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1.
Front Psychol ; 11: 2174, 2020.
Article in English | MEDLINE | ID: mdl-33013559

ABSTRACT

Organization-sponsored sharing platforms extend the sharing economy to workplaces by connecting employees in a private online community where they can socially exchange goods and services with coworkers. Employees share costs but do not earn income during this collaborative consumption. Furthermore, employers pay for their employees to have access to the platform technology and any related transaction fees. Trust is a crucial antecedent for engagement on sharing platforms because it helps mitigate risks during collaborative consumption. However, the literature on trust in the sharing economy has focused almost exclusively on platforms that broker peer-to-peer rental transactions rather than social exchanges. There is also a lack of research about providers' perspectives. We address these gaps by investigating the nature of trust among employees who initially provide goods and services on an organization-sponsored sharing platform. We also explore how these employees' initial trust influences their collaborative consumption with coworkers. Through abductive analysis of 22 interviews with 15 providers on an organization-sponsored sharing platform, we shed light on how employees initially develop trust when providing goods and services to coworkers. By integrating prior research on initial trust among employees and cognitive framing with in-depth qualitative insights, we develop a conceptual model depicting how identity, interaction and issue frames shape these providers' beliefs about coworker trustworthiness and intended sharing strategy. In particular, our empirical findings reveal that employees' social categorization, illusions of control and engagement motive framed their initial trust and enactment of collaborative consumption as citizens in a community or consumers in a marketplace.

2.
Plant Biol (Stuttg) ; 22(6): 1041-1051, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32609914

ABSTRACT

Pseudophoenix ekmanii is a critically endangered palm species that can be found in the southeast of the Dominican Republic. The temperatures to which P. ekmanii seeds are exposed upon dispersal range from 32 to 23 °C (max and min) and can reach a low of approximately 20 °C in January. Our aim was to analyse the effect of suboptimal (20 °C) and optimal (30 °C) germination temperature on seed imbibition, moisture content, embryo growth and gene expression patterns in this tropical palm species. Seed imbibition was tracked using whole seeds, while moisture content was assessed for individual seed sections. Embryo and whole seed size were measured before and after full imbibition. For transcriptome sequencing, mRNA was extracted from embryo tissues only and the resulting reads were mapped against the Elaeis guineensis reference genome. Differentially expressed genes were identified after statistical analysis and subsequently probed for enrichment of Gene Ontology categories 'Biological process' and 'Cellular component'. Our results show that prolonged exposure to 20 °C slows whole seed and embryo imbibition and causes germination to be both delayed and inhibited. Embryonic transcriptome patterns associated with the negative regulation of germination by suboptimal temperature include up-regulation of ABA biosynthesis genes, ABA-responsive genes, as well as other genes previously related to physiological dormancy and inhibition of germination. Thus, our manuscript provides the first insights into the gene expression patterns involved in the response to suboptimal temperature during seed imbibition in a tropical palm species.


Subject(s)
Arecaceae , Gene Expression Regulation, Plant , Germination , Seeds , Temperature , Arecaceae/genetics , Genes, Plant/genetics , Germination/genetics , Seeds/genetics
3.
J Hosp Infect ; 100(1): 92-98, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29608938

