996 resultados para late season diseases
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Background: To ascertain the population rates and proportion of late entry into HIV care, as well as to determine whether such late entry correlates with individual and contextual factors. Methods: Data for the 2003-2006 period in Brazil were obtained from public health records. A case of late entry into HIV care was defined as one in which HIV infection was diagnosed at death, one in which HIV infection was diagnosed after the condition of the patient had already been aggravated by AIDS-related diseases, or one in which the CD4(+) T-cell count was <= 200 cells/mm(3) at the time of diagnosis. We also considered extended and stricter sets of criteria (in which the final criterion was <= 350 cells/mm(3) and <= 100 cells/mm(3), respectively). The estimated risk ratio was used in assessing the effects of correlates, and the population rates (per 100,000 population) were calculated on an annual basis. Results: Records of 115,369 HIV-infected adults were retrieved, and 43.6% (50,358) met the standard criteria for late entry into care. Diagnosis at death accounted for 29% (14,457) of these cases. Late entry into HIV care (standard criterion) was associated with certain individual factors (sex, age, and transmission category) and contextual factors (region with less economic development/increasing incidence of AIDS, lower local HIV testing rate, and smaller municipal population). Use of the extended criteria increased the proportion of late entry by 34% but did not substantially alter the correlations analyzed. The overall population rate of late entry was 9.9/100,000 population, specific rates being highest for individuals in the 30-59 year age bracket, for men, and for individuals living in regions with greater economic development/higher HIV testing rates, collectively accounting for more than half of the cases observed. Conclusions: Although the high proportion of late entry might contribute to spreading the AIDS epidemic in less developed regions, most cases occurred in large cities, with broader availability of HIV testing, and in economically developed regions.
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Despite evidence for the important role of oestrogens in the aetiology and pathophysiology of chronic immune/inflammatory diseases, the previous view of an unequivocal beneficial effect of oestrogens on RA compared with a detrimental effect on SLE has to be reconsidered. Likewise, the long-held belief that RA remits in the majority of pregnant patients has been challenged, and shows that only half of the patients experience significant improvement when objective disease activity measurements are applied. Pregnancies in patients with SLE are mostly successful when well planned and monitored interdisciplinarily, whereas a small proportion of women with APS still have adverse pregnancy outcomes in spite of the standard treatment. New prospective studies indicate better outcomes for pregnancies in women with rare diseases such as SSc and vasculitis. Fertility problems are not uncommon in patients with rheumatic disease and need to be considered in both genders. Necessary therapy, shortly before or during the pregnancy, demands taking into account the health of both mother and fetus. Long-term effects of drugs on offspring exposed in utero or during lactation is a new area under study as well as late effects of maternal rheumatic disease on children.
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BACKGROUND: The neuronal ceroid lipofuscinoses (NCL) are a heterogenous group of inherited progressive neurodegenerative diseases in different mammalian species. Tibetan Terrier and Polish Owczarek Nizinny (PON) dogs show rare late-onset NCL variants with autosomal recessive inheritance, which can not be explained by mutations of known human NCL genes. These dog breeds represent animal models for human late-onset NCL. In mice the chloride channel 3 gene (Clcn3) encoding an intracellular chloride channel was described to cause a phenotype similar to NCL. RESULTS: Two full-length cDNA splice variants of the canine CLCN3 gene are reported. The current canine whole genome sequence assembly was used for gene structure analyses and revealed 13 coding CLCN3 exons in 52 kb of genomic sequence. Sequence analysis of the coding exons and flanking intron regions of CLCN3 using six NCL-affected Tibetan terrier dogs and an NCL-affected Polish Owczarek Nizinny (PON) dog, as well as eight healthy Tibetan terrier dogs revealed 13 SNPs. No consistent CLCN3 haplotype was associated with NCL. CONCLUSION: For the examined animals we excluded the complete coding region and adjacent intronic regions of canine CLCN3 to harbor disease-causing mutations. Therefore it seems to be unlikely that a mutation in this gene is responsible for the late-onset NCL phenotype in these two dog breeds.
