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OBJECTIVE: Pre-eclampsia (PE) is a serious complication of pregnancy associated with maternal and fetal morbidity and mortality. As current prediction models have limitations and may not be applicable in resource-limited settings, we aimed to develop a machine-learning (ML) algorithm that offers a potential solution for developing accurate and efficient first-trimester prediction of PE. METHODS: We conducted a prospective cohort study in Mexico City, Mexico to develop a first-trimester prediction model for preterm PE (pPE) using ML. Maternal characteristics and locally derived multiples of the median (MoM) values for mean arterial pressure, uterine artery pulsatility index and serum placental growth factor were used for variable selection. The dataset was split into training, validation and test sets. An elastic-net method was employed for predictor selection, and model performance was evaluated using area under the receiver-operating-characteristics curve (AUC) and detection rates (DR) at 10% false-positive rates (FPR). RESULTS: The final analysis included 3050 pregnant women, of whom 124 (4.07%) developed PE. The ML model showed good performance, with AUCs of 0.897, 0.963 and 0.778 for pPE, early-onset PE (ePE) and any type of PE (all-PE), respectively. The DRs at 10% FPR were 76.5%, 88.2% and 50.1% for pPE, ePE and all-PE, respectively. CONCLUSIONS: Our ML model demonstrated high accuracy in predicting pPE and ePE using first-trimester maternal characteristics and locally derived MoM. The model may provide an efficient and accessible tool for early prediction of PE, facilitating timely intervention and improved maternal and fetal outcome. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Eficiencia de un enfoque de aprendizaje automático para la predicción de la preeclampsia en un país de ingresos medios OBJETIVO: La preeclampsia (PE) es una complicación grave del embarazo asociada a morbilidad y mortalidad materna y del feto. Dado que los modelos de predicción actuales tienen limitaciones y pueden no ser aplicables en situaciones con recursos limitados, se propuso desarrollar un algoritmo de aprendizaje automático (AA) que ofrezca una solución con potencial para desarrollar una predicción precisa y eficiente de la PE en el primer trimestre. MÉTODOS: Se realizó un estudio de cohorte prospectivo en Ciudad de México para desarrollar un modelo de predicción de la PE pretérmino (PEp) en el primer trimestre utilizando AA. Para la selección de variables se utilizaron las características maternas y los múltiplos de la mediana (MdM) obtenidos localmente para la presión arterial media, el índice de pulsatilidad de la arteria uterina y el factor de crecimiento placentario sérico. El conjunto de datos se dividió en subconjuntos de datos de entrenamiento, de validación y de test estadístico. Se empleó un método de red elástica para la selección de predictores, y el rendimiento del modelo se evaluó mediante el área bajo la curva de características operativas del receptor (ABC) y las tasas de detección (TD) con tasas de falsos positivos (TFP) del 10%. RESULTADOS: El análisis final incluyó a 3050 mujeres embarazadas, de las cuales 124 (4,07%) desarrollaron PE. El modelo de AA mostró una buena eficiencia, con un ABC de 0,897, 0,963 y 0,778 para la PEp, la PE de aparición temprana (PEat) y cualquier tipo de PE (todas las PE), respectivamente. Las TD con TFP del 10% fueron del 76,5%, 88,2% y 50,1% para la PEp, PEat y todas las PE, respectivamente. CONCLUSIONES: Nuestro modelo de AA demostró una alta precisión en la predicción de la PEp y la PEat utilizando características maternas del primer trimestre y MdM calculados localmente. El modelo puede proporcionar una herramienta eficiente y accesible para la predicción temprana de la PE, facilitando la intervención oportuna y la mejora de los resultados maternos y del feto.
