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1.
Trop Anim Health Prod ; 54(2): 130, 2022 Mar 08.
Article in English | MEDLINE | ID: mdl-35258761

ABSTRACT

Desmodus rotundus is one of the wild animal species that has benefitted by habitat alteration and its population has increased due to livestock activities. Common vampire bat population management has been implemented across Mexico due to the economic losses to livestock production, inflicted by vampire bat attacks and rabies transmission. Yucatan is one of the seven most impacted states in Mexico by the number of cattle rabies cases per year. However, there is little research on D. rotundus populations such as the frequency and attack patterns to cattle. This study's objective was to analyze the relationship between D. rotundus abundance and number of bovines attacked in livestock landscapes in Yucatan. The study used data gathered by the State Committee for Protection and Promotion of Livestock in Yucatan through the National Campaign for Common Vampire Bat Population Control. Data collected from January 2014 to December 2017 was analyzed using Pearson correlation. Distribution maps on Desmodus rotundus abundance and number of bovines attacked were also created. Higher abundance of Desmodus rotundus and number of cattle attacks were observed in the central region of Yucatan, particularly in Izamal municipality. Positive correlations were found between (1) abundance of Desmodus rotundus and number of cattle in the region, (2) total number of cattle and number of cattle attacked, and (3) abundance of Desmodus rotundus and number of cattle attacked. We can conclude that there is a relationship between Desmodus rotundus abundance and frequency of cattle attacks in most municipalities across Yucatan. Some outstanding exceptions were observed, which require further detailed investigations.


Subject(s)
Cattle Diseases , Chiroptera , Rabies virus , Rabies , Animals , Cattle , Cattle Diseases/prevention & control , Mexico/epidemiology , Rabies/veterinary
2.
Healthcare (Basel) ; 9(8)2021 Aug 19.
Article in English | MEDLINE | ID: mdl-34442202

ABSTRACT

Bright light therapy (BLT) has demonstrated positive short- and long-term effects in people with cognitive impairment or dementia; however, the immediate impact of BLT sessions has been scarcely investigated. In this study, we aimed to explore the immediate effects of BLT on behavior, mood, and physiological parameters (oxygen saturation/heart rate) in a sample of institutionalized older adults with moderate to very severe dementia, with a median age of 85.0 (interquartile range, IQR, 82.0-90.0), being higher in men (87.0 years, IQR 80.0-94.0) than in women (84.5 years, IQR 82.0-89.5). The BLT protocol consisted of 30-min morning sessions of 10,000 lux, Monday through Friday, for 4 weeks. The physiological parameters were recorded immediately before and after each session by pulse oximetry. Mood and behavior were assessed before, after, and during the sessions using the Interact scale. Post-session Interact scores showed a significant decrease in the items Tearful/sad and Talked spontaneously, and a significant increase in the items Enjoying self, active or alert, and Relaxed, content or sleeping appropriately. Interact scores during the sessions reflected a significant decrease in the speech-related items. Both physiological parameters changed positively from before to after sessions. Our results suggest that BLT provides immediate positive effects on mood, stimulation level, and physiological parameters, as well as a trend toward decreased speech. More robust research is needed to further explore the immediate impact of BLT. This study is registered with Clinicaltrials.gov (NCT04949984).

3.
Geriatr Nurs ; 41(6): 970-983, 2020.
Article in English | MEDLINE | ID: mdl-32758377

ABSTRACT

This systematic review aims to assess the efficacy of light therapy on behavioural and psychological symptoms of dementia (BPSD), cognition, functional status, and quality of life in older adults with cognitive impairment; and secondarily, to identify the optimal characteristics of light therapy to establish an adequate protocol for its clinical application. We searched Web of Science and Medline databases through December 2019, resulting in 36 included articles: 3 evaluated the effects on BPSD, 25 on sleep, 12 on agitation, 10 on mood, 4 on neuropsychiatric symptoms, 4 on cognition, 2 on quality of life and 2 on functional status. Literature has shown potential evidence for positive effects of light therapy on managing sleep, behavioural and mood disturbances in people with cognitive impairment, but a limited effect on cognition, quality of life and functional status. This review provides guidelines for intervention protocols with light therapy in older people with cognitive impairment.