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Late presentation remains a major concern despite the dramatically improved prognosis realized by ART. We define a first presentation for HIV care during the course of HIV infection as 'late' if an AIDS-defining opportunistic disease is apparent, or if CD4+ T-cells are <200/microl. In the Western world, approximately 10 and 30% of HIV-infected individuals still present with CD4+ T-cells <50 and <200/microl, respectively; estimates are substantially higher for developing countries. Diagnosis and treatment of opportunistic diseases and intense supportive in-hospital care take precedence over ART. Benefits of starting ART without delay, that is, when opportunistic diseases are still active, include faster resolution of opportunistic diseases and a decreased risk of recurrence. The downside of starting ART without delay could include toxicity, drug interactions and immune reconstitution inflammatory syndrome (IRIS). Among asymptomatic or oligosymptomatic individuals presenting late, where ART and primary prophylaxis are initiated, approximately 10-20% will become symptomatic from drug toxicity or undiagnosed opportunistic complications, including IRIS, which require appropriate therapies. In this review we describe late presentation to HIV care, the scale of the problem, the evaluation of a late-presenting patient and challenges associated with initiation of potent antiretroviral therapy (ART) in the setting of acute opportunistic infections and other comorbidities.
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Lung transplantation (uni- or bilateral) is an accepted treatment option for patients with end-stage chronic obstructive pulmonary disease. Pulmonary function improves significantly and 5-year-actuarial survival is more than 70% at acceptable early mortality rates. Careful evaluation of risks and benefits in necessary because of the known donor-organ shortage and the risks of life-long immunosuppressive treatment. The bronchiolitis obliterans syndrome is still a nonsolved problem in the long-term course after LTx and it can influence late graft function and patient survival.
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The Andean piedmont of eastern Bolivia is situated at the southern margin of Amazonia characterized by an overall humid climate regime with a marked contrast between the rainy and dry seasons. The nearby Subandean foothills deliver abundant sandy sediments to the piedmont, leading to a complex array of sediments and paleosol horizons. Within this setting, the presented study analyzes four profiles of paleosol-sediment-sequences along incised ephemeral streams near Santa Cruz de la Sierra with a focus on past pedogenic variability in the context of the regional late Quaternary geomorphic and environmental evolution. Based on field observations, micromorphological analysis, geochemical and clay mineralogical data five classes of paleosol horizons could be distinguished. The individual paleosol horizons as well as the sediments, in which they developed, were interpreted regarding their paleoenvironmental significance, taking into consideration the various controls on soil formation with particular focus on changes of local environmental conditions through time. Thus, three different pathways of soil formation were established. On the late Quaternary timescale, the results suggest a strong relation between paleoenvironmental conditions (climate, vegetation etc.), soil environment (soil water flow, micro-environment) and the type of paleosol horizons developed in the study area. The formation of “red beds” (Bw horizons) implies very dry soil environments under dominantly dry conditions, which seem to have prevailed in the study area some time before ∼ 18 cal ka BP. Moderately dry but markedly seasonal environmental conditions with a long dry season and strong seasonal contrasts in soil water flow could explain the formation of moderately developed Bwt horizons around ∼ 18 cal ka BP and much of the mid-Holocene. The formation of Bt horizons and/or clay lamellae in relation to intense neoformation of clay and dominant clay illuviation by soil water points to wet conditions similar to today, which have probably prevailed in the study area before ∼ 8 cal ka BP and since ∼ 5 cal ka BP.
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Seasonal lamb supply has been established as one of the major hindrances to the American sheep industry. The ability to consistently lamb ewes on an accelerated production system offers additional benefits of reduced maintenance costs, more uniform cash flow along with reduced labor and facility demands. Previous work at McNay with spring breeding indicated that light priming rams regardless of genetic base improved conception rates, however, MGA feeding postweaning gave inconsistent and sometimes depressed reproductive activity in ewes. This study was conducted to evaluate the use of MGA in late lactation and a single PG600 injection at weaning, either individually or in combination.
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BACKGROUND Infectious diseases and social contacts in early life have been proposed to modulate brain tumour risk during late childhood and adolescence. METHODS CEFALO is an interview-based case-control study in Denmark, Norway, Sweden and Switzerland, including children and adolescents aged 7-19 years with primary intracranial brain tumours diagnosed between 2004 and 2008 and matched population controls. RESULTS The study included 352 cases (participation rate: 83%) and 646 controls (71%). There was no association with various measures of social contacts: daycare attendance, number of childhours at daycare, attending baby groups, birth order or living with other children. Cases of glioma and embryonal tumours had more frequent sick days with infections in the first 6 years of life compared with controls. In 7-19 year olds with 4+ monthly sick day, the respective odds ratios were 2.93 (95% confidence interval: 1.57-5.50) and 4.21 (95% confidence interval: 1.24-14.30). INTERPRETATION There was little support for the hypothesis that social contacts influence childhood and adolescent brain tumour risk. The association between reported sick days due to infections and risk of glioma and embryonal tumour may reflect involvement of immune functions, recall bias or inverse causality and deserve further attention.
