RESUMO
BACKGROUND: Recent data on the prevalence of H. pylori infection in Jamaica are lacking. It is postulated that there has been a decline in the prevalence of H. pylori infection and its associated complications. We determined sociodemographic characteristics, prevalence of H. pylori infection and clinical outcomes among adults undergoing esophagogastroduodenoscopy (EGD) and histology at the University Hospital of the West Indies (UHWI) between May 2018 and December 2020. MATERIALS AND METHODS: A cross-sectional study of patients (≥18 years old), who underwent EGD and histological evaluation for H. pylori infection, was conducted. Associations of H. pylori positivity and gastric cancer with sociodemographic/clinical variables and endoscopic findings were determined by stepwise logistic regression using backward selection. Unadjusted and adjusted odds ratios with related 95% confidence intervals (Cis) were calculated for H. pylori positivity and gastric cancer status. RESULTS: There were 323 participants (mean age 58.6 ± 17.8 years, 54.2% females). H. pylori prevalence was 22.2% (n = 70 of 315), 5.6% had gastric neoplasia (GN), 15.5% gastric atrophy, 11.4% intestinal metaplasia and 3.7% dysplasia on histology. Mucositis (64.5%), gastric ulcer (14.9%), and duodenal ulcer (13.9%) were the most common endoscopic findings. Participants with peptic ulcer disease (PUD) (unOR = 4.0; p = .017), gastric cancer (unOR = 9.5; p = .003), gastric atrophy (unOR = 12.8; p < .001), and intestinal metaplasia (unOR = 5.0; p < .001) had a significantly higher odds of being H. pylori positive, but after multivariable analyses only gastric atrophy remained significant (aOR = 27.3; p < .001). Participants with mucositis had a significantly lower odds of gastric cancer (unOR 0.1; p = .035) while participants with dysplasia had significantly higher odds (unOR 8.0; p = .042), but these were no longer significant after multivariable analyses (aOR = 0.2; p = .156 and aOR = 18.9; p = .070, respectively). CONCLUSIONS: Histology based prevalence of H. pylori infection is lower than previously reported in Jamaica. Gastric atrophy is a significant predictor of H. pylori positivity.
Assuntos
Gastrite Atrófica , Infecções por Helicobacter , Helicobacter pylori , Mucosite , Neoplasias Gástricas , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Adolescente , Masculino , Estudos Transversais , Jamaica/epidemiologia , Neoplasias Gástricas/patologia , Mucosite/complicações , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/patologia , Endoscopia Gastrointestinal , Gastrite Atrófica/complicações , Atrofia , Hospitais de Ensino , Metaplasia/complicações , PrevalênciaRESUMO
ABSTRACT Introduction: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material and methods: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. Results: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median follow-up after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12-26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. Conclusions: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease.
Assuntos
Humanos , Masculino , Idoso , Complicações Pós-Operatórias/etiologia , Prostatectomia/efeitos adversos , Neoplasias da Próstata/cirurgia , Neoplasias da Próstata/patologia , Tempo para o Tratamento , Complicações Intraoperatórias/etiologia , Prostatectomia/métodos , Fatores de Tempo , Biópsia , Modelos Logísticos , Estudos Retrospectivos , Fatores de Risco , Análise de Variância , Resultado do Tratamento , Antígeno Prostático Específico/sangue , Medição de Risco , Progressão da Doença , Gradação de Tumores , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de NeoplasiasRESUMO
INTRODUCTION: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. MATERIAL AND METHODS: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. RESULTS: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median followup after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12-26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. CONCLUSIONS: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease.
Assuntos
Complicações Intraoperatórias/etiologia , Complicações Pós-Operatórias/etiologia , Prostatectomia/efeitos adversos , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Tempo para o Tratamento , Idoso , Análise de Variância , Biópsia , Progressão da Doença , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Antígeno Prostático Específico/sangue , Prostatectomia/métodos , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
ABSTRACT Objectives: Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. Materials and methods: Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome. Results: Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5%) were diagnosed with BCR, 30 (34.5%) developed SP, and 38 (43.7%) died, with 11 (12.6%) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Ten-year BCR-free survival, SP-free survival, and OS was 37%, 64%, and 70% respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR: 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP. Conclusions: Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.