Subject(s)
Cognitive Dysfunction , Dementia , Aged , Cognition , Cognitive Dysfunction/therapy , Dementia/therapy , Humans , Phototherapy , Quality of Life
4.
Front Psychol ; 11: 964, 2020.
Article in English | MEDLINE | ID: mdl-32499745

ABSTRACT

BACKGROUND: We explored sex-related differences in sociodemographic, medical, psychological, and functional conditions in older adults attending to senior citizens' centers. MATERIALS AND METHODS: An exploratory study was conducted as part of the VERISAÚDE project, a cross-sectional population-based study of individuals aged ≥65 years enrolled in senior community centers located in Galicia, Northwest of Spain (n = 749). A comprehensive gerontological evaluation was used to assess the social, medical, psychological, and functional characteristics of the sample. RESULTS: Women presented a higher prevalence of frailty (p = 0.017), a higher risk of malnutrition (p = 0.029), more medication consumption (p = 0.002), and polypharmacy (p = 0.008), higher depressive scores (p = 0.007), and lower cognitive scores (p = 0.045) than men, who showed a higher prevalence of hearing impairment (p = 0.034), toxic habits (all ps = 0.0001), and comorbidity (p = 0.002), and better quality of life (p = 0.030), and social resources (p = 0.002). Participants considered that attending and being involved in senior centers has a positive influence on their health and promotes successful aging. DISCUSSION: Important differences were found between women and men in health variables, suggesting that sex exerts a powerful influence on health status in older age. These differences should be identified and taking into account when designing interventions to promote active aging and to improve the quality of life of older adults. Taking a sex perspective during the evaluation process could lead to a higher number of older people being effectively treated in clinical practice.

5.
Front Plant Sci ; 10: 1544, 2019.
Article in English | MEDLINE | ID: mdl-31850032

ABSTRACT

Worldwide olive industry has expanded into new climatic regions outside the Mediterranean basin due to an increase in extra virgin olive oil demand posing new challenges. This is the case of Uruguay, South America, where the olive crop area reached 10,000 hectares in the last 15 years and is intended to the production of EVOO. Uruguay has a temperate humid climate with mean precipitations above 1,100 mm per year but unequally distributed, mild winters, and warm summers, with mean annual temperatures of 17.7°C. Different agroecological conditions require local knowledge to achieve good productivity whereby the objective of this work was to show the feasibility and potential of olive oil production under our climatic conditions. For this the agronomic performance of Arbequina, Barnea, Frantoio, Leccino, Manzanilla de Sevilla, and Picual cultivars was evaluated along 10 years of full production. Phenology behavior, vegetative growth rate, productive efficiency, alternate bearing, and oil yield were determined. Sprouting and flowering processes occur in a wide window within the annual cycle between the months of August to November with great interannual variation. More than 8 t/ha fruit yield and 40% oil yields in dry weight basis were obtained in promising cultivars. However, alternate bearing arose as the main production limiting factor, with ABI values greater than 0.60 for most cultivars. We conclude that olive oil production in humid climate regions is feasible and the most promising cultivars based on productive efficiency are Arbequina and Picual.

6.
J Med Entomol ; 56(5): 1331-1337, 2019 09 03.
Article in English | MEDLINE | ID: mdl-31120502

ABSTRACT

A cluster-randomized controlled trial quantified the entomological efficacy of aerial ultra-low volume (AULV) applications of the insecticide chlorpyrifos against Aedes aegypti in Puerto Vallarta, México, during November-October 2017. The trial involved 16 large (1 × 1 km) clusters distributed between treatment-control arms. Primary endpoint was the abundance of Ae. aegypti indoors (total adults, females, and blood-fed females) collected using Prokopack aspirators. After four consecutive weekly cycles of AULV, all adult Ae. aegypti infestation indices were significantly lower in the treatment arm (OR and IRR ≤ 0.28). Efficacy in reducing indoor Ae. aegypti increased with each weekly application cycle from 30 to 73% (total adults), 33 to 76% (females), and 45.5 to 89% (blood-fed females). Entomological indices remained significantly lower in the treatment arm up to 2 wk after the fourth spraying round. Performing AULV spraying can have significant and lasting entomological impact on Ae. aegypti as long as multiple (ideally four) spray cycles are implemented using an effective insecticide.


