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1.
Genet Med ; 26(7): 101144, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38641994

RESUMO

PURPOSE: GM1 gangliosidosis (GM1) a lysosomal disorder caused by pathogenic variants in GLB1, is characterized by relentless neurodegeneration. There are no approved treatments. METHODS: Forty-one individuals with type II (late-infantile and juvenile) GM1 participated in a single-site prospective observational study. RESULTS: Classification of 37 distinct variants using American College of Medical Genetics and Genomics criteria resulted in the upgrade of 6 and the submission of 4 new variants. In contrast to type I infantile disease, children with type II had normal or near normal hearing and did not have cherry-red maculae or hepatosplenomegaly. Some older children with juvenile onset disease developed thickened aortic and/or mitral valves. Serial magnetic resonance images demonstrated progressive brain atrophy, more pronounced in late infantile patients. Magnetic resonance spectroscopy showed worsening elevation of myo-inositol and deficit of N-acetyl aspartate that were strongly correlated with scores on the Vineland Adaptive Behavior Scale, progressing more rapidly in late infantile compared with juvenile onset disease. CONCLUSION: Serial phenotyping of type II GM1 patients expands the understanding of disease progression and clarifies common misconceptions about type II patients; these are pivotal steps toward more timely diagnosis and better supportive care. The data amassed through this 10-year effort will serve as a robust comparator for ongoing and future therapeutic trials.

2.
Curr Opin Cardiol ; 39(4): 364-370, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38652248

RESUMO

PURPOSE OF REVIEW: The incorporation of genetic counseling and testing is essential to evaluation and management of thoracic aortic disease in patients under 60 years of age and those with family histories suspicious for heritable thoracic aortic disease and disorders associated with increased risk for acute type-A aortic dissection. RECENT FINDINGS: As many as 20% of individuals with thoracic aortic disease under the age of 60 years have autosomal dominant patterns of inheritance. A considerable number of heritability factors remain undefined for these families. SUMMARY: Genetic aortopathy programs require a collaborative approach including cardiovascular specialists and surgeons, medical geneticists, genetic counselors, and allied healthcare professionals. Comprehensive evaluation and management of these patients includes collection of detailed phenotypic data to inform the broader community and identify new associated and causative genes of interest, genetic modifiers, and other risk factors. These programs optimize outcomes and reduce the overall burden in the population of acute aortic dissection and related comorbidities.


Assuntos
Doenças da Aorta , Humanos , Doenças da Aorta/genética , Doenças da Aorta/terapia , Doenças da Aorta/diagnóstico , Aconselhamento Genético/métodos , Testes Genéticos/métodos , Desenvolvimento de Programas , Dissecção Aórtica/genética , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/terapia , Aneurisma da Aorta Torácica/genética , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/terapia , Equipe de Assistência ao Paciente , Predisposição Genética para Doença , Pessoa de Meia-Idade
3.
Curr Opin Cardiol ; 39(4): 340-347, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38606680

RESUMO

PURPOSE OF REVIEW: The aim of this study is to provide an update on mitral valve prolapse (MVP) and mitral annular disjunction (MAD) and who may be at risk for ventricular arrhythmias and sudden cardiac death. RECENT FINDINGS: MVP is generally considered a benign condition. However, a small subset of patients may be at risk for life-threatening ventricular arrhythmias. Among the risk factors identified in adults include patients with bileaflet mitral valves, myxomatous changes, myocardial fibrosis, and the presence of MAD. Advances in multimodal imaging have allowed for improved identification of fibrosis, anatomical valve derangements, and the amount of MAD. Recent guidelines have suggested that patients with MVP with or without MAD may be at risk for life-threatening arrhythmias if they have had prior ventricular arrhythmias, ventricular dysfunction, or unexplained syncope. Yet, extrapolation of adult data to a pediatric cohort with similar MVP and MAD at this juncture is challenging. There is, however, early evidence that some pediatric patients with significant myocardial fibrosis or abnormal tissue Doppler may be at risk for ventricular tachycardia. SUMMARY: Mitral valve prolapse and mitral annular disjunction at times coexist and at other times can be seen as isolated entities. While the incidence of arrhythmic MVP is quite rare, there is increasing evidence that certain select adults with MVP may be at risk for ventricular tachycardia and sudden cardiac death. Future multicenter studies are needed to better understand the natural history of arrhythmic mitral valve disease and how early disease manifestation in children may impact findings now being reported in young adults.


