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1.
Br Dent J ; 232(1): 5, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35031723
2.
Conserv Biol ; 31(3): 559-569, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27696505

RESUMO

The effectiveness of parks for forest conservation is widely debated in Africa, where increasing human pressure, insufficient funding, and lack of management capacity frequently place significant demands on forests. Tropical forests house a substantial portion of the world's remaining biodiversity and are heavily affected by anthropogenic activity. We analyzed park effectiveness at the individual (224 parks) and national (23 countries) level across Africa by comparing the extent of forest loss (as a proxy for deforestation) inside parks to matched unprotected control sites. Although significant geographical variation existed among parks, the majority of African parks had significantly less forest loss within their boundaries (e.g., Mahale Park had 34 times less forest loss within its boundary) than control sites. Accessibility was a significant driver of forest loss. Relatively inaccessible areas had a higher probability (odds ratio >1, p < 0.001) of forest loss but only in ineffective parks, and relatively accessible areas had a higher probability of forest loss but only in effective parks. Smaller parks less effectively prevented forest loss inside park boundaries than larger parks (T = -2.32, p < 0.05), and older parks less effectively prevented forest loss inside park boundaries than younger parks (F2,154 = -4.11, p < 0.001). Our analyses, the first individual and national assessment of park effectiveness across Africa, demonstrated the complexity of factors (such as geographical variation, accessibility, and park size and age) influencing the ability of a park to curb forest loss within its boundaries.


Assuntos
Conservação dos Recursos Naturais , Florestas , África , Biodiversidade , Geografia , Humanos , Clima Tropical
3.
J Environ Manage ; 183(Pt 3): 972-979, 2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-27687633

RESUMO

In this study we estimate selected visitors' demand and value for recreational trips to settings such as developed vs. undeveloped sites in U.S. national forests in the Southern United States using the travel cost method. The setting-based approach allows for valuation of multi-activity trips to particular settings. The results from an adjusted Poisson lognormal estimator corrected for truncation and endogenous stratification reveal that economic value per trip estimates are higher for wilderness compared to day-use developed settings, overnight-use developed settings, and general forest areas. Estimates of these economic values are important to resource managers because their management decisions and actions typically control recreational settings. For example, managers control developed campground capacity in a national forest, but typically not the number of campers below the capacity constraint and the number and types of activities visitors engage in during a multi-activity trip to a developed campground (within limits since some activities such as discharging a firearm are not permitted in a developed campground).


Assuntos
Conservação dos Recursos Naturais/economia , Florestas , Recreação/economia , Viagem/economia , Acampamento , Conservação dos Recursos Naturais/métodos , Custos e Análise de Custo , Humanos , Modelos Econômicos , Estados Unidos , Meio Selvagem
4.
Water Res ; 46(7): 2324-32, 2012 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-22386884