Subject(s)
Aedes , Chlorpyrifos , Insecticides , Mosquito Control , Animals , Female , Male , Mexico
7.
IDCases ; 15: e00519, 2019.
Article in English | MEDLINE | ID: mdl-30937284

ABSTRACT

We describe a case of immune reconstitution inflammatory syndrome (IRIS) secondary to reactivation of Mycobacterium tuberculosis in an HIV-infected patient with a high CD4+ cell count, who presented with a generalized seizure 6 weeks after starting antiretroviral therapy (ART). In our patient, the inflammatory response resulted in radiological features of neurological, pulmonary, and lymph node (LN) tuberculosis- (TB) IRIS, without the typical symptoms. Diagnosis was confirmed by LN biopsy and acid-fast bacilli (AFB) culture of LN and sputum. Treatment with isoniazid, rifabutin, ethambutol, and pyrazinamide was started in addition to continuation of ART. To our knowledge, we describe the first case of an atypical clinical presentation of an unmasking reaction of disseminated TB-IRIS in an HIV infected patient without acquired immune deficiency syndrome (AIDS), with restoring immunity during ART. Clinical and radiological predictors of TB-IRIS in co-infected patients starting ART are therefore essential in anticipating complications and facilitating expeditious management and prompt therapy.

8.
Maturitas ; 119: 54-60, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30502751

ABSTRACT

OBJECTIVES: Greater understanding of changes in the degree of frailty is important for clarifying the natural history of frailty and may help clinical decision-making regarding preventive interventions. The objectives of this study were to explore natural frailty transition rates at 1-year follow-up and to identify the main determinants of such transitions. STUDY DESIGN: Prospective longitudinal study covering a representative sample of community-dwelling older adults aged ≥65 years (n = 749) at baseline, and transition information at 1-year follow-up (n = 537). MEAN OUTCOME MEASURES: The assessment of frailty status was based on phenotypic criteria (unintentional weight loss, weakness, exhaustion, slow walking speed, low physical activity). Frailty transitions (progressed, regressed, no change, or death) and associated factors were assessed. RESULTS: Most participants remained unchanged from their baseline status (57.1% non-frail, 83.4% pre-frail, 66.7% frail). Regarding frailty transitions, 42.9% of non-frail older adults at baseline had progressed to a pre-frail status by the 1-year follow-up, and 7.9% of pre-frail older adults had become frail. Importantly, 33.3% of frail older adults regressed to a pre-frail status and 8.7% of pre-frail adults had regressed to a non-frail status. Non-frail females tended to progress to pre-frailty significantly more than males (p = 0.006), and mortality was higher among participants classified as frail at baseline (10.7%). Logistic regression showed that the main determinants of worsening frailty were hearing impairment (OR 3.180; 95% CI 1.078-9.384), congestive heart failure (OR 10.864; 95% CI 1.379-85.614), and polypharmacy (OR 2.572, 95% CI 1.096-6.037). CONCLUSION: Our results confirm the dynamic of frailty and the bidirectional nature of frailty transitions, and indicate the need for preventing and treating these conditions in later life in order to minimize the burden of frailty.


Subject(s)
Frailty/epidemiology , Frailty/physiopathology , Hearing Loss/epidemiology , Heart Failure/epidemiology , Polypharmacy , Aged , Aged, 80 and over , Comorbidity , Disease Progression , Female , Frailty/mortality , Geriatric Assessment , Humans , Independent Living , Longitudinal Studies , Male , Prospective Studies , Recovery of Function , Remission, Spontaneous , Spain/epidemiology
9.
BMC Geriatr ; 18(1): 66, 2018 03 07.
Article in English | MEDLINE | ID: mdl-29514599