Assuntos
Prolapso da Valva Mitral , Valva Mitral , Humanos , Prolapso da Valva Mitral/complicações , Valva Mitral/diagnóstico por imagem , Valva Mitral/patologia , Adulto , Adolescente , Morte Súbita Cardíaca/etiologia , Morte Súbita Cardíaca/epidemiologia , Fatores de Risco , Arritmias Cardíacas/etiologia
4.
medRxiv ; 2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38313286

RESUMO

Purpose: GM1 gangliosidosis (GM1) is an ultra-rare lysosomal storage disease caused by pathogenic variants in galactosidase beta 1 (GLB1; NM_000404), primarily characterized by neurodegeneration, often in children. There are no approved treatments for GM1, but clinical trials using gene therapy (NCT03952637, NCT04713475) and small molecule substrate inhibitors (NCT04221451) are ongoing. Understanding the natural history of GM1 is essential for timely diagnosis, facilitating better supportive care, and contextualizing the results of therapeutic trials. Methods: Forty-one individuals with type II GM1 (n=17 late infantile and n=24 juvenile onset) participated in a single-site prospective observational study. Here, we describe the results of extensive multisystem assessment batteries, including clinical labs, neuroimaging, physiological exams, and behavioral assessments. Results: Classification of 37 distinct variants in this cohort was performed according to ACMG criteria and resulted in the upgrade of six and the submission of four new variants to pathogenic or likely pathogenic. In contrast to type I infantile, children with type II disease exhibited normal or near normal hearing and did not have cherry red maculae or significant hepatosplenomegaly. Some older children with juvenile onset developed thickened aortic and/or mitral valves with regurgitation. Serial MRIs demonstrated progressive brain atrophy that were more pronounced in those with late infantile onset. MR spectroscopy showed worsening elevation of myo-inositol and deficit of N-acetyl aspartate that were strongly correlated with scores on the Vineland Adaptive Behavior Scale and progress more rapidly in late infantile than juvenile onset disease. Conclusion: The comprehensive serial phenotyping of type II GM1 patients expands the understanding of disease progression and clarifies some common misconceptions about type II patients. Findings from this 10-year endeavor are a pivotal step toward more timely diagnosis and better supportive care for patients. The wealth of data amassed through this effort will serve as a robust comparator for ongoing and future therapeutic trials.

5.
Cureus ; 15(3): e36132, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37065351

RESUMO

Background Hypertension control is critical to reducing cardiovascular disease, challenging to achieve, and exacerbated by socioeconomic inequities. Few states have established statewide quality improvement (QI) infrastructures to improve blood pressure (BP) control across economically disadvantaged populations. In this study, we aimed to improve BP control by 15% for all Medicaid recipients and by 20% for non-Hispanic Black participants. Methodology This QI study used repeated cross-sections of electronic health record data and, for Medicaid enrollees, linked Medicaid claims data for 17,672 adults with hypertension seen at one of eight high-volume Medicaid primary care practices in Ohio from 2017 to 2019. Evidence-based strategies included (1) accurate BP measurement; (2) timely follow-up; (3) outreach; (4) a standardized treatment algorithm; and (5) effective communication. Payers focused on a 90-day supply (vs. 30-day) of BP medications, home BP monitor access, and outreach. Implementation efforts included an in-person kick-off followed by monthly QI coaching and monthly webinars. Weighted generalized estimating equations were used to estimate the baseline, one-year, and two-year implementation change in the proportion of visits with BP control (<140/90 mm Hg) stratified by race/ethnicity. Results For all practices, the percentage of participants with controlled BP increased from 52% in 2017 to 60% in 2019. Among non-Hispanic Whites, the odds of achieving BP control in year one and year two were 1.24 times (95% confidence interval: 1.14, 1.34) and 1.50 times (1.38, 1.63) higher relative to baseline, respectively. Among non-Hispanic Blacks, the odds for years one and two were 1.18 times (1.10, 1.27) and 1.34 times (1.24, 1.45) higher relative to baseline, respectively. Conclusions A hypertension QI project as part of establishing a statewide QI infrastructure improved BP control in practices with a high volume of disadvantaged patients. Future efforts should investigate ways to reduce inequities in BP control and further explore factors associated with greater BP improvements and sustainability.

