ABSTRACT
BACKGROUND: Despite an increase in patients with end-stage heart failure, the acceptance rate has been going down in recent years owing to a change in donor demographics. Furthermore, the rate of emergency heart transplantation has progressively increased. The result is an increase in the time awaiting heart transplantation in elective patients and therefore in the risk of sudden death in this population. Implantable cardioverter defibrillators (ICDs) could be a preventive option in these cases. However, indications for the implantation in this population are not well established. OBJECTIVE: We sought to evaluate the effectiveness of ICDs for primary prevention in patients with left ventricular ejection fraction (LVEF) ≤ 30% included on the heart transplantation list. METHODS: Records from patients accepted for heart transplantation in our institution from January 1, 2006, to July 30, 2012, and whose LVEF was <31% were reviewed. Patients who received ICDs for primary prevention (n = 28) were compared with patients without ICDs (n = 51). Descriptive and univariate (χ(2) and t tests) statistics and Kaplan-Meier survival curves were used for analyses. RESULTS: With a median follow-up of 77 days (range 1-1,231), the overall mortality in the ICD group was 7.1% (2/28) and in the non-ICD group was 17.6% (9/51; P = .062). The main cause of death in patients without ICDs was sudden death (5/9, 55.6%), followed by heart failure (4/9, 44.4%). In patients with ICDs, heart failure was the only reported cause of death. Appropriate ICD therapies were recorded in 42.9% (12/28) in this population. CONCLUSIONS: This study suggests that ICD could reduce the risk of sudden death in patients with LVEF ≤ 30% while awaiting heart transplantation. However, more studies are needed to confirm these results.
Subject(s)
Death, Sudden, Cardiac/prevention & control , Defibrillators, Implantable , Electric Countershock/instrumentation , Heart Failure/therapy , Heart Transplantation , Primary Prevention/instrumentation , Ventricular Dysfunction, Left/therapy , Ventricular Function, Left , Waiting Lists , Adult , Aged , Cause of Death , Chi-Square Distribution , Death, Sudden, Cardiac/etiology , Electric Countershock/adverse effects , Electric Countershock/mortality , Female , Heart Failure/complications , Heart Failure/diagnosis , Heart Failure/mortality , Heart Failure/physiopathology , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Retrospective Studies , Risk Factors , Stroke Volume , Time Factors , Treatment Outcome , Ventricular Dysfunction, Left/diagnosis , Ventricular Dysfunction, Left/etiology , Ventricular Dysfunction, Left/mortality , Ventricular Dysfunction, Left/physiopathology , Waiting Lists/mortalityABSTRACT
Recycling of municipal wastewater requires treatment with flocculants, such as polyacrylamide. It is unknown how polyacrylamide in sludge affects removal of polycyclic aromatic hydrocarbons (PAH) from soil. An alkaline-saline soil and an agricultural soil were contaminated with phenanthrene and anthracene. Sludge with or without polyacrylamide was added while emission of CO(2) and concentrations of NH(4)(+), NO(3)(-), NO(2)(-), phenanthrene and anthracene were monitored in an aerobic incubation experiment. Polyacrylamide in the sludge had no effect on the production of CO(2), but it reduced the concentration of NH(4)(+), increased the concentration of NO(3)(-) in the Acolman soil and NO(2)(-) in the Texcoco soil, and increased N mineralization compared to the soil amended with sludge without polyacrylamide. After 112d, polyacrylamide accelerated the removal of anthracene from both soils and that of phenanthrene in the Acolman soil. It was found that polyacrylamide accelerated removal of phenanthrene and anthracene from soil.
Subject(s)
Anthracenes/isolation & purification , Flocculation , Nitrogen/chemistry , Phenanthrenes/isolation & purification , Soil Pollutants/isolation & purification , Polycyclic Aromatic Hydrocarbons/isolation & purificationABSTRACT
BACKGROUND: The identification of the molecular basis of disorders of keratinisation has significantly advanced our understanding of skin biology, revealing new information on key structures in the skin, such as the intermediate filaments, desmosomes, and gap junctions. Among these disorders, there is an extraordinarily heterogeneous group known as palmoplantar keratodermas (PPK), for which only a few molecular defects have been described. A particular form of PPK, known as punctate PPK, has been described in a few large autosomal dominant pedigrees, but its genetic basis has yet to be identified. AIM: Identification of the gene for punctate PPK. METHODS: Clinical examination and linkage analysis in three families with punctate PPK. RESULTS: A genomewide scan was performed on an extended autosomal dominant pedigree, and linkage to chromosome 15q22-q24 was identified. With the addition of two new families with the same phenotype, we confirmed the mapping of the locus for punctate PPK to a 9.98 cM interval, flanked by markers D15S534 and D15S818 (maximum two point lod score of 4.93 at theta = 0 for marker D15S988). CONCLUSIONS: We report the clinical and genetic findings in three pedigrees with the punctate form of PPK. We have mapped a genetic locus for this phenotype to chromosome 15q22-q24, which indicates the identification of a new gene involved in skin integrity.