RESUMO

It is generally well recognised that suspended particulate matter (SPM), from nano-scale particles to sand-sized sediments, can cause serious degradation of aquatic ecosystems. However, at present there is a poor understanding of the SPM conditions that water quality managers should aim to achieve in contrasting environments in order to support good ecological status. In this article, we analyse long-term SPM data collected from a wide range of reference-condition temperate environments in the UK (638 stream/river sites comprising 42 different ecosystem-types). One-way analysis of variance reveals that there is a statistically significant difference (p < 0.001) between the background SPM concentrations observed in contrasting ecosystems that are in reference condition (minimal anthropogenic disturbance). One of the 42 ecosystems studied had mean background concentrations of SPM in excess of the current European Union (EU) water quality guideline, despite being in reference condition. The implications of this finding are that the EU's current blanket water quality guideline (25 mg L(-1) for all environments) is inappropriate for this specific ecosystem-type which will be non-compliant with the guideline regardless of the intensity of land-use. The other 41 ecosystems studied had mean concentrations below the current EU water quality guideline. However, this does not necessarily mean that the guideline is appropriate for these ecosystems, as previous research has demonstrated that detrimental impacts can be experienced by some freshwater organisms, of all trophic levels, when exposed to concentrations below 25 mg L(-1). Therefore, it is suggested here that it is likely that some ecosystems, particularly those with mean concentrations in the 0.00-5.99 mg L(-1) range, require much lower guideline values in order to be effectively protected. We propose a model for predicting environment-specific water quality guidelines for SPM. In order to develop this model, the 638 reference condition sites were first classified into one of five mean background SPM ranges (0.00-5.99, 6.00-11.99, 12.00-17.99, 18.00-23.99 and >24.00 mg L(-1)). Stepwise Multiple Discriminant Analysis (MDA) of these ranges showed that a site's SPM range can be predicted as a function of: mean annual air temperature, mean annual precipitation, mean altitude of upstream catchment, distance from source, slope to source, channel width and depth, the percentage of catchment area comprised of clay, chalk, and hard rock solid geology, and the percentage of the catchment area comprised of blown sand as the surface (drift) material. The MDA technique, with cross-validation (Wilks-Lambda 0.358, p 0.000), can predict the correct or the next closest SPM range of a site in 90% of cases. This technique can also predict SPM range membership in a probabilistic manner, allowing for an estimate of uncertainty to be made in the allocation of a site to an environment-specific SPM range.


Assuntos
Ecossistema , Modelos Teóricos , Material Particulado/normas , Rios , Qualidade da Água/normas , Análise de Variância , Análise Discriminante , Guias como Assunto , Material Particulado/análise , Reino Unido
5.
Environ Manage ; 49(3): 623-35, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22218459

RESUMO

Wildland fire in the South commands considerable attention, given the expanding wildland urban interface (WUI) across the region. Much of this growth is propelled by higher income retirees and others desiring natural amenity residential settings. However, population growth in the WUI increases the likelihood of wildfire fire ignition caused by people, as humans account for 93% of all wildfires fires in the South. Coexisting with newly arrived, affluent WUI populations are working class, poor or otherwise socially vulnerable populations. The latter groups typically experience greater losses from environmental disasters such as wildfire because lower income residents are less likely to have established mitigation programs in place to help absorb loss. We use geographically weighted regression to examine spatial variation in the association between social vulnerability (SOVUL) and wildfire risk. In doing so, we identify "hot spots" or geographical clusters where SOVUL varies positively with wildfire risk across six Southern states--Alabama, Arkansas, Florida, Georgia, Mississippi, and South Carolina. These clusters may or may not be located in the WUI. These hot spots are most prevalent in South Carolina and Florida. Identification of these population clusters can aid wildfire managers in deciding which communities to prioritize for mitigation programming.


Assuntos
Conservação dos Recursos Naturais , Emigração e Imigração , Incêndios , Geografia , Habitação , Humanos , Análise dos Mínimos Quadrados , Modelos Estatísticos , Análise de Regressão , Condições Sociais , Sudeste dos Estados Unidos
6.
Sci Total Environ ; 409(18): 3418-30, 2011 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-21624642