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Pré-Eclâmpsia , Recém-Nascido , Gravidez , Feminino , Humanos , Pré-Eclâmpsia/diagnóstico , Fator de Crescimento Placentário , Estudos Prospectivos , Biomarcadores , Primeiro Trimestre da GravidezRESUMO
The Gram-positive bacteria lactic acid bacteria (LAB) are used in the food industry but are also known for inhibiting certain food spoilage microorganisms, especially fungi. Sources of nitrogen (N) for culture media are generally organic and expensive. Many attempts have been made to formulate economical culture media with alternative N sources obtained from agricultural and industrial byproducts. This study describes the design and optimization of an inexpensive culture medium for Lactiplantibacillus plantarum (formerly Lactobacillus plantarum) MZ809351 strain B31. The culture medium was optimized using statistical experimental designs to identify the factors with the most significant effects on biomass concentration to reduce the overall cost, aiming to obtain a biomass concentration similar to that obtained with the reference LAB culture medium (de Man, Rogosa and Sharpe; MRS). Sodium acetate and magnesium sulfate were the most significant factors (p < 0.005), and their contents were reduced by 22 % and 40 %, respectively, without affecting biomass concentration. Malt germ extract (MGE) was used as an alternative nitrogen source to replace meat extract (ME) and proteose peptone (PP). Through these experiments, the composition of a culture medium that is less expensive than MRS broth was defined, which produced a biomass concentration (3.8 g/L) similar to that obtained with MRS medium. The inhibitory effects of two LAB strains isolated from the Ivory Coast and Mexico on the growth and production of ochratoxin A (OTA) in an ochratoxigenic fungus was tested. The minimum cellular concentration of the LAB to prevent the development of Aspergillus carbonarius Ac 089 and the production of OTA was determined in a model assay in Petri dishes. The conditions to inhibit the germination of A. carbonarius Ac 089 and the production of OTA were found. Using the optimized medium and a ratio of 2 × 104 LAB/spore (1 × 108 CFU/mL) strain B7 (L. plantarum MZ809351) and 2 × 103 LAB/spore (1 × 107 CFU/mL) strain B31 (L. plantarum MN922335) completely inhibited the growth of the fungus. A ratio of 2 × 105 LAB/spore (1 × 109 CFU/mL) was required to inhibit OTA production with strains B7 and B31. This study indicates the potential of cultivating LAB in an optimized and inexpensive culture medium for use as a biological control agent against ochratoxigenic fungi in food.
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Lactobacillales , Ocratoxinas , Humanos , Meios de Cultura , Nitrogênio/farmacologia , Extratos VegetaisAssuntos
Neoplasias do Íleo , Valva Ileocecal , Tumores Neuroendócrinos , Humanos , Neoplasias do Íleo/diagnóstico por imagem , Neoplasias do Íleo/cirurgia , Valva Ileocecal/diagnóstico por imagem , Valva Ileocecal/patologia , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/cirurgiaRESUMO
OBJECTIVE: Mortality in pregnancy due to coronavirus disease 2019 (COVID-19) is a current health priority in developing countries. Identification of clinical and sociodemographic risk factors related to mortality in pregnant women with COVID-19 could guide public policy and encourage such women to accept vaccination. We aimed to evaluate the association of comorbidities and socioeconomic determinants with COVID-19-related mortality and severe disease in pregnant women in Mexico. METHODS: This is an ongoing nationwide prospective cohort study that includes all pregnant women with a positive reverse-transcription quantitative polymerase chain reaction result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the Mexican National Registry of Coronavirus. The primary outcome was maternal death due to COVID-19. The association of comorbidities and socioeconomic characteristics with maternal death was explored using a log-binomial regression model adjusted for possible confounders. RESULTS: There were 176 (1.35%) maternal deaths due to COVID-19 among 13 062 consecutive SARS-CoV-2-positive pregnant women. Maternal age, as a continuous (adjusted relative risk (aRR), 1.08 (95% CI, 1.05-1.10)) or categorical variable, was associated with maternal death due to COVID-19; women aged 35-39 years (aRR, 3.16 (95% CI, 2.34-4.26)) or 40 years or older (aRR, 4.07 (95% CI, 2.65-6.25)) had a higher risk for mortality, as compared with those aged < 35 years. Other clinical risk factors associated with maternal mortality were pre-existing diabetes (aRR, 2.66 (95% CI, 1.65-4.27)), chronic hypertension (aRR, 1.75 (95% CI, 1.02-3.00)) and obesity (aRR, 2.15 (95% CI, 1.46-3.17)). Very high social vulnerability (aRR, 1.88 (95% CI, 1.26-2.80)) and high social vulnerability (aRR, 1.49 (95% CI, 1.04-2.13)) were associated with an increased risk of maternal mortality, while very low social vulnerability was associated with a reduced risk (aRR, 0.47 (95% CI, 0.30-0.73)). Being poor or extremely poor were also risk factors for maternal mortality (aRR, 1.53 (95% CI, 1.09-2.15) and aRR, 1.83 (95% CI, 1.32-2.53), respectively). CONCLUSION: This study, which comprises the largest prospective consecutive cohort of pregnant women with COVID-19 to date, has confirmed that advanced maternal age, pre-existing diabetes, chronic hypertension, obesity, high social vulnerability and low socioeconomic status are risk factors for COVID-19-related maternal mortality. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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COVID-19/epidemiologia , Morte Materna/estatística & dados numéricos , Complicações Infecciosas na Gravidez/epidemiologia , Vulnerabilidade Social , Adulto , Estudos de Coortes , Comorbidade , Feminino , Humanos , Mortalidade Materna , México , Pobreza , Gravidez , Nascimento Prematuro/epidemiologia , Estudos ProspectivosRESUMO