6.
Front Bioeng Biotechnol ; 10: 971096, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36246387

RESUMO

Purpose: The aim of this study was to outline a fully automatic tool capable of reliably predicting the most suitable total knee replacement implant sizes for patients, using bi-planar X-ray images. By eliminating the need for manual templating or guiding software tools via the adoption of convolutional neural networks, time and resource requirements for pre-operative assessment and surgery could be reduced, the risk of human error minimized, and patients could see improved outcomes. Methods: The tool utilizes a machine learning-based 2D-3D pipeline to generate accurate predictions of subjects' distal femur and proximal tibia bones from X-ray images. It then virtually fits different implant models and sizes to the 3D predictions, calculates the implant to bone root-mean-squared error and maximum over/under hang for each, and advises the best option for the patient. The tool was tested on 78, predominantly White subjects (45 female/33 male), using generic femur component and tibia plate designs scaled to sizes obtained for five commercially available products. The predictions were then compared to the ground truth best options, determined using subjects' MRI data. Results: The tool achieved average femur component size prediction accuracies across the five implant models of 77.95% in terms of global fit (root-mean-squared error), and 71.79% for minimizing over/underhang. These increased to 99.74% and 99.49% with ±1 size permitted. For tibia plates, the average prediction accuracies were 80.51% and 72.82% respectively. These increased to 99.74% and 98.98% for ±1 size. Better prediction accuracies were obtained for implant models with fewer size options, however such models more frequently resulted in a poor fit. Conclusion: A fully automatic tool was developed and found to enable higher prediction accuracies than generally reported for manual templating techniques, as well as similar computational methods.

7.
Mol Genet Genomic Med ; 10(8): e1947, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35795918

RESUMO

BACKGROUND: Duplication of the distal end of chromosome 15q has been previously implicated in a characteristic overgrowth syndrome. Additionally, many patients have other congenital malformations, including cardiac, renal, genital, and musculoskeletal anomalies. However, some patients may present with intrauterine growth restriction and short stature. Different breakpoints within 15q, as well as different environmental factors, may underlie these varied presentations. CASE PRESENTATION: We discuss monochorionic-diamniotic twins with a ~345 kb maternally inherited duplication in 15q26.3. The twins presented with discordant pathology-one twin with a single umbilical artery, selective intrauterine growth restriction, and multiple cardiac defects including aortic coarctation, aortic valve stenosis, and ventricular septal defect, whereas the other twin was unaffected. To our knowledge, this case represents the smallest reported duplication of distal 15q. CONCLUSION: The discordant phenotype seen in the twins is likely due to a complex interplay between genetic and environmental causes. The affected infant presented prenatally with growth restriction and a single umbilical artery rather than overgrowth, potentially due to a unique breakpoint within 15q. This, in turn, may have produced hemodynamic perturbations between the twins, leading to discordant cardiac disease. Our report thus highlights the importance of genetic and nongenetic mechanisms underlying discordant anomalies in monochorionic twins.


Assuntos
Cardiopatias Congênitas , Artéria Umbilical Única , Feminino , Retardo do Crescimento Fetal/genética , Cardiopatias Congênitas/genética , Humanos , Gêmeos Monozigóticos/genética
8.
Arch Orthop Trauma Surg ; 140(11): 1825-1835, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32852593

