RESUMO
INTRODUCCIÓN: La cesárea electiva antes de las 39 semanas de edad gestacional (EG) se ha asociado a un incremento en la incidencia de distrés respiratorio iatrogénico y de neumotórax en el recién nacido a término (RNT), probablemente en relación con una mayor morbilidad respiratoria y necesidad de reanimación. Estos aspectos no han sido evaluados sistemáticamente en nuestro medio. OBJETIVO: Conocer si la EG, el tipo de parto y la intensidad de la reanimación cardiopulmonar (RCP) se asocian con un incremento en la incidencia de neumotórax en el RNT. PACIENTES Y MÉTODOS: Se estudiaron todos los RNT (≥ 37 semanas de EG) nacidos en nuestra maternidad durante el periodo 2006-2010, según el tipo de parto (vaginal, cesárea o fórceps) y su indicación en el caso de las cesáreas. Se consideró RCP avanzada la aplicación de presión positiva con mascarilla, intubación, o necesidad de compresiones torácicas y/o medicación. El diagnóstico de neumotórax fue clínico y radiológico. RESULTADOS: Se incluyeron un total de 32.238 RNT. Tipo de parto: vaginal 76,1%, cesárea 12,4% y fórceps 11,5%. La incidencia de neumotórax fue del 0,316%, siendo significativamente mayor en las cesáreas (0,85%) que en los fórceps (0,59%) o nacimientos vaginales (0,19%) (p < 0,001); en ≥ 40 semanas de EG (0,37%) frente a ≤ 39 semanas de EG (0,24%) (p = 0,033) y en RCP avanzada (4,29%) frente a RCP básica (0,18%) (p < 0,001). CONCLUSIONES: La EG ≥ 40 semanas, el parto mediante cesárea o fórceps y la RCP avanzada se asociaron significativamente a una mayor incidencia de neumotórax en el RNT. En nuestra población no se observó un aumento en la incidencia de neumotórax tras cesárea electiva en menores de 39 semanas de EG
BACKGROUND: Elective caesarean section before 39 weeks gestational age (GA) has been associated with a higher incidence of iatrogenic respiratory distress and pneumothorax in term newborn babies, probably because of a higher respiratory morbidity and the need for resuscitation. These factors have not been systematically evaluated in our patients. OBJECTIVE: To determine whether the gestational age, type of delivery, and intensity of resuscitation, are associated with an increase in the incidence of pneumothorax in term neonates. PATIENTS AND METHODS: Full term neonates (≥37 weeks GA) born in our maternity unit from January 2006 to December 2010 were studied, along with the type of delivery (vaginal, forceps or caesarean section). Advanced cardiopulmonary resuscitation (CPR) was defined as the need of bag and mask intermittent ventilation, intubation, chest compression, and/or administration of medication. The diagnosis of pneumothorax was clinical and radiological in all cases. RESULTS: A total of 32,238 full term newborns were included. Type of delivery: vaginal 76.1%, C-section 12.4%, and forceps 11.5%. The incidence of pneumothorax was 0.316%. It was significantly higher in C-section (0.85%), than in forceps (0.59%), or non-instrumental vaginal deliveries (0.19%) (P < 0.001), and in infants ≥40 weeks GA (0.37%) compared to ≤39 weeks GA (0.24%) (P = 0.033), and in advanced CPR (4.29%) compared to basic CPR (0.18%) (P < 0.001). CONCLUSIONS: A GA≥40 weeks, C-section, or forceps delivery, and advanced CPR immediately after birth were significantly associated with a higher incidence of pneumothorax in full term newborn babies. In our population, we did not observe an increase in pneumothorax among neonates born by elective C-section before 39 weeks of gestation
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Pneumotórax/epidemiologia , Asfixia Neonatal/complicações , Fatores de Risco , Idade Gestacional , Complicações do Trabalho de Parto/epidemiologia , Reanimação Cardiopulmonar , Cesárea/efeitos adversosRESUMO
BACKGROUND: Elective caesarean section before 39 weeks gestational age (GA) has been associated with a higher incidence of iatrogenic respiratory distress and pneumothorax in term newborn babies, probably because of a higher respiratory morbidity and the need for resuscitation. These factors have not been systematically evaluated in our patients. OBJECTIVE: To determine whether the gestational age, type of delivery, and intensity of resuscitation, are associated with an increase in the incidence of pneumothorax in term neonates. PATIENTS AND METHODS: Full term neonates (≥ 37 weeks GA) born in our maternity unit from January 2006 to December 2010 were studied, along with the type of delivery (vaginal, forceps or caesarean section). Advanced cardiopulmonary resuscitation (CPR) was defined as the need of bag and mask intermittent ventilation, intubation, chest compression, and/or administration of medication. The diagnosis of pneumothorax was clinical and radiological in all cases. RESULTS: A total of 32,238 full term newborns were included. Type of delivery: vaginal 76.1%, C-section 12.4%, and forceps 11.5%. The incidence of pneumothorax was 0.316%. It was significantly higher in C-section (0.85%), than in forceps (0.59%), or non-instrumental vaginal deliveries (0.19%) (P<.001), and in infants ≥ 40 weeks GA (0.37%) compared to ≤ 39 weeks GA (0.24%) (P=.033), and in advanced CPR (4.29%) compared to basic CPR (0.18%) (P<.001). CONCLUSIONS: A GA ≥ 40 weeks, C-section, or forceps delivery, and advanced CPR immediately after birth were significantly associated with a higher incidence of pneumothorax in full term newborn babies. In our population, we did not observe an increase in pneumothorax among neonates born by elective C-section before 39 weeks of gestation.