Assuntos
Humanos , Masculino , Idoso , Prostatectomia/estatística & dados numéricos , Neoplasias da Próstata/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias da Próstata/cirurgia , Neoplasias da Próstata/mortalidade , Estados Unidos/epidemiologia , Biópsia , Análise Multivariada , Antígeno Prostático Específico , Intervalo Livre de Doença , Pessoa de Meia-Idade , Estadiamento de NeoplasiasRESUMO
OBJECTIVES: Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. MATERIALS AND METHODS: Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome. RESULTS: Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5%) were diagnosed with BCR, 30 (34.5%) developed SP, and 38 (43.7%) died, with 11 (12.6%) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Tenyear BCR-free survival, SP-free survival, and OS was 37%, 64%, and 70% respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR: 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP. CONCLUSIONS: Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.
Assuntos
Recidiva Local de Neoplasia/patologia , Prostatectomia/estatística & dados numéricos , Neoplasias da Próstata/patologia , Idoso , Biópsia , Intervalo Livre de Doença , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Antígeno Prostático Específico , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/cirurgia , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To compare the distribution of histological subtypes of thyroid cancer in Kingston and St Andrew (KSA), Jamaica, within two consecutive 15-year periods. METHODS: We extracted all cases of thyroid carcinoma archived in the Jamaica Cancer Registry files over the 30-year period from 1978 to 2007. The cases were separated into two groups: 1978-1992 (Group I) and 1993-2007 (Group II). We analysed age, gender and histological subtype distribution within each group, and then made comparative analyses between the two periods. RESULTS: There were 311 cases in which the histological subtype was documented. The patients ranged in age from 12 to 94 years, with male to female ratios of 1:4.2 (group I) and 1:5.6 (group II). The highest frequencies of cases occurred in patients between the ages of 20 and 59 years. The commonest histological subtype in group I was follicular (52.7%); in group II, it was papillary (60%), followed by follicular (26.7%) and medullary (6.7%). There was an overall 263% increase in the papillary to follicular cancer ratio from group I (0.62) to group II (2.25). The increase in papillary carcinomas was statistically significant (p < 0.001) overall, and in patients less than 50 years of age (p < 0.001). CONCLUSION: The recent KSA thyroid cancer data show a histological profile similar to that described globally, with papillary carcinomas being commonest, followed by follicular and then medullary. The significant increase in papillary cancer frequency in KSA is most likely the result of gradual recognition of the entity follicular variant of papillary cancer
Assuntos
Carcinoma/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Carcinoma/patologia , Distribuição de Qui-Quadrado , Criança , Feminino , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores Sexuais , Neoplasias da Glândula Tireoide/patologiaRESUMO
The ubiquity and importance of Giardia and Cryptosporidium as pathogens are reflected in the increasing number of publications concerning these organisms, but they are not the only reason why researchers are increasingly turning their attention to studying Giardia and Cryptosporidium. As new tools and databases become available, it is now possible to investigate fundamental issues related to their biology and relationship with their hosts. In this article, we highlight recent advances in research and outline questions arising that need to be addressed as a way of focusing the attention of the research and health communities and encouraging further dialogue and collaboration.