RESUMO

The water quality of the River Frome, Dorset, southern England, was monitored at weekly intervals from 1965 until 2009. Determinands included phosphorus, nitrogen, silicon, potassium, calcium, sodium, magnesium, pH, alkalinity and temperature. Nitrate-N concentrations increased from an annual average of 2.4 mg l⁻¹ in the mid to late 1960s to 6.0 mg l⁻¹ in 2008-2009, but the rate of increase was beginning to slow. Annual soluble reactive phosphorus (SRP) concentrations increased from 101 µg l⁻¹ in the mid 1960s to a maximum of 190 µg l⁻¹ in 1989. In 2002, there was a step reduction in SRP concentration (average=88 µg l⁻¹ in 2002-2005), with further improvement in 2007-2009 (average=49 µg l⁻¹), due to the introduction of phosphorus stripping at sewage treatment works. Phosphorus and nitrate concentrations showed clear annual cycles, related to the timing of inputs from the catchment, and within-stream bioaccumulation and release. Annual depressions in silicon concentration each spring (due to diatom proliferation) reached a maximum between 1980 and 1991, (the period of maximum SRP concentration) indicating that algal biomass had increased within the river. The timing of these silicon depressions was closely related to temperature. Excess carbon dioxide partial pressures (EpCO2) of 60 times atmospheric CO2 were also observed through the winter periods from 1980 to 1992, when phosphorus concentration was greatest, indicating very high respiration rates due to microbial decomposition of this enhanced biomass. Declining phosphorus concentrations since 2002 reduced productivity and algal biomass in the summer, and EpCO2 through the winter, indicating that sewage treatment improvements had improved riverine ecology. Algal blooms were limited by phosphorus, rather than silicon concentration. The value of long-term water quality data sets is discussed. The data from this monitoring programme are made freely available to the wider science community through the CEH data portal (http://gateway.ceh.ac.uk/).


Assuntos
Fósforo/análise , Rios/química , Poluentes Químicos da Água/análise , Poluição Química da Água/estatística & dados numéricos , Cálcio/análise , Dióxido de Carbono/análise , Monitoramento Ambiental , Política Ambiental , Concentração de Íons de Hidrogênio , Magnésio/análise , Nitrogênio/análise , Potássio/análise , Estações do Ano , Silício/análise , Sódio/análise , Reino Unido , Poluição Química da Água/prevenção & controle
7.
Diabetes Res Clin Pract ; 70(1): 8-12, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16126117

RESUMO

We studied the number of testing sites and the proportion needed to be insensate for the optimal assessment of foot ulcer risk with the 10 g monofilament. Also, we compared the sensitivity and specificity of the 10 g monofilament with other methodologies. Fifty-two individuals with either a current foot ulcer, a history of a foot ulcer or the presence of Charcot neuroarthopathy and 51 individuals with no history of any of these conditions were assessed with the 10 g monofilament at four sites on each foot, the 128 Hz tuning fork at the halluces, the Biothesiometer at the halluces and the modified neuropathy disability score. Sensitivities and specificities were calculated for the various modalities. The Biothesiometer and the neuropathy disability score had the highest sensitivities (0.92 for both). The 128 Hz tuning fork tested only at the halluces (criterion: >or=1 insensate site) had the same sensitivity (0.86) as the 10 g monofilament tested at eight sites (criterion: >or=1 insensate site) with similar specificities (0.56 and 0.58, respectively). The Biothesiometer and the modified neuropathy disability score tend to be more sensitive than the 10 g monofilament for the assessment of individuals at risk for foot ulcers. The 128 Hz tuning fork tested at only two sites is as sensitive as the 10 g monofilament tested at eight sites. These data suggest that the 10 g monofilament may not be the optimum methodology for identifying individuals at risk of foot ulcers.


Assuntos
Pé Diabético/diagnóstico , Exame Neurológico/métodos , Suscetibilidade a Doenças , Pé/inervação , Humanos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Limiar Sensorial
8.
Neuroscience ; 131(2): 451-64, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15708486

RESUMO

Diet restriction (DR) in rodents increases lifespan, reduces age-related disease and pathology, increases stress responses, and maintains better function later into life compared with conventional ad libitum (AL) feeding. We have been investigating different DR regimens and also DR mimetics that stimulate stress response pathways that are activated by DR. By inhibiting glycolysis, feeding or injection of 2-deoxy-D-glucose (2DG) has been proposed as a DR mimetic and has been shown to provide neuroprotection. In the current study, we examined whether 2DG treatment produces behavioral changes similar to those observed in DR rats following stimulation of the dopaminergic (DA) system by D-amphetamine (AMPH). Male Fischer 344 rats were maintained on different dietary regimens: 40% daily DR (40% DR); every-other-day feeding (EOD); or AL with some groups provided food containing 0.4% 2DG or injected i.p. with 2DG. In addition, we examined the persistence of effects of DR or 2DG feeding after switching rats to AL. When locomotor activity was assessed at different time points following initiation of dietary treatments, we noted that the enhancement of AMPH-induced locomotor responses emerged earlier in DR rats than observed in 2DG fed rats, but 40% DR and EOD rats responded in a similar manner. Enhanced locomotor responses persisted in 2DG fed rats even when returned to normal diet for 1 month and in the case of DR rats even after 2 months of AL feeding. Three weeks of 2DG injections also enhanced AMPH response, but this effect was transient. The most important finding was that 2DG did not affect body weight or diet intake yet had effects similar to DR. Thus, 2DG appears to activate DA pathways in the same direction as DR does but without the necessity of reducing caloric intake.