ABSTRACT

BACKGROUND: Frailty is a multidimensional clinical geriatric syndrome that may be reversed in its early stages. Most studies have paid attention to its physical or phenotypic boundaries, however, little is known about the social aspects surrounding this geriatric syndrome. The study examined the relationship between socio-demographic factors, social resources, quality of life and frailty in older adults. METHODS: This cross-sectional study included a representative sample (n = 749) of adults aged ≥65 years enrolled in forty-three senior centers located in North-West Spain. Socio-demographic data, social resources by the Older Americans Resources and Services Scale, quality of life by the World Health Organization's Quality of Life measure-brief version (WHOQOL-BREF), and frailty status diagnosed by the Frailty phenotype were measured. RESULTS: Female gender, age older than 75 years, single marital status, a poor quality of life, and low scores in the physical health domain of the WHOQOL-BREF were the main determinants of being non-robust. Together, these variables explained 24.4% of the variance. Age between 80 and 89 years, and a poor quality of life were the main determinants for non-robust men, whilst the physical health domain of the WHOQOL-BREF was the single main determinant for women. CONCLUSIONS: Our study found evidence that physical frailty is associated with social determinants and several quality of life domains. More research on this understudied topic is needed to avoid healthcare expenditures and improve the quality of life of non-robust elders.


Subject(s)
Frail Elderly/psychology , Frailty/epidemiology , Frailty/psychology , Independent Living/psychology , Interpersonal Relations , Quality of Life/psychology , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Frailty/diagnosis , Geriatric Assessment/methods , Humans , Male , Physical Examination/methods , Spain/epidemiology , Surveys and Questionnaires , World Health Organization
10.
BMC Geriatr ; 17(1): 108, 2017 05 15.
Article in English | MEDLINE | ID: mdl-28506216

ABSTRACT

BACKGROUND: Frailty is a geriatric syndrome that affects multiple domains of human functioning. A variety of problems contributes to the development of this syndrome; poor nutritional status is an important determinant of this condition. The purpose of this systematic review was to examine recent evidence regarding the association between nutritional status and frailty syndrome in older adults. METHODS: PubMed, Web of Science, and Scopus electronic databases were searched using specific key words, for observational papers that were published during the period from 2005 to February 2017 and that studied the association or relationship between nutritional status and frailty in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed to assess the quality of the included articles. RESULTS: Of the 2042 studies found, nineteen met the inclusion criteria. Of these studies, five provided data on micronutrients and frailty, and reported that frailty syndrome is associated with low intakes of specific micronutrients. Five studies provided data on macronutrients and frailty, and among those studies, four revealed that a higher protein intake was associated with a lower risk of frailty. Three studies examined the relationship between diet quality and frailty, and showed that the quality of the diet is inversely associated with the risk of being frail. Two studies provided data on the antioxidant capacity of the diet and frailty, and reported that a high dietary antioxidant capacity is associated with a lower risk of developing frailty. Finally, seven studies evaluated the relationship between scores on both the Mini Nutritional Assessment (MNA) and the MNA-SF (Short Form) and frailty, and revealed an association between malnutrition and/or the risk of malnutrition and frailty. CONCLUSIONS: This systematic review confirms the importance of both quantitative (energy intake) and qualitative (nutrient quality) factors of nutrition in the development of frailty syndrome in older adults. However, more longitudinal studies on this topic are required to further understand the potential role of nutrition in the prevention, postponement, or even reversion of frailty syndrome.


Subject(s)
Frail Elderly , Frailty/diagnosis , Frailty/metabolism , Nutritional Status/physiology , Adult , Aged , Cross-Sectional Studies , Energy Intake/physiology , Female , Frailty/epidemiology , Humans , Male , Micronutrients/administration & dosage , Micronutrients/metabolism
11.
Geriatr Nurs ; 38(2): 110-118, 2017.
Article in English | MEDLINE | ID: mdl-27623026

