RESUMEN

Phaffia rhodozyma is a basidiomycetous yeast characterized by its production of the carotenoid pigment astaxanthin, which holds high commercial value for its significance in aquaculture, cosmetics and as nutraceutics, and the UV-B-absorbing compound mycosporine-glutaminol-glucoside (MGG), which is of great biotechnological relevance for its incorporation into natural sunscreens. However, the industrial exploitation has been limited to the production of astaxanthin in small quantities. On the other hand, the accumulation of MGG in P. rhodozyma was recently reported and could add value to the simultaneous production of both metabolites. In this work, we obtain a mutant strain that overproduces both compounds, furthermore we determined how the accumulation of each is affected by the carbon-to-nitrogen ratio and six biotic and abiotic factors. The mutant obtained produces 159% more astaxanthin (470.1 µg g-1) and 220% more MGG (57.9 mg g-1) than the parental strain (295.8 µg g-1 and 26.2 mg g-1 respectively). Furthermore, we establish that the carotenoids accumulate during the exponential growth phase while MGG accumulates during the stationary phase. The carbon-to-nitrogen ratio affects each metabolite differently, high ratios favoring carotenoid accumulation while low ratios favoring MGG accumulation. Finally, the accumulation of both metabolites is stimulated only by photosynthetically active radiation and low concentrations of hydrogen peroxide. The mutant strain obtained is the first hyper-productive mutant capable of accumulating high concentrations of MGG and astaxanthin described to date. The characterization of how both compounds accumulate during growth and the factors that stimulate their accumulation, are the first steps toward the future commercial exploitation of strains for the simultaneous production of two biotechnologically important metabolites.

Asunto(s)

Basidiomycota , Técnicas de Cultivo Celular por Lotes , Carotenoides , Carbono , Glucósidos , Nitrógeno , Xantófilas

RESUMEN

BACKGROUND: Irregular sleep-wake rhythm disorder (ISWRD) is a common sleep disorder in individuals with Alzheimer's disease dementia (AD-D). OBJECTIVES: This exploratory phase 2 proof-of-concept and dose-finding clinical trial evaluated the effects of lemborexant compared with placebo on circadian rhythm parameters, nighttime sleep, daytime wakefulness and other clinical measures of ISWRD in individuals with ISWRD and mild to moderate AD-D. DESIGN: Multicenter, randomized, double-blind, placebo-controlled, parallel-group study. SETTING: Sites in the United States, Japan and the United Kingdom. PARTICIPANTS: Men and women 60 to 90 years of age with documentation of diagnosis with AD-D and Mini-Mental State Exam (MMSE) score 10 to 26. INTERVENTION: Subjects were randomized to placebo or one of four lemborexant treatment arms (2.5 mg, 5 mg, 10 mg or 15 mg) once nightly at bedtime for 4 weeks. MEASUREMENTS: An actigraph was used to collect subject rest-activity data, which were used to calculate sleep-related, wake-related and circadian rhythm-related parameters. These parameters included least active 5 hours (L5), relative amplitude of the rest-activity rhythm (RA) and mean duration of sleep bouts (MDSB) during the daytime. The MMSE and the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) were used to assess for changes in cognitive function. RESULTS: Sixty-two subjects were randomized and provided data for circadian, daytime and nighttime parameters (placebo, n = 12; lemborexant 2.5 mg [LEM2.5], n = 12; lemborexant 5 mg [LEM5], n = 13, lemborexant 10 mg [LEM10], n = 13 and lemborexant 15 mg [LEM15], n = 12). Mean L5 showed a decrease from baseline to week 4 for LEM2.5, LEM5 and LEM15 that was significantly greater than with placebo (all p < 0.05), suggesting a reduction in restlessness. For RA, LS mean change from baseline to week 4 versus placebo indicated greater distinction between night and day with all dose levels of lemborexant, with significant improvements seen with LEM5 and LEM15 compared with placebo (both p < 0.05). The median percentage change from baseline to week 4 in MDSB during the daytime indicated a numerical decrease in duration for LEM5, LEM10 and LEM15, which was significantly different from placebo for LEM5 and LEM15 (p < 0.01 and p = 0.002, respectively). There were no serious treatment-emergent adverse events or worsening of cognitive function, as assessed by the MMSE and ADAS-Cog. Lemborexant was well tolerated. No subjects discontinued treatment. CONCLUSIONS: This study provides preliminary evidence of the potential utility of lemborexant as a treatment to address both nighttime and daytime symptoms in patients with ISWRD and AD-D.