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Four stalagmites covering the last 7.0 ka were sampled on Socotra, an island in the northern Indian Ocean to investigate the evolution of the northeast Indian Ocean Monsoon (IOM) since the mid Holocene. On Socotra, rain is delivered at the start of the southwest IOM in May–June and at the start of the northeast IOM from September to December. The Haggeher Mountains act as a barrier forcing precipitation brought by the northeast winds to fall preferentially on the eastern side of the island, where the studied caves are located. δ18O and δ13C and Mg/Ca and Sr/Ca signals in the stalagmites reflect precipitation amounts brought by the northeast winds. For stalagmite STM6, this amount effect is amplified by kinetic effects during calcite deposition. Combined interpretation of the stalagmites' signals suggest a weakening of the northeast precipitation between 6.0 and 3.8 ka. After 3.8 ka precipitation intensities remain constant with two superimposed drier periods, between 0 and 0.6 ka and from 2.2 to 3.8 ka. No link can be established with Greenland ice cores and with the summer IOM variability. In contrast to the stable northeast rainy season suggested by the records in this study, speleothem records from western Socotra indicate a wettening of the southwest rainy season on Socotra after 4.4 ka. The local wettening of western Socotra could relate to a more southerly path (more over the Indian Ocean) taken by the southwest winds. Stalagmite STM5, sampled at the fringe between both rain areas displays intermediate δ18O values. After 6.2 ka, similar precipitation changes are seen between eastern Socotra and northern Oman indicating that both regions are affected similarly by the monsoon. Different palaeoclimatologic records from the Arabian Peninsula currently located outside the ITCZ migration pathway display an abrupt drying around 6 ka due to their disconnection from the southwest rain influence. Records that are nowadays still receiving rain by the southwest winds, suggest a more gradual drying reflecting the weakening of the southwest monsoon.
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Various N fertilizer sources are available for lawn turf. Few field studies, however, have determined the losses of nitrate (NO3-N) from lawns receiving different formulations of N fertilizers. The objectives of this study were to determine the differences in NO3-N leaching losses among various N fertilizer sources and to ascertain when losses were most likely to occur. The field experiment was set out in a completely random design on a turf typical of the lawns in southern New England. Treatments consisted of four fertilizer sources with fast- and slow-release N formulations: (i) ammonium nitrate (AN), (ii) polymer-coated sulfur-coated urea (PCSCU), (iii) organic product, and (iv) a nonfertilized control. The experiment was conducted across three years and fertilized to supply a total of 147 kg N ha-1 yr-1. Percolate was collected with zero-tension lysimeters. Flow-weighted NO3-N concentrations were 4.6, 0.57, 0.31, and 0.18 mg L-1 for AN, PCSCU, organic, and the control, respectively. After correcting for control losses, average annual NO3-N leaching losses as a percentage of N applied were 16.8% for AN, 1.7% for PCSCU, and 0.6% for organic. Results indicate that NO3-N leaching losses from lawn turf in southern New England occur primarily during the late fall through the early spring. To reduce the threat of NO3-N leaching losses, lawn turf fertilizers should be formulated with a larger percentage of slow-release N than soluble N.