OBJECTIVE: In addition to the lungs, the placenta and the endothelium can be affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are markers of endothelial dysfunction and could potentially serve as predictors of severe coronavirus disease 2019 (COVID-19). We aimed to investigate the association of serum concentrations of sFlt-1 and PlGF with the severity of COVID-19 in pregnancy. METHODS: This was a prospective cohort study carried out in a tertiary care hospital in Mexico City, Mexico. Symptomatic pregnant women with a positive reverse-transcription quantitative polymerase chain reaction test for SARS-CoV-2 infection who fulfilled the criteria for hospitalization were included. The primary outcome was severe pneumonia due to COVID-19. Secondary outcomes were intensive care unit (ICU) admission, viral sepsis and maternal death. sFlt-1 levels were expressed as multiples of the median (MoM). The association between sFlt-1 and each adverse outcome was explored by logistic regression analysis, adjusted for gestational age for outcomes occurring in more than five patients, and the predictive performance was assessed by receiver-operating-characteristics-curve analysis. RESULTS: Among 113 pregnant women with COVID-19, higher sFlt-1 MoM was associated with an increased probability of severe pneumonia (adjusted odds ratio (aOR), 1.817 (95% CI, 1.365-2.418)), ICU admission (aOR, 2.195 (95% CI, 1.582-3.047)), viral sepsis (aOR, 2.318 (95% CI, 1.407-3.820)) and maternal death (unadjusted OR, 5.504 (95% CI, 1.079-28.076)). At a 10% false-positive rate, sFlt-1 MoM had detection rates of 45.2%, 66.7%, 83.3% and 100% for severe COVID-19 pneumonia, ICU admission, viral sepsis and maternal death, respectively. PlGF values were similar between women with severe and those with non-severe COVID-19 pneumonia. CONCLUSION: sFlt-1 MoM is higher in pregnant women with severe COVID-19 and has the capability to predict serious adverse pregnancy events, such as severe pneumonia, ICU admission, viral sepsis and maternal death. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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COVID-19 , Unidades de Terapia Intensiva/estatística & dados numéricos , Pneumonia Viral , Complicações Infecciosas na Gravidez , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/sangue , Adulto , COVID-19/sangue , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/terapia , Estudos de Coortes , Endotélio Vascular/metabolismo , Endotélio Vascular/fisiopatologia , Feminino , Idade Gestacional , Humanos , México/epidemiologia , Mortalidade , Placenta/metabolismo , Placenta/fisiopatologia , Fator de Crescimento Placentário/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/terapia , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vertical transmission has been investigated extensively. Recently, the World Health Organization (WHO) published strict criteria to classify the timing of mother-to-child transmission of SARS-CoV-2 into different categories. The aim of this study was to investigate the possibility of vertical transmission in asymptomatic SARS-CoV-2-positive women. METHODS: Pregnant women attending for delivery at a perinatology center in Mexico City, Mexico, who had a SARS-CoV-2-positive nasopharyngeal swab 24-48 h before delivery, were asymptomatic at the time of the test and had an obstetric indication for Cesarean section were eligible for inclusion in this study. Amniotic fluid was collected during Cesarean delivery, and neonatal oral and rectal swabs were collected at birth and at 24 h after birth. SARS-CoV-2 detection was carried out using real-time reverse-transcription polymerase chain reaction in all samples. Relevant medical information was retrieved from clinical records. The WHO criteria for classifying the timing of mother-to-child transmission of SARS-CoV-2 were applied to the study population. RESULTS: Forty-two SARS-CoV-2-positive asymptomatic pregnant women fulfilled the inclusion criteria. Twenty-five (59%) women developed mild disease after discharge. Neonatal death occurred in three (7%) cases, of which one had a positive SARS-CoV-2 test at birth and none had coronavirus disease 2019-related symptoms. There were five (12%) cases with strong evidence of intrauterine transmission of SARS-CoV-2, according to the WHO criteria, as amniotic fluid samples and neonatal samples at birth and at 24 h after birth were positive for SARS-CoV-2. Our results also showed that 40-60% of infected neonates would have been undetected if only one swab (oral or rectal) was tested. CONCLUSION: This study contributes evidence to reinforce the potential for vertical transmission of SARS-CoV-2 even in asymptomatic women and highlights the importance of testing more than one neonatal sample in order to increase the detection rate of SARS-CoV-2 in affected cases. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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COVID-19/transmissão , Transmissão Vertical de Doenças Infecciosas , Adulto , COVID-19/diagnóstico , COVID-19/epidemiologia , Teste de Ácido Nucleico para COVID-19 , Cesárea , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , México/epidemiologia , Pessoa de Meia-Idade , Triagem Neonatal , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/patogenicidadeRESUMO