Asunto(s)

Enfermedad de Alzheimer/complicaciones , Ritmo Circadiano/efectos de los fármacos , Antagonistas de los Receptores de Orexina/administración & dosificación , Piridinas/administración & dosificación , Pirimidinas/administración & dosificación , Trastornos del Sueño-Vigilia/tratamiento farmacológico , Actigrafía/métodos , Anciano , Anciano de 80 o más Años , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antagonistas de los Receptores de Orexina/farmacología , Piridinas/farmacología , Pirimidinas/farmacología , Trastornos del Sueño-Vigilia/etiología

RESUMEN

Recent studies predict that the Arctic Ocean will have ice-free summers within the next 30 years. This poses a significant challenge for the marine organisms associated with the Arctic sea ice, such as marine mammals and, not least, the ice-associated crustaceans generally considered to spend their entire life on the underside of the Arctic sea ice. Based upon unique samples collected within the Arctic Ocean during the polar night, we provide a new conceptual understanding of an intimate connection between these under-ice crustaceans and the deep Arctic Ocean currents. We suggest that downwards vertical migrations, followed by polewards transport in deep ocean currents, are an adaptive trait of ice fauna that both increases survival during ice-free periods of the year and enables re-colonization of sea ice when they ascend within the Arctic Ocean. From an evolutionary perspective, this may have been an adaptation allowing success in a seasonally ice-covered Arctic. Our findings may ultimately change the perception of ice fauna as a biota imminently threatened by the predicted disappearance of perennial sea ice.

Asunto(s)

Adaptación Biológica/fisiología , Anfípodos/fisiología , Cambio Climático , Cubierta de Hielo , Movimiento/fisiología , Movimientos del Agua , Anfípodos/química , Animales , Regiones Árticas , Lípidos/análisis , Biología Marina , Modelos Teóricos

RESUMEN

This study examines the composition and activity of the planktonic community during the polar night in the high Arctic Kongsfjord, Svalbard. Our results are the first published evidence of bioluminescence among zooplankton during the Arctic polar night. The observations were collected by a bathyphotometer detecting bioluminescence, integrated into an autonomous underwater vehicle, to determine the concentration and intensity of bioluminescent flashes as a function of time of day and depth. To further understand community dynamics and composition, plankton nets were used to collect organisms passing through the bathyphotometer along with traditional vertical net tows. Additionally, using a moored bathyphotometer closed to the sampling site, the bioluminescence potential itself was shown not to have a diurnal or circadian rhythm. Rather, our results provide evidence for a diel vertical migration of bioluminescent zooplankton that does not correspond to any externally detectable changes in illumination.

RESUMEN

OBJECTIVES: Women constitute two-thirds of patients suffering from common depressive disorders. The treatment of depression in women is therefore a substantial public health concern. High-quality, empirical data on depressive disorders specific to women are limited. As a result, there are no comprehensive evidence-based practice guidelines on the best treatment approaches for these illnesses. We conducted a consensus survey of expert opinion on the treatment of 4 depressive conditions specific to women: premenstrual dysphoric disorder (PMDD), depression in pregnancy, postpartum depression in a mother choosing to breast-feed, and depression related to perimenopause/menopause. METHOD: After reviewing the literature and convening a work group of leading experts, we prepared a written survey covering a total of 858 treatment options in 117 specific clinical situations. Depression severity (mild to severe) was specified for most clinical situations. Treatment options included a broad range of pharmacological, psychosocial, and alternative medicine approaches. Most options were scored using a modified version of the RAND 9-point scale for rating appropriateness of medical decisions. We identified 40 national experts, 36 (90%) of whom completed the survey. Consensus on each option was defined as a non-random distribution of scores by chi-square "goodness-of-fit" test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating. Guideline tables indicating preferred treatment strategies were then developed for key clinical situations. RESULTS: The expert panel reached consensus on 76% of the options, with greater consensus in situations involving severe symptoms. For women with severe symptoms in each of the 4 central disorder areas we asked about, the first-line recommendation was for antidepressant medication combined with other modalities (generally psychotherapy), paralleling existing guidelines for severe depression in general populations. For milder symptoms in each situation, the panel was less uniform in recommending antidepressants. For the initial treatment of milder symptoms, the panel either gave equal endorsement to other treatment modalities (e.g., nutritional or psychobehavioral approaches in PMDD; hormone replacement in perimenopause) or preferred psychotherapy over medication (in conception, pregnancy, or lactation). In all milder cases, however, antidepressants were recommended as at least second-line options. Among antidepressants, selective serotonin reuptake inhibitors (SSRIs) as a class were recommended as first-line treatment in all situations. The specific SSRIs that were preferred depended on the particular clinical situation. Tricyclic antidepressants were highly rated alternatives to SSRIs in pregnancy and lactation. CONCLUSIONS: The experts reached a high level of consensus on the appropriateness of including both antidepressant medication, specifically SSRIs, and nonpharmacological modalities in treatment plans for severe depression in 4 key clinical situations unique to women. To evaluate many of the treatment options in this survey, the experts had to extrapolate beyond controlled data in comparing modalities with each other or in combination. Within the limits of expert opinion and with the expectation that future research data will take precedence, these guidelines provide some direction for addressing common clinical dilemmas in women. They can be used to inform clinicians and educate patients regarding the relative merits of a variety of interventions.