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El objetivo de este trabajo fue analizar el efecto de diferentes dosis de fertilizantes foliares con macronutrientes en plantas de naranja Valencia y de tangor Murcott. Los experimentos fueron realizados durante tres campañas consecutivas en Corrientes Argentina. El diseño experimental fue en bloques completos al azar con cuatro repeticiones y parcelas experimentales de cuatro plantas. Los tratamientos ensayados fueron T1 control; T2 N (12%) 2 L.ha-1; T3 N (12%) 4 L.ha-1; T4 N (9%) y P (2,6%) 2 L ha- 1; T5 N (9%) y P (2,6%) 4 L.ha-1; T6 N (9,3%), P (2,6%) y K (2,1%) 2 L.ha-1; T7 N (9,3%), P (2,6%) y K (2,1%) 4 L.ha-1, de fertilizante foliar formulados en base a sales de sulfato de amonio, fosfato monoamónico y nitrato de potasio según tratamiento. Los mismos fueron aplicados por campaña en prefloración, plena floración y en otoño. Se midieron las concentraciones foliares de N, P y K en hojas de otoño de ramas fructíferas y al momento de cosecha se determinó rendimiento total, diámetro de fruta, porcentaje de jugo, sólidos solubles, acidez y relación sólidos solubles/acidez. En Valencia late todos los tratamientos incrementaron el contenido de P foliar en comparación con el control. El tratamiento T7 incrementó un 38,7% el rendimiento respecto de T1, aunque los frutos presentaron menor diámetro. En "Murcott" todos los tratamientos incrementaron el rendimiento comparados con T1, y las máximas producciones se observaron en los tratamientos T7 (64,9% mayor) y T6 (43,8% mayor) además T7 incrementó el contenido de P foliar y disminuyó el contenido de sólidos solubles en comparación con el control. La fertilización foliar con macronutrientes incrementó la productividad en naranja Valencia late y tangor Murcott. Este trabajo muestra la utilidad de la fertilización foliar con macronutrientes como una herramienta complementaria en los programas de fertilización diseñados para optimizar el rendimiento.
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The Miocene Lincang leaf assemblage is used in this paper as proxy data to reconstruct the palaeoclimate of southwestern Yunnan (SW China) and the evolution of monsoon intensity. Three quantitative methods were chosen for this reconstruction, i.e. Leaf Margin Analysis (LMA), Climate Leaf Analysis Multivariate Program (CLAMP), and the Coexistence Approach (CA). These methods, however, yield inconsistent results, particularly for the precipitation, as also shown in European and other East Asian Cenozoic floras. The wide range of the reconstructed climatic parameters includes the Mean Annual Temperature (MAT) of 18.5-24.7 °C and the Mean Annual Precipitation (MAP) of 1213-3711 mm. Compared with the modern Lincang climate (MAT, 17.3 °C; MAP, 1178.7 mm), the Miocene climate is slightly warmer, wetter and has a higher temperature seasonality. A detailed comparison on the palaeoclimatic variables with the coeval Late Miocene Xiaolongtan flora from the eastern part of Yunnan allows us to investigate the development and interactions of both South Asian and East Asian monsoons during the Late Miocene in southwest China, now under strong influence of these monsoon systems. Our results suggest that the monsoon climate has already been established in southwest Yunnan during the Late Miocene. Furthermore, our results support that both Southeast Asian and East Asian monsoons co-occurred in Yunnan during the Late Miocene.
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Sea-ice growth and decay in Antarctica is one of the biggest seasonal changes on Earth, expanding ice cover from 4x10**6 km**2 to a maximum of 19x10**6 km**2 during the austral winter. Analyses of six marine sediment cores from the Scotia Sea, SW Atlantic, yield records of sea-ice migration across the basin since the Lateglacial. The cores span nearly ten degrees of latitude from the modern seasonal sea-ice zone to the modern Polar Front. Surface sediments in the cores comprise predominantly diatomaceous oozes and muddy diatom oozes that reflect Holocene conditions. The cores exhibit similar down-core stratigraphies with decreasing diatom concentrations and increasing magnetic susceptibility from modern through to the Last Glacial Maximum (LGM). Sediments in all cores contain sea-ice diatoms that preserve a signal of changing sea-ice cover and permit reconstruction of past sea-ice dynamics. The sea-ice records presented here are the first to document the position of both the summer and winter sea-ice cover at the Last Glacial Maximum (LGM) in the Scotia Sea. Comparison of the LGM and Holocene sea-ice conditions shows that the average winter sea-ice extent was at least 5° further north at the LGM. Average summer sea-ice extent was south of the most southerly core site at the LGM, and suggests that sea-ice expanded from approximately 61°S to 52°S each season. Our data also suggest that the average summer sea-ice position at the LGM was not the maximum extent of summer sea-ice during the last glacial. Instead, the sediments contain evidence of a pre-LGM maximum extent of summer sea-ice between ab. 30 ka and 22 ka that extended to ab. 59°S, close to the modern average winter sea-ice limit. Based on our reconstruction we propose that the timing of the maximum extent of summer sea-ice and subsequent retreat by 22 ka, could be insolation controlled and that the strong links between sea-ice and bottom water formation provide a potential mechanism by which Southern Hemisphere regional sea-ice dynamics at the LGM could have a global impact and promote deglaciation.