Assuntos
Cryptosporidium , Giardia , Animais , Criptosporidiose/epidemiologia , Criptosporidiose/parasitologia , Criptosporidiose/fisiopatologia , Cryptosporidium/genética , Cryptosporidium/metabolismo , Cryptosporidium/patogenicidade , Cryptosporidium/fisiologia , Perfilação da Expressão Gênica , Genoma de Protozoário , Giardia/genética , Giardia/metabolismo , Giardia/patogenicidade , Giardia/fisiologia , Giardíase/epidemiologia , Giardíase/parasitologia , Giardíase/fisiopatologia , Interações Hospedeiro-Parasita , Humanos , Proteômica , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismoRESUMO
Samples of Echinococcus granulosus from seven pigs from Mexico were compared with isolates of the parasite from pigs in Poland and representative strains and species of Echinococcus. Isolates from pigs in Mexico were found to be genetically identical to E. granulosus from Polish pigs and distinct from other major genotypes by sequencing part of the mitochondrial cytochrome c oxidase I (COI) mtDNA locus, restriction fragment length polymorphism (RFLP) of the polymerase chain reaction (PCR) amplified rDNA internal transcribed spacer (ITS) 1 using five different enzymes, and random amplified polymorphic DNA (RAPD) analysis. These results were complemented by data on hook morphology and together strengthen the view that Echinococcus maintained in a cycle involving pigs and dogs is a distinct strain that is conserved genetically in different geographical areas. The present study supports the close relationship of the cervid, camel and pig strains and raises the question of their taxonomic status.
Assuntos
Equinococose/parasitologia , Echinococcus granulosus/genética , Suínos/parasitologia , Animais , DNA Mitocondrial/química , DNA Mitocondrial/genética , Echinococcus granulosus/classificação , Echinococcus granulosus/isolamento & purificação , Complexo IV da Cadeia de Transporte de Elétrons/química , Complexo IV da Cadeia de Transporte de Elétrons/genética , Genótipo , México , Polônia , Reação em Cadeia da PolimeraseRESUMO
Fatal peripheral cholangiocarcinoma developed in 2 girls with progressive familial intrahepatic cholestasis, ABCB11 mutations, and absent bile salt export pump (BSEP) expression. BSEP deficiency may cause cholangiocarcinoma through bile-composition shifts or bile-acid damage within cells capable of hepatocytic/cholangiocytic differentiation. This observation suggests the need for hepatobiliary-malignancy surveillance and early consideration for liver transplantation.
Assuntos
Transportadores de Cassetes de Ligação de ATP/genética , Neoplasias dos Ductos Biliares/genética , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/genética , Colestase Intra-Hepática/genética , Mutação , Membro 11 da Subfamília B de Transportadores de Cassetes de Ligação de ATP , Feminino , Humanos , LactenteRESUMO
BACKGROUND: Small bowel volvulus is rare in adults and often has a precipitating factor. METHODS: This report describes a case of small bowel volvulus secondary to a mesenteric lipoma and reviews the literature describing this condition. CONCLUSION: Mesenteric lipoma is a rare precipitating cause of small bowel volvulus in adults. Computed tomography scanning may be useful for diagnosis preoperatively. The treatment of choice is surgery with complete excision of the lipoma.
Assuntos
Doenças do Íleo/etiologia , Volvo Intestinal/etiologia , Lipoma/complicações , Neoplasias Peritoneais/complicações , Adulto , Humanos , Doenças do Íleo/cirurgia , Volvo Intestinal/cirurgia , Lipoma/cirurgia , Masculino , Mesentério , Neoplasias Peritoneais/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Echinococcosis is a frequent hepatic parasitic disease in several countries but it is practically absent in Mexico. A cattle strain of Echinococcus granulosus was identified by RAPD, PCR-RFLP and mitochondrial CO1 gene analysis in an autochthonous case. The parasite was obtained after a laparoscopic excision of a liver cyst from a patient that was symptomatic for 6 years but mis-diagnosed before hospitalization.