Asunto(s)

Antidepresivos/uso terapéutico , Depresión Posparto/terapia , Trastorno Depresivo/terapia , Menopausia/psicología , Complicaciones del Embarazo/terapia , Síndrome Premenstrual/terapia , Psicoterapia , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Terapias Complementarias , Depresión Posparto/tratamiento farmacológico , Trastorno Depresivo/tratamiento farmacológico , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Síndrome Premenstrual/tratamiento farmacológico

Asunto(s)

Antidepresivos/uso terapéutico , Terapia Conductista , Dieta , Trastornos del Humor/terapia , Síndrome Premenstrual/terapia , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Femenino , Humanos , Trastornos del Humor/tratamiento farmacológico , Síndrome Premenstrual/tratamiento farmacológico

Asunto(s)

Antidepresivos/uso terapéutico , Trastorno Depresivo Mayor/terapia , Complicaciones del Embarazo/psicología , Complicaciones del Embarazo/terapia , Psicoterapia , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Femenino , Fertilización , Humanos , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico

Asunto(s)

Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Depresión Posparto/terapia , Psicoterapia , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Consejo , Depresión Posparto/tratamiento farmacológico , Femenino , Humanos

Asunto(s)

Antidepresivos/uso terapéutico , Trastorno Depresivo Mayor/terapia , Terapia de Reemplazo de Estrógeno , Menopausia/psicología , Psicoterapia , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Femenino , Humanos

RESUMEN

Women constitute two-thirds of patients suffering from common depressive disorders, making the treatment of depression in women a substantial public health concern. However, high-quality, empirical data on depressive disorders specific to women are limited, and there are no comprehensive evidence-based practice guidelines on the best treatments for these illnesses. To bridge the gap between research evidence and key clinical decisions, the authors developed a survey of expert opinion concerning treatment of four depressive conditions specific to women: premenstrual dysphoric disorder, depression in pregnancy, postpartum depression in a mother choosing to breast-feed, and depression related to perimenopause/menopause. The survey asked about 858 treatment options in 117 clinical situations and included a broad range of pharmacological, psychosocial, and alternative medicine approaches. The survey was sent to 40 national experts on women's mental health issues, 36 (90%) of whom completed it. The options, scored using a modified version of the RAND Corporation's 9-point scale for rating appropriateness of medical decisions, were assigned one of three categorical rankings-first line/preferred choice, second line/alternate choice, third line/usually inappropriate-based on the 95% confidence interval of each item's mean rating. The expert panel reached consensus (defined as a non-random distribution of scores by chi-square "goodness-of-fit" test) on 76% of the options, with greater consensus in situations involving severe symptoms. Guideline tables indicating preferred treatment strategies were then developed for key clinical situations. The authors summarize the expert consensus methodology they used and then, for each of the four key areas, review the treatment literature and summarize the experts' recommendations and how they relate to the research findings. For women with severe symptoms in each area we asked about, the first-line recommendation was antidepressant medication combined with other modalities (generally psychotherapy). These recommendations parallel existing guidelines for severe depression in general populations. For initial treatment of milder symptoms in each situation, the panel was less uniform in recommending antidepressants, and either gave equal endorsement to other treatment modalities (e.g., nutritional or psychobehavioral approaches in PMDD; hormone replacement in perimenopause) or preferred psychotherapy over medication (during conception, pregnancy, or lactation). In all milder cases, however, antidepressants were recommended as at least second-line options. Among antidepressants, selective serotonin reuptake inhibitors (SSRIs) were recommended as first-line treatment in all situations. The specific SSRIs that were preferred depended on the particular clinical situation. Tricyclic antidepressants were highly rated alternatives to SSRIs in pregnancy and lactation. In evaluating many of the treatment options, the experts had to extrapolate beyond controlled data in comparing treatment options with each other or in combination. Within the limits of expert opinion and with the expectation that future research data will take precedence, these guidelines provide some direction for addressing common clinical dilemmas in women, and can be used to inform clinicians and educate patients regarding the relative merits of a variety of interventions.