Assuntos
Anfetamina/farmacologia , Restrição Calórica , Desoxiglucose/farmacologia , Atividade Motora/efeitos dos fármacos , Animais , Peso Corporal/efeitos dos fármacos , Peso Corporal/fisiologia , Restrição Calórica/métodos , Relação Dose-Resposta a Droga , Sinergismo Farmacológico , Ingestão de Alimentos/efeitos dos fármacos , Ingestão de Alimentos/fisiologia , Atividade Motora/fisiologia , Ratos , Ratos Endogâmicos F344
9.
Sci Total Environ ; 314-316: 67-87, 2003 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-14499527

RESUMO

Historical and contemporary records have been used to assess the impact of urbanisation on the aquatic plants of the River Cam and its narrow floodplain in Cambridge. Of the 62 native aquatic plant species which have been recorded in the study area since 1660, 40 (65%) were still present in the period 1985-1999 whereas 22 (35%) are apparently extinct. There is a striking relationship between the fate of species and their trophic requirements, with species of less eutrophic habitats having suffered disproportionately. Historical records demonstrate that the River Cam became grossly polluted by sewage from Cambridge in the 19th century, but the chemical and biological quality of the river improved from 1897 onwards. However, the majority of the species recorded from the river and nearby ditches persisted until after maximum incidence of sewage pollution, which may even have stimulated the growth of 'weed' in the river. Losses of aquatic plant species from two riparian commons, Coe Fen (35%) and Sheep's Green (50%), have been particularly great. The level of these and other areas of low-lying common land by the river has been systematically raised by the controlled tipping of waste in hollows, followed by levelling and resowing. The main effects of urbanisation on the flora therefore arose from the transformation of riparian pastures into suburban open spaces. Commons which are used purely for amenity purposes have lost almost all their aquatic plant species. Those which are still grazed retain more, and continuance of grazing is probably essential if a varied aquatic flora is to be maintained. The interpretation of botanical records in terms of recorded management history is likely to throw further light on the processes of urbanisation, although the number of sites with a sufficiently detailed botanical record may be limited.


Assuntos
Plantas , Urbanização , Poluentes da Água/história , Poluentes da Água/toxicidade , Abastecimento de Água , Agricultura , Animais , Animais Domésticos , Cidades , Ecossistema , Cadeia Alimentar , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , Dinâmica Populacional , Esgotos , Urbanização/história
10.
J Environ Manage ; 65(3): 301-12, 2002 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12357661

RESUMO

Coastal coral reefs, especially in the Florida Keys, are declining at a disturbing rate. Marine ecologists and reef scientists have emphasized the importance of establishing nonmarket values of coral reefs to assess the cost effectiveness of coral reef management and remediation programs. The purpose of this paper is to develop a travel cost-contingent valuation model of demand for trips to the Florida Keys focusing on willingness to pay (WTP) to preserve the current water quality and health of the coral reefs. The stated and revealed preference models allow the marginal valuation of recreationists to adjust depending on current and planned trip commitments in valuing nonmarginal policy changes in recreational opportunities. The integrated model incorporates key factors for establishing baseline amenity values for tourist dive sites, including perceptions of reef quality and dive conditions, the role of substitute sites, and the quality and availability of tourist facilities and recreation opportunities. The travel cost and WTP model differ in identifying critical variables and provide insight into the adjustment of trip decisions across alternative destination sites and the valuation of trips. In contrast to the travel cost model, a measure of the availability of substitute sites and total recreation activities does not have a significant impact on WTP valuations reported by snorkelers. Snorkelers engage in a relatively focused set of activities, suggesting that these recreationists may not shift expenditures to other sites or other recreation activities in the Florida Keys when confronted with increased access costs for the snorkeling experience.