RESUMO

INTRODUCTION: Acetabular component revision surgery can be a challenging task due to the encountered bone defects. Both cemented and uncemented techniques are described. We report on the survivorship of the Thackray cross plate with rim reinforcement ring for cemented acetabular revision. PATIENTS AND METHODS: This is a retrospective case series of all patients treated with the implant with a minimum follow-up of 2 years. Acetabular defects were characterized according to the Paprosky classification. Data on potential risk factors for failure of the construct as well as the Oxford Hip Score (OHS) were collected. Kaplan-Meier survival analysis with radiographic aseptic loosening or revision for aseptic loosening as the end point was performed. RESULTS: From 2000 to 2017, 35 revisions in 18 male and 17 female patients with an average age of 72 years were included. Bone allograft was used in 26 cases and additional implants (medial or supero-lateral mesh) in 13. Seven patients have deceased and the fate of all revisions is known. At an average clinical follow-up of 9.7 (2.6 to 19.6) years, there were no further re-revisions for construct failure. Five hips have demonstrated radiological evidence of aseptic loosening. Radiologically loose components were associated with more severe grades of acetabular bone defects (Paprosky Type 3) (60% vs 3%, p = 0.006). Kaplan-Meier survival analysis demonstrates 79.8% overall survivorship at 7 years. Survivorship for Type 2 defects was significantly higher compared to Type 3 (90% vs 0% at 7 years, Logrank test p = 0.002, Cox proportional hazards p = 0.03). The final median OHS was 38 (12-48) and was not affected by component loosening. CONCLUSION: This is a cost-effective device that protects the underlying bone graft (81% complete remodeling) and prevents subsidence of the cemented cup (2 mm on average). It should be used with caution in high-grade defects and perhaps not advised.


Assuntos
Acetábulo/cirurgia , Artroplastia de Quadril , Placas Ósseas , Prótese de Quadril , Reoperação , Idoso , Transplante Ósseo , Feminino , Humanos , Masculino , Falha de Prótese , Estudos Retrospectivos
9.
Environ Toxicol Chem ; 39(4): 904-912, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32072671

RESUMO

Estrogen toxicity has been an area of priority in aquatic toxicology over the last 20 yr. Currently, estrogen toxicity is primarily linked to classical estrogen signaling, the interaction of estrogen receptors alpha and beta (ERα and ERß). Recent evidence has indicated that a rapid, nongenomic, nonclassical estrogen signaling pathway exists via the G protein-coupled estrogen receptor (GPER), which is expressed in many biological systems, with roles in the cardiovascular system. The objective of the present study was to investigate the effect of 17α-ethinylestradiol (EE2) on the heart rate of embryonic Japanese medaka (Oryzias latipes). A significant decrease (bradycardia) in embryonic heart rate was observed at all treatment concentrations (0.1, 1, 10, 100, and 1000 ng/L EE2) at 144, 168, and 192 h postfertilization (hpf; p ≤ 0.05), whereas 120 and 216 hpf embryos experienced a significant decrease from the control at 10, 100, and 1000 ng/L EE2 and 0.1, 100, and 1000 ng/L EE2, respectively (p ≤ 0.05). In addition, using select estrogen receptor modulators, it was demonstrated that estrogen-induced bradycardia appears to be linked to GPER and not ERα and ERß. The present study highlights GPER as a novel and alternative mode of action for EE2 toxicity at environmentally relevant concentrations. Environ Toxicol Chem 2020;39:904-912. © 2020 SETAC.


Assuntos
Embrião não Mamífero/efeitos dos fármacos , Disruptores Endócrinos/toxicidade , Etinilestradiol/toxicidade , Frequência Cardíaca/efeitos dos fármacos , Oryzias/fisiologia , Poluentes Químicos da Água/toxicidade , Animais , Relação Dose-Resposta a Droga , Embrião não Mamífero/fisiologia , Receptor alfa de Estrogênio/metabolismo , Receptor beta de Estrogênio/metabolismo , Estrogênios/metabolismo , Feminino , Masculino , Transdução de Sinais
10.
Conserv Biol ; 34(1): 207-219, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31385631