ABSTRACT

BACKGROUND: Emergency departments (EDs) carry a high risk of infectious disease transmission and have also been implicated in tuberculosis (TB) outbreaks. AIM: To determine if patients who visit EDs have an increased risk of TB infection. Using South Korean inpatient sample data (2012), the risk of TB occurrence during 90 days after hospitalization for patients admitted via EDs was compared with that for patients admitted via outpatient clinics. METHODS: The data of the 2012 Health Insurance Review and Assessment Service - National Inpatient Sample were used. TB diagnosis was based on International Classification of Diseases Version 10 [all TB (A15-A19), pulmonary TB (A15-A16) and extrapulmonary TB (A17-A18)]. FINDINGS: After propensity score matching using the demographic and clinical characteristics of the patients, 191,997 patients (64,017 patients admitted via EDs and 127,908 patients admitted via outpatient clinics) were included in this study. There was no significant difference in baseline patient characteristics between the two groups. The percentage of patients with TB admitted via EDs was higher than that of patients admitted via outpatient clinics. The likelihood of active TB occurrence was 30% higher for all TB [hazard ratio (HR) 1.30; 95% confidence interval (CI) 1.12-1.52] and pulmonary TB (HR 1.30; 95% CI 1.10-1.53) in patients admitted via EDs compared with patients admitted via outpatient clinics; this difference was significant. However, no difference in the occurrence of extrapulmonary TB was observed between the two groups. CONCLUSIONS: The likelihood of TB infection was greater in patients admitted via EDs than in patients admitted via outpatient clinics.


Subject(s)
Disease Transmission, Infectious , Emergency Medical Services/methods , Tuberculosis/epidemiology , Tuberculosis/transmission , Adult , Aged , Aged, 80 and over , Emergency Service, Hospital , Female , Humans , Male , Middle Aged , Propensity Score , Republic of Korea/epidemiology , Risk Assessment , Young Adult
4.
J Wound Care ; 26(12): 752-760, 2017 12 02.
Article in English | MEDLINE | ID: mdl-29244972

ABSTRACT

OBJECTIVE: This pilot study tested the reliability, validity and sensitivity of an innovative prototype iPad app, WoundAide, developed to measure wound dimension (length, width and surface area) using image analysis. METHOD: A prospective evaluation was conducted comparing WoundAide (WA) with two gold standard instruments, Wound Zoom (WZ) and Visitrak (VT). The study was conducted in a tertiary hospital in Singapore. Patients were recruited after obtaining local ethics approval. RESULTS: We recruited six patients with 10 venous wounds. Images were captured by two researchers. Generally, 7/10 (70%) of the wounds had surface areas of less than 16cm². The intraclass correlation coefficient was greater than 0.95 for length, width and surface area for all measuring devices. The mean differences for length, width and surface area were not statistically significant. The average percentage of coefficient of variation for WA ranged from 3% to 33.3%, WZ 1.3% to 19.3%, and VT 2.1% to 43.4%. Length, width and surface area fell within the 95% limit of agreement. The capturing sensitivity was, on average, 75% for WA, 99.4% for VT, and 100% for WZ. CONCLUSION: WA has similar reliability and validity as WZ and VT. However, WA has the least sensitivity in image captures. Nonetheless, with enhancements made to its user-interface and system algorithm, this limitation can be addressed.


Subject(s)
Computers, Handheld , Foot Ulcer/diagnosis , Mobile Applications , Varicose Ulcer/diagnosis , Adult , Aged , Female , Foot Ulcer/pathology , Humans , Image Processing, Computer-Assisted , Leg Ulcer/diagnosis , Leg Ulcer/pathology , Male , Middle Aged , Photography , Pilot Projects , Reproducibility of Results , Varicose Ulcer/pathology , Wounds and Injuries/diagnosis , Wounds and Injuries/pathology
5.
Acta Paediatr ; 106(7): 1053-1066, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28326623

ABSTRACT

A systematic scoping search to describe the neurophysiological methods used in infant acute pain assessment research was conducted. Of the 2411 abstracts screened, 19 articles were retained. Nine studies utilised near-infrared spectroscopy (NIRS), two utilised functional magnetic resonance imaging (fMRI), and eight utilised electroencephalography (EEG). There was methodological variability in studies utilising NIRS, whereas EEG and fMRI studies reported consistent methods. Of the eight EEG studies, six identified a nociceptive-specific event-related potential. CONCLUSION: While more methodologically rigorous studies are needed, ERPs appear to hold some promise as indicators of infant nociception during clinical procedures to supplement existing measures.