ABSTRACT

Prevalence of neuropsychiatric symptoms (NPS) and correlation between its intensity and caregiver distress were evaluated as a function of the care-setting in a cross-sectional study including 72 patient-caregiver dyads. The Neuropsychiatric Inventory and the Caregiver Distress Scale were administered. The most prevalent symptoms were: in the formal care-setting, agitation/aggression and depression/dysphoria (42.4%), and in the informal care-setting, aberrant motor behavior (59.0%). While changes in appetite and eating behaviors, depression/dysphoria and irritability/lability were more prevalent in the formal care-setting (p < .0001, p = .011, p = .021), aberrant motor behavior was more prevalent in the informal care-setting (p = .007). NPS were positively correlated with caregiver distress. High patients' scores in hallucinations, sleep and night-time disturbances, anxiety, and aberrant motor behavior were the best predictors of professional caregiver's distress. Agitation/aggression, delusions, disinhibition, apathy/indifference, depression/dysphoria, and elation/euphoria were the best predictors of informal caregiver's distress. Findings may have important clinical implications.


Subject(s)
Caregivers/psychology , Stress, Psychological/psychology , Aged, 80 and over , Aggression , Alzheimer Disease/complications , Alzheimer Disease/epidemiology , Alzheimer Disease/nursing , Alzheimer Disease/psychology , Anxiety/etiology , Cross-Sectional Studies , Delusions/etiology , Depression/etiology , Female , Hallucinations/etiology , Humans , Male , Prevalence , Psychiatric Status Rating Scales
12.
Arch Gerontol Geriatr ; 61(3): 337-43, 2015.
Article in English | MEDLINE | ID: mdl-26321734

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the efficacy of a multimedia and interactive cognitive program on cognition and depressive symptomatology in healthy older adults. METHODS: Adults aged ≥65 years were randomly assigned to two groups: the experimental group in which the participants received a computerized cognitive training application; and the control group in which the participants received no intervention during the protocol. Performance on the mini-mental state examination (MMSE) and the short-form of the geriatric depression scale (GDS-SF) were analysed using a three-way repeated-measure analysis of variance. RESULTS: To determine cognition after the training, the cognitive program was used and the results were assessed using the MMSE, indicating that the significant time effects within the groups reflected the score for cognitive assessment that was significantly better after the intervention in the experimental group. No significant differences were observed with regard to the depressive symptomatology or between the groups according to sex or educational level on the two dimensions previously established (cognition and depressive symptomatology). CONCLUSION: The development of technological applications for intervention in older adults is increasing. Based on the established objective, we can conclude that the computerized intervention may constitute a good alternative to enhance the cognitive status in older people.


Subject(s)
Cognition Disorders/prevention & control , Cognition/physiology , Computers , Depression/prevention & control , Learning , Memory , Aged , Aged, 80 and over , Female , Humans , Male , Neuropsychological Tests
13.
Clin Interv Aging ; 10: 695-702, 2015.
Article in English | MEDLINE | ID: mdl-25914528

ABSTRACT

PURPOSE: The possible relationship between audiometric hearing thresholds and cognitive performance on language tests was analyzed in a cross-sectional cohort of older adults aged ≥65 years (N=98) with different degrees of cognitive impairment. MATERIALS AND METHODS: Participants were distributed into two groups according to Reisberg's Global Deterioration Scale (GDS): a normal/predementia group (GDS scores 1-3) and a moderate/moderately severe dementia group (GDS scores 4 and 5). Hearing loss (pure-tone audiometry) and receptive and production-based language function (Verbal Fluency Test, Boston Naming Test, and Token Test) were assessed. RESULTS: Results showed that the dementia group achieved significantly lower scores than the predementia group in all language tests. A moderate negative correlation between hearing loss and verbal comprehension (r=-0.298; P<0.003) was observed in the predementia group (r=-0.363; P<0.007). However, no significant relationship between hearing loss and verbal fluency and naming scores was observed, regardless of cognitive impairment. CONCLUSION: In the predementia group, reduced hearing level partially explains comprehension performance but not language production. In the dementia group, hearing loss cannot be considered as an explanatory factor of poor receptive and production-based language performance. These results are suggestive of cognitive rather than simply auditory problems to explain the language impairment in the elderly.