Addressing the improvement of the textile characteristics is currently required in natural color production of alpaca fiber. This study analyses the possibility of implementing a genetic improvement program aiming to reduce the fiber diameter and the percentage of medullation in natural colors under the incomplete definition of the natural colors of alpaca fiber. The study considers color determination analysis in three separate steps. The first step aimed at finding the values of lightness (L*), red/green axis (a*), yellow/blue axis (b*) of three-dimensional space of color and chroma (C*ab), tone (h*ab) and color difference (ΔE) with mathematical models for the description of the coat color. The second analysis is aimed at estimating genetic parameters of color traits and their correlation with fiber traits (fiber diameter, standard deviations and percentage of medullation - PM). The third step was to determine the potential selection criteria of breeding animals based on the parameters provided by a three-dimensional space values regarding the coat color assignment in alpacas. The colorimetric data were taken using a Chroma meter device analyzing 3 008 records from Huacaya type alpacas, collected between 2018 and 2019. In the first objective of the study, the color traits were subjected to a principal component analysis. The analysis of variance components and the estimation of genetic parameters were carried out using a restricted maximum likelihood procedure. The discriminant analysis was used for the correct assignment of the coat color. The principal component analysis results showed that the L*, a*, b*, h*ab and ΔE values can be grouped into two Principal Components (PC) to describe the color, where the L* value is mainly distributed in PC2, b* is distributed in PC1, while a* is distributed in both components. The heritabilities found were 0.144, 0.128, 0.151, 0.104 and 0.152 for L*, a*, b*, PC1 and PC2. The relevant genetic correlations were between L*-PM (-0.557) and b*-PM (-0.622). The discriminant analysis showed a high percentage of correct assignment in white (99.15%) and black (99.19%) coat colors for Huacaya type alpacas, while for the intermediate colors, the accuracy was lower. The three analyses showed that there is no pure natural color, but a range of color variation. It is better to use the values of the three-dimensional space and within them, the values of L* and b* are potential selection criteria to be included in a genetic improvement program.
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Camelídeos Americanos , Colorimetria , Animais , Cor , Colorimetria/veterinária , Fibras na Dieta , FenótipoRESUMO
BACKGROUND: HPV self-sampling has been widely supported by the scientific community following a strong body of literature on the subject. Self-sampling is important in cervical cancer screening as it has been shown to improve participation. It is well documented that HPV-testing has proven superior to cytology with regards to sensitivity in detection of CIN and cancer. The value of self-collected samples is reliant on the quality of the molecular testing performed, as well as the patients' preference in sampling procedure and compliance to follow up on positive test results. Due to the incompatibility of self-samples and cytology, triage of HPV-DNA positives by testing for molecular biomarkers is highly warranted. METHODS: Our objective was to compare the detection rate of genital Human Papillomavirus (HPV) infection in self- and clinician-collected samples by a 14-type HPV-DNA test and a 7-type mRNA E6/E7 test. RESULTS: Five hundred five women were recruited. Each study participant had two sample collection procedures performed upon the same visit, alternating order in execution of the self-collection or the clinician-taken procedure first or second, 1010 samples in total. HPV-DNA prevalence was 22.8% in self-collected versus 19.2% in clinician-collected samples (P = 0.19). Overexpression of mRNA E6/E7 from 7 HPV types was 7.1 and 6.3%, respectively (P = 0.71). The difference between HPV-DNA and HPV-mRNA positivity rates were statistically significant in both self-collected (22.8% versus 7.1%, P < 0.001) and clinician-collected samples (19.2% versus 6.3%, P < 0.001). Overall agreement between the two collection methods was fair, with a concordance rate of 78.2% (390/505), k = 0.34 (95% CI: 0.25-0.44), P < 0.001, for the HPV-DNA test and 92.5% (467/505), k = 0.40 (95% CI, 0.25-0.56), P < 0.001, for the mRNA test, respectively. 96.8% of the participants reported they felt confident carrying out the self-collection themselves, and 88.8% reported no discomfort at all performing the procedure. CONCLUSIONS: This comparative study of two sampling methods reports fair agreement of HPV positivity rates between the self-collected and clinician-collected specimens using Abbott hrHPV and PreTect HPV-Proofer'7 tests. Only one third of HPV-DNA positive women had overexpression of mRNA E6/E7. TRIAL REGISTRATION: ISRCTN77337300 .