RESUMEN

The highly conserved Wnt family of growth factors is essential for generating embryonic pattern in many animal species [1]. In the fruit fly Drosophila, most Wnt-mediated patterning is performed by a single family member, Wingless (Wg), acting through its receptors Frizzled (Fz) and DFrizzled2 (Dfz2). In the ventral embryonic epidermis, Wg signaling generates two different cell-fate decisions: the production of diverse denticle types and the specification of naked cuticle separating the denticle belts. Mutant alleles of wg disrupt these cellular decisions separately [2], suggesting that some aspect of ligand-receptor affinity influences cell-fate decisions, or that different receptor complexes mediate the distinct cellular responses. Here, we report that overexpression of Dfz2, but not Fz, rescues the mutant phenotype of wgPE2, an allele that produces denticle diversity but no naked cuticle. Fz was able to substitute for Dfz2 only under conditions where the Wg ligand was present in excess. The wgPE2 mutant phenotype was also sensitive to the dosage of glycosaminoglycans, suggesting that the mutant ligand is excluded from the receptor complex when proteoglycans are present. We conclude that wild-type Wg signaling requires efficient interaction between ligand and the Dfz2-proteoglycan receptor complex to promote the naked cuticle cell fate.

Asunto(s)

Proteínas de Drosophila , Drosophila/metabolismo , Proteínas de la Membrana/metabolismo , Proteínas Proto-Oncogénicas/metabolismo , Receptores de Superficie Celular/metabolismo , Receptores de Neurotransmisores/metabolismo , Animales , Animales Modificados Genéticamente , Drosophila/anatomía & histología , Drosophila/embriología , Drosophila/genética , Embrión no Mamífero/metabolismo , Receptores Frizzled , Proteínas de Insectos/genética , Proteínas de Insectos/metabolismo , Proteínas de la Membrana/genética , Mutación , Fenotipo , Proteoglicanos/metabolismo , Proteínas Proto-Oncogénicas/genética , Receptores de Superficie Celular/genética , Receptores Acoplados a Proteínas G , Receptores de Neurotransmisores/genética , Proteínas Recombinantes de Fusión/metabolismo , Proteína Wnt1

RESUMEN

Premenstrual syndrome (PMS), a common disorder in women, refers to physical and/or mood symptoms that appear predictably during the latter half of the menstrual cycle, last until menses begin, and are absent during the early part of the menstrual cycle. A diagnosis of PMS requires that the symptoms be severe enough to affect a woman's ability to function at home or in the workplace or in her relationships with others. Diagnostic assessment entails a thorough medical and psychiatric history and prospective daily ratings. Disorders such as major depression, anxiety, hypothyroidism, and diabetes must be excluded before a diagnosis of PMS can be considered. Treatment strategies include either eliminating the hormonal cycle associated with ovulation or treating the symptom(s) causing the most distress to the patient. Medical therapies are available for both treatment approaches but should be initiated only after behavioral measures have failed; the physician must also carefully weigh the severity of symptoms against the potential for adverse effects of treatment.