RESUMO

Habitat fragmentation is a primary driver of wildlife loss, and establishment of biological corridors is a common strategy to mitigate this problem. A flagship example is the Mesoamerican Biological Corridor (MBC), which aims to connect protected forest areas between Mexico and Panama to allow dispersal and gene flow of forest organisms. Because forests across Central America have continued to degrade, the functioning of the MBC has been questioned, but reliable estimates of species occurrence were unavailable. Large mammals are suitable indicators of forest functioning, so we assessed their conservation status across the Isthmus of Panama, the narrowest section of the MBC. We used large-scale camera-trap surveys and hierarchical multispecies occupancy models in a Bayesian framework to estimate the occupancy of 9 medium to large mammals and developed an occupancy-weighted connectivity metric to evaluate species-specific functional connectivity. White-lipped peccary (Tayassu pecari), jaguar (Panthera onca), giant anteater (Myrmecophaga tridactyla), white-tailed deer (Odocoileus virginianus), and tapir (Tapirus bairdii) had low expected occupancy along the MBC in Panama. Puma (Puma concolor), red brocket deer (Mazama temama), ocelot (Leopardus pardalis), and collared peccary (Pecari tajacu), which are more adaptable, had higher occupancy, even in areas with low forest cover near infrastructure. However, the majority of species were subject to ≥1 gap that was larger than their known dispersal distances, suggesting poor connectivity along the MBC in Panama. Based on our results, forests in Darien, Donoso-Santa Fe, and La Amistad International Park are critical for survival of large terrestrial mammals in Panama and 2 areas need restoration.


Efectividad de Panamá como un Puente Terrestre Intercontinental para Mamíferos Mayores Resumen La fragmentación del hábitat es un causante primario de la pérdida de biodiversidad, y el establecimiento de corredores biológicos es una estrategia común para mitigar este problema. El Corredor Biológico Mesoamericano (CBM) es un ejemplo notable que pretende conectar áreas boscosas protegidas entre México y Panamá para permitir la dispersión y flujo genético de organismos del bosque. El funcionamiento del CBM se ha cuestionado debido a que la degradación de los bosques en Centroamérica continúa, pero no se dispone de estimaciones confiables de la ocurrencia de especies. Los mamíferos grandes son indicadores adecuados del funcionamiento de los bosques tropicales Por lo tanto evaluamos su estado de conservación en el Istmo de Panamá, la sección más angosta del CBM. Utilizamos muestreos con cámaras trampa y modelos de ocupación para múltiples especies bajo un modelo Bayesiano para estimar la ocupación de 9 especies de mamíferos medianos a grandes, y desarrollamos una métrica de conectividad ponderada por la ocupación para evaluar la conectividad funcional para cada especie. El puerco de monte (Tayassu pecari), jaguar (Panthera onca), hormiguero gigante (Myrmecophaga tridactyla), venado cola blanca (Oidocoileus virginianus), y tapir (Tapirus bairdii) presentaron una ocupación baja en el CBM en Panamá. El puma (Puma concolor), venado corzo (Mazama temama), ocelote (Leopardus pardalis) y el saino (Pecari tajacu), que son más adaptables, presentaron mayor ocupación, aún en áreas con poca cobertura boscosa, cercanas a infraestructura. Sin embargo, la mayoría de las especies estuvo sujeta a ≥ 1 vacío que era mayor que sus distancias de dispersión conocidas, lo que sugiere una conectividad pobre a lo largo del CBM en Panamá. Basados en nuestros resultados, los bosques de Darién, Donoso-Santa Fé y el Parque Internacional La Amistad son críticos para la supervivencia de mamíferos terrestres grandes en Panamá mientras que 2 áreas requieren restauración.


Assuntos
Conservação dos Recursos Naturais , Cervos , Animais , Teorema de Bayes , América Central , Ecossistema , Florestas , Mamíferos , México , Panamá
11.
J Phys Chem Lett ; 10(20): 6032-6037, 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31539470

RESUMO

Polyoxometalates are known to be inhibitors of a diverse collection of enzymes, although the specific interactions that lead to this bioactivity are still unclear. Spectroscopic characterization may be an invaluable if indirect tool for remedying this problem, yet this requires clear, cogent assignment of polyoxometalate spectra before the complicating effect of their binding to large biomolecules can be considered. We report the use of FT-IR and resonance Raman spectroscopies alongside density functional theory to describe the vibrational and electronic structures of decavanadate, [V10O28]6-. Our computational model, which reproduced the majority of vibrational features to within 10 cm-1, was used to identify an axial oxo ligand as the most likely position of the acidic proton in the related cluster [HV10O28]5-. As resonance Raman spectroscopy can directly interrogate chromophores embedded in complex systems, this approach may be of general use in answering structural questions about polyoxometalate-enzyme systems.