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Técnicas de Diagnóstico Molecular/métodos , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Manejo de Espécimes/métodos , Adulto , DNA Viral/genética , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Papillomaviridae/genética , RNA Mensageiro/genética , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/virologiaRESUMO
This study aimed to estimate genetic parameters for four guinea pig lines of a crossbreeding scheme. Two paternal lines are selected for growth rate (P1) and feed conversion rate (P2), whereas two maternal lines are selected for growth rate of litter (M1) and litter size at birth (M2). The heritabilities and genetic correlations were estimated with animal linear models employing multivariate analyses with REML. The heritabilities for birth weight (BW) were 0.21±0.02 and 0.23±0.03 for P1 and P2, respectively, and for weaning weight (WW), the heritability was 0.28±0.03 for P2. The estimates for weight at 60 days of age (W60) were 0.34±0.01 and 0.47±0.04 for P1 and P2, respectively, and for partial feed conversion rate was 0.46±0.03 for P2. Heritabilities for litter weight at birth (LW) were 0.09±0.03 and 0.10±0.03 for P1 and M1, respectively. For litter weight at 10 days of age (LW10), the heritability was 0.15±0.03 for M1. Heritabilities for litter size (LS) were 0.17±0.03, 0.20±0.03 and 0.11±0.03, and for number of pups born alive (BA) were 0.09±0.03, 0.14±0.03 and 0.09±0.03 for P1, M1 and M2, respectively. Similarly, high genetic correlations were found between BW, WW and W60 and between LW, LS, LW10 and BA. The genetic correlation between BW direct and maternal was moderately negative (- 0.24 ± 0.10) for P1. These results show the genetic status for all four guinea pig lines, which is essential for the further improvement of the currently implemented breeding programme and also indicate an opportunity for genetic improvement.
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Cobaias/genética , Hibridização Genética , Modelos Genéticos , Animais , Peso ao Nascer/genética , Peso Corporal/genética , Feminino , Modelos Lineares , Tamanho da Ninhada de Vivíparos , Masculino , Análise Multivariada , Peru , GravidezRESUMO
The physicochemical, nutritional and sensory properties of flours, doughs and tortillas made with traditional nixtamalization (TN) and ecological nixtamalization (EN) and enriched (9%) with the traditional maguey mushroom (Pleurotus agaves) were analysed. EN resulted in flours and tortillas having a greater content of bioactive compounds than that of TN flours, which represents a production process of maize tortillas containing high amounts of antioxidants. The addition of mushrooms to EN flours improved their sensory properties, whereas the addition of mushrooms to TN flours decreased them. The amount of P. agaves added to tortillas was equivalent to 3% enrichment with ß-glucans. The edible mushroom P. agaves, highly appreciated in many Mexican regions, improved the nutritional and sensory quality of blue maize tortillas when added to flours prepared by EN. A new product was developed using local traditional foods of complementary nutritional value.
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Pão/análise , Farinha/análise , Alimentos Fortificados/análise , Pleurotus , Zea mays , Manipulação de Alimentos/métodos , Humanos , México , Valor NutritivoRESUMO
In this study, insecticide resistance and the mechanisms responsible were characterized in Ae. aegypti of Boyeros municipality from Havana, Cuba. Boyeros represents a high epidemiological risk because it is located near the Havana International Airport, it is highly urbanized, and it has a large influx of people from endemic countries so that it qualifies as a sentinel site for surveillance. The larvae collected from five areas of this municipality showed resistance to temephos associated with metabolic enzymes. The adult mosquitoes displayed a deltamethrin resistance and less distinctly to other pyrethroids associated with a high frequency of sodium channel gene mutations (F1534C and V1016I), detected for the first time in a field population from Cuba. The presence in the field populations of two insecticide resistance mechanisms represents a limiting factor in the success of the control operations of this vector, so other strategies should be considered to preserve the effectiveness of the insecticides available in public health for vector control in Cuba.