Subject(s)
Pain Measurement/methods , Electroencephalography , Humans , Infant , Magnetic Resonance Imaging , Spectroscopy, Near-Infrared
6.
Ann R Coll Surg Engl ; 98(8): e194-e196, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27551898

ABSTRACT

INTRODUCTION Foreign bodies (FBs) in the masticator space (MS) are a unique problem because of the difficulty of accessing this deep compartment within the head and neck. In addition, MS contents include critical structures such as the internal maxillary artery (IMA) and mandibular nerve. CASE HISTORY A 39-year-old tradesman was involved in a construction accident whereby a metallic projectile from a machinery drill penetrated his left cheek. Computed tomography revealed a metallic object of dimension 1.9 ×1.2 cm within the MS, with concomitant fracture of left maxillary anterior and lateral walls. Surgery was indicated in view of constant pain and swelling. The FB was removed through the cheek laceration with the aid of an X-ray image intensifier. Persistent significant bleeding was observed within the wound cavity after FB removal that could not be arrested despite attempts at haemostasis with adrenaline packing and oxidised cellulose polymers. Urgent selective left external carotid angiography showed breach of a distal branch of the left internal maxillary artery with contrast extravasation. Embolisation of this branch was undertaken successfully with a liquid agent. CONCLUSIONS This is the first time a FB within the MS with injury to the internal maxillary artery has been described.


Subject(s)
Facial Injuries/surgery , Foreign Bodies/surgery , Maxilla/injuries , Maxillary Artery/injuries , Adult , Angiography , Facial Injuries/diagnostic imaging , Facial Injuries/etiology , Foreign Bodies/diagnostic imaging , Foreign Bodies/etiology , Humans , Male , Maxilla/diagnostic imaging , Maxilla/surgery , Maxillary Artery/diagnostic imaging , Maxillary Artery/surgery , Occupational Injuries/surgery , Tomography, X-Ray Computed
7.
Eur J Gynaecol Oncol ; 37(2): 270-7, 2016.
Article in English | MEDLINE | ID: mdl-27172762

ABSTRACT

Malignant mesonephric tumor (MMT) is a relatively uncommon malignancy of the female genital tract. The diagnosis of metastatic MMT is difficult because cytological, pathological, immunohistochemical characteristics of MMT are under-recognized. The authors present a 55-year-old female with metastatic pulmonary nodules. The bronchial washing cytology revealed three dimensional clusters of bland epithelial cells with slight nuclear grooves. A corresponding lung histology had ductal or tubular clusters of epithelial cells with intraglandular eosinophilic materials. These epithelial cells were positive for immunohistochemical stain of CD10, suggesting metastasis from MMT. The cervical smear showed clusters of bland, gland-forming epithelial cells with intraglandular eosinophilic materials. On histologic examination, mesonephric adenocarcinoma with papillary and solid proliferation was identified in the uterine cervix. A review of the literature for 72 cases of MMT is also included. Clinical and cytopathological features of MMT are herein made available.


Subject(s)
Lung Neoplasms/secondary , Mesonephroma/secondary , Multiple Pulmonary Nodules/secondary , Uterine Cervical Neoplasms/pathology , Biopsy , Bronchoalveolar Lavage Fluid/cytology , Female , Humans , Lung Neoplasms/diagnosis , Mesonephroma/diagnosis , Middle Aged , Multimodal Imaging , Positron-Emission Tomography , Tomography, X-Ray Computed
8.
J Med Entomol ; 51(5): 1035-42, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25276934