12.
Photochem Photobiol Sci ; 17(9): 1267, 2018 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-30074604

RESUMO

Correction for 'Visible light-promoted alkylation of imines using potassium organotrifluoroborates' by Davis P. Plasko et al., Photochem. Photobiol. Sci., 2018, 17, 534-538.

13.
Front Immunol ; 9: 976, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29867956

RESUMO

Background: Recent technological advances in immune repertoire sequencing have created tremendous potential for advancing our understanding of adaptive immune response dynamics in various states of health and disease. Immune repertoire sequencing produces large, highly complex data sets, however, which require specialized methods and software tools for their effective analysis and interpretation. Results: VDJServer is a cloud-based analysis portal for immune repertoire sequence data that provide access to a suite of tools for a complete analysis workflow, including modules for preprocessing and quality control of sequence reads, V(D)J gene segment assignment, repertoire characterization, and repertoire comparison. VDJServer also provides sophisticated visualizations for exploratory analysis. It is accessible through a standard web browser via a graphical user interface designed for use by immunologists, clinicians, and bioinformatics researchers. VDJServer provides a data commons for public sharing of repertoire sequencing data, as well as private sharing of data between users. We describe the main functionality and architecture of VDJServer and demonstrate its capabilities with use cases from cancer immunology and autoimmunity. Conclusion: VDJServer provides a complete analysis suite for human and mouse T-cell and B-cell receptor repertoire sequencing data. The combination of its user-friendly interface and high-performance computing allows large immune repertoire sequencing projects to be analyzed with no programming or software installation required. VDJServer is a web-accessible cloud platform that provides access through a graphical user interface to a data management infrastructure, a collection of analysis tools covering all steps in an analysis, and an infrastructure for sharing data along with workflows, results, and computational provenance. VDJServer is a free, publicly available, and open-source licensed resource.


Assuntos
Computação em Nuvem , Biologia Computacional/métodos , Genômica/métodos , Éxons VDJ/imunologia , Animais , Metodologias Computacionais , Humanos , Disseminação de Informação , Camundongos , Software , Interface Usuário-Computador , Navegador , Fluxo de Trabalho
14.
Photochem Photobiol Sci ; 17(5): 534-538, 2018 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-29722411

RESUMO

A mild, redox-neutral, alkylation of imines with potassium alkyltrifluoroborates is described. The reaction proceeds under photoredox conditions at ∼30 °C with primary, secondary, and tertiary alkyltrifluoroborates, leading to alkylation products in moderate to good yield in most cases. Aryl-, vinyl-, and cyclopropyltrifluoroborates failed to react under the reported conditions.

15.
J Saudi Heart Assoc ; 28(3): 170-2, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27358535

RESUMO

The following report describes the case of newborn girl with an asymptomatic systolic murmur, which on imaging revealed a nearly obstructive mass in the left-ventricular outflow tract. The mass was resected and found to be consistent with a rhabdomyoma. Here, we describe the pathologic and clinical characteristics of this tumor.

16.
PLoS One ; 11(3): e0151372, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27007122

RESUMO

Central America is experiencing rapid forest loss and habitat degradation both inside and outside of protected areas. Despite increasing deforestation, the Caribbean region of Nicaragua plays an important role in the survival or extinction of large mammal populations in Central America given that it still retains core areas of habitat for large mammal species. The proposed interoceanic canal project that would bisect the southern half of this Caribbean region represents a new threat that, combined with an advancing agricultural frontier, could affect populations of large mammal species such as jaguars, white-lipped peccaries, and Baird's tapirs. We used occupancy models to examine the relative occupancy probabilities for an assemblage of terrestrial mammals in the south Caribbean region of Nicaragua to identify current core areas for our study species and conduct a preliminary evaluation of the potential impacts of the proposed interoceanic canal. We modeled a community level distribution of eight species with varying levels of sensitivity to human encroachment and a range of habitat associations. Our model results reveal three priority areas for terrestrial mammal conservation in our study area. The mapped predictions show that the only remaining area of suitable habitat for large mammals in the path of the proposed interoceanic canal is a relatively thin strip of forest that runs along the Caribbean Coast. In light of these findings, we propose five recommendations that will help ensure the conservation of this area of the proposed canal route as suitable habitat for our study species.


