Brain Barrier , Contrast Media , Feasibility Studies , Magnetic Resonance Imaging , Mice, Transgenic , Rats, Sprague-Dawley , Blood-Brain Barrier/diagnostic imaging , Animals , Mice , Magnetic Resonance Imaging/methods , Rats , Alzheimer Disease/diagnostic imaging , Alzheimer Disease/metabolism , Capillary Permeability/physiology , Imaging, Three-Dimensional/methodsABSTRACT
Synaptic spine loss is an early pathophysiologic hallmark of Alzheimer disease (AD) that precedes overt loss of dendritic architecture and frank neurodegeneration. While spine loss signifies a decreased engagement of postsynaptic neurons by presynaptic targets, the degree to which loss of spines and their passive components impacts the excitability of postsynaptic neurons and responses to surviving synaptic inputs is unclear. Using passive multicompartmental models of CA1 pyramidal neurons (PNs), implicated in early AD, we find that spine loss alone drives a boosting of remaining inputs to their proximal and distal dendrites, targeted by CA3 and entorhinal cortex (EC), respectively. This boosting effect is higher in distal versus proximal dendrites and can be mediated by spine loss restricted to the distal compartment, enough to impact synaptic input integration and somatodendritic backpropagation. This has particular relevance to very early stages of AD in which pathophysiology extends from EC to CA1.
ABSTRACT
Rabies is a zoonotic disease that affects livestock worldwide. The distribution of rabies is highly correlated with the distribution of the vampire bat Desmodus rotundus, the main vector of the disease. In this study, climatic, topographic, livestock population, vampire distribution and urban and rural zones were used to estimate the risk for presentation of cases of rabies in Mexico by co- Kriging interpolation. The highest risk for the presentation of cases is in the endemic areas of the disease, i.e. the States of Yucatán, Chiapas, Campeche, Quintana Roo, Tabasco, Veracruz, San Luis Potosí, Nayarit and Baja California Sur. A transition zone for cases was identified across northern Mexico, involving the States of Sonora, Sinaloa, Chihuahua, and Durango. The variables topography, vampire distribution, bovine population and rural zones are the most important to explain the risk of cases in livestock. This study provides robust estimates of risk and spread of rabies based on geostatistical methods. The information presented should be useful for authorities responsible of public and animal health when they plan and establish strategies preventing the spread of rabies into rabies-free regions of México.
Subject(s)
Chiroptera , Rabies , Animals , Cattle , Rabies/epidemiology , Rabies/veterinary , Mexico/epidemiology , Risk Factors , Environment , LivestockABSTRACT
BACKGROUND: The Pneumococcal conjugate vaccine (PCV) has decreased cases of invasive pneumococcal disease (IPD) worldwide. However, the impact of PCVs introduction may be affected by the serotype distribution in a specific context. METHODS: Cross-sectional multicenter passive surveillance study of IPD cases in pediatric patients hospitalized in Lima, Peru between 2016 and 2019 (after PCV13 introduction) to determine the serotype distribution and antimicrobial resistance of Streptococcus pneumoniae. Serotyping was performed by a sequential multiplex PCR and confirmed by whole genome sequencing. RESULTS: Eighty-five S. pneumoniae isolates were recovered (4.07/100,000 among children <60 months of age). Serotype 19A was the most common (49.4%). Children infected with serotype 19A in comparison with children infected with other serotypes were younger, had a lower rate of meningitis and higher rates of pneumonia, complicated pneumonia and antimicrobial resistance; 28.6% of patients with serotype 19A have received at least one dose of PCV13 vs. 62.8% of patients with other serotypes. Using MIC-breakpoints, 81.2% (56/69) of non-meningitis strains and 31.2% (5/16) of meningitis strains were susceptible to penicillin; 18.8% (3/16) of meningitis strains had intermediate resistance to ceftriaxone. Resistance to azithromycin was 78.8% (67/85). Serotype 19A frequency increased over time in the same study population, from 4.2% (4/96) in 2006-2008, to 8.6% (5/58) in 2009-2011, to 49.4% (42/85) in the current study (2016-2019) (p < 0.001). CONCLUSIONS: After PCV13 introduction in Peru, serotype 19A remains the most prevalent; however, the vaccination coverage is still not optimal. Therefore, additonal surveillance studies are needed to determine the remaining IPD burden.