Assuntos
Conservação dos Recursos Naturais , Mergulho , Ecossistema , Modelos Econômicos , Recreação/economia , Poluição da Água/economia , Poluição da Água/prevenção & controle , Animais , Antozoários , Custos e Análise de Custo , Florida , Humanos , Viagem
11.
J Bone Joint Surg Am ; 82(11): 1571-4, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11097446

RESUMO

BACKGROUND: A method for closure of a knee disarticulation wound with use of the posterior calf skin and gastrocnemius muscle bellies as an integral flap, without destruction of the perforating vessels, was described by Klaes and Eigler in 1985. The purposes of the present study were to report our experience with use of this technique in a prospective series of knee disarticulations and to determine the healing rate and the functional result after use of the flap. METHODS: Eighty knee disarticulations, performed with use of the flap described by Klaes and Eigler, in seventy-seven patients were evaluated in a prospective manner. The patients ranged in age from nineteen to ninety-two years (mean, sixty-four years). Thirty-one patients had diabetes mellitus with peripheral vascular disease, and twenty-nine had peripheral vascular disease alone as the primary cause of gangrene. Fourteen patients had a traumatic injury, two had a sarcoma, and one had Ollier disease. RESULTS: Five patients died in the early postoperative period, leaving seventy-five stumps available for evaluation. A total of sixty-seven stumps (89 percent) healed; sixty-three (84 percent) of them healed primarily. Major wound dehiscence occurred in seven stumps (9 percent), requiring revision to the transfemoral level. Six of those patients had a serum albumin level of less than thirty millimoles per liter. Twenty-two (81 percent) of the twenty-seven patients who could walk before surgery were able to walk with a prosthesis after it. CONCLUSIONS: This simple technique offers reliable healing of knee disarticulation wounds in properly selected patients with a variety of conditions. It also provides comfortable end-bearing for prosthesis wearers because the distal flap is thick and mobile.


Assuntos
Desarticulação , Articulação do Joelho/cirurgia , Retalhos Cirúrgicos , Angiopatias Diabéticas/cirurgia , Feminino , Humanos , Articulação do Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/cirurgia , Estudos Prospectivos , Cicatrização
12.
Clin Orthop Relat Res ; (361): 23-8, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10212592

RESUMO

Knee disarticulation is a muscle balanced amputation level that can be used in patients with diabetes, peripheral vascular disease, and trauma. Patients who are capable of sitting in a chair retain an excellent platform for sitting, a lever arm for transfer, and are unlikely to have joint contractures develop. In patients who are ambulatory and have vascular disease and in patients with trauma, this amputation level provides a well padded residual limb that allows distal endbearing. The use of a four bar linkage prosthetic knee joint confers intrinsic knee joint stability during walking.


Assuntos
Desarticulação/métodos , Articulação do Joelho/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Membros Artificiais , Contratura/prevenção & controle , Diabetes Mellitus/cirurgia , Fáscia/transplante , Seguimentos , Humanos , Artropatias/prevenção & controle , Perna (Membro)/irrigação sanguínea , Traumatismos da Perna/cirurgia , Pessoa de Meia-Idade , Músculo Esquelético/transplante , Doenças Vasculares Periféricas/cirurgia , Postura/fisiologia , Desenho de Prótese , Transplante de Pele , Retalhos Cirúrgicos , Caminhada/fisiologia , Suporte de Carga/fisiologia , Cicatrização
14.
AIDS ; 12(14): 1785-91, 1998 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-9792379

