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1.
Rev Esp Quimioter ; 36(2): 169-179, 2023 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-36645021

RESUMO

OBJECTIVE: To estimate the prevalence of unknown HIV infection in patients who consulted in hospital emergency services (ED) for conditions defined in the SEMES-GESIDA Consensus Document (DC), evaluate the efficiency of its im-plementation and investigate the efficiency of HIV serology determination in other conditions. METHODS: Results were reviewed in 10 Catalan EDs for 12 months (July-21-June-22) after implementing CD recommendations: request HIV serology in case of suspected sexually transmitted infection, chemsex, post-exposure prophylaxis (PEP), mononucleosis syndrome, community pneumonia (18-65 y-o) or herpes zoster (18-65 y-o). Other reasons for request were included. Prevalence (%) of global seropositivity and for each circumstance was calculated, with a 95% confidence interval (95%CI). The efficient strategy was considered if the lower limit of the CI95%>0.1%. RESULTS: A total of5,107 HIV serologies were performed: 2,847(56%) in situations specified in CD, and 2,266 (44%) in other 138 circumstances. Forty-eight unknown HIV infections were detected (prevalence=0.94%;95%CI=0.69-1.24). The prevalence was somewhat higher in DC requests (30 cas-es 1.12%) than the rest (18 cases 0.71%; p=0.16). The individualized prevalence of CD reasons ranged between 7.41% (95%CI=0.91-24.3) in chemsex and 0.42% 95%CI=0.14-0.98) in PPE, always efficient except herpes zoster (0.76%; CI95%=0.02-4.18). In other reasons, cases were detected in 12 circumstances, and in four the determination could be efficient: lymphopenia (10%;CI95%=0.25-44.5), fever with polyarthralgia-polyarthritis (7.41%;CI95% =0.91-24.3), behavioral alteration-confusion-encephalopathy (3.45%;95%CI=0.42-11.9) and fever of unknown origin (2.50%;95%CI=0.82-5.74). CONCLUSIONS: The determination of HIV serology in HES in the processes defined by DC SEMES-GESIDA is efficient. Some circumstances are identified that could be added to those previously contemplated to increase efficiency.


Assuntos
Infecções por HIV , Herpes Zoster , Infecções Sexualmente Transmissíveis , Humanos , Infecções por HIV/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia
2.
Rev. calid. asist ; 31(4): 227-233, jul.-ago. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-153998

RESUMO

Objetivo. Evaluar el impacto de una intervención en la adecuación del uso y en la mejora del cuidado del sondaje uretral (SU), así como en la frecuencia de infección del tracto urinario asociada al SU (ITU-SU) en pacientes hospitalizados. Material y métodos. Estudio cuasi-experimental. En el periodo preintervención se midieron indicadores basales de uso del SU. La intervención consistió en educación sobre el SU y en la implementación de recordatorios para su retirada. En el periodo postintervención se evaluaron las mismas variables. Resultados. Se incluyeron 197 pacientes durante el periodo preintervención y 194 durante el periodo postintervención. La prevalencia (17,3% versus 15,3%) y los días de SU (4,8 ± 5,8 versus 4,3 ± 4,2) experimentaron un descenso no significativo. Se incrementaron las sondas correctamente prescritas (41,1% versus 61,9%; p < 0,001) y fijadas (0% versus 38,1%; p < 0,001) y descendieron las bolsas de diuresis en el suelo (26,4% versus 6,2%; p < 0,001). El incremento en la adecuación de la indicación del SU (86,8% versus 92,3%) y el descenso en la densidad de incidencia de ITU-SU (2,1 versus 1,2 episodios/1.000 días de SU) no fueron significativos, aunque superaron los estándares. Conclusiones. Tras la intervención se incrementó de forma significativa el número de SU correctamente prescritas y fijadas, y disminuyó las bolsas de diuresis en el suelo. La mejora en la indicación del SU y en la frecuencia de ITU-SU alcanzaron los estándares de calidad. Las actividades formativas y el uso de recordatorios mejoran la seguridad del paciente ingresado con SU (AU)