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Aedes/efeitos dos fármacos , Resistência a Inseticidas , Controle de Mosquitos , Aedes/genética , Animais , Cuba , Piretrinas/farmacologia , Canais de Sódio/genética , Temefós/farmacologiaRESUMO
PURPOSE: To review the efficacy and safety of transitioning from dexmedetomidine to clonidine to facilitate weaning of patients from sedation with dexmedetomidine. There is a paucity of data describing dexmedetomidine withdrawal syndrome (DWS) as well as clonidine's place in therapy for DWS. This review will describe and analyze current literature to provide clinical recommendations. SUMMARY: A MEDLINE literature search was performed to identify original research articles describing DWS and/or transitioning from dexmedetomidine to clonidine for the purpose of weaning patients from sedation with dexmedetomidine. Four case reports describing DWS, 3 case reports describing the use of clonidine to treat DWS, and 3 observational studies describing the use of clonidine to facilitate dexmedetomidine weaning were identified. The incidence of and risk factors for DWS are unknown; factors including patient age and dexmedetomidine infusion rate, loading dose, and discontinuation strategy have inconsistent associations with DWS. All cases of DWS have been associated with infusion durations greater than 72 hours. While there are limited data describing clonidine use for the treatment of dexmedetomidine withdrawal, clonidine appears to be beneficial for dexmedetomidine weaning and its use for that purpose has been well described. Clonidine dosages that have been assessed for discontinuing dexmedetomidine vary from 0.1 to 0.3 mg orally or enterally every 6 to 8 hours; one study assessed use of transdermal clonidine (100 µg/24 h patch). Patients with extensive cardiac comorbidities may be more susceptible to adverse effects of clonidine, which may limit the drug's use for DWS intervention. CONCLUSION: Despite limited supportive data, clonidine provides a promising option for sedation management in adult ICU patients, with successful transitions from dexmedetomidine reported within 24 hours after clonidine initiation.
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Clonidina/administração & dosagem , Dexmedetomidina/administração & dosagem , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Agonistas de Receptores Adrenérgicos alfa 2/administração & dosagem , Adulto , Estado Terminal , Relação Dose-Resposta a Droga , Substituição de Medicamentos , Humanos , Hipnóticos e Sedativos/administração & dosagem , Fatores de RiscoRESUMO
Background: Inflammation is a condition that jeopardizes the continuity of pregnancy because it increases the secretion of chemokines that favor the migration of leukocytes from maternal and fetal circulations to the cervix, placenta, and the chorioamniotic membranes. During pregnancy, the level of prolactin (PRL) in the amniotic fluid is high; there is evidence to suggest that PRL contributes to maintain a privileged immune environment in the amniotic cavity. We test the effect of prolactin on the secretion profile of chemokines in human fetal membranes.Methods: Nine fetal membranes collected from healthy nonlabouring cesarean deliveries at term. We placed whole membrane explants in a two-chamber culture system. Choriodecidua and amniotic chambers were pretreated with 250, 500, 1000, or 4000 ng/ml of PRL for 24 h, then choriodecidua was cotreated with 500 ng/ml of lipopolysaccharide (LPS) and PRL for 24 h. We used ELISA to measure secreted levels of four chemokines (RANTES, monocyte chemoattractant protein 1 (MCP-1), MIP-1α, and IL-8) in both amnion and choriodecidua regions.Results: In comparison with basal conditions, LPS treatment induced significantly higher secretion of RANTES, MCP-1, and MIP-1α, but not of IL-8. RANTES was mainly produced by choriodecidua and cotreatment with PRL significantly decreased its LPS-induced secretion. MCP-1 was primarily produced by the amnion and its secretion was only inhibited by 4000 ng/ml of PRL. Both membrane regions produced MIP-1α, which was significantly inhibited at 1000 and 4000 ng/ml PRL concentrations. IL-8 showed no significant changes regardless of PRL concentration.Conclusion: PRL inhibits the differential secretion of proinflammatory chemokines by human fetal membranes.