Assuntos
Reanimação Cardiopulmonar , Parto Obstétrico , Idade Gestacional , Pneumotórax/epidemiologia , Cesárea , Humanos , Incidência , Recém-Nascido , Estudos RetrospectivosRESUMO
Introducción: La punción suprapúbica (PSP) es una técnica ampliamente aceptada para la obtención de muestras de orina estéril en lactantes con sospecha de infección urinaria. El control ecográfico permite mejorar su rendimiento, pero los estándares de medición han sido escasamente evaluados. Objetivo: Estudiar el rendimiento de la PSP guiada por ecografía en comparación con PSP ciega y establecer el valor de medición óptimo que garantice el éxito del procedimiento. Pacientes y métodos: Se realizó PSP guiada por ecografía a 50 lactantes ≤4 meses con sospecha de infección urinaria, determinándose el diámetro anteroposterior (DAP) y transversal de la vejiga. Se utilizaron ecógrafos Esaote MyLab® 25 Gold y Hewlett Packard Sonos® 5500, con sonda convexa de 3,5MHz. El porcentaje de éxito de la técnica y el volumen total de orina obtenido se compararon con los de un grupo control de 50 pacientes de la misma edad y características clínicas, a quienes se realizó PSP ciega. Resultados: La proporción de éxitos de la PSP ecoguiada fue del 92,3% frente al 30,8% de la PSP ciega (p<0,05), y el volumen de orina obtenido fue de 7,65±1,85ml y 6,1±2,13ml, respectivamente (p=0,001). Un DAP≥2cm resultó óptimo para garantizar el éxito de la técnica (97,8%). No se observaron complicaciones mayores en ninguno de los 2 grupos. Conclusiones: La PSP asistida con ecografía aumenta significativamente el éxito de la técnica en lactantes menores de 4 meses, siendo un DAP≥2cm el criterio óptimo para su realización (AU)
Introduction: Suprapubic bladder aspiration (SBA) is a widely accepted technique used to collect uncontaminated urine samples from infants with suspected urinary tract infection (UTI). Ultrasound-based guidance improves the success rates. The standard measurements for a successful procedure, however, have been scarcely evaluated. Objective: To assess the efficacy of ultrasound-guided SBA versus blind SBA, and to establish the bladder measurements associated with optimal results. Patients and method: Ultrasound-guided SBA was performed in 50 infants≤4 months of age with suspected UTI, and the anteroposterior (APD) and transverse diameter of the bladder were determined using ultrasound equipment (Esaote MyLab® 25 Gold, and Hewlett Packard Sonos® 5500) with a 3.5MHz convex probe. The success rates and the total volumes of collected urine were compared to a control group of 50 patients of similar age and clinical characteristics, to whom conventional blind SBA was performed. Results: The rate of successful ultrasound-guided SBA was 92.3% compared to 30.8% in the blind SBA group (P<0.05). The collected urine volumes were 7.65±1.85ml and 6.1±2.13ml, respectively (P<0.001). An APD≥2cm was associated with an optimal performance of the technique (97.8% success). No major complications were observed in either group. Conclusions: Ultrasound-guided SBA is significantly more successful than blind SBA in infants less than 4 months of age, with an APD≥2cm being optimal for conducting the procedure (AU)
Assuntos
Humanos , Masculino , Feminino , Lactente , Punções/métodos , Cirurgia Assistida por Computador/métodos , Infecções Urinárias/diagnóstico , Cistostomia , Coleta de Urina/métodosRESUMO