Subject(s)
Anti-Infective Agents , Meningitis , Pneumococcal Infections , Pneumonia , Child , Humans , Infant , Streptococcus pneumoniae , Serogroup , Vaccines, Conjugate , Child, Hospitalized , Peru/epidemiology , Cross-Sectional Studies , Pneumococcal Vaccines , Pneumococcal Infections/epidemiology , Pneumococcal Infections/prevention & control , SerotypingABSTRACT
Background: Cancer is the second cause of death all over the world and it causes considerable morbidity, disability, and treatment sequela, which often lead to post-treatment pain and disfigurement. This study aims to evaluate such physical sequelae, and their psychological, (cognitive and emotional), impact, in a cohort of patients treated for Head and Neck (HNC) cancer, in search for methods to help such patients deal effectively with the psychological effects of their cancer treatments adverse consequences. Material and methods: The sample consists of 56 subjects, 47 men and 9 women, ranging from 47 years to 86 years of age, who were treated for head and neck cancers at Spanish Public General Hospital in the Otolaryngology Unit, Surgery Section. Two types of questionnaires were used in the study: the Questionnaire of Sequelae after Treatment of head and neck carcinoma and the State-Trait Anxiety Inventory (STAI-E and R). Results: With respect to anxiety, the study found high levels of state anxiety which was significantly associated with the degree of perception of social stigma but was not associated with the post-treatment sequelae themselves nor with the level of discomfort that such symptomatic sequelae produced. The presence of a post-surgical stoma with cannula, increased patient's stigma (both components: external rejection and self-rejection) and state anxiety ratings, while there was no difference in state anxiety between cannulated and non-cannulated patients. There are few differences between men and women in terms of the presence of anxiety and their responses are similar in terms of the after-effects of surgery. Conclusions: Our study confirmed that current treatments for Head and Neck carcinoma generate adverse symptomatic sequela that impose significant psychological and physical burden for these patients. We will discuss the various pathways for preventive intervention that these findings open up. (AU)
Subject(s)
Humans , Male , Female , Head and Neck Neoplasms/therapy , Mental Health , Surveys and Questionnaires , Anxiety/etiology , Anxiety/prevention & control , Anxiety Disorders , Depression/psychology , Quality of Life/psychologyABSTRACT
CONTEXT AND PURPOSE: This work aimed to study the seroprevalence of natural infection by T. gondii in different population segments of dogs from Aguascalientes, Mexico as well as its possible association with some risk factors. METHODS: The study included 210 clinically healthy dogs from three population segments: rural, stray and pet. A blood serum sample was collected on a single occasion and processed by indirect immunofluorescence considering a dilution of 1:16 as a positive reaction; the association between the presence of antibodies and the potential risk factors was estimated with logistic regression. RESULTS: The overall prevalence of anti-T. gondii antibodies in the studied population was 59% (123/210; CI 95% 51-65) being different between population segments, in rural dogs 74% (59/80; CI 95% 62-82), in stray dogs 60% (48/80; CI 95% 48-70) and in pet dogs 32% (16/50; CI 95% 19-46), the titers of the positive sera were in a range of 1:16-1:128. In rural dogs the seroprevalence according to the municipality was in a range of 55% to 100% finding positive dogs in all the studied municipalities. The zootechnical function of guarding the property in rural dogs was identified as a risk factor (OR 2.4), while in pet dogs it was living with cats (OR 7) as well as sharing the drinking water container (OR 4); in stray dogs it was not possible to identify any risk factor. CONCLUSIONS: This study documents the wide presence of anti-T. gondii antibodies in the population groups examined, this being more important in rural dogs.