RESUMO

OBJECTIVES: To determine the spectrum of serum immunoreactive erythropoietin (SIE) levels amongst HIV-infected children aged < 13 years in relation to the levels among healthy children as well as those with renal failure; to examine the relationship between clinical and laboratory parameters and SIE levels. DESIGN: A cross-sectional study with a descriptive non-interventional format. HIV-infected Canadian subjects were recruited through four tertiary Canadian and one Bahamian centre. Children with renal failure and healthy children were recruited from one of the Canadian centres. METHODS: Study subjects had clinical and laboratory profiles determined at baseline and at each of five follow-up periods over 1 year. SIE levels were measured by radioimmunoassay with a normal range of 12-28 IU/I. Data handling and statistical functions were performed by the Canadian HIV Trials Network. RESULTS: The study enrolled 133 HIV-infected subjects and 38 controls. Of these, 117 HIV-infected subjects, 24 healthy controls, and 11 controls with renal failure were eligible for analysis. The median age of infected subjects was 44 months, whereas that of healthy controls was 56 months, and 95 months for controls with renal failure. The median SIE levels were 14 and 11 IU/I for subjects with renal failure and healthy subjects, respectively. The median SIE level was 61 IU/I among zidovudine (ZDV)-treated subjects and 22 IU/I among ZDV-naive HIV-infected subjects. HIV-infected children almost invariably had SIE levels < 200 IU/I. The median SIE levels amongst HIV-infected subjects whose hemoglobin levels were < 100 g/l were 98 and 31 IU/I for ZDV-treated and ZDV-naive subjects, respectively (P = 0.002). This difference in median SIE levels between ZDV-treated subjects and ZDV-naive subjects was also observed among subjects whose hemoglobin levels were > 100 g/l (median, 58 and 15 IU/l, respectively; P < 0.001). Hemoglobin level was the most important predictor of log10 SIE (P < 0.01 for ZDV-treated and ZDV-naive subjects). CONCLUSIONS: SIE levels amongst HIV-infected children were affected by HIV infection, use of ZDV, and presence or absence of anemia. SIE levels amongst HIV-infected children were generally lower than 200 IU/I. This characterization of SIE levels will facilitate clinical trials of exogenous recombinant human erythropoietin in HIV-infected children with anemia.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Eritropoetina/sangue , Infecções por HIV/sangue , Zidovudina/uso terapêutico , Anemia/prevenção & controle , Bahamas , Canadá , Criança , Pré-Escolar , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Hemoglobinas/análise , Humanos , Lactente , Masculino , Insuficiência Renal/sangue
15.
AIDS ; 12(14): 1785-91, Oct. 1, 1998.
Artigo em Inglês | MedCarib | ID: med-1379

RESUMO

OBJECTIVES: To determine the spectrum of serum immunoreactive erythropoietin (SIE) levels amongst HIV-infected children aged <13 years in relation to the levels among healthy children as well as those with renal failure; to examine the relationship between clinical and laboratory parameters and SIE levels. DESIGN: A cross-sectional study with a descriptive non-interventional format. HIV-infected Canadian subjects were recruited through four tertiary Canadian and one Bahamian centre. Children with renal failure and healthy children were recruited from one of the Canadian centres. METHODS: Study subjects had clinical and laboratory profiles determined at baseline and at each of five follow-up periods over 1 year. SIE levels were measured by radio-immunoassay with a normal range of 12-28 IU/I. Data handling and statistical functions were performed by the Canadian HIV Trials Network. RESULTS: Ths study enrolled 133 HIV-infected subjects and 38 controls. Of these, 117 HIV-infected subjects, 24 healthy controls, and 11 controls with renal failure were eligible for analysis. The median age of infected subjects was 44 months, whereas that of healthy controls was 56 months, and 95 months for controls with renal failure. The median SIE levels were 14 and 11 IU/I for subjects with renal failure and healthy subjects, respectively. The median SIE level was 61 IU/I among zidovudine (ZDV)-treated subjects and 22 IU/I among ZDV-naive HIV-infected subjects. HIV-infected children almost invariably had SIE levels < 200 IU/I. The median SIE levels amongst HIV-infected subjects whose hemoglobin levels were < 100 g/l were 98 and 31 IU/I for ZDV-treated and ZDV-naive subjects, respectively (P = 0.002). This difference in median SIE levels between ZDV-treated subjects and ZDV-naive subjects was also observed among subjects whose hemoglobin levels were > 100 g/l (median, 58 and 15 IU/I, respectively; P < 0.001). Hemoglobin level was the most important predictor of log10 SIE (P < 0.001 for ZDV-treated and ZDV-naive subjects). CONCLUSIONS: SIE levels amongst HIV-infected children were affected by HIV infection, use of ZDV, and presence or absence of anemia. SIE levels amongst HIV-infected children were generally lower than 200 IU/I. This characterization of SIE levels will facilitate clinical trials of exogenous recombinant human erythropoietin in HIV-infected children with anemia.(Au)


