984 resultados para R. Johnson
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BACKGROUND/AIMS: Calcium homeostasis requires regulated cellular and interstitial systems interacting to modulate the activity and movement of this ion. Disruption of these systems in the kidney results in nephrocalcinosis and nephrolithiasis, important medical problems whose pathogenesis is incompletely understood. METHODS: We investigated 25 patients from 16 families with unexplained nephrocalcinosis and characteristic dental defects (amelogenesis imperfecta, gingival hyperplasia, impaired tooth eruption). To identify the causative gene, we performed genome-wide linkage analysis, exome capture, next-generation sequencing, and Sanger sequencing. RESULTS: All patients had bi-allelic FAM20A mutations segregating with the disease; 20 different mutations were identified. CONCLUSIONS: This autosomal recessive disorder, also known as enamel renal syndrome, of FAM20A causes nephrocalcinosis and amelogenesis imperfecta. We speculate that all individuals with biallelic FAM20A mutations will eventually show nephrocalcinosis.
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La atención domiciliaria constituye hoy una modalidad de atención que permite solventar las dificultades derivadas de la sobreocupación hospitalaria y la cronicidad, los cuales constituyen un problema de interés en salud pública en los paÃses desarrollados y que pueden ser manejados en el domicilio del paciente como una opción costo-efectiva y segura. Para lo cual es necesario buscar estrategias que permitan su desarrollo, gestión de riesgos y modelos de atención, logrando mejorar las condiciones de salud de la población. Uno de los principales retos de la gestión de programas de atención en salud, se encuentra en definir los aspectos donde intervenir para potenciar la eficacia y la calidad en la prestación del servicio, por lo que dichos aspectos se constituyen como determinantes de la atención del paciente y su familia. En este documento se abordan los principales determinantes en la atención de personas con secuelas de Enfermedad cerebrovascular, que reciben manejo medico domiciliario, con el objetivo de identificar las áreas prioritarias de intervención, garantizando una mejor gestión clÃnica en tres áreas especÃficas: sobrecarga del cuidador, Polimedicación y ulceras por decúbito.
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The environment where galaxies are found heavily influences their evolution. Close groupings, like the ones in the cores of galaxy clusters or compact groups, evolve in ways far more dramatic than their isolated counterparts. We have conducted a multi-wavelength study of Hickson Compact Group 7 (HCG 7), consisting of four giant galaxies: three spirals and one lenticular. We use Hubble Space Telescope (HST) imaging to identify and characterize the young and old star cluster populations. We find young massive clusters (YMCs) mostly in the three spirals, while the lenticular features a large, unimodal population of globular clusters (GCs) but no detectable clusters with ages less than a few Gyr. The spatial and approximate age distributions of the similar to 300 YMCs and similar to 150 GCs thus hint at a regular star formation history in the group over a Hubble time. While at first glance the HST data show the galaxies as undisturbed, our deep ground-based, wide-field imaging that extends the HST coverage reveals faint signatures of stellar material in the intragroup medium (IGM). We do not, however, detect the IGM in H I or Chandra X-ray observations, signatures that would be expected to arise from major mergers. Despite this fact, we find that the H I gas content of the individual galaxies and the group as a whole are a third of the expected abundance. The appearance of quiescence is challenged by spectroscopy that reveals an intense ionization continuum in one galaxy nucleus, and post-burst characteristics in another. Our spectroscopic survey of dwarf galaxy members yields a single dwarf elliptical galaxy in an apparent stellar tidal feature. Based on all this information, we suggest an evolutionary scenario for HCG 7, whereby the galaxies convert most of their available gas into stars without the influence of major mergers and ultimately result in a dry merger. As the conditions governing compact groups are reminiscent of galaxies at intermediate redshift, we propose that HCGs are appropriate for studying galaxy evolution at z similar to 1-2.
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Conselho Nacional de Desenvolvimento CientÃfico e Tecnológico (CNPq)
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Objective To report the severe metabolic acidosis identified in a group of 11 healthy mules anaesthetized with halothane for castration.Study design Data generated from a prospective study.Animals Eleven mules aged 2.5-8 years, weighing 230-315 kg and 11 horses aged 1.5-3.5 years, weighing 315-480 kg.Methods Animals were anaesthetized for castration as part of an electroencephalographic study. Preanaesthetic medication was acepromazine (0.03 mg kg(-1)) administered through a preplaced jugular venous catheter. Anaesthesia was induced 30-90 minutes later with intravenous thiopental (10 mg kg(-1)). After orotracheal intubation, anaesthesia was maintained with halothane vaporised in oxygen. The animals' lungs were ventilated to maintain the end-tidal CO(2) concentration between 3.9 and 4.5 kPa (29-34 mmHg). Anaesthetic monitoring included invasive blood pressure measurement via the auricular artery (mules) and submandibular branch of the facial artery (horses). Arterial blood gas samples were drawn from these catheters at three time points during surgery and pH, PaCO(2), base excess (ecf) and HCO(3)(-) were measured. Values were compared between groups using a Mann-Whitney test. p was taken as <0.05. Results are reported as median (range).Results PaCO(2) did not differ between groups but pH was significantly lower in mules [7.178 (7.00-7.29)] compared to horses [7.367 (7.24-7.43)] (p = 0.0002). HCO(3)(-) values were significantly lower in the mules [16.6 (13.0-22.3) mM] compared to horses [23.7 (20.9-23.7) mM] (p = 0.0001), whilst base excess (ecf) was significantly more negative in the mules [-11.4 (-1.27 to -16) mM] compared to horses [-1.3 (-5.8 to +2.4) mM] (p = 0.0004).Conclusion and clinical relevance This study demonstrated severe metabolic acidosis in healthy mules, which may have prompted intervention with drug therapies in a clinical arena. It is probable that the acidosis existed prior to anaesthesia and caused by diet, but other possible causes are considered.