Subject(s)
Cognition , Hearing Loss/complications , Language Tests , Aged , Aged, 80 and over , Cross-Sectional Studies , Educational Status , Female , Hearing Tests , Humans , Male , Speech Perception
14.
Clin Interv Aging ; 9: 887-94, 2014.
Article in English | MEDLINE | ID: mdl-24940051

ABSTRACT

PURPOSE: Cognitive decline and depression are two common mental health problems that may create a need for long-term care among the elderly. In the last decade, the percentage of older adults who receive health care in nursing homes, day care centers, or home support services has increased in Europe. The objectives of this descriptive and nonrandomized longitudinal study were to evaluate and to compare the cognitive and affective evolution of day care versus institutionalized older patients through a 1-year period, and to assess the presence of cognitive and affective impairment as a function of the care setting. PATIENTS AND METHODS: Ninety-four patients were assessed at baseline, and 63 (67.0%) were reassessed 1 year later. Neuropsychological assessment included measures of cognitive performance (general cognitive status, visuospatial, and language abilities) and affective status (depressive symptoms). RESULTS: Our findings indicated that the majority of the participants (day care and institutionalized patients) had mild-moderate cognitive impairment at baseline, which significantly increased in both groups after 1-year follow-up. However, the rate of change in global cognitive function did not significantly differ between groups over time. Regarding language abilities, naming function maintained among day care patients in comparison with institutionalized patients, who showed worse performance at follow-up. As regards to affective status, results revealed that institutionalized patients had a significant reduction in depressive symptoms at follow-up, when compared to day care patients. Results also highlight the high frequency of cognitive impairment and depressive symptoms regardless of the care setting. CONCLUSION: Our findings revealed a similar global cognitive decline rate between patients receiving day care services and those residing in a nursing home at the 1-year follow-up, and slightly different trajectories in other outcomes such as naming function and depressive symptoms.


Subject(s)
Cognition Disorders/epidemiology , Day Care, Medical/psychology , Depression/epidemiology , Homes for the Aged , Institutionalization , Nursing Homes , Affect , Aged , Aged, 80 and over , Cognition Disorders/diagnosis , Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/epidemiology , Day Care, Medical/statistics & numerical data , Depression/diagnosis , Female , Homes for the Aged/statistics & numerical data , Humans , Institutionalization/statistics & numerical data , Longitudinal Studies , Male , Neuropsychological Tests , Nursing Homes/statistics & numerical data , Psychiatric Status Rating Scales
15.
Int J STD AIDS ; 25(5): 383-6, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24108450

ABSTRACT

Toxoplasma encephalitis (TE) is usually diagnosed in advanced stages of HIV infection when the CD4+ count is <100-200 cells/µl. A 55-year-old woman with HIV/AIDS, well controlled on antiretroviral therapy (ART), CD4+ count in the 300 cells/µl range for >1 year presented with acute onset of headache, nausea and vomiting. She had been on her current ART regimen consisting of raltegravir, co-formulated emtricitabine/tenofovir and etravirine for three years and had been off Pneumocystis prophylaxis for 10 months (trimethoprim-sulfamethoxazole). Brain MRI showed multiple ring-enhancing, supratentorial and infra-tentorial parenchymal lesions suspicious for metastases. She had no other evidence of metastatic disease in her body. The possibilities of TE and primary CNS lymphoma were considered but deemed unlikely given the high CD4+ count. A brain biopsy demonstrated Toxoplasma tachyzoites. There was no evidence of lymphoma or carcinoma. Anti-toxoplasma treatment yielded good initial clinical and radiographic responses. While on TE maintenance therapy, she developed similar symptoms. Repeat MRI showed progression of lesions. Further work-up including CSF Epstein-Barr virus PCR and SPECT Th 201 imaging was not conclusive for CNS lymphoma. The patient's clinical condition deteriorated and she died. We postulate that functional immunological dysfunction is a possible mechanism by which our patient developed TE despite demonstrating sustained immune response on ART.