Assuntos
Criança , Pré-Escolar , Estudo Comparativo , Feminino , Humanos , Masculino , Lactente , Fármacos Anti-HIV/uso terapêutico , Eritropoetina/sangue , Zidovudina/uso terapêutico , Infecções por HIV/sangue , Bahamas , Canadá , Estudos Transversais , Hemoglobinas/análise , Infecções por HIV/tratamento farmacológico , Insuficiência Renal/sangue , Anemia/prevenção & controle
17.
Paraplegia ; 31(10): 660-6, 1993 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-8259329

RESUMO

The goal of the present study was to use intravenous etidronate in the acute phase of heterotopic ossification (HO) in an attempt to achieve a high initial drug concentration at the site of the active ectopic ossification. The study included 27 consecutive patients with an acute onset of HO after spinal cord injury (SCI). The three-phase bone scan was used to confirm clinical diagnosis of HO. Disodium etidronate (Didronel) 300 mg was administered intravenously daily for 3 to 5 days. In 20 patients there was a rapid (1-2 days) decrease of soft tissue swelling (p < 0.01) with no side effects associated with the intravenous administration. In seven patients there was minimal or no improvement of edema after intravenous etidronate. In these patients deep vein thrombosis was found in the affected limbs. The effect of high dose etidronate on HO was determined in the group of 13 patients with positive clinical and scintigraphic finding of an acute HO, but negative radiographic studies. After intravenous administration of etidronate for 3 days (300 mg/day) the drug was continued orally with 20 mg/kg/day for 6 months. A placebo was not used in this study. In eight patients there was no radiographic evidence of HO after therapy while two patients had minimal ossifications. In three patients therapy was interrupted and all developed HO in 1-2 months.


Assuntos
Ácido Etidrônico/administração & dosagem , Ossificação Heterotópica/tratamento farmacológico , Ossificação Heterotópica/etiologia , Traumatismos da Medula Espinal/complicações , Administração Oral , Adolescente , Adulto , Esquema de Medicação , Edema/tratamento farmacológico , Ácido Etidrônico/uso terapêutico , Feminino , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade
18.
Blood ; 80(8): 1998-2005, 1992 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-1391957