INTRODUCTION: Suprapubic bladder aspiration (SBA) is a widely accepted technique used to collect uncontaminated urine samples from infants with suspected urinary tract infection (UTI). Ultrasound-based guidance improves the success rates. The standard measurements for a successful procedure, however, have been scarcely evaluated. OBJECTIVE: To assess the efficacy of ultrasound-guided SBA versus blind SBA, and to establish the bladder measurements associated with optimal results. PATIENTS AND METHOD: Ultrasound-guided SBA was performed in 50 infants≤4 months of age with suspected UTI, and the anteroposterior (APD) and transverse diameter of the bladder were determined using ultrasound equipment (Esaote MyLab® 25 Gold, and Hewlett Packard Sonos® 5500) with a 3.5MHz convex probe. The success rates and the total volumes of collected urine were compared to a control group of 50 patients of similar age and clinical characteristics, to whom conventional blind SBA was performed. RESULTS: The rate of successful ultrasound-guided SBA was 92.3% compared to 30.8% in the blind SBA group (P<.05). The collected urine volumes were 7.65±1.85ml and 6.1±2.13ml, respectively (P<.001). An APD≥2cm was associated with an optimal performance of the technique (97.8% success). No major complications were observed in either group. CONCLUSIONS: Ultrasound-guided SBA is significantly more successful than blind SBA in infants less than 4 months of age, with an APD≥2cm being optimal for conducting the procedure.
Assuntos
Punções/métodos , Ultrassonografia de Intervenção , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/cirurgia , Infecções Urinárias/diagnóstico , Infecções Urinárias/urina , Humanos , Lactente , Recém-Nascido , Estudos ProspectivosRESUMO
The atherogenic lipoprotein phenotype (ALP) is a common heritable trait characterized by a predominance of small, dense low density lipoprotein particles (subclass pattern B), increased levels of triglyceride-rich lipoproteins, reductions in high density lipoproteins, and an increased risk for myocardial infarction. In a previous linkage study of 11 families, evidence for tight linkage of subclass pattern B with the LDL receptor (LDLR) locus on chromosome 19p13.2 was obtained. To test whether a mutation in the structural portion of the LDLR gene could be responsible for the phenotype, we first sequenced the exons of the receptor binding domain for each pair of parents in these 11 pedigrees. For the remaining portion of the LDLR coding region, exons as well as cloned LDLR cDNAs were sequenced for selected members of the pedigrees. No mutations that changed the amino acid sequence of the LDLR were found. We conclude that it is unlikely that a mutant allele of the LDLR protein is responsible for ALP.
Assuntos
Arteriosclerose/genética , Mutação , Receptores de LDL/genética , Cromossomos Humanos Par 19 , Humanos , Lipoproteínas LDL/sangue , Fenótipo , Polimorfismo de Fragmento de RestriçãoAssuntos
Anticorpos Monoclonais/genética , Dioxinas/imunologia , Cadeias Pesadas de Imunoglobulinas/genética , Cadeias Leves de Imunoglobulina/genética , Região Variável de Imunoglobulina/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , DNA Complementar/genética , Camundongos , Dados de Sequência MolecularRESUMO
Sialyl Lewis x and related fucosylated glycans are differentially expressed in human cells and form ligands for selectin adhesion receptors. alpha(1,3)Fucosyltransferases (FUTs) that complete their biosynthesis also show tissue specificity. We have established physical maps of the FUT3-6 loci to study regulation of this gene family. FUT4 has previously been localized to chromosome 11q21; FUT3, FUT6, and now FUT5 are localized to chromosome 19p13.3. Conventional and pulsed-field gel electrophoresis mapping of total genomic DNA and large genomic clones were used to generate a fine map of both loci, defining the order, orientation, and distances between FUTs. A P1 clone with all three 19p FUT genes in tandem orientation was isolated and used to study regions flanking FUT3, -5, and -6. Our studies provide preliminary information to study regulation of human FUT genes.