Assuntos
Ecossistema , Florestas , Mamíferos/classificação , Animais , Biodiversidade , Região do Caribe , Conservação dos Recursos Naturais , Modelos Teóricos , Nicarágua
17.
Heart Rhythm ; 13(5): 1096-1104, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26690060

RESUMO

BACKGROUND: Epicardial implantable cardioverter-defibrillator (ICD) placement in infants, children, and patients with complex cardiac anatomy requires an open surgical thoracotomy and is associated with increased pain, longer length of stay, and higher cost. OBJECTIVE: The purpose of this study was to compare an open surgical epicardial placement approach with percutaneous pericardial placement of an ICD lead system in an infant piglet model. METHODS: Animals underwent either epicardial placement by direct suture fixation through a left thoracotomy or minimally invasive pericardial placement with thoracoscopic visualization. Initial lead testing and defibrillation threshold testing (DFT) were performed. After the 2-week survival period, repeat lead testing and DFT were performed before euthanasia. RESULTS: Minimally invasive placement was performed in 8 piglets and open surgical placement in 7 piglets without procedural morbidity or mortality. The mean initial DFT value was 10.5 J (range 3-28 J) in the minimally invasive group and 10.0 J (range 5-35 J) in the open surgical group (P = .90). After the survival period, the mean DFT value was 12.0 J (range 3-20 J) in the minimally invasive group and 12.3 J (range 3-35 J) in the open surgical group (P = .95). All lead and shock impedances, R-wave amplitudes, and ventricular pacing thresholds remained stable throughout the survival period. CONCLUSION: Compared with open surgical epicardial ICD lead placement, minimally invasive pericardial placement demonstrates an equivalent ability to effectively defibrillate the heart and has demonstrated similar lead stability. With continued technical development and operator experience, the minimally invasive method may provide a viable alternative to epicardial ICD lead placement in infants, children, and adults at risk of sudden cardiac death.


Assuntos
Morte Súbita Cardíaca/prevenção & controle , Desfibriladores Implantáveis , Cardiopatias Congênitas/complicações , Implantação de Prótese , Cirurgia Torácica Vídeoassistida , Toracotomia , Animais , Pesquisa Comparativa da Efetividade , Modelos Animais de Doenças , Humanos , Lactente , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Pediatria/métodos , Implantação de Prótese/efeitos adversos , Implantação de Prótese/métodos , Suínos , Cirurgia Torácica Vídeoassistida/efeitos adversos , Cirurgia Torácica Vídeoassistida/métodos , Toracotomia/efeitos adversos , Toracotomia/métodos , Resultado do Tratamento
18.
Oncotarget ; 7(3): 3186-200, 2016 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-26672603

RESUMO

Curcumin (Cur) has been extensively studied in several types of malignancies including colorectal cancer (CRC); however its clinical application is greatly affected by low bioavailability. Several strategies to improve the therapeutic response of Cur are being pursued, including its combination with small molecules and drugs. We investigated the therapeutic efficacy of Cur in combination with the small molecule tolfenamic acid (TA) in CRC cell lines. TA has been shown to inhibit the growth of human cancer cells in vitro and in vivo, via targeting the transcription factor specificity protein1 (Sp1) and suppressing survivin expression. CRC cell lines HCT116 and HT29 were treated with TA and/or Cur and cell viability was measured 24-72 hours post-treatment. While both agents caused a steady reduction in cell viability, following a clear dose/ time-dependent response, the combination of TA+Cur showed higher growth inhibition when compared to either single agent. Effects on apoptosis were determined using flow cytometry (JC-1 staining to measure mitochondrial membrane potential), Western blot analysis (c-PARP expression) and caspase 3/7 activity. Reactive oxygen species (ROS) levels were measured by flow cytometry and the translocation of NF-kB into the nucleus was determined using immunofluorescence. Results showed that apoptotic markers and ROS activity were significantly upregulated following combination treatment, when compared to the individual agents. This was accompanied by decreased expression of Sp1, survivin and NF-kB translocation. The combination of TA+Cur was more effective in HCT116 cells than HT29 cells. These results demonstrate that TA may enhance the anti-proliferative efficacy of Cur in CRC cells.