Objective. To evaluate the impact of an intervention regarding the adequate use and improvement in the care of indwelling urinary catheters (IUC) and the frequency of catheter-associated urinary tract infections (CAUTI) in hospitalised patients. Material and methods. A quasi-experimental study was performed. Basic data on the use of IUC were recorded before and after the intervention, which consisted of training on IUC use and the implementation of reminders for their removal. Results. There were 197 patients in the pre-intervention period and 194 in the post-intervention period. There was a non-significant decrease in the prevalence (17.3% versus 15.3%) and days with IUC (4.8 ± 5.8 versus 4.3 ± 4.2). There was an increase in adequately prescribed (41.1% versus 61.9%; P < .001) and attached IUC (0% vs 38.1%; P < .001), and a decrease in the urine collection bags on the floor (26.4% vs 6,2%; P < .001). The increase in the appropriate indications for IUC (86.8% vs 92.3%) and the decrease in CAUTI incidence density (2.1 vs 1.2 episodes/1,000 catheter days) were not significant, although above the standards. Conclusions. After the intervention there was a significant increase in the number of adequately prescribed and attached IUC, and a decrease in the number of urine collection bags on the floor. Improvement in IUC indication and frequency of CAUTI reached the quality standards. Educational activities and the use of reminders improve safety of hospitalised patients with IUC (AU)


Assuntos
Humanos , Masculino , Feminino , Cateteres de Demora , Infecções Urinárias/prevenção & controle , Infecções Urinárias/terapia , Segurança do Paciente/normas , Infecção Hospitalar/prevenção & controle , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/normas , Qualidade da Assistência à Saúde/organização & administração , Qualidade da Assistência à Saúde/normas , Qualidade da Assistência à Saúde
3.
Food Funct ; 7(6): 2692-705, 2016 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-27189193

RESUMO

Prediabetes is a condition affecting 35% of US adults and about 50% of US adults age 65+. Foods rich in polyphenols, including flavanols and other flavonoids, have been studied for their putative beneficial effects on many different health conditions including type 2 diabetes mellitus and prediabetes. Studies have shown that some flavanols increase glucagon-like peptide 1 (GLP-1) secretion. GLP-1 is a feeding hormone that increases insulin secretion after carbohydrate consumption, and increased GLP-1 secretion may be responsible for some of the beneficial effects on glycemic control after flavanol consumption. The present study explored the effects of grape powder consumption on metrics of glycemic health in normoglycemic and prediabetic C57BL/6J mice; additionally, the mechanism of action of grape powder polyphenols was investigated. Grape powder significantly reduced (p < 0.01) blood glucose levels following oral glucose gavage after GLP-1 receptor antagonism by exendin-3 (9-39) compared to sugar-matched control, indicating that it was able to attenuate the hyperglycemic effects of GLP-1 receptor antagonism. Grape powder was employed in acute (1.6 g grape powder per kg bodyweight) and long-term high fat diet (grape powder incorporated into treatment diets at 5% w/w) feeding studies in normoglycemic and prediabetic (diet-induced obesity) mice; grape powder did not impove glycemic control in these studies versus sugar-matched control. The mechanisms by which grape powder ameliorates the deleterious effects of GLP-1 receptor antagonism warrant further study.


Assuntos
Receptor do Peptídeo Semelhante ao Glucagon 1/metabolismo , Peptídeos/farmacologia , Fitoterapia , Preparações de Plantas/farmacologia , Polifenóis/farmacologia , Vitis/química , Animais , Glicemia/metabolismo , Dieta Hiperlipídica , Modelos Animais de Doenças , Flavonoides/farmacologia , Receptor do Peptídeo Semelhante ao Glucagon 1/antagonistas & inibidores , Camundongos , Camundongos Endogâmicos C57BL , Pós , Estado Pré-Diabético/tratamento farmacológico
4.
Rev Calid Asist ; 31(4): 227-33, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-26705914

RESUMO

OBJECTIVE: To evaluate the impact of an intervention regarding the adequate use and improvement in the care of indwelling urinary catheters (IUC) and the frequency of catheter-associated urinary tract infections (CAUTI) in hospitalised patients. MATERIAL AND METHODS: A quasi-experimental study was performed. Basic data on the use of IUC were recorded before and after the intervention, which consisted of training on IUC use and the implementation of reminders for their removal. RESULTS: There were 197 patients in the pre-intervention period and 194 in the post-intervention period. There was a non-significant decrease in the prevalence (17.3% versus 15.3%) and days with IUC (4.8±5.8 versus 4.3±4.2). There was an increase in adequately prescribed (41.1% versus 61.9%; P<.001) and attached IUC (0% vs 38.1%; P<.001), and a decrease in the urine collection bags on the floor (26.4% vs 6,2%; P<.001). The increase in the appropriate indications for IUC (86.8% vs 92.3%) and the decrease in CAUTI incidence density (2.1 vs 1.2 episodes/1,000 catheter days) were not significant, although above the standards. CONCLUSIONS: After the intervention there was a significant increase in the number of adequately prescribed and attached IUC, and a decrease in the number of urine collection bags on the floor. Improvement in IUC indication and frequency of CAUTI reached the quality standards. Educational activities and the use of reminders improve safety of hospitalised patients with IUC.