ABSTRACT

In Guatemala, the most widespread vector of Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae), the causative agent of Chagas disease, is Triatoma dimidiata (Latreille) (Hemiptera: Reduviidae: Triatominae). T. dimidiata is native to Guatemala and is present in both domestic and sylvatic habitats. Consequently, control of T. dimidiata is difficult because after successful elimination from homes, individual insects can recolonize homes from the surrounding environment. Therefore, intensive long-term surveillance of this species is essential to ensure adequate control is achieved. Manual inspection for signs of infestation, the current method used to monitor Triatominae throughout Central and South America, is labor and time-consuming, so cost-effective alternatives are needed. The current study compared the effectiveness of the current method of surveillance of T. dimidiata with community-based techniques of G6mez-Nuñez sensor boxes, collection and observation of bugs by householders, and presence of triatomine-like feces on walls. Although manual inspection was the most sensitive method when used alone, collection by householders also was sensitive and specific and involved less effort. Sensor boxes were not sensitive indicators of T. dimidiata infestation when used alone. Two recorded variables, visual inspection for feces and the sighting of bugs by householders, were sensitive and specific indicators of infestation, and in combination with collection by householders and sensor boxes these methods were significantly more likely to detect infestations than manual inspection alone. A surveillance program that combines multiple community-based techniques should have low cost and involve minimal effort from the government and at the same time promote sustainable community involvement in disease prevention.


Subject(s)
Chagas Disease/epidemiology , Chagas Disease/parasitology , Triatoma/parasitology , Animals , Guatemala
9.
Int Nurs Rev ; 61(3): 398-405, 2014 09.
Article in English | MEDLINE | ID: mdl-25131708

ABSTRACT

AIM: To gain ideas and information from healthcare providers to optimize the education and clinical practices of nurses caring for sick or at-risk newborns in India. BACKGROUND: Improving infant survival has been identified as a Millennium Development Goals; however, India still faces many challenges with 3.1 million neonatal deaths and 2.6 million stillbirths annually. Skilled nursing care has been associated with decreased morbidity and mortality in newborns. However, core competencies in newborn care education and training are lacking for nurses. METHODS: Qualitative data were collected from 12 focus groups with 101 newborn care providers from three areas of India as well as from a 2-day stakeholders' meeting. Data analysis was undertaken using descriptive and thematic content analysis. RESULTS: Perceived challenges included limited manpower and high nurse turnover, lack of access to evidence-based orientation to newborn care and problems with access to appropriate learner-based, neonatal training. Relevant, ongoing education opportunities, led by nursing leaders were identified to be important solutions. CONCLUSION: Findings provide insight into the current healthcare system in India with specific reference to the nursing care of at-risk newborns. There is a lack of existing resources to provide standardized and specific orientation curricula for nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Policy makers in health and education need to: support and enact learner-based orientation and continuing educational opportunities as well as ongoing competency-based education programmes; encourage nurse leader involvement and support; and provide sustainable system-related supports. Nurses and other health providers need to work together to influence government policy.

10.
Placenta ; 34(9): 799-804, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23830491

ABSTRACT

INTRODUCTION: Preeclampsia (PE) is a leading cause of maternal and neonatal mortality and morbidity worldwide. However, the pathophysiology of this disease is not yet fully understood. MiRNA plays an important role in post-transcriptional gene regulation. Recent studies have suggested that dysregulation of miRNAs in placental tissue is involved in the pathogenesis of PE. Therefore, we investigated miRNA profiles in PE placenta to understand the miRNA function in PE pathogenesis. METHODS: MiRNA profiling was performed in 20 formalin-fixed and paraffin-embedded samples (10 placentas from severe PE and 10 from a control group). We used a hybridization-based microarray with a PNA-probe comprised of 158 miRNAs. RESULTS: Thirteen miRNAs (miR-92b, miR-197, miR-342-3p, miR-296-5p, miR-26b, miR-25, miR-296-3p, miR-26a, miR-198, miR-202, miR-191, miR-95, and miR-204) were significantly overexpressed and two miRNAs (miR-21 and miR-223) were underexpressed in PE compared with the control group. Among 15 differentially expressed miRNAs, miR-26b, miR-296-5p, and miR-223 were found to be consistent with results from previous studies. We identified 893 genes that were predicted by at least three of four computational algorithms. Target genes participated in several signaling pathways, adherens junction, focal adhesion, and regulation of the actin cytoskeleton. CONCLUSIONS: Several miRNAs are found to be dysregulated in placentas of PE patients and they seem to be closely associated with the early pathogenesis of PE. Further study is necessary to develop tools for early detection and management.