Subject(s)
Dog Diseases , Toxoplasma , Toxoplasmosis, Animal , Animals , Dogs , Seroepidemiologic Studies , Mexico/epidemiology , Antibodies, Protozoan , Dog Diseases/epidemiology , Risk FactorsABSTRACT
OBJECTIVE: To determinate the frequency of Streptococcus pneumoniae nasopharyngeal carriers, serotypes and antimicrobial resistance in healthy children in Lima, Peru, post-PCV13 introduction and to compare the results with a similar study conducted between 2006 and 2008 before PCV7 introduction (pre-PCV7). METHODS: A cross-sectional multicenter study was conducted between January 2018 and August 2019 in 1000 healthy children under two years of age. We use standard microbiological methods to determinate S. pneumoniae from nasopharyngeal swab, Kirby Bauer and minimum inhibitory concentration methods to determinate antimicrobial susceptibility and whole genomic sequencing to determinate pneumococcal serotypes. RESULTS: The pneumococcal carriage rate was 20.8 % vs. 31.1 % in pre-PCV7 (p < 0.001). The most frequent serotypes were 15C, 19A and 6C (12.4 %, 10.9 % and 10.9 % respectively). The carriage of PCV13 serotypes after PCV13 introduction decreased from 59.1 % (before PCV7 introduction) to 18.7 % (p < 0.001). Penicillin resistance was 75.5 %, TMP/SMX 75.5 % and azithromycin 50.0 %, using disk diffusion. Penicillin resistance rates using MIC breakpoint for meningitis (MIC ≥ 0.12) increased from 60.4 % to 74.5 % (p = 0.001). CONCLUSION: The introduction of PCV13 in the immunization program in Peru has decreased the pneumococcal nasopharyngeal carriage and the frequency of PCV13 serotypes; however, there has been an increase in non-PCV13 serotypes and antimicrobial resistance.
Subject(s)
Anti-Infective Agents , Pneumococcal Infections , Humans , Child , Infant , Pneumococcal Infections/epidemiology , Pneumococcal Infections/prevention & control , Serogroup , Cross-Sectional Studies , Peru/epidemiology , Carrier State/microbiology , Streptococcus pneumoniae/genetics , Nasopharynx/microbiology , Penicillin Resistance , Pneumococcal Vaccines , Vaccines, ConjugateABSTRACT
Giardia is a protozoan that affects humans as well as a wide range of domestic species. It is distributed worldwide, and the highest frequency is seen in developing countries. Due to the potential for domestic cats to be carriers of this parasite and subsequently transmit the infection to humans, it is important to know the risk of transmission. For this reason, the objective of this study was to determine the frequency of this parasite in the cat population of the city of Santiago de Queretaro, Mexico, and identify the assemblages present to determine the role this host plays in public health, this being the first study of its type to be performed in the country. This was a cross-sectional study during which 200 fecal samples were collected from cats of both sexes and varying ages and strata of origin. The samples were analyzed by microscopy following the flotation technique, having obtained a general frequency of 25%. Giardia cysts were found at higher frequency in pasty stools. The assemblages found were zoonotic, specifically assemblage A, which suggests that the cat poses an important risk for the dissemination of the parasite to humans, making it an important public health problem.
ABSTRACT
Bovine tuberculosis (bTB) is a disease of cattle that represents a risk to public health and causes severe economic losses to the livestock industry. Recently, one of the strategies recommended for reducing the prevalence of the disease in animals is the use of the BCG vaccine, alone or in combination with proteins. It has been shown that the vaccine elicits a strong immune response, downsizes the number of animals with visible lesions, and reduces the rate of infection as well as the bacillary count. This paper, based on scientific evidence, makes suggestions about some practical vaccination alternatives that can be used in infected herds to reduce bTB prevalence, considering BCG strains, vaccine doses, routes of application, and age of the animals. Our conclusion is that vaccination is a promising alternative to be included in current control programs in underdeveloped countries to reduce the disease burden.