Assuntos
Infecções Relacionadas a Cateter/prevenção & controle , Cateteres de Demora/efeitos adversos , Infecções Urinárias/etiologia , Infecção Hospitalar , Humanos , Incidência , Cateterismo Urinário/efeitos adversos , Cateteres Urinários/efeitos adversos
5.
Eur J Clin Microbiol Infect Dis ; 34(12): 2395-402, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26407620

RESUMO

The objective of this study was to analyse the characteristics of healthcare-associated febrile urinary tract infection (HCA-FUTI) compared to community-acquired FUTI (CA-FUTI) in men. An ambispective cross-sectional study in which we recorded clinical and microbiology data and outcomes from males with FUTI attended in the Emergency Department was carried out. A total of 479 males with FUTI, 162 (33.8%) HCA-FUTI and 317 (66.2%) CA-FUTI, were included. HCA-FUTI patients were older (p < 0.001), had higher Charlson scores (p < 0.001) and received previous antimicrobial treatment more frequently (p < 0.001) compared to CA-FUTI patients. HCA-FUTI was less likely caused by Escherichia coli (p < 0.001) and more frequently by Klebsiella spp. (p = 0.02), Enterobacter spp. (p < 0.001) and Pseudomonas aeruginosa (p < 0.001). Resistance to ceftriaxone (p = 0.006), gentamicin (p < 0.001), quinolones (p < 0.001), co-trimoxazole (p = 0.001) and fosfomycin (p = 0.009) was higher among E. coli strains isolated from males with HCA-FUTI and so was the prevalence of extended-spectrum beta-lactamase and AmpC E. coli and Klebsiella spp.-producing strains (p = 0.012). Inadequate antimicrobial treatment and all-cause in-hospital mortality was associated with HCA-FUTI (p < 0.001 and p = 0.004, respectively). Independent factors for mortality were severe sepsis or septic shock [odds ratio (OR) 29; 95% confidence interval (CI): 3.9-214] and cirrhosis (OR 23.7; 95% CI: 1.6-350.6). Male patients with HCA-FUTI have different clinical characteristics, outcomes and microbiological features compared to CA-FUTI patients. Previous contact with the healthcare system has to be taken into consideration when deciding the optimal antimicrobial treatment in males with FUTI.


Assuntos
Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/patologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/patologia , Infecções Urinárias/microbiologia , Infecções Urinárias/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/classificação , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Estudos Transversais , Farmacorresistência Bacteriana , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Sobrevida , Resultado do Tratamento , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Adulto Jovem , beta-Lactamases/análise
6.
Regul Pept ; 179(1-3): 71-6, 2012 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-22960405

RESUMO

BACKGROUND: ROSE-010, a Glucagon-Like Peptide-1 (GLP-1) analog, reduces gastrointestinal motility and relieves acute pain in patients with irritable bowel syndrome (IBS). The rat small bowel migrating myoelectric complex (MMC) is a reliable model of pharmacological effects on gastrointestinal motility. Accordingly, we investigated whether ROSE-010 works through GLP-1 receptors in gut musculature and its effectiveness when administered by pulmonary inhalation. MATERIALS AND METHODS: Rats were implanted with bipolar electrodes at 5, 15 and 25 cm distal to pylorus and myoelectric activity was recorded. First, intravenous or subcutaneous injections of ROSE-010 or GLP-1 (1, 10, 100 µg/kg) with or without the GLP-1 receptor blocker exendin(9-39)amide (300 µg/kg·h), were studied. Second, ROSE-010 (100, 200 µg/kg) Technosphere® powder was studied by inhalation. RESULTS: The baseline MMC cycle length was 17.5±0.8 min. GLP-1 and ROSE-010, administered intravenously or subcutaneously, significantly inhibited myoelectric activity and prolonged MMC cycling; 100 µg/kg completely inhibited spiking activity for 49.1±4.2 and 73.3±7.7 min, while the MMC cycle length increased to 131.1±11.4 and 149.3±15.5 min, respectively. Effects of both drugs were inhibited by exendin(9-39)amide. Insufflation of ROSE-010 (100, 200 µg/kg) powder formulation totally inhibited myoelectric spiking for 52.6±5.8 and 70.1±5.4 min, and increased MMC cycle length to 102.6±18.3 and 105.9±9.5 min, respectively. CONCLUSIONS: Pulmonary delivery of ROSE-010 inhibits gut motility through the GLP-1R similar to natural GLP-1. ROSE-010 causes receptor-mediated inhibition of MMC comparable to that of intravenous or subcutaneous administration. This suggests that ROSE-010 administered as a Technosphere® inhalation powder has potential in IBS pain management and treatment.