Subject(s)
Chromosomes, Human, Pair 15 , Keratoderma, Palmoplantar/genetics , Chromosome Mapping , Female , Humans , Keratoderma, Palmoplantar/pathology , Male , Pedigree , PhenotypeABSTRACT
Antecedentes: La exploración del estado nutricional mediante métodos antropométricos incluye la medida de los pliegues cutáneos. El pliegue submandibular ha sido muy poco empleado en dicha valoración. Objetivos: Conocer los valores normales del pliegue submandibular en nuestra población y sus relaciones con otros parámetros antropométricos. Material y métodos: Se han estudiado 188 niños y 177 niñas sanos de 6 a 14 años de edad. Se midieron: peso, talla, perímetro braquial, pliegues cutáneos (submandibular, bicipital, tricipital, subescapular, suprailiaco), índice de masa corporal, índices de distribución grasa, indicadores de grasa corporal, para cada edad y sexo. Se calcularon los percentiles del pliegue submandibular, para cada edad y sexo; se compararon sus medidas entre sexos para cada edad mediante el test t de Student, y sus correlaciones con todos los parámetros antropométricos. Resultados: El valor máximo del pliegue submandibular en los niños es a los 12 años y en las niñas a los 11. No se han encontrado diferencias entre sexos. Las correlaciones más elevadas son con los otros pliegues cutáneos, con la suma de los pliegues y con el área grasa del brazo. Conclusiones: El pliegue submandibular tiene una alta correlación con los indicadores de grasa corporal. Por ello puede ser útil para valorar el estado nutricional en la infancia (AU)
Subject(s)
Adolescent , Female , Male , Child , Humans , Skinfold Thickness , Anthropometry , Nutritional Physiological PhenomenaABSTRACT
El objetivo de este estudio es conocer el perfil epidemiológico de las madres en tratamiento con metadona durante la gestación y caracterizar el síndrome de abstinencia en el recién nacido. Se revisan los aspectos maternos, perinatales y neonatales de 30 recién nacidos de madres en tratamiento con metadona que ingresaron en nuestra Unidad de Neonatología desde enero de 1995 hasta mayo de 2001.Los antecedentes más frecuentes en las madres estudiadas son: edad cercana a los 29 años, familia monoparental, con más de dos embarazos y frecuentes antecedentes de abortos, sin control obstétrico durante la gestación. El parto es generalmente eutócico y los test de Apgar, también suelen estar acordes a la normalidad. El neonato presenta bajo peso al nacimiento y el síndrome de abstinencia con casi total seguridad (29 de 30). El síndrome de abstinencia es de inicio precoz e intensidad y duración elevadas. Menos de tres horas de sueño y el llanto agudo son los síntomas más comunes al inicio y los más frecuentes en aparecer son los generales y neurológicos (AU)
Subject(s)
Pregnancy , Female , Pregnancy , Humans , Infant, Newborn , Neonatal Abstinence Syndrome , Methadone/therapeutic use , Methadone/adverse effects , Health ProfileABSTRACT
We describe 2 patients who both developed cellulitis due to Neisseria meningitidis and review 8 other cases reported since 1966. Female patients outnumbered male patients by 8 to 2, and there were 5 children and 5 adults. Four cases were caused by the serogroup C meningococcus, 2 cases by serogroup B and 2 others by serogroup Y (the nature of the meningococcal group was not available in 2 cases). Diverse medical underlying conditions were present in 4 of the adult patients. The periorbital region (in all 5 children), limb (in 3 adults), neck (in 1 adult) and face and neck (in 1 adult) were the locations of the meningococcal cellulitis. In all 10 patients, a favorable clinical response to the antibiotic therapy was documented and no relapses occurred. These cases indicate that N. meningitidis should be considered as a causative agent of cellulitis in the appropriate clinical setting, particularly in children with signs of periorbital infection or adults with underlying diseases.
Subject(s)
Cellulitis/microbiology , Meningococcal Infections/diagnosis , Acute Disease , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Infant , Male , Meningococcal Infections/complications , Middle AgedSubject(s)
Focal Dermal Hypoplasia/diagnosis , Aortic Valve Stenosis/diagnostic imaging , Echocardiography , Focal Dermal Hypoplasia/psychology , Humans , Infant , Infant, Newborn , Intellectual Disability/etiology , Male , Pelvic Bones/abnormalities , Pelvic Bones/diagnostic imaging , Psychomotor Disorders/etiology , RadiographyABSTRACT
The authors evaluated the anti-inflammatory effect of nordihydroguaiaretic acid (NDGA) and dexamethasone on an endotoxin induced uveitis (EIU) model, in rabbits. Six groups of 12 rabbits were formed. In groups II to V a uveitis was induced by an intravitreal injection of 5 ul of saline, containing 10 ng of endotoxin of Salmonella typhi. In group I, which is considered as the control, an intravitreal injection of 5 ul of saline was given. Each group received a different treatment and the inflammatory reaction was evaluated after 24 hours, quantifying the following parameters: clinical scoring, cells, proteins, PGE2, LTB4 in the aqueous and histopathological scoring. Compared to group II (non treated), group VI (treated with intraperitoneal 2 mg/kg dexamethasone) showed a decrease of 61% of proteins and LTB4, and a decrease of more than 90% of the other parameters studied. All these differences are statistically significant (p < 0.001). In groups III (intraperitoneal NDGA 10 mg/kg), IV and V (NDGA 1% topically every two and four hours respectively), the proteins showed a change of less than 5.5% and the PGE2 was reduced to around 50% compared to group II; these changes are not statistically significant (p > 0.05). The authors observed an important and significant decrease of the other parameters when compared to group II (p < 0.001). It can be concluded that at the doses given here, NDGA shows an effective action on the lipoxygenase pathway without an increase of the production of PGE2.