ABSTRACT
The objectives of the study were to estimate the prevalence of anti-Toxoplasma gondii antibodies in free-range chickens in Aguascalientes, Mexico, its association with certain risk factors, and the frequency of parasite DNA in the heart. Eighty-one small rural family farms were included, and blood and heart samples were taken from 150 clinically healthy, adult, free-range chickens. Serum samples were processed by indirect immunofluorescence antibody test considering a dilution of 1:16 as a positive reaction, while the DNA detection was done by PCR. The correlation between the presence of antibodies and the potential risk factors was estimated with logistic regression. The overall seroprevalence in the examined populations was 67%, with a range from 33% to 100% among municipalities, and 78% of the farms having at least one seropositive bird. The PCR test identified the presence of parasite DNA for one case only. Among the variables, the presence of cats and the presence of other animal species on the farm were the ones that had the highest values, while the presence of feral cats and the presence of noxious fauna were also identified as potential risk factors. The results indicate high soil contamination by T. gondii oocysts, which implies the active role of cats living on the farms.
Subject(s)
Cat Diseases , Parasites , Toxoplasmosis, Animal , Animals , Cats , Chickens , Seroepidemiologic Studies , Toxoplasmosis, Animal/epidemiology , Toxoplasmosis, Animal/parasitology , Mexico/epidemiology , DNAABSTRACT
Streptococcus pneumoniae upper respiratory infections and pneumonia are often treated with macrolides, but recently macrolide resistance is becoming an increasingly important problem. The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the National Immunization Program of Peru in 2015. This study aimed to evaluate the temporal evolution of macrolide resistance in S. pneumoniae isolates collected in five cross-sectional studies conducted before and after this vaccine introduction, from 2006 to 2019 in Lima, Peru. A total of 521 and 242 S. pneumoniae isolates recovered from nasopharyngeal swabs from healthy carrier children < 2 years old (2 carriage studies) and samples from normally sterile body areas from pediatric patients with invasive pneumococcal disease (IPD) (3 IPD studies), respectively, were included in this study. Phenotypic macrolide resistance was detected using the Kirby-Bauer method and/or MIC test. We found a significant increase in macrolide resistance over time, from 33.5% to 50.0% in carriage studies, and from 24.8% to 37.5% and 70.8% in IPD studies. Macrolide resistance genes [erm(B) and mef(A/E)] were screened using PCR. In carriage studies, we detected a significant decrease in the frequency of mef(A/E) genes among macrolide-resistant S. pneumoniae strains (from 66.7% to 50.0%) after introduction of PCV13. The most common mechanism of macrolide-resistant among IPD strains was the presence of erm(B) (96.0%, 95.2% and 85.1% in the 3 IPD studies respectively). Macrolide resistance was more common in serotype 19A strains (80% and 90% among carriage and IPD strains, respectively) vs. non-serotype 19A (35.5% and 34.4% among carriage and IPD strains, respectively). In conclusion, S. pneumoniae macrolide resistance rates are very high among Peruvian children. Future studies are needed in order to evaluate macrolide resistance trends among pneumococcal strains, especially now after the COVID-19 pandemic, since azithromycin was vastly used as empiric treatment of COVID-19 in Peru.