Assuntos
Equinococose Hepática/transmissão , Echinococcus granulosus/classificação , Echinococcus granulosus/isolamento & purificação , Adulto , Animais , Bovinos/parasitologia , Equinococose Hepática/parasitologia , Feminino , Humanos , México , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Fragmento de Restrição , Técnica de Amplificação ao Acaso de DNA Polimórfico , Suínos/parasitologia , Zoonoses/transmissãoRESUMO
Remote sensing (RS) permits evaluation of spatial and temporal variables that can be used for vector-borne disease models. A Landsat Thematic Mapper scene covering Canindé, Ceará in northeastern Brazil (September 25, 1986) was spectrally enhanced and classified using ERDAS (Atlanta, GA) Imagine for 873 4-km2 areas. The population and number of cases of American visceral leishmaniasis (AVL) were determined for each 4-km2 area. Relative risk (RR) ratios were calculated for climate, demographic, and case data recorded for 17 years by the Municipality of Conidé. The RR of AVL for a child less than 10 years old from the foothills relative to non-foothill residency was 4.0 (95% confidence limit = 3.5, 4.5). The RR of AVL in children was 9.1 during a time when the three-year rolling rain average (current year plus two previous year's precipitation) was between 40 and 60 cm relative to rain greater than 100 cm. The results suggest that features detected by RS techniques combined with climatic variables can be used to determine the risk of AVL in northeastern Brazil.
Assuntos
Clima , Demografia , Leishmaniose Visceral/epidemiologia , Adulto , Brasil/epidemiologia , Pré-Escolar , Ecossistema , Humanos , Incidência , Fatores de Risco , Comunicações Via SatéliteRESUMO
Eosinophils, immunoglobulin (Ig)E and cytokines have important roles in defence mechanisms against helminths. In this study, the influence of HTLV-1 infection, characterized by a Th1 type of immune response, was evaluated on the cytokine pattern and parasitic specific IgE response in patients with strongyloidiasis. Patients were divided into four groups: strongyloidiasis without HTLV-1 infection, strongyloidiasis with HTLV-1, HTLV-1 without strongyloidiasis and controls without either helminth infection or HTLV-1. The cytokine profile was determined in supernatants of mononuclear cells stimulated with Strongyloides stercoralis crude antigen and the parasite specific IgE was measured by ELISA. Patients coinfected with HTLV-1 had higher levels of interferon (IFN)-gamma and interleukin (IL)-10 (P < 0.05) and lower levels of IL-5 and IgE (P < 0.05) than patients with strongyloidiasis without HTLV-1. There was an inverse relationship between IFN-gamma and IL-5 (P = 0.01; rs = - 0.37) and between IFN-gamma and parasite specific IgE (P = 0.01; rs = - 0.39), and a direct relationship between IFN-gamma and IL-10 (P = 0.04; rs = 0.35). These data show that coinfection with HTLV-1 decreases IL-5 and IgE responses in patients with strongyloidiasis consistent with a relative switch from Th2 to Th1 response. Immunological responses such as these are important in the control of this helminthic infection.
Assuntos
Citocinas/sangue , Infecções por HTLV-I/imunologia , Strongyloides stercoralis/imunologia , Estrongiloidíase/imunologia , Células Th2/imunologia , Adulto , Animais , Anticorpos Anti-Helmínticos/sangue , Células Cultivadas , Citocinas/biossíntese , Infecções por HTLV-I/sangue , Infecções por HTLV-I/complicações , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Humanos , Imunoglobulina E/sangue , Interferon gama/sangue , Interleucina-10/sangue , Interleucina-13/sangue , Interleucina-5/sangue , Leucócitos Mononucleares/citologia , Leucócitos Mononucleares/imunologia , Estrongiloidíase/sangue , Estrongiloidíase/complicaçõesRESUMO
OBJECTIVES: To compare the results of serial neuropsychologic testing in children with sickle cell disease with the results of serial magnetic resonance imaging (MRI) examinations, particularly to evaluate neuropsychologic function in the absence of overt stroke. STUDY DESIGN: In the Cooperative Study of Sickle Cell Disease, serial neuropsychologic and MRI tests were performed in 373 patients (255 with hemoglobin SS and 118 with hemoglobin SC), 6 to 18 years of age. MRI of the brain and a neuropsychologic battery that included the Wechsler Intelligence Scale for Children (WISC-R or WISC-III) and the Woodcock-Johnson Math and Reading Achievement Tests were performed concurrently and repeated every 2 to 3 years. A silent infarct was defined as an MRI finding of increased signal intensity on T(2) imaging in a patient without a history of stroke. RESULTS: Twenty-seven patients, all with hemoglobin SS, had overt strokes and 62 had silent infarcts (52 with hemoglobin SS). Patients with hemoglobin SS and silent infarcts had significantly lower scores for math and reading achievement, Full-Scale IQ, Verbal IQ, and Performance IQ, when compared with those with normal MRI findings. In children with hemoglobin SS and normal MRI findings, the scores for Verbal IQ, math achievement, and coding (a subscale of Performance IQ) declined with increasing age. CONCLUSIONS: School-aged children with sickle cell disease had compromised neuropsychologic function in the presence of silent infarcts. In addition, they had declines in performance in certain areas of function over time. Therapeutic interventions that prevent or lessen cognitive impairment are needed before school entry for children with sickle cell disease.