Asunto(s)

Síndrome Premenstrual/terapia , Diagnóstico Diferencial , Femenino , Humanos , Síndrome Premenstrual/diagnóstico , Síndrome Premenstrual/psicología

RESUMEN

Active endocytotic processes are required for the normal distribution of Wingless (Wg) protein across the epidermal cells of each embryonic segment. To assess the functional consequences of this broad Wg distribution, we have devised a means of perturbing endocytosis in spatially restricted domains within the embryo. We have constructed a transgene expressing a dominant negative form of shibire (shi), the fly dynamin homologue. When this transgene is expressed using the GAL4-UAS system, we find that Wg protein distribution within the domain of transgene expression is limited and that Wg-dependent epidermal patterning events surrounding the domain of expression are disrupted in a directional fashion. Our results indicate that Wg transport in an anterior direction generates the normal expanse of naked cuticle within the segment and that movement of Wg in a posterior direction specifies diverse denticle cell fates in the anterior portion of the adjacent segment. Furthermore, we have discovered that interfering with posterior movement of Wg rescues the excessive naked cuticle specification observed in naked (nkd) mutant embryos. We propose that the nkd segment polarity phenotype results from unregulated posterior transport of Wg protein and therefore that wild-type Nkd function may contribute to the control of Wg movement within the epidermal cells of the segment.

Asunto(s)

Proteínas de Drosophila , Drosophila/embriología , Embrión no Mamífero/anatomía & histología , Epidermis/embriología , Proteínas Proto-Oncogénicas/metabolismo , Alelos , Animales , Animales Modificados Genéticamente , Tipificación del Cuerpo , Dinaminas , Embrión no Mamífero/metabolismo , Endocitosis/fisiología , Receptores Frizzled , GTP Fosfohidrolasas/metabolismo , Genes Dominantes , Modelos Biológicos , Fenotipo , Receptores Acoplados a Proteínas G , Receptores de Neurotransmisores/metabolismo , Factores de Tiempo , Proteína Wnt1

RESUMEN

The tumor suppressor adenomatous polyposis coli (APC) negatively regulates Wingless (Wg)/Wnt signal transduction by helping target the Wnt effector beta-catenin or its Drosophila homologue Armadillo (Arm) for destruction. In cultured mammalian cells, APC localizes to the cell cortex near the ends of microtubules. Drosophila APC (dAPC) negatively regulates Arm signaling, but only in a limited set of tissues. We describe a second fly APC, dAPC2, which binds Arm and is expressed in a broad spectrum of tissues. dAPC2's subcellular localization revealed colocalization with actin in many but not all cellular contexts, and also suggested a possible interaction with astral microtubules. For example, dAPC2 has a striking asymmetric distribution in neuroblasts, and dAPC2 colocalizes with assembling actin filaments at the base of developing larval denticles. We identified a dAPC2 mutation, revealing that dAPC2 is a negative regulator of Wg signaling in the embryonic epidermis. This allele acts genetically downstream of wg, and upstream of arm, dTCF, and, surprisingly, dishevelled. We discuss the implications of our results for Wg signaling, and suggest a role for dAPC2 as a mediator of Wg effects on the cytoskeleton. We also speculate on more general roles that APCs may play in cytoskeletal dynamics.

Asunto(s)

Proteínas del Citoesqueleto/metabolismo , Citoesqueleto/metabolismo , Proteínas de Drosophila , Drosophila melanogaster/metabolismo , Epidermis/embriología , Proteínas Proto-Oncogénicas/metabolismo , Transducción de Señal , Transactivadores , Actinas/metabolismo , Secuencia de Aminoácidos , Animales , Proteínas del Dominio Armadillo , Clonación Molecular , Proteínas del Citoesqueleto/química , Proteínas del Citoesqueleto/genética , Drosophila melanogaster/citología , Drosophila melanogaster/embriología , Drosophila melanogaster/genética , Células Epidérmicas , Epidermis/metabolismo , Epistasis Genética , Femenino , Genes de Insecto/genética , Genes de Insecto/fisiología , Humanos , Proteínas de Insectos/química , Proteínas de Insectos/genética , Proteínas de Insectos/metabolismo , Larva/citología , Masculino , Datos de Secuencia Molecular , Mutación/genética , Neuronas/citología , Neuronas/metabolismo , Fosforilación , Proteínas Proto-Oncogénicas/genética , Huso Acromático/metabolismo , Factores de Transcripción , Células Tumorales Cultivadas , Proteína Wnt1