Subject(s)
COVID-19 , Pneumococcal Infections , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Cross-Sectional Studies , Drug Resistance, Bacterial , Humans , Infant , Macrolides/pharmacology , Pandemics , Peru/epidemiology , Pneumococcal Infections/epidemiology , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines , Serogroup , Streptococcus pneumoniae , Vaccines, ConjugateABSTRACT
The spatio-temporal epidemiology of rabies has related the influence of environmental factors and anthropogenic changes on the movements of the hematophagous bat Desmodus rotundus. In Mexico, D. rotundus is the main transmitter of the rabies virus for different livestock species, modifying annually the fluctuation of the number of cases of rabies and its dissemination in subtropical areas and regions considered free of the disease. The purpose of this study was to perform a descriptive analysis of the distribution of cases of rabies in Mexico, and to perform a time-series analysis to evaluate stationarity and to predict the number of cases for the following year. A total of 3,469 cases were reported in the period of interest, of which the 89.1% occurred in cattle, 4.3% in horses, 1.5% in sheep, 0.6% in goats, 0.01% in pig, 3.1% in vampire bats, 0.3% in cervids, 0.2% in skunks, 0.1% in insectivorous bats, 0.1% in foxes, 0.1% in buffaloes, and 0.02% in coatis; 0.5% were not identified. The most frequent antigenic variants reported were AgV11, AgV5, and AgV3, associated with D. rotundus. The distribution of cases in bats correlates with the distribution of cases in domestic and wild animals; however, cases were observed in wild species in non-endemic areas of Mexico, like the State of Chihuahua. The additive model used in the time-series analysis showed a seasonal pattern with a peak of cases at the beginning of each year, from January to March. The model showed a good predicting value; the Pearson correlation coefficient R2 was 0.705. The highest probability for the occurrence of rabies cases in the different species estimated by Ordinary Kriging was in the coast of the Gulf of Mexico, involving the states of Tamaulipas, Veracruz, Tabasco, Chiapas, and Yucatan. This study confirms that rabies in domestic and wild species is endemic in tropical and subtropical areas-however, cases have been observed in new geographic areas-and provides useful information to support actions to stop the spread of the rabies virus or the reservoir, and for planning vaccination strategies considering time and place.
ABSTRACT
RESUMEN: El Ambystoma mexicanum o comúnmente llamado axolote, es un anfibio miembro del género Ambystoma que comprende 32 especies presentes desde el sur de Canadá hasta la región central de México. Actualmente esta especie se encuentra en peligro de extinción debido a cambios fisicoquímicos en su medio ambiente y la depredación por organismos introducidos en su hábitat. Dentro de las múltiples estrategias para su conservación se encuentran el desarrollo de programas de investigación, educación y desarrollo del manejo clínico. El objetivo del presente trabajo estuvo enfocado en obtener y analizar datos morfométricos acompañados por una descripción de la anatomía externa e interna de la especie Ambystoma mexicanum con el propósito de contribuir a su conservación. Por lo anterior, cinco ejemplares de la especie Ambystoma mexicanum de 2 años, criados en cautiverio, fueron estudiados para obtener valores morfométricos externos e internos utilizando un calibrador vernier, balanzas analíticas y rayos X. Los resultados de la observación externa mostraron el dimorfismo sexual característico de estas especies presentes en la zona peri cloacal, además, el análisis radiográfico permitió observar y señalar algunas estructuras óseas del esqueleto axial y apendicular. Los ejemplares presentaron un peso promedio de 31,6 g y una longitud de 15,7 cm. Los miembros anteriores mostraron una longitud de 2,92 cm y 2,8 cm en los miembros posteriores. El análisis de los órganos internos mostró que el corazón tiene un peso de 0,036 g y una longitud de 0,75 cm, los pulmones un peso de 0,019 g y una longitud de 2,6 cm, el estómago arrojó una longitud de 4,86 cm y el intestino 10,88 cm. En conclusión, los valores presentados en el presente trabajo sirven de referencia en futuros trabajos de investigación clínica veterinaria y manejo zootécnico del axolote para su conservación y preservación.
SUMMARY: The Ambystoma mexicanum commonly known as axolotl, is an amphibian and member of the genus Ambystoma which includes 32 species that can be found from southern Canada to central Mexico. Currently this species is in danger of extinction due to physicochemical changes in its environment and predation by organisms introduced into its habitat. Among the multiple strategies to aid in its conservation are the development of research programs, education and development of clinical management. The objective of this work is focused on obtaining and analyzing morphometric data accompanied by a description of the external and internal anatomy of the species Ambystoma mexicanum with the purpose of contributing to the conservation of this species. Therefore, five 2-year-old specimens of the Ambystoma mexicanum species, raised in captivity, were studied to obtain external and internal morphometric values using a vernier caliper, analytical balances and X-rays. The results of external observation showed the characteristic sexual dimorphism of these species present in the pericloacal zone. Furthermore, the radiographic analysis allowed to observe and point out some bony structures of the axial and appendicular skeleton. The specimens presented an average weight of 31.60 g and a length of 15.70 cm. The forelimbs showed a length of 2.92 cm and 2.8 cm in the hindlimbs. Analysis of the internal organs showed that the heart had a weight of 0.036 g and a length of 0.75 cm, the lungs a weight of 0.019 g and a length of 2.6 cm, the stomach had a length of 4.86 cm and the intestine 10.88 cm. In conclusion, the values presented in this work serve as a reference for future veterinary clinical research and zootechnical management of the axolotl for its conservation and preservation.