Assuntos
Anemia Falciforme/complicações , Infarto do Miocárdio/complicações , Testes Neuropsicológicos , Escalas de Wechsler , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Acidente Vascular Cerebral/complicaçõesRESUMO
We used the PCR-SSCP method followed by sequencing in order to assess the genetic variability of coding and noncoding parts of the genome of Echinococcus granulosus (Cestoda; Taeniidae) and to test whether or not the parasite populations are mainly self-fertilizing. For this, we analysed a sample of 110 E. granulosus metacestode isolates collected from different geographical regions (Southern Brazil, Europe and Australia) and from different intermediate hosts (ovine, bovine, human, macropod, swine and equine). Using appropriate controls, we were able to identify 4 strains in that sample (sheep, cattle, pig and horse strains). The high degree of genetic differentiation between strains, but not within, and the monomorphism found in most loci (EgAg4, EgActII, EgHbx2 and EgAg6-non-coding-EgAgB/1 and EgND1-coding) indicated that they are largely selfed. On the other hand, outcrossing was also shown to occur, since 5 potential hybrid genotypes between cattle and sheep strains were found in populations of Southern Brazil, but absent in other geographical areas. We suggest that both processes are adaptive. The article also reports, for the first time, the occurrence of the E. granulosus cattle strain in South America.
Assuntos
Echinococcus/genética , Endogamia , Animais , Bovinos , Echinococcus/fisiologia , Variação Genética/genética , Genética Populacional , Genótipo , Cavalos/parasitologia , Reação em Cadeia da Polimerase/métodos , Alinhamento de Sequência , Ovinos/parasitologia , Suínos/parasitologiaRESUMO
The Chilean oyster (Ostrea chilensis) broods its offspring almost to the settlement stage (about 8 weeks). Larvae are maintained inside the infrabranchial chamber of the female. Samples from all embryo and larval developmental stages were obtained from mantle cavities of brooding females and analyzed by scanning electron microscopy, with particular attention to the velar structures. All embryos and the earliest veliger stages of O. chilensis are devoid of cilia. Cilia first appear when shell length reaches 290-300 {mu}m, and the first cilia to grow on the velum form the outer preoral cilia. In larvae 340 {mu}m long, all the ciliary rings on the velum can be distinguished. These are the apical cilia (AC), inner preoral cilia (IPC), outer preoral cilia (OPC), and adoral cilia (AOC). The absence of the apical tuft in both O. chilensis and the closely related species O. edulis represents an adaptation to brooding by the embryos and larvae, but the lack of the postoral cilia (POC) in O. chilensis and the lack of cilia in the embryonic and early veliger stages are associated with an extreme brooding condition in this species.