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Membranas Extraembrionárias , Lipopolissacarídeos , Prolactina , Âmnio , Quimiocinas , Feminino , Humanos , Gravidez , Prolactina/fisiologiaRESUMO
The performance of crossbred (1/2 Holstein x Zebu) cows supplemented on Brachiaria decumbens pasture during the wet-dry transition period was evaluated. Eight cows with 497±50kg, during third and fourth lactations and after the lactation peak were distributed in two 4 x 4 Latin squares. The treatments consisted of a factorial with two types of mineral supplements (nitrogenous and mineral salt) and two levels of concentrate (0.3 and 0.6% body weight (BW)/cow/day), based on corn and soybean meal (60:40), and supplied during the morning and afternoon milking. The experiment lasted 56 days, divided into four periods of 14 days, with seven days for adaptation and seven for data collection. No interaction (P> 0.05) was observed between the supplements and the concentrate levels. The nitrogenous salt and the highest concentrate level increased (P< 0.05) the intake of crude protein, and the highest concentrate level increased (P< 0.05) the intake of non-fibrous carbohydrates and the digestibility of crude protein. No effect (P> 0.05) of supplement and concentrate level was observed on the milk constituents and feed efficiency. Grazing crossbred after the lactation peak during the wet-dry transition period achieve the productive potential with 0.3% BW of concentrate per day and mineral salt.(AU)
Foi avaliado o desempenho de vacas mestiças (1/2 Holandês x Zebu) suplementadas em pastagens de Brachiaria decumbens durante o período de transição águas-seca. Oito vacas com 497±50kg, durante a terceira e a quarta lactação e após o pico de produção, foram distribuídas em dois quadrados latinos 4 x 4. Os tratamentos consistiram de um fatorial com dois tipos de suplementos (sal nitrogenado e sal mineral) e dois níveis de concentrado (0,3 e 0,6% do peso corporal (PC)/vaca/dia), baseado em milho e farelo de soja (60:40) e suprido durante as ordenhas da manhã e da tarde. O experimento durou 56 dias, divididos em quatro períodos de 14 dias, sendo sete dias para adaptação e sete para coletas. Não foi encontrada interação (P>0,05) entre os suplementos e os níveis de concentrado. O sal nitrogenado e o maior nível de concentrado aumentaram (P<0,05) o consumo de proteína bruta, e o maior nível de concentrado aumentou (P<0,05) o consumo de carboidratos não fibrosos e a digestibilidade da proteína bruta. Não foi observado efeito (P>0,05) de suplemento e de nível de concentrado sobre os componentes do leite e a eficiência alimentar. Vacas mestiças após o pico de lactação durante o período de transição águas-seca alcançam seu potencial produtivo com 0,3% do PC/dia de concentrado e sal mineral.(AU)
Assuntos
Animais , Feminino , Bovinos , Bovinos , Dieta/veterinária , Ração Animal , PastagensRESUMO
RESUMEN El café es la segunda bebida más consumida en el mundo después del agua, en el que Colombia contribuye con el 9% de la producción, destacándose la calidad del café del departamento del Huila (cafés de altura); sin embargo, no hay suficiente evidencia sobre la incidencia de la altura en la calidad sensorial y composición química. En ese sentido, se buscó caracterizar y diferenciar cafés, mediante el análisis del espectro infrarrojo (FTIR) y evaluación sensorial. 62 muestras de cafés especiales fueron caracterizados, cosechados en diferentes altitudes, obtenidas en dos periodos de cosecha. Los espectros obtenidos permitieron encontrar diferenciación en los picos asociados a ácidos clorogénicos (1600-1650cm-1), entre grano verde y tostado, aunque no se observaron diferencias en los picos, según el periodo de cosecha, por sí solos. La evaluación sensorial, según la metodología SCA, 2015, no generaron diferencias estadísticamente significativas entre periodos de cosecha y variedades evaluadas. Al considerar conjuntamente el análisis sensorial y el análisis del espectro infrarrojo, se presentaron diferencias estadísticamente significativas entre periodos de cosecha, atribuibles al contenido de cafeína y al puntaje total en taza. Los resultados encontrados muestran que no existe correlación entre la altura del cultivo de café y la calidad final de la bebida.
ABSTRACT Coffee is the second most consumed beverage in the world after water, the Colombian coffee production contributes with 9% of total world production and Colombian coffee is recognized by quality and mild coffee. Today, there is not enough evidence on the influence of altitude in sensory quality and coffee chemical composition. In this sense, we sought to characterize and differentiate coffees by infrared spectrum analysis (FTIR) and sensory evaluation. 62 specialty coffees samples were harvested at different altitudes, obtained in two harvest periods. The spectra obtained allowed finding differentiation in the peaks associated with chlorogenic acids (1600-1650cm-1) between green and roasted coffee beans, although no differences were observed in the peaks according to the harvest period; by itself. The sensory evaluation, according to the SCA methodology, 2015 did not generate statistically significant differences between harvest periods and evaluated varieties. When jointly considering the sensory analysis and the infrared spectrum analysis, there were statistically significant differences between harvest periods, attributable to the caffeine content and the total cup score. The results found show that there is no correlation between the height of the coffee crop and the final quality of the beverage.