Assuntos
Antineoplásicos/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Neoplasias do Colo/tratamento farmacológico , Curcumina/farmacologia , Proteínas Inibidoras de Apoptose/biossíntese , Espécies Reativas de Oxigênio/metabolismo , Fator de Transcrição Sp1/biossíntese , ortoaminobenzoatos/farmacologia , Transporte Ativo do Núcleo Celular/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Caspase 3/metabolismo , Caspase 7/metabolismo , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Citometria de Fluxo , Células HCT116 , Células HT29 , Humanos , Potencial da Membrana Mitocondrial/efeitos dos fármacos , NF-kappa B/metabolismo , Poli(ADP-Ribose) Polimerase-1/biossíntese , Survivina
19.
Inorg Chem ; 54(8): 3736-47, 2015 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-25839944

RESUMO

5'-deoxyadenosylcobalamin (coenzyme B12, AdoCbl) serves as the cofactor for several enzymes that play important roles in fermentation and catabolism. All of these enzymes initiate catalysis by promoting homolytic cleavage of the cofactor's Co-C bond in response to substrate binding to their active sites. Despite considerable research efforts, the role of the lower axial ligand in facilitating Co-C bond homolysis remains incompletely understood. In the present study, we characterized several derivatives of AdoCbl and its one-electron reduced form, Co(II)Cbl, by using electronic absorption and magnetic circular dichroism spectroscopies. To complement our experimental data, we performed computations on these species, as well as additional Co(II)Cbl analogues. The geometries of all species investigated were optimized using a quantum mechanics/molecular mechanics method, and the optimized geometries were used to compute absorption spectra with time-dependent density functional theory. Collectively, our results indicate that a reduction in the basicity of the lower axial ligand causes changes to the cofactor's electronic structure in the Co(II) state that replicate the effects seen upon binding of Co(II)Cbl to Class I isomerases, which replace the lower axial dimethylbenzimidazole ligand of AdoCbl with a protein-derived histidine (His) residue. Such a reduction of the basicity of the His ligand in the enzyme active site may be achieved through proton uptake by the catalytic triad of conserved residues, DXHXGXK, during Co-C bond homolysis.


Assuntos
Carbono/química , Cobalto/química , Cobamidas/química , Compostos Organometálicos/química , Teoria Quântica , Carbono/metabolismo , Dicroísmo Circular , Cobalto/metabolismo , Cobamidas/metabolismo , Modelos Moleculares , Estrutura Molecular , Compostos Organometálicos/metabolismo
20.
Gen Dent ; 63(1): 73-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25574724

RESUMO

The application and incomplete removal of a computer-aided design/computer-aided manufacture imaging powder may affect the dentin surface prior to bonding a ceramic restoration. The purpose of this study was to compare the effect of imaging powder residue on the shear bond strength of a self-adhesive resin cement to dentin. Mounted human third molars were sectioned coronally with a diamond saw to expose the dentin, which was then prepared with a diamond bur mounted in a custom jig. The dentin surface was sprayed with 3 different imaging powders. The 3 powder groups were then divided into 3 subgroups based on the method of powder removal: no rinse, 1-second rinse, and 10-second rinse. A control group was created that had no application of imaging powder. A self-adhesive resin cement was bonded to the surfaces and loaded to failure in a universal testing machine after 24 hours of storage. Data was analyzed with Kruskal-Wallis and Mann-Whitney nonparametric tests. The bonding to dentin surfaces of the powder groups that were rinsed for 1 or 10 seconds were not significantly different from each other or the nonpowdered control. The type of imaging powder did not significantly affect the bond strength. The nonrinsed powdered dentin surface had a significant reduction in bond strength compared to both the control and the rinsed powdered surfaces.


Assuntos
Colagem Dentária , Técnica de Moldagem Odontológica/efeitos adversos , Cimentos de Resina/metabolismo , Desenho Assistido por Computador , Colagem Dentária/métodos , Materiais Dentários/uso terapêutico , Falha de Restauração Dentária , Análise do Estresse Dentário , Humanos , Pós/uso terapêutico
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