Subject(s)
Gene Expression Regulation, Developmental , MicroRNAs/biosynthesis , Placenta/metabolism , Pre-Eclampsia/metabolism , Adult , Decidua/blood supply , Decidua/metabolism , Decidua/pathology , Down-Regulation , Female , Gene Expression Profiling/methods , Humans , Immunohistochemistry , Oligonucleotide Array Sequence Analysis , Peptide Nucleic Acids/metabolism , Placenta/blood supply , Placenta/pathology , Pre-Eclampsia/pathology , Pre-Eclampsia/physiopathology , Pregnancy , Pregnancy Trimester, Third , Real-Time Polymerase Chain Reaction , Reproducibility of Results , Retrospective Studies , Severity of Illness Index , Up-Regulation
11.
Bull Entomol Res ; 103(6): 634-43, 2013 Dec.
Article in English | MEDLINE | ID: mdl-23597014

ABSTRACT

In Guatemala prior to control initiatives, the main vectors of Trypanosoma cruzi, the causative agent of Chagas disease, were Rhodnius prolixus and Triatoma dimidiata. This study conducted in 2006 in the department of Chiquimula recorded a high level of T. dimidiata infestation and an absence of R. prolixus in all surveyed communities. In Guatemala, the presence of T. dimidiata as domestic, peridomestic and sylvatic populations results in control difficulties as houses are re-infested from the surrounding environment. Entomological surveys, the current method used to select houses in need of control efforts, are labour intensive and time consuming. A time- and cost-effective way to prioritize houses for evaluation and subsequent treatment is the stratification of houses based on the risk of triatomine infestation. In the present study, 17 anthropogenic risk factors were evaluated for associations with house infestation of T. dimidiata including: wall, floor and roof type. There was an increased likelihood of domestic infestation with T. dimidiata associated with the presence of dirt floors (18/29; OR 8.075, 95% CI 2.13-30.6), uncoated bajareque walls (12/17; OR 4.80, 95% CI 1.35-17.1) and triatomine-like faeces on walls (16/26; OR 3.89, 95% CI 1.19-12.7). These factors could be used to target control of T. dimidiata to communities with an increased risk of being infested.


Subject(s)
Housing/statistics & numerical data , Insect Vectors , Triatoma , Animals , Chagas Disease/transmission , Guatemala , Risk Factors
12.
J Bone Joint Surg Br ; 94(8): 1016-23, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22844040

ABSTRACT

The current indications for functional restoration of extension of the knee following quadriceps resection or loss require reappraisal. The contribution of pedicled and free functional muscle transfer is likely to be over-emphasised in many studies, with good functional outcomes predominantly reported only in the context of cases with residual quadriceps function. In cases with total quadriceps resection or loss, all forms of reconstruction perform poorly. Furthermore, in smaller resections with loss of two or fewer components of the quadriceps, minimal impairment of function occurs in the absence of functional reconstruction, suggesting that functional restoration may not be warranted. Thus there is a paradox in the current approach to quadriceps reconstruction, in that small resections are likely to be over-treated and large resections remain under-treated. This review suggests a shift is required in the approach and rationale for reconstructing functional extension of the knee after quadriceps resection or loss. A classification based on current evidence is suggested that emphasises more clearly the indications and rationale for functional transfers.


Subject(s)
Knee Joint/surgery , Quadriceps Muscle/surgery , Humans , Knee Joint/physiopathology , Muscle, Skeletal/transplantation , Recovery of Function , Treatment Outcome
13.
J Environ Manage ; 105: 138-43, 2012 Aug 30.
Article in English | MEDLINE | ID: mdl-22542982

ABSTRACT

To improve the air quality in the Seoul Metropolitan area (SMA), the Korean government has implemented special measures in the 1990s. As part of these measures, the Cap-and-Trade System (CATS) was introduced and executed in July 1, 2007 for the oxides of nitrogen (NOx) and sulfur (SOx) to provide added flexibility for large sources to meet the required emission reductions. However, the trade via the SMA CATS for the air pollutants has not been active because of the limited buyers and sellers within the system as well as limited tradable species. For more flexible operation of the SMA CATS, following strategies have been suggested and their merits are discussed; (1) to link the SMA CATS with the Korea Voluntary Emission Reduction (KVER) program which is a program to manage greenhouse gases (GHGs), and (2) to extend the system, such as extension of the tradable species, participants, and introducing a project-based certification mechanism for pollutants reduction.