Assuntos
Peptídeo 1 Semelhante ao Glucagon/análogos & derivados , Complexo Mioelétrico Migratório/efeitos dos fármacos , Fragmentos de Peptídeos/administração & dosagem , Fragmentos de Peptídeos/farmacologia , Receptores de Glucagon/antagonistas & inibidores , Administração por Inalação , Administração Intravenosa , Animais , Estado de Consciência , Avaliação Pré-Clínica de Medicamentos , Eletrodos Implantados , Motilidade Gastrointestinal/efeitos dos fármacos , Peptídeo 1 Semelhante ao Glucagon/administração & dosagem , Peptídeo 1 Semelhante ao Glucagon/farmacologia , Receptor do Peptídeo Semelhante ao Glucagon 1 , Injeções Subcutâneas , Intestino Delgado/efeitos dos fármacos , Intestino Delgado/metabolismo , Síndrome do Intestino Irritável/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley , Receptores de Glucagon/metabolismo , Estatísticas não Paramétricas , Fatores de Tempo
7.
Eur J Clin Microbiol Infect Dis ; 31(4): 423-30, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21761126

RESUMO

The purpose of this study was to evaluate the prevalence and clinical risk factors for quinolone resistance (QR) in E. coli strains from males with febrile urinary tract infection (FUTI). An ambispective cross-sectional study was performed in which we evaluated 153 males with a community FUTI caused by E. coli. Among the 153 FUTI episodes, 101 (66%) were due to quinolone susceptible E. coli strains while 52 (34%) were caused by QR E. coli strains. In the univariate analysis QR was associated with older age, higher Charlson scores, dementia, past UTI, urinary tract abnormalities, previous antibiotic use, particularly with fluoroquinolones (FQ), a healthcare-associated (HA)-UTI (HA-UTI) and to four of the components included in the definition of HA-UTI: hospital admission, nursing home residence, indwelling urethral catheter and invasive urinary instrumentation. In the multivariate analysis, HA-UTI (OR 3.82, 95% CI 1.3-11.24; P 0.015) and use of antimicrobials in the previous month (OR 5.82, 95% CI 2.3-14.88; P < 0.001) mainly with FQ (OR 13.97, 95% CI 2.73-71.53; P 0.002) were associated with QR. To have a HA-UTI and a previous use of FQ in the preceding month were strong risk factors for QR E. coli, and thus empirical antimicrobial treatment with quinolones should be avoided in these patients.


Assuntos
Infecções Comunitárias Adquiridas/microbiologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli/microbiologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Quinolonas/farmacologia , Infecções Urinárias/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Comunitárias Adquiridas/epidemiologia , Estudos Transversais , Infecções por Escherichia coli/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Infecções Urinárias/epidemiologia
10.
Diabetes Obes Metab ; 11(11): 1050-9, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19732123

RESUMO

AIM: The feasibility of administering native glucagon-like peptide 1 (GLP-1) as GLP-1 Technosphere Inhalation Powder for diabetes therapy has been demonstrated in a rat model. METHODS: GLP-1 Technosphere Inhalation Powders containing 5, 10 and 15% GLP-1 were prepared and administered to healthy female Sprague-Dawley rats and to male Zucker diabetic obese rats. Rats received a single dose of GLP-1 Technosphere Powder by pulmonary insufflation. GLP-1 pharmacokinetic and pharmacodynamic responses were measured. RESULTS: Maximum circulating GLP-1 concentrations were achieved at approximately 10 min after dosing with detectable levels at 40 min. In a food consumption study, Sprague-Dawley rats receiving GLP-1 Technosphere Powder once-daily consumed less food than control rats for up to 24 h after dosing. Cumulative food consumption was decreased approximately 10% after 78 h. In an intraperitoneal glucose tolerance test, Zucker diabetic fatty rats receiving 2 mg GLP-1 Technosphere Powder (0.3 mg GLP-1) by pulmonary insufflation exhibited lower glucose concentrations and higher insulin concentrations than control rats. Pancreatic evaluations showed no differences in apoptotic index or cell proliferation of beta-cells. In addition, a dose-related increase in insulin expression within the pancreas was observed. CONCLUSIONS: These data demonstrate the feasibility of administering native GLP-1 as GLP-1 Technosphere Inhalation Powder for diabetes therapy.