RESUMO
In well-trained animals, infusion of the GABA-B agonist baclofen into the cerebellar interpositus nucleus and overlying cortex abolished the conditioned response (CR) with no effect on the unconditioned response (UR) with doses at or above 5.0 mM. Infusion of the GABA-B antagonist CGP 5584-5A alone had no effect on the CR or UR. However, administration of 5 mM baclofen soon after infusion of CGP 5584-5A (15 min) resulted in no reduction of percent CR and only partial reduction of CR amplitude. Naive animals given interpositus infusions of baclofen during training showed no learning, yet learned normally in postinfusion training. The distribution of (radiolabelled) baclofen was localized and remained within the cerebellum. The results presented here are consistent with a growing body of literature supporting the hypothesis that the memory trace for eyeblink conditioning is formed and stored in the cerebellum and may involve GABAergic mechanisms.
Assuntos
Piscadela/efeitos dos fármacos , Condicionamento Clássico/efeitos dos fármacos , Receptores de GABA-B/fisiologia , Animais , Baclofeno/administração & dosagem , Baclofeno/farmacologia , Cerebelo/fisiologia , Relação Dose-Resposta a Droga , Agonistas GABAérgicos/administração & dosagem , Agonistas GABAérgicos/farmacologia , Antagonistas GABAérgicos/administração & dosagem , Antagonistas GABAérgicos/farmacologia , Agonistas dos Receptores de GABA-B , Antagonistas de Receptores de GABA-B , Infusões Intravenosas , Injeções , Masculino , Ácidos Fosfínicos/administração & dosagem , Ácidos Fosfínicos/farmacologia , Propanolaminas/administração & dosagem , Propanolaminas/farmacologia , CoelhosRESUMO
Medium-chain acyl-coenzyme A dehydrogenase deficiency is an autosomal recessive disorder of beta-oxidation of fatty acids manifested by episodic hypoglycemia, encephalopathy, apnea, and sudden death. Medical data were obtained on 120 patients with medium-chain acyl-coenzyme A dehydrogenase deficiency referred to Duke University Medical Center for biochemical testing. There were 55 male and 65 female subjects ranging from birth to 19 years of age; 118 subjects were white. Twenty-three children (19%) died before the diagnosis was made. Follow-up data were available in the 97 surviving patients for an average of 2.6 years after diagnosis. Psychodevelopmental data were collected on 73 patients older than 2 years of age. Unexpected morbidity included developmental and behavioral disability, chronic muscle weakness, failure to thrive, and cerebral palsy. We conclude that unidentified patients with this disorder have a significant risk of sudden death in early childhood and that survivors have a significant risk of developmental disability and chronic somatic illness.
Assuntos
Ácidos Graxos Dessaturases/deficiência , Erros Inatos do Metabolismo Lipídico/complicações , Acil-CoA Desidrogenase , Adolescente , Adulto , Criança , Pré-Escolar , Insuficiência de Crescimento/etiologia , Feminino , Humanos , Hipoglicemia/etiologia , Lactente , Recém-Nascido , Erros Inatos do Metabolismo Lipídico/genética , Erros Inatos do Metabolismo Lipídico/mortalidade , Masculino , Hipotonia Muscular/etiologia , Estudos Retrospectivos , Convulsões/etiologiaRESUMO
BACKGROUND AND OBJECTIVES: In Venezuela, family medicine is taught and practiced almost exclusively in ambulatory care settings. This article describes the evolution of the educational strategies that emphasize family and community aspects of clinical practice within one residency program in the country of Venezuela. METHODS: Three distinct phases of development are depicted, beginning with a biomedical and individual-centered approach. Subsequent efforts to involve residents in the community provoked criticism. Resident-faculty dialogue led to modifications and to the success of the current program. Some of the specific educational strategies are: a structured weekly five-hour community afternoon, a 40-hour course titled "Family Dynamics and Counseling," use of the family-oriented home visit to introduce residents to the community aspects of health care, and completion of a community-based and health-related project. RESULTS: A sample of residents and graduates noted an improved doctor-patient relationship, improved ability to work with groups, and improved skills for incorporating preventive medicine with a community focus into their clinical practice. CONCLUSIONS: The community involvement is enthusiastically supported by the residents, as it is perceived as useful for clinical practice. The program prepares family physicians to become more responsive to the health needs and the reality of Venezuelan society.