Subject(s)
Air Pollutants/analysis , Conservation of Natural Resources/legislation & jurisprudence , Nitrogen Oxides/chemistry , Sulfur Oxides/chemistry , Conservation of Natural Resources/methods , Environmental Monitoring/methods , Republic of Korea
14.
Colorectal Dis ; 14(3): e103-10, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22094022

ABSTRACT

AIM: The study aimed to identify factors that predict postoperative deviation from an enhanced recovery programme (ERP) and/or delayed discharge following colorectal surgery. METHOD: Data were prospectively collected from all patients undergoing elective laparoscopic colorectal resection between January 2006 and December 2009. They included Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) variables, body mass index (BMI), sex, preoperative serum albumin, pathology, conversion from a laparoscopic to an open approach and postoperative length of hospital stay. RESULTS: There were 176 patients (90 women) of mean age 68 years. Fifteen (9%) operations were converted from laparoscopic to open. The remainder were completed laparoscopically. Fifty-five (31%) deviated from the ERP, with most failing multiple elements. The most common reason was failure to mobilize, which often occurred in conjunction with paralytic ileus or analgesic failure. Factors independently predicting ERP deviation on multivariate analysis were pathology and intra-operative complications. The median length of stay was 5 days. Sixty-four (36%) patients had a prolonged length of stay that was predicted by age, number of procedures and ERP deviation. CONCLUSION: Pathology and intra-operative complications are independent predictors of ERP deviation. Prolonged length of stay can be predicted by age, multiple procedures and ERP deviation. Failure to mobilize should be considered as a red flag sign prompting further investigation following colorectal resection.


Subject(s)
Colon/surgery , Elective Surgical Procedures , Intestinal Diseases/surgery , Laparoscopy , Length of Stay/statistics & numerical data , Perioperative Care/methods , Rectum/surgery , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Colectomy , Female , Humans , Intestinal Diseases/pathology , Intraoperative Complications , Logistic Models , Male , Middle Aged , Patient Discharge , Recovery of Function , Retrospective Studies , Young Adult
15.
J Evol Biol ; 24(6): 1351-62, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21507117

ABSTRACT

In Drosophila melanogaster, the DDT resistance allele (DDT-R) is beneficial in the presence of DDT. Interestingly, DDT-R also elevates female fitness in the absence of DDT and existed in populations before DDT use. However, DDT-R did not spread regardless of DDT-independent selective advantages in females. We ask whether sexual antagonism could explain why DDT-R did not spread before pesticide use. We tested pre- and post-copulatory male fitness correlates in two genetic backgrounds into which we backcrossed the DDT-R allele. We found costs to DDT-R that depended on the genetic background in which DDT-R was found and documented strong epistasis between genetic background and DDT-R that influenced male size. Although it remains unclear whether DDT-R is generally sexually antagonistic, or whether the fitness costs noted would be sufficient to retard the spread of DDT-R in the absence of DDT, general fitness advantages to DDT-R in the absence of DDT may be unlikely.