RESUMEN

Wingless/Wnt signalling directs cell-fate choices during embryonic development. Inappropriate reactivation of the pathway causes cancer. In Drosophila, signal transduction from Wingless stabilizes cytosolic Armadillo, which then forms a bipartite transcription factor with the HMG-box protein Drosophila Tcf (dTcf) and activates expression of Wingless-responsive genes. Here we report that in the absence of Armadillo, dTcf acts as a transcriptional repressor of Wingless-responsive genes, and we show that Groucho acts as a corepressor in this process. Reduction of dTcf activity partially suppresses wingless and armadillo mutant phenotypes, leading to derepression of Wingless-responsive genes. Furthermore, overexpression of wild-type dTcf enhances the phenotype of a weak wingless allele. Finally, mutations in the Drosophila groucho gene also suppress wingless and armadillo mutant phenotypes as Groucho physically interacts with dTcf and is required for its full repressor activity.

Asunto(s)

Proteínas de Unión al ADN/metabolismo , Proteínas de Drosophila , Proteínas del Grupo de Alta Movilidad/metabolismo , Proteínas de Insectos/metabolismo , Proteínas Represoras/metabolismo , Transducción de Señal , Transactivadores , Factores de Transcripción/metabolismo , Animales , Proteínas del Dominio Armadillo , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico , Células COS , Proteínas de Unión al ADN/genética , Drosophila , Proteínas de Insectos/genética , Unión Proteica , Proteínas Proto-Oncogénicas/metabolismo , Proteínas Represoras/genética , Proteína Wnt1

RESUMEN

Previous research has shown evidence of a widening gap between scientific research and clinical teaching in sleep and sleep disorders. To address the deficiencies in current medical education in sleep, the Taskforce 2000 was established by the American Sleep Disorders Association. The present study was undertaken to assess the teaching activities, needs and interests of the membership of the two largest professional sleep societies (American Sleep Disorders Association and Sleep Research Society). Survey instruments included a brief, 5-item postcard survey, which was mailed to all members, followed by an in-depth, 34-item questionnaire, which was completed by 158 respondents from the intitial postcard survey (N = 808). Results indicated that the majority of respondents (65.2%) are currently involved in teaching sleep to medical students or postgraduate trainees, although the average amount of teaching time was only 2.1 hours for undergraduate and 4.8 hours for graduate education in sleep. Teaching of sleep laboratory procedures and clinical evaluation of sleep-disordered patients is limited at either an undergraduate or postgraduate level. The major deficiencies noted were the lack of time in the medical curriculum and the need for better resources and teaching facilities. A large majority of respondents indicated their willingness to be involved in sleep education for physicians, and rated this a high priority for the professional organization.

Asunto(s)

Educación Médica/normas , Trastornos del Sueño-Vigilia , Sueño , Encuestas y Cuestionarios , Curriculum , Humanos

RESUMEN

The authors report a case of mania occurring in a woman in late life who had begun receiving hormone replacement therapy for osteoporosis. They discuss related literature reports of mania or rapid cycling after adjunctive estrogen administration for refractory depression.

Asunto(s)

Trastorno Bipolar/inducido químicamente , Terapia de Reemplazo de Estrógeno/efectos adversos , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Osteoporosis Posmenopáusica/tratamiento farmacológico , Escalas de Valoración Psiquiátrica

Asunto(s)

Trastorno Depresivo/fisiopatología , Estrógenos/fisiología , Posmenopausia/fisiología , Anciano , Terapia de Reemplazo de Estrógeno , Femenino , Humanos , Persona de Mediana Edad

RESUMEN

Se describe el caso de una paciente de 2 meses de edad, sin antecedentes mórbidos. Sus manifestaciones clínicas consistieron en constipación, rechazo alimentario e hipotonía agregándose luego dificultad respiratoria progresiva, diplejía facial y pupilas hiporreactivas. Se descartó una enfermedad metabólica e infecciosa. La punción lumbar fue normal y la TAC cerebral normal. La electromiografía fue sugerente de botulismo certificándose el diagnóstico con detección de toxina botulínica tipo A en deposiciones. Requirió ventilación mecánica por 37 días. Presenta mejoría espontánea dándose de alta a los 98 días de hospitalización con hipotonía leve

Asunto(s)

Humanos , Femenino , Recién Nacido , Botulismo/diagnóstico , Clostridium botulinum/patogenicidad , Botulismo/terapia , Diagnóstico Diferencial , Toxinas Botulínicas/aislamiento & purificación