Assuntos
Cromossomos Humanos Par 11/genética , Cromossomos Humanos Par 19/genética , Fucosiltransferases/genética , Mapeamento Cromossômico , Biblioteca Genômica , Humanos , Mapeamento por RestriçãoRESUMO
We report the cDNA cloning of the gamma- and kappa-chain-encoding genes for two mouse monoclonal antibodies (mAb) which recognize dioxins. The nucleotide sequences encoding the variable regions of these mAb were also determined. Although the mAb have similar dioxin-binding characteristics, their deduced variable region amino-acid sequences are very different.
Assuntos
Anticorpos Monoclonais/biossíntese , Dioxinas/imunologia , Genes de Imunoglobulinas , Cadeias Pesadas de Imunoglobulinas/biossíntese , Cadeias Leves de Imunoglobulina/biossíntese , Região Variável de Imunoglobulina/biossíntese , Sequência de Aminoácidos , Animais , Anticorpos Monoclonais/genética , Sequência de Bases , Clonagem Molecular , DNA Complementar/química , Cadeias Pesadas de Imunoglobulinas/genética , Cadeias Leves de Imunoglobulina/genética , Região Variável de Imunoglobulina/genética , Camundongos , Dados de Sequência Molecular , Sinais Direcionadores de Proteínas/genéticaRESUMO
The DNA sequence of the bacteriophage T4 denV gene which encodes the DNA repair enzyme endonuclease V was previously constructed behind the hybrid lambda promoter OLPR in a plasmid vector. The OLPR-denV sequence was subcloned in M13mp18 and used as template to construct site-specific mutations in the denV structural gene in order to investigate structure/function relationships between the primary structure of the protein and its various DNA binding and catalytic activities. The Lys-130 residue of the wild-type endonuclease V has been postulated to be associated with its apurinic endonuclease (AP-endonuclease) activity. The codon for Lys-130 was changed to His-130 or Gly-130, and each denV sequence was subcloned into a pEMBL expression vector. These plasmids were transformed into repair-deficient Escherichia coli (uvrA recA), and the following parameters were examined for cells or cell extracts: expression and accumulation of endonuclease V protein (K-130, H-130, or G-130); survival after UV irradiation; dimer-specific DNA binding; and kinetics of phosphodiester bond scission at pyrimidine dimer sites, dimer-specific N-glycosylase activity, and AP-endonuclease activity. The enzyme's intracellular accumulation was significantly decreased for G-130 and slightly decreased for H-130 despite normal levels of denV-specific mRNA for each mutant. On a molar basis, the endonuclease V gene products generally gave parallel levels of each of the catalytic and binding functions with K-130 greater than H-130 greater than G-130 much greater than control denV-.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Endodesoxirribonucleases/genética , Escherichia coli/genética , Genes Virais , Genes , Lisina , Mutação , Fagos T/genética , Proteínas Virais , Desoxirribonuclease (Dímero de Pirimidina) , Escherichia coli/enzimologia , Escherichia coli/efeitos da radiação , Cinética , Plasmídeos , Regiões Promotoras Genéticas , Fagos T/enzimologia , Raios UltravioletaRESUMO
The expression of the T4 denV gene, which previously had been cloned in plasmid constructs downstream of the bacteriophage lambda hybrid promoter-operator oLpR, was analyzed under a variety of growth parameters. Expression of the denV gene product, endonuclease V, was confirmed in DNA repair-deficient Escherichia coli (uvrA recA) by Western blot analyses and by enhancements of resistance to UV irradiation.
Assuntos
Endodesoxirribonucleases/genética , Escherichia coli/genética , Genes Virais , Genes , Fagos T/genética , Clonagem Molecular , DNA Recombinante , Desoxirribonuclease (Dímero de Pirimidina) , Endodesoxirribonucleases/biossíntese , Escherichia coli/enzimologia , Escherichia coli/efeitos da radiação , Plasmídeos , Fagos T/enzimologia , Raios UltravioletaRESUMO
Procedures have been developed which simplify and expedite the screening of recombinant DNA constructions for those which only exhibit the desired DNA-DNA junctions. A synthetic DNA oligonucleotide designed to span (or "bridge") sequences around correct restriction enzyme junctions was used as a hybridization probe for the rapid identification of those sequences in several molecular cloning methodologies. It facilitated analyses of the products of random ligation reactions, as well as constructions harbored in bacteria and bacteriophage. "Bridge" probes, [32P]-end-labeled to very high specific activity, remained useful after several hybridizations and often circumvented lengthy restriction analyses.