Subject(s)
DDT , Drosophila melanogaster/genetics , Epistasis, Genetic , Insecticide Resistance/genetics , Insecticides , Mating Preference, Animal , Alleles , Animals , Body Size/genetics , Drosophila melanogaster/anatomy & histology , Drosophila melanogaster/drug effects , Female , Male , Spermatozoa/physiology
17.
Infect Genet Evol ; 11(1): 44-51, 2011 Jan.
Article in English | MEDLINE | ID: mdl-21029792

ABSTRACT

Trypanosoma cruzi and Trypanosoma rangeli are human-infective blood parasites, largely restricted to Central and South America. They also infect a wide range of wild and domestic mammals and are transmitted by a numerous species of triatomine bugs. There are significant overlaps in the host and geographical ranges of both species. The two species consist of a number of distinct phylogenetic lineages. A range of PCR-based techniques have been developed to differentiate between these species and to assign their isolates into lineages. However, the existence of at least six and five lineages within T. cruzi and T. rangeli, respectively, makes identification of the full range of isolates difficult and time consuming. Here we have applied fluorescent fragment length barcoding (FFLB) to the problem of identifying and genotyping T. cruzi, T. rangeli and other South American trypanosomes. This technique discriminates species on the basis of length polymorphism of regions of the rDNA locus. FFLB was able to differentiate many trypanosome species known from South American mammals: T. cruzi cruzi, T. cruzi marinkellei, T. dionisii-like, T. evansi, T. lewisi, T. rangeli, T. theileri and T. vivax. Furthermore, all five T. rangeli lineages and many T. cruzi lineages could be identified, except the hybrid lineages TcV and TcVI that could not be distinguished from lineages III and II respectively. This method also allowed identification of mixed infections of T. cruzi and T. rangeli lineages in naturally infected triatomine bugs. The ability of FFLB to genotype multiple lineages of T. cruzi and T. rangeli together with other trypanosome species, using the same primer sets is an advantage over other currently available techniques. Overall, these results demonstrate that FFLB is a useful method for species diagnosis, genotyping and understanding the epidemiology of American trypanosomes.


Subject(s)
Trypanosoma/genetics , Animals , Genotype , Polymerase Chain Reaction , South America , Species Specificity
18.
Br J Anaesth ; 105(3): 371-6, 2010 Sep.
Article in English | MEDLINE | ID: mdl-20573635

ABSTRACT

BACKGROUND: Multimodal analgesia is advocated for perioperative pain management to reduce opioid use and its associated adverse effects. Serotonin and norepinephrine are involved in the modulation of endogenous analgesic mechanisms via descending inhibitory pain pathways in the brain and spinal cord. An increase in serotonin and norepinephrine may increase inhibition of nociceptive input and improve pain relief. Duloxetine, a selective serotonin and norepinephrine reuptake inhibitor, has demonstrated efficacy in chronic pain conditions such as painful diabetic neuropathy and post-herpetic neuralgia. The objective of the study was to evaluate the efficacy of duloxetine in reducing morphine requirements in patients after knee replacement surgery. METHODS: Fifty patients received either two doses of oral duloxetine 60 mg (2 h before surgery and on first postoperative day) or placebo. All patients received patient-controlled analgesia with morphine for 48 h after operation. Pain and adverse effects were assessed at 0.5, 1, 2, 6, 12, 24, and 48 h after surgery on an 11-point numeric rating scale. RESULTS: Twenty-three patients in the duloxetine group and 24 patients in the placebo group completed the study. Morphine requirements during the 48 h after surgery were significantly lower in the duloxetine group [19.5 mg, standard deviation (sd) 14.5 mg] compared with the placebo group (30.3 mg, sd 18.1 mg) (P=0.017). There were no statistically significant differences between the groups in pain scores (at rest and on movement) or in adverse effects. CONCLUSIONS: Perioperative administration of duloxetine reduced postoperative morphine requirements during the first 48 h after knee replacement surgery, without significant adverse effects.