Subject(s)
Animals , Ambystoma mexicanum/anatomy & histology , Anatomy, VeterinaryABSTRACT
Bovine paralytic rabies (BPR) is a form of viral encephalitis that is of substantial economic importance throughout Latin America, where it poses a major zoonotic risk. Here, our objective was to utilize a laboratory protocol to determine the relative copy number of the rabies virus (RABV) genome in different bovine brain anatomical structures using quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). qRT-PCR quantifies the specific number of gene copies present in a sample based on fluorescence emitted after amplification that is directly proportional to the amount of target nucleic acid present in the sample. This method is advantageous owing to its short duration, reduced risk of contamination, and potential to detect viral nucleic acids in different samples more easily compared to other techniques. The brains of six rabid animals were divided into six anatomical structures, namely the Ammon's horn, cerebellum, cortex, medulla, pons, and thalamus. All brains were identified as positive for RABV antigens based on a direct immunofluorescence test. The same anatomical structures from the brains of four RABV-negative bovines were also assessed. RNA was extracted from each structure and used for qRT-PCR. An assay was performed to determine the copy numbers of RABV genes using an in vitro transcribed nucleoprotein gene. The standard curve used to quantify viral RNA exhibited an efficiency of 100% and linearity of 0.99. Analysis revealed that the cortex, medulla, and thalamus were the ideal CNS portions for use in RABV detection, based on the observation that these structures possessed the highest levels of RABV. The test specificity was 100%. All samples were positive, no false positives were detected. This method can be used to detect RABV in samples that contain low levels of RABV during diagnosis of BPR.
Subject(s)
Rabies virus , Rabies , Animals , Brain/virology , Cattle , RNA, Viral/genetics , Rabies/veterinary , Rabies virus/genetics , Real-Time Polymerase Chain ReactionABSTRACT
Attempts to improve the immune response and efficacy of vaccines against tuberculosis in cattle, goats, and other animal species have been the focus of research in this field during the last two decades. Improving the vaccine efficacy is essential prior to running long-lasting and expensive field trials. Studies have shown that vaccine protocols utilizing boosting with proteins improve the vaccine efficacy. The use of polymers such as chitosan and PolyLactic-co-Glycolic Acid (PLGA) improves the immune response against different diseases by improving the interaction of antigens with the cellular immune system and modulating the host immune response. This study shows that the prime BCG vaccination, boosted with a culture filtrate protein (CFP), alone or in combination with chitosan and PolyLactic-co-Glycolic Acid (PLGA), have the potential to reduce tuberculosis (TB) dissemination by reducing the number of animals with lesions, the number of lesions per animal, and the size of the lesions in vaccinated animals, compared with those not vaccinated or those vaccinated with BCG alone. The vaccinated groups showed significantly higher Interferon-γ levels in the blood compared to the control, nonvaccinated group after vaccination, after boosting, and after the challenge with the wild-type Mycobacterium bovis strain.
ABSTRACT
Fetal sex discordance is an entity that is becoming more frequent due to the expansion of the cfDNA for prenatal diagnosis. Its incidence can be estimated in 1/1500-2000 pregnancies, a frequency as high as that of some common chromosomopathies. The causes of this phenomenon are multiple and diverse, ranging from laboratory errors to important pathologies such as disorders of sexual differentiation. The management of a case of fetal sex discordance must be structured, starting with the review of the clinical history and the tests performed, and may require the performance of invasive tests to reach a diagnosis. Prevention through adequate pretest counseling and ultrasound confirmation can help to reduce its incidence.