Subject(s)
Antiretroviral Therapy, Highly Active , Encephalitis/diagnosis , HIV Infections/drug therapy , Toxoplasmosis, Cerebral/diagnosis , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Biopsy , CD4 Lymphocyte Count , Encephalitis/drug therapy , Fatal Outcome , Female , HIV Infections/virology , Humans , Immune Reconstitution Inflammatory Syndrome , Magnetic Resonance Imaging , Middle Aged , Toxoplasma/immunology , Toxoplasmosis, Cerebral/drug therapy , Toxoplasmosis, Cerebral/virology
16.
Int J Cardiol ; 166(2): 499-504, 2013 Jun 20.
Article in English | MEDLINE | ID: mdl-22178059

ABSTRACT

BACKGROUND/OBJECTIVES: Insufficient blood supply to the heart results in ischemic injury manifested clinically as myocardial infarction (MI). Following ischemia, inflammation is provoked and related to the clinical outcomes. A recent basic science study indicates that complement factor MASP-2 plays an important role in animal models of ischemia/reperfusion injury. We investigated the role of MASP-2 in human acute myocardial ischemia in two clinical settings: (1) Acute MI, and (2) Open heart surgery. METHODS: A total of 187 human subjects were enrolled in this study, including 50 healthy individuals, 27 patients who were diagnosed of coronary artery disease (CAD) but without acute MI, 29 patients with acute MI referred for coronary angiography, and 81 cardiac surgery patients with surgically-induced global heart ischemia. Circulating MASP-2 levels were measured by ELISA. RESULTS: MASP-2 levels in the peripheral circulation were significantly reduced in MI patients compared with those of healthy individuals or of CAD patients without acute MI. The hypothesis that MASP-2 was activated during acute myocardial ischemia was evaluated in cardiac patients undergoing surgically-induced global heart ischemia. MASP-2 was found to be significantly reduced in the coronary circulation of such patients, and the reduction of MASP-2 levels correlated independently with the increase of the myocardial necrosis marker, cardiac troponin I. CONCLUSIONS: These results indicate an involvement of MASP-2 in ischemia-related necrotic myocardial injury in humans.


Subject(s)
Mannose-Binding Protein-Associated Serine Proteases/metabolism , Myocardial Ischemia/blood , Myocardial Ischemia/enzymology , Myocardium/enzymology , Myocardium/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers/blood , Enzyme Activation/physiology , Female , Humans , Male , Middle Aged , Myocardial Ischemia/diagnosis , Necrosis , Young Adult
17.
J Am Vet Med Assoc ; 240(11): 1310-5, 2012 Jun 01.
Article in English | MEDLINE | ID: mdl-22607597

ABSTRACT

OBJECTIVE: To evaluate samarium Sm 153 lexidronam ((153)Sm-EDTMP) as a treatment option for dogs with bony tumors of the skull. DESIGN: Retrospective case series. ANIMALS: Dogs with multilobular osteochondrosarcoma (MLO) or osteosarcoma (OSA) of the skull. PROCEDURES: Veterinary Medical Teaching Hospital records from the Universities of Missouri and Florida from 1986 to 2006 were searched for dogs with primary skull tumors treated with (153)Sm-EDTMP. RESULTS: 25 dogs were initially evaluated, with 5 dogs subsequently excluded because of inadequate follow-up or unrelated death. Seven OSAs and 13 MLOs were diagnosed. Tumors involved the occipital and frontal bones (n = 10), zygomatic arch and maxilla region (6), palate (3), and mandible (1). No clinically important adverse effects related to (153)Sm-EDTMP treatment were documented. Of the 20 dogs evaluated 21 days after injection with (153)Sm-EDTMP, 4 had subjective improvement, 13 had progressive disease, and 3 had insufficient follow-up. On the basis of radiographic findings, metastasis was suspected in 1 dog; 16 dogs had no metastasis evident, and medical records were insufficient for 3 dogs. Survival time, defined as the (153)Sm-EDTMP injection date to the date of death, ranged from 3 to 1,314 days (median, 144 days). CONCLUSIONS AND CLINICAL RELEVANCE: The subjective improvement in 4 patients and lack of clinical evidence of adverse effects suggested that (153)Sm-EDTMP injection may be an option for the treatment of dogs with MLO or OSA of the skull when other treatments have failed or surgery is not possible.