RESUMO

The hemostatic system is assumed to be similar in children and adults and reference ranges established for adults are commonly used to evaluate children suspected of having congenital or acquired hemostatic problems. However, we know that the hemostatic system is not fully mature by 6 months of age and comprehensive studies of healthy older children have not been published. Therefore, we conducted a prospective cohort study of the hemostatic system in healthy children having minor, elective day surgery. After obtaining informed consent, a 3-mL blood sample was obtained at the time routine preoperative blood work was drawn. The plasma was fractioned and stored at -70 degrees C for batch assaying. We measured the concentration of 33 components of the hemostatic system (functional and immunologic assays) and the bleeding time (automated pediatric device) in 246 children aged 1 to 16 inclusive (a minimum of four subjects at each age). Eleven components of hemostasis (fibrinogen, prekallikrein, high-molecular weight kininogen, factors VIII and XIII, antithrombin III [ATIII], heparin cofactor II [HCII], alpha 1-antitrypsin [alpha 1AT], protein S, plasminogen, alpha 2-antiplasmin [alpha 2AP]) had mean values and ranges of normal that were similar to adults. Mean values of seven coagulants (II, V, VII, IX, X, XI, XII) were significantly lower than adult values and varied with age. Values for three inhibitors, alpha 2-macroglobulin (alpha 2M), protein C, and protein C1-inhibitor (C1-Inh) also differed from adults. Alpha 2M and C1-Inh inhibitor levels were elevated throughout childhood, whereas protein C levels were low, with a lower limit of normal of 0.40 U/mL until the age of 11. Finally, the upper limit of normal for the bleeding time was longer in children during the first 10 years of life, but decreased to adult values in the teenage years. In summary, there are important physiologic differences in the hemostatic system in children compared with adults. The decreased levels of several critical coagulants and increased levels of alpha 2M may contribute in part to the lower risk of thrombotic events in childhood. Age-matched controls should be used for evaluation of the hemostatic system in children with suspected congenital or acquired defects.


Assuntos
Envelhecimento/fisiologia , Fatores de Coagulação Sanguínea/análise , Hemostasia/fisiologia , Adolescente , Fatores de Coagulação Sanguínea/antagonistas & inibidores , Criança , Pré-Escolar , Fibrinólise , Humanos , Lactente , Valores de Referência , Vitamina K/farmacologia
19.
Am J Hematol ; 35(4): 275-7, 1990 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-2239923

RESUMO

Sick infants frequently developed impaired hemostasis as a secondary event. Abnormal platelet-vessel wall interaction contributes to the hemorrhagic side effects. Currently, the bleeding time is the best measure of in vivo platelet participation in small vessel hemostasis. Bleeding times in the newborn have been previously determined with an automated device designed for the adult or with nonautomated devices. The automated bleeding time device for the adult is not suitable for the infant (length 5 mm, depth 1 mm). We evaluated the performance of an automated bleeding time device designed specifically for the newborn making a cut 2.5 mm in length and 0.5 mm in depth. The results with the automated device showed a strong correlation with the modified template bleeding time device previously used for the newborn. The normal range was shorter and the sensitivity to abnormal vessel wall interaction was greater with the automated device. As well, the ease of determining the bleeding time with the automated device was considerably improved over the template device.


Assuntos
Tempo de Sangramento , Equipamentos e Provisões/normas , Estudos de Avaliação como Assunto , Humanos , Lactente
20.
Clin Orthop Relat Res ; (256): 64-75, 1990 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-2194731

RESUMO

Regardless of age, conventional prostheses and traditional rehabilitation programs no longer meet the needs and expectations of active amputees. The emphasis on fitness, the availability of stronger and lighter materials, and strong consumer demand have led to plethora of new prosthetic designs by progressive prosthetists and engineers. Prosthetic training techniques now take into account the amputee's recreational and sports needs and desires, using advanced athletic training concepts to achieve superior performance in a wide variety of activities. The surgeon, as a key member of the amputee team, should be aware of these profound changes so that they may contribute his or her skill in surgically crafting an optimally functional residual limb. This will allow the amputee to reach for the maximum in cardiopulmonary fitness while achieving social reintegration after amputation. The combination of skills, concepts, and techniques of the amputation surgeon, prosthetist, and therapist/trainer has led to a unique situation, in which for the first time, amputees are able to successfully compete in sports because of their prostheses, rather than in spite of them.


Assuntos
Amputação Cirúrgica/reabilitação , Membros Artificiais/tendências , Recreação , Braço , Membros Artificiais/instrumentação , Humanos , Perna (Membro) , Desenho de Prótese , Esportes
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