Subject(s)
Maternal Serum Screening Tests/standards , Sex Characteristics , Sex Determination Analysis/standards , Cell-Free Nucleic Acids/standards , Disorders of Sex Development/diagnosis , Female , Humans , Pregnancy , Ultrasonography, PrenatalABSTRACT
The most common indications for early liver retransplantation (eRe-LT) are vascular complications and primary nonfunction (PNF). These patients are usually in a critical clinical condition that can affect their chances of survival. In fact, the survival of these patients is usually lower compared with the patients undergoing a first transplant. To the best of our knowledge, no specific series of pediatric patients undergoing eRe-LT has been published to date. Therefore, the aim of this study is to report the results of eRe-LT and to analyze factors potentially related to success or failure. Our work is of a retrospective cohort study of patients who underwent eRe-LT at the Juan P. Garrahan Pediatric Hospital of Buenos Aires, Argentina, between May 1995 and December 2018 (n = 60). Re-LT was considered early when performed ≤30 days after the previous LT. A total of 40 (66.7%) patients were enrolled due to vascular causes and 20 (33.3%) were enrolled because of PNF. Of all the relisted patients, 36 underwent eRe-LT, 14 died on the waiting list, and 10 recovered without eRe-LT. A total of 23 (63.9%) patients died after eRe-LT, most of them due to infection-related complications. Survival rates at 1 and 5 years were 42.4% and 33.9%, respectively. On univariate logistic regression analysis, Pediatric End-Stage Liver Disease (PELD)/Model for End-Stage Liver Disease (MELD) scores, transplant era, and advanced life support at eRe-LT were found to be related to 60-day mortality. However, on multivariate analysis, era (odds ratio [OR], 9.3; 95% confidence interval [CI], 1.19-72.35; P = 0.033) and PELD/MELD scores (OR, 1.07; 95% CI, 1-1.14; P = 0.036) were significantly associated with 60-day patient mortality. This study found that the level of acuity before retransplant, measured by the requirement of advanced life support and the PELD/MELD score at eRe-LT, was significantly associated with the chances of post-eRe-LT patient survival.
Subject(s)
End Stage Liver Disease , Liver Transplantation , Argentina , Child , End Stage Liver Disease/diagnosis , End Stage Liver Disease/surgery , Humans , Liver Transplantation/adverse effects , Prognosis , Reoperation , Retrospective Studies , Severity of Illness Index , Waiting ListsABSTRACT
The population activity of CA1 pyramidal neurons (PNs) segregates along anatomical axes with different behaviors, suggesting that CA1 PNs are functionally subspecialized based on somatic location. In dorsal CA1, spatial encoding is biased toward CA2 (CA1c) and in deep layers of the radial axis. In contrast, nonspatial coding peaks toward subiculum (CA1a) and in superficial layers. While preferential innervation by spatial vs. nonspatial input from entorhinal cortex (EC) may contribute to this specialization, it cannot fully explain the range of in vivo responses. Differences in intrinsic properties thus may play a critical role in modulating such synaptic input differences. In this study we examined the postsynaptic integrative properties of dorsal CA1 PNs in six subpopulations along the transverse (CA1c, CA1b, CA1a) and radial (deep, superficial) axes. Our results suggest that active and passive properties of deep and superficial neurons evolve over the transverse axis to promote the functional specialization of CA1c vs. CA1a as dictated by their cortical input. We also find that CA1b is not merely an intermediate mix of its neighbors, but uniquely balances low excitability with superior input integration of its mixed input, as may be required for its proposed role in sequence encoding. Thus synaptic input and intrinsic properties combine to functionally compartmentalize CA1 processing into at least three transverse axis regions defined by the processing schemes of their composite radial axis subpopulations.NEW & NOTEWORTHY There is increasing interest in CA1 pyramidal neuron heterogeneity and the functional relevance of this diversity. We find that active and passive properties evolve over the transverse and radial axes in dorsal CA1 to promote the functional specialization of CA1c and CA1a for spatial and nonspatial memory, respectively. Furthermore, CA1b is not a mean of its neighbors, but features low excitability and superior integrative capabilities, relevant to its role in nonspatial sequence encoding.