Subject(s)
Analgesics, Non-Narcotic/therapeutic use , Antineoplastic Agents/therapeutic use , Organometallic Compounds/therapeutic use , Organophosphorus Compounds/therapeutic use , Osteosarcoma/veterinary , Skull Neoplasms/veterinary , Animals , Dog Diseases/drug therapy , Dogs , Female , Male , Osteosarcoma/drug therapy , Radioisotopes/therapeutic use , Retrospective Studies , Samarium/therapeutic use , Skull Neoplasms/drug therapy , Treatment Outcome
18.
Article in English | MEDLINE | ID: mdl-23882355

ABSTRACT

BACKGROUND: Congestive heart failure (CHF) is one of the leading causes of hospital readmissions within 30 days of discharge. Due to the substantial costs associated with these readmissions, several interventions to reduce CHF readmissions have been developed and implemented. METHODS: To reduce CHF readmissions at our community teaching hospital, the Smooth Transitions Equal Less Readmission (STELR) program was developed. Utilizing the Plan-Do-Check-Act cycle for quality improvement, resident physicians tracked patients enrolled in the STELR program. The resident contribution to the program was substantial in that they were able to quantify the improvement in both physician practices and patient readmissions. This provided insight into program areas requiring further modification, which the hospital would not have obtained without resident participation. RESULTS: The readmission rate for patients diagnosed with heart failure decreased from 32% prior to program implementation, to 24% hospital wide (including patients who were not tracked in the STELR program), and 21% among patients tracked by the residents. CONCLUSION: This effective CHF readmission reduction program requires less financial resources compared to government funded programs. The resident involvement in the STELR program helped to assess and improve the program and also allowed the residents to gain an awareness of the resources available to their patients to facilitate their transition home. The program exposed the residents to systems-based practice, a fundamental element of their residency training and, more generally, community care.

20.
BMC Genet ; 10: 73, 2009 Nov 13.
Article in English | MEDLINE | ID: mdl-19912643

ABSTRACT

BACKGROUND: This study is a comparative epigenetic evaluation of the methylation status of the DLC1 tumor suppressor gene in naturally-occurring canine lymphoma. Canine non-Hodgkin's lymphoma (NHL) has been proposed to be a relevant preclinical model that occurs spontaneously and may share causative factors with human NHL due to a shared home environment. The canine DLC1 mRNA sequence was derived from normal tissue. Using lymphoid samples from 21 dogs with NHL and 7 normal dogs, the methylation status of the promoter CpG island of the gene was defined for each sample using combined bisulfite restriction analysis (COBRA), methylation-specific PCR (MSP), and bisulfite sequencing methods. Relative gene expression was determined using real-time PCR. RESULTS: The mRNA sequence of canine DLC1 is highly similar to the human orthologue and contains all protein functional groups, with 97% or greater similarity in functional regions. Hypermethylation of the 5' and 3' flanking regions of the promoter was statistically significantly associated with the NHL phenotype, but was not associated with silencing of expression or differences in survival. CONCLUSION: The canine DLC1 is constructed highly similarly to the human gene, which has been shown to be an important tumor suppressor in many forms of cancer. As in human NHL, the promoter CpG island of DLC1 in canine NHL samples is abnormally hypermethylated, relative to normal lymphoid tissue. This study confirms that hypermethylation occurs in canine cancers, further supporting the use of companion dogs as comparative models of disease for evaluation of carcinogenesis, biomarker diagnosis, and therapy.


Subject(s)
CpG Islands , DNA Methylation , Dog Diseases/genetics , Gene Expression Regulation, Neoplastic , Lymphoma, Non-Hodgkin/veterinary , Tumor Suppressor Proteins/genetics , Amino Acid Sequence , Animals , Conserved Sequence , Dog Diseases/diagnosis , Dogs , Female , Humans , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/genetics , Male , Molecular Sequence Data , Promoter Regions, Genetic , Sequence Alignment , Tumor Suppressor Proteins/chemistry
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