Subject(s)
Analgesics, Opioid/administration & dosage , Arthroplasty, Replacement, Knee , Morphine/administration & dosage , Pain, Postoperative/prevention & control , Thiophenes/administration & dosage , Adolescent , Adrenergic Uptake Inhibitors/administration & dosage , Adrenergic Uptake Inhibitors/adverse effects , Adult , Aged , Analgesia, Patient-Controlled/methods , Analgesics, Opioid/adverse effects , Double-Blind Method , Drug Therapy, Combination , Duloxetine Hydrochloride , Female , Follow-Up Studies , Humans , Male , Middle Aged , Morphine/adverse effects , Pain Measurement/methods , Postoperative Care/methods , Selective Serotonin Reuptake Inhibitors/administration & dosage , Selective Serotonin Reuptake Inhibitors/adverse effects , Thiophenes/adverse effects , Young Adult
19.
Parasitology ; 136(12): 1509-28, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19691868

ABSTRACT

Trypanosoma cruzi is the protozoan agent of Chagas disease, and the most important parasitic disease in Latin America. Protozoa of the genus Leishmania are global agents of visceral and cutaneous leishmaniasis, fatal and disfiguring diseases. In the 1970s multilocus enzyme electrophoresis demonstrated that T. cruzi is a heterogeneous complex. Six zymodemes were described, corresponding with currently recognized lineages, TcI and TcIIa-e--now defined by multiple genetic markers. Molecular epidemiology has substantially resolved the phylogeography and ecological niches of the T. cruzi lineages. Genetic hybridization has fundamentally influenced T. cruzi evolution and epidemiology of Chagas disease. Genetic exchange of T. cruzi in vitro involves fusion of diploids and genome erosion, producing aneuploid hybrids. Transgenic fluorescent clones are new tools to elucidate molecular genetics and phenotypic variation. We speculate that pericardial sequestration plays a role in pathogenesis. Multilocus sequence typing, microsatellites and, ultimately, comparative genomics are improving understanding of T. cruzi population genetics. Similarly, in Leishmania, genetic groups have been defined, including epidemiologically important hybrids; genetic exchange can occur in the sand fly vector. We describe the profound impact of this parallel research on genetic diversity of T. cruzi and Leishmania, in the context of epidemiology, taxonomy and disease control.


Subject(s)
Chagas Disease/epidemiology , Leishmania , Leishmaniasis/epidemiology , Molecular Epidemiology , Phylogeny , Trypanosoma cruzi , Animals , Chagas Disease/parasitology , Chagas Disease/transmission , Ecosystem , Leishmania/classification , Leishmania/genetics , Leishmaniasis/parasitology , Leishmaniasis/transmission , South America/epidemiology , Trypanosoma cruzi/classification , Trypanosoma cruzi/genetics
20.
Digestion ; 80(1): 58-63, 2009.
Article in English | MEDLINE | ID: mdl-19494492

ABSTRACT

BACKGROUND/AIMS: Ghrelin affects gastric motility. However, little is known about the role of ghrelin in the pathophysiology of functional dyspepsia (FD). We investigated plasma ghrelin levels and their relationship with gastric emptying time in dysmotility-like FD patients. METHODS: 42 patients with dysmotility-like FD and 14 healthy volunteers were enrolled in the study. Gastric half-emptying time was measured using a radiolabeled meal. Plasma total ghrelin levels before and after the meal were determined using a radioimmunoassay kit. RESULTS: Preprandial ghrelin levels were significantly lower in FD patients than in controls. Postprandial ghrelin levels were similar between the two groups. Abnormally low preprandial ghrelin levels were observed in 7 out of 42 patients, in whom significant postprandial decrease of ghrelin levels was absent. Delayed gastric emptying was observed in 5 out of 7 patients with abnormally low ghrelin levels. Pre- or postprandial ghrelin levels were not significantly correlated with gastric half-emptying time, both in the patient group and in the control group. CONCLUSIONS: Abnormally low preprandial ghrelin levels and absence of significant postprandial decrease of ghrelin levels are present in a subset of dysmotility-like FD patients. Further investigation on the pathogenetic implication of these alterations in FD is required.


Subject(s)
Dyspepsia/blood , Gastric Emptying , Ghrelin/blood , Adult , Aged , Case-Control Studies , Dyspepsia/physiopathology , Female , Ghrelin/deficiency , Humans , Male , Middle Aged , Postprandial Period , Young Adult
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