RESUMO
The performance of crossbred (1/2 Holstein x Zebu) cows supplemented on Brachiaria decumbens pasture during the wet-dry transition period was evaluated. Eight cows with 497±50kg, during third and fourth lactations and after the lactation peak were distributed in two 4 x 4 Latin squares. The treatments consisted of a factorial with two types of mineral supplements (nitrogenous and mineral salt) and two levels of concentrate (0.3 and 0.6% body weight (BW)/cow/day), based on corn and soybean meal (60:40), and supplied during the morning and afternoon milking. The experiment lasted 56 days, divided into four periods of 14 days, with seven days for adaptation and seven for data collection. No interaction (P> 0.05) was observed between the supplements and the concentrate levels. The nitrogenous salt and the highest concentrate level increased (P< 0.05) the intake of crude protein, and the highest concentrate level increased (P< 0.05) the intake of non-fibrous carbohydrates and the digestibility of crude protein. No effect (P> 0.05) of supplement and concentrate level was observed on the milk constituents and feed efficiency. Grazing crossbred after the lactation peak during the wet-dry transition period achieve the productive potential with 0.3% BW of concentrate per day and mineral salt.(AU)
Foi avaliado o desempenho de vacas mestiças (1/2 Holandês x Zebu) suplementadas em pastagens de Brachiaria decumbens durante o período de transição águas-seca. Oito vacas com 497±50kg, durante a terceira e a quarta lactação e após o pico de produção, foram distribuídas em dois quadrados latinos 4 x 4. Os tratamentos consistiram de um fatorial com dois tipos de suplementos (sal nitrogenado e sal mineral) e dois níveis de concentrado (0,3 e 0,6% do peso corporal (PC)/vaca/dia), baseado em milho e farelo de soja (60:40) e suprido durante as ordenhas da manhã e da tarde. O experimento durou 56 dias, divididos em quatro períodos de 14 dias, sendo sete dias para adaptação e sete para coletas. Não foi encontrada interação (P>0,05) entre os suplementos e os níveis de concentrado. O sal nitrogenado e o maior nível de concentrado aumentaram (P<0,05) o consumo de proteína bruta, e o maior nível de concentrado aumentou (P<0,05) o consumo de carboidratos não fibrosos e a digestibilidade da proteína bruta. Não foi observado efeito (P>0,05) de suplemento e de nível de concentrado sobre os componentes do leite e a eficiência alimentar. Vacas mestiças após o pico de lactação durante o período de transição águas-seca alcançam seu potencial produtivo com 0,3% do PC/dia de concentrado e sal mineral.(AU)
Assuntos
Animais , Feminino , Bovinos , Bovinos , Dieta/veterinária , Ração Animal , PastagensRESUMO
BACKGROUND: Neuromuscular impairment makes individuals with cerebral palsy (CP) more prone to drooling. Among the treatment options, there are procedures that interfere with saliva production. It is imperative to evaluate the effect of the different modalities since the reduction in salivary flow rate/production may exacerbate the risk of dental caries. MATERIAL AND METHODS: The aim of this study was to compare the effects of different treatments for drooling on caries risk and salivary parameters in children and adolescents with CP. STUDY DESIGN: A total of 142 children and adolescents with CP, aged 6 to 18 years, were assigned to groups based on the different treatments they had received for drooling: G1-anticholinergic drugs (n = 18), G2-botulinum toxin injection (n = 16), G3-salivary glands surgery (n = 16), G4-no treatment (n = 42), and G5-non-drooling subjects (n = 50). All participants were evaluated on the Simplified Oral Hygiene Index, and for the prevalence of dental caries (decayed, missing, and filled teeth index and white spot lesions). Unstimulated whole saliva was collected, and salivary flow rate and osmolality were measured. Chi-square, ANOVA and Poisson regression were calculated. Prevalence ratios and their respective 95 % confidence intervals were obtained. The significance level was fixed at 5%. RESULTS: No differences were found in the decayed, missing, and filled teeth index (p = 0.128) and Simplified Oral Hygiene Index (p = 0.674) among the different groups. G3 presented significantly higher percentages of WSL (p < 0.001), lower values of salivary flow rate (p < 0.001), and higher values of osmolality (p < 0.001). The white spot lesion prevalence ratio was higher only for G3 (Prevalence ratio = 14.36; IC 95% = 4.64-44.40; p < 0.001). CONCLUSIONS: Children and adolescents with CP who had received surgical treatment for drooling exhibited higher number of white spot lesions because of the reduced salivary flow rate and higher salivary osmolality.
Assuntos
Paralisia Cerebral/complicações , Cárie Dentária/epidemiologia , Sialorreia/complicações , Sialorreia/terapia , Adolescente , Toxinas Botulínicas/uso terapêutico , Brasil , Criança , Antagonistas Colinérgicos/uso terapêutico , Estudos Transversais , Índice CPO , Feminino , Humanos , Masculino , Higiene Bucal , Concentração Osmolar , Prevalência , Análise de Regressão , Saliva , Glândulas Salivares/cirurgia , Sialorreia/cirurgiaRESUMO
TITLE: Sindrome meningeo en un paciente tratado con combinacion de inhibidores de puntos de control inmunologico para melanoma metastasico.