Assuntos
Glicemia/efeitos dos fármacos , Peptídeo 1 Semelhante ao Glucagon/farmacocinética , Hipoglicemiantes/farmacocinética , Fragmentos de Peptídeos/farmacocinética , Administração por Inalação , Animais , Glicemia/metabolismo , Sistemas de Liberação de Medicamentos , Feminino , Peptídeo 1 Semelhante ao Glucagon/administração & dosagem , Hipoglicemiantes/administração & dosagem , Masculino , Fragmentos de Peptídeos/administração & dosagem , Ratos , Ratos Sprague-Dawley , Ratos Zucker
11.
J Urol ; 177(1): 365-8, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17162092

RESUMO

PURPOSE: Escherichia coli strains are the most frequent cause of urinary tract infections. Biofilm formation allows the strains to persist a long time in the genitourinary tract and interfere with bacterial eradication. We determined the possible relationships between the different urinary tract infections, and in vitro biofilm formation, the presence of urovirulence factors and nalidixic acid resistance. MATERIALS AND METHODS: A total of 151 E. coli strains collected from patients with cystitis (44 strains), pyelonephritis (75) and prostatitis (32) were analyzed for in vitro biofilm formation, the phylogenetic group, the presence of several urovirulence factors and resistance to nalidixic acid. RESULTS: E. coli strains causing prostatitis produced biofilm in vitro more frequently than those causing other urinary tract infections and had a higher frequency of hemolysin (p = 0.03 and 0.0002, respectively). However, only hemolysin was independently associated with prostatitis. On the other hand, strains forming biofilm presented a significantly higher frequency of hemolysin and type 1 fimbriae expression. CONCLUSIONS: Although hemolysin is the main virulence factor by which E. coli causes acute prostatitis, the association between hemolysin and biofilm formation may result in increased ability of E. coli strains to persist in the prostate.


Assuntos
Biofilmes , Cistite/microbiologia , Infecções por Escherichia coli , Escherichia coli/fisiologia , Escherichia coli/patogenicidade , Prostatite/microbiologia , Fatores de Virulência , Farmacorresistência Bacteriana , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Clin Microbiol Infect ; 12(10): 1034-6, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16961644

RESUMO

Escherichia coli is the most frequent microorganism involved in urinary tract infection (UTI). Acute UTI caused by uropathogenic E. coli (UPEC) can lead to recurrent infection, which can be defined as either re-infection or relapse. E. coli strains causing relapse (n = 27) and re-infection (n = 53) were analysed. In-vitro production of biofilm, yersiniabactin and aerobactin was significantly more frequent among strains causing relapse. Biofilm assays may be helpful in selecting patients who require a therapeutic approach to eradicate persistent biofilm-forming E. coli strains and prevent subsequent relapses.


Assuntos
Biofilmes , Infecções por Escherichia coli/microbiologia , Escherichia coli/patogenicidade , Infecções Urinárias/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Escherichia coli/metabolismo , Feminino , Humanos , Ácidos Hidroxâmicos/metabolismo , Pessoa de Meia-Idade , Fenóis/metabolismo , Tiazóis/metabolismo , Virulência
15.
Proc Biol Sci ; 268(1475): 1435-41, 2001 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-11454285

RESUMO

The Orchidaceae characteristically contain a very large number of species that attract pollinators but do not offer them any form of reward in return for visitation. Such a strategy is highly unusual in the plant kingdom. We conducted experiments in order to manipulate the reward strategy of the rewardless bumble-bee-pollinated orchid Barlia robertiana by adding sucrose solution to inflorescences. We found that supplementation decreased the probability of a pollinator removing pollinia by approximately ten times. Despite pollinators visiting many more flowers per inflorescence on supplemented plants, eight times fewer pollinia were removed from supplemented inflorescences during each visit. Pollinia deposition patterns were not significantly affected by supplementation and no geitonogamous deposition was recorded. In populations where inflorescences were supplemented for 20 days, pollinia removal was reduced by over half for supplemented inflorescences, whereas fruit set was unmodified by supplementation. We conclude that rewardlessness would increase total seed paternity, but not change either total seed maternity or the probability that offspring were outcrossed in this species. To the authors' knowledge this is the first time that there has been an unequivocal experimental demonstration of an evolutionary advantage for rewardlessness in the Orchidaceae.


Assuntos
Abelhas/fisiologia , Orchidaceae/fisiologia , Análise de Variância , Animais , Comportamento Animal , Frutas/crescimento & desenvolvimento , Caules de Planta/crescimento & desenvolvimento , Pólen/fisiologia , Reprodução , Sementes/efeitos dos fármacos , Sementes/crescimento & desenvolvimento , Sacarose/farmacologia
16.
Proc Natl Acad Sci U S A ; 98(11): 6253-5, 2001 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-11353863

RESUMO

The orchid Dactylorhiza sambucina shows a stable and dramatic flower-color polymorphism, with both yellow- and purple-flowered individuals present in natural populations throughout the range of the species in Europe. The evolutionary significance of flower-color polymorphisms found in many rewardless orchid species has been discussed at length, but the mechanisms responsible for their maintenance remain unclear. Laboratory experiments have suggested that behavioral responses by pollinators to lack of reward availability might result in a reproductive advantage for rare-color morphs. Consequently, we performed an experiment varying the relative frequency of the two color morphs of D. sambucina to test whether rare morph advantage acted in the natural habitat of the species. We show here clear evidence from this manipulative experiment that rare-color morphs have reproductive advantage through male and female components. This is the first demonstration, to our knowledge, that negative frequency-dependent selection through pollinator preference for rare morphs can cause the maintenance of a flower-color polymorphism.


Assuntos
Genes de Plantas , Magnoliopsida/genética , Polimorfismo Genético , Seleção Genética , Cor , Frequência do Gene , Pólen
19.
Clin Otolaryngol Allied Sci ; 24(4): 335-8, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10472470

RESUMO

Laser palatoplasty (LPP) is widely used for the treatment of non-apnoeic snoring, despite the lack of objective data supporting its use. We report measurements of snoring in a prospective study of LPP, and we compare the results with a previous study of uvulopalatopharyngoplasty (UPPP). Twenty patients with an apnoea/hypopnoea index < 20 h-1 underwent LPP for habitual snoring. Overnight sound recordings were compared before and 6 months after operation using three objective indices; L, (the level exceeded by the loudest 1% of sound), L5 (the level exceeded by the loudest 5% of sound) and P50 (% total sleep time above 50 dBA). The subjective impression of snoring severity (Wilcoxon test, P < 0.001), and objective indices L1 and P50 (t-test, P < 0.001) showed significant reductions after LPP. The mean change in L1 was 4.2 dBA, comparable to that we previously reported for UPPP, while P50 was reduced to less than one-third its preoperative value. No other sleep variables changed significantly following LPP. We conclude that LPP results in reduced snoring volume comparable to that following UPPP.


Assuntos
Terapia a Laser , Palato Mole/cirurgia , Ronco/cirurgia , Acústica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Estudos Prospectivos
20.
Med Pediatr Oncol ; 28(2): 92-7, 1997 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8986144

RESUMO

There is little information available regarding epidemiologic risk factors for Langerhans cell histiocytosis (LCH). An exploratory investigation was conducted using information obtained from parents of 177 cases of LCH diagnosed before 21 years of age (median 2 years). Utilizing data available from the Children's Cancer Group, LCH cases were compared to two matched control groups including 614 patients diagnosed with a variety of childhood cancers and 318 community controls. Questionnaire data included information on demographics, prenatal and perinatal factors, complications in the neonatal period, environmental exposures, family medical history, and childhood exposures. Factors found to be statistically significantly associated with an increased risk of LCH included: maternal urinary tract infection during the index pregnancy, feeding problems during infancy, and blood transfusions during infancy. Use of supplemental vitamins was associated with a significantly decreased risk of LCH. Results from this exploratory study provide a basis for speculation on potential etiologic risk factors for LCH. Future epidemiologic investigations of LCH need to consider the presenting disease characteristics in assessing possible etiologic factors.


Assuntos
Histiocitose de Células de Langerhans/epidemiologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Exposição Ambiental , Saúde da Família , Feminino , Histiocitose de Células de Langerhans/etiologia , Humanos , Lactente , Masculino , Análise Multivariada , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia
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