For marine mammals, the ability to tolerate apnea and make extended dives is a defining adaptive trait, facilitating the exploitation of marine food resources. Elevated levels of myoglobin within the ...muscles are a consistent hallmark of this trait, allowing oxygen collected at the surface to be stored in the muscles and subsequently used to support extended dives. In mysticetes, the largest of marine predators, details on muscular myoglobin levels are limited. The developmental trajectory of muscular myoglobin stores has yet to be documented and any physiological links between early behavior and the development of muscular myoglobin stores remain unknown. In this study, we used muscle tissue samples from stranded mysticetes to investigate these issues. Samples from three different age cohorts and three species of mysticetes were included (total sample size = 18). Results indicate that in mysticete calves, muscle myoglobin stores comprise only a small percentage (17-23%) of conspecific adult myoglobin complements. Development of elevated myoglobin levels is protracted over the course of extended maturation in mysticetes. Additionally, comparisons of myoglobin levels between and within muscles, along with details of interspecific differences in rates of accumulation of myoglobin in very young mysticetes, suggest that levels of exercise may influence the rate of development of myoglobin stores in young mysticetes. This new information infers a close interplay between the physiology, ontogeny and early life history of young mysticetes and provides new insight into the pressures that may shape adaptive strategies in migratory mysticetes. Furthermore, the study highlights the vulnerability of specific age cohorts to impending changes in the availability of foraging habitat and marine resources.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
For marine mammals, the ability to tolerate apnea and make extended dives is a defining adaptive trait, facilitating the exploitation of marine food resources. Elevated levels of myoglobin within the ...muscles are a consistent hallmark of this trait, allowing oxygen collected at the surface to be stored in the muscles and subsequently used to support extended dives. In mysticetes, the largest of marine predators, details on muscular myoglobin levels are limited. The developmental trajectory of muscular myoglobin stores has yet to be documented and any physiological links between early behavior and the development of muscular myoglobin stores remain unknown. In this study, we used muscle tissue samples from stranded mysticetes to investigate these issues. Samples from three different age cohorts and three species of mysticetes were included (total sample size = 18). Results indicate that in mysticete calves, muscle myoglobin stores comprise only a small percentage (17-23%) of conspecific adult myoglobin complements. Development of elevated myoglobin levels is protracted over the course of extended maturation in mysticetes. Additionally, comparisons of myoglobin levels between and within muscles, along with details of interspecific differences in rates of accumulation of myoglobin in very young mysticetes, suggest that levels of exercise may influence the rate of development of myoglobin stores in young mysticetes. This new information infers a close interplay between the physiology, ontogeny and early life history of young mysticetes and provides new insight into the pressures that may shape adaptive strategies in migratory mysticetes. Furthermore, the study highlights the vulnerability of specific age cohorts to impending changes in the availability of foraging habitat and marine resources.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Objectives Thrombotic microangiopathy (TMA) is characterized by thrombocytopenia, microangiopathic hemolytic anemia and target organ damage. Pregnancy is associated with several forms of ...TMA, including preeclampsia (PE), HELLP syndrome, thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). When HUS is secondary to a deregulation of the alternative complement pathway, it is known as atypical HUS (aHUS). Differential diagnosis is challenging, as these forms share clinical characteristics. However, early diagnosis is crucial for a specific treatment to be established and improve prognosis. Case presentation We present the case of a 43 year-old primiparous woman admitted to hospital for an urgent C-section at 33 gestational weeks due to a diagnosis of severe preeclampsia and fetal distress. In the immediate postpartum, the patient developed acute liver failure and anuric renal failure in the context of the HELLP syndrome, anemia, thrombocytopenia, arterial hypertension (HTN) and neurological deficit. TMA study and differential diagnosis confirmed pregnancy-associated aHUS. Treatment with eculizumab was initiated, with good response and progressive improvement of clinical and analytical parameters. Conclusions aHUS is a rare multifactorial disease that used to be associated with high mortality rates before the advent of eculizumab. Due to challenging diagnosis, the clinical laboratory plays a major role in the differential diagnosis and management of the disease.
Introducción: La depresión en adultos mayores es un tema importante debido a que afecta de manera significativa la salud y calidad de vida. A medida que las personas envejecen, pueden experimentar ...cambios físicos, emocionales y sociales que los hacen más susceptibles a tener depresión. La Organización Mundial de la Salud (OMS) estima que entre 2015 y 2050 la población mundial mayor de 60 años pasará del 12% al 22% de padecer algún síntoma depresivo. Objetivo: Identificar la prevalencia y factores asociados a la depresión en adultos mayores del Municipio de Mochitlán, Guerrero. Materiales y métodos: Investigación mixta, cuantitativa con diseño transversal analítico, muestreo aleatorio simple en una población de 26 adultos mayores, se recabo información mediante una encuesta aplicada por los investigadores con opción múltiple utilizando un instrumento de cuatro apartados. Para el enfoque cualitativo se utilizó el método etnográfico, mediante una entrevista semiestructurada con 3 preguntas abiertas a un grupo focal de siete adultos mayores. Resultados: Se encontró depresión leve (38,46%), moderada (7,69%) y grave (3,85%). Los factores asociados fueron género femenino, tipo de trabajo; ingreso mensual. El análisis cualitativo mostro emociones positivas y negativas. Conclusiones: 50% de la población presento algún tipo de depresión.
Abstract Background and Aims Relapsing peritonitis is a new episode of peritonitis caused by the same microorganism occurring less than 4 weeks after the end of treatment of the previous one. It is ...associated with the formation of biofilm formation in the lumen of the peritoneal catheter and may lead to its removal. It is associated with increased technique failure, morbidity and mortality and health care costs. The aim of this study is to demonstrate the efficacy of peritoneal catheter sealing with taurolidine-heparin (T-H) in the prevention of relapsing peritonitis and thus avoid more aggressive measures in these cases, such as catheter removal. Method We performed a single-center retrospective analysis study. We analyzed episodes of peritonitis in our peritoneal dialysis (PD) unit over a 5-year period from January 1st 2019 to December 31st 2023. We collected demographic data and risk factors during this period: age, sex, CKD etiology, diabetes, modality, assisted PD, and S. aureus nasal carrier status. We documented peritonitis during the period, causative germs, treatment performed, and catheter sealing. We documented sealing patterns and evolution (cure, recurrence, catheter removal). We performed T-H sealing with a full abdomen and once the treatment had been completed. The catheter sealing with antibiotics was performed right after the intraperitoneal antibiotics’ doses during the treatment. Results We analyzed a total of 84 patients. Demographic characteristics were: mean age 66.5 years (range 24-88 years), 71.4% male, 28.6% diabetic, 45.2% on APD, 11.9% assisted PD, 5.9% nasal S. aureus carriers. Etiology of CKD: 66.7% unaffiliated etiology, 11.9% glomerulonephritis, 7.1% ADPKD, 5.9% chronic tubulo-interstitial nephritis and 1.2% vasculitis, multiple myeloma, anephritis, acute tubular necrosis, lupus, Alport syndrome and nephronophthisis. There were 71 episodes of peritonitis, in 32 patients. The causative germs were: 36.6% coagulase negative staphylococci, 21.1% streptococci, 19.7% negative culture, 7% enterobacteria, 7% polymicrobial, 4.2% S. aureus, 2.8% enterococci and 1.4% corynebacteria. We performed some type of sealing in 47 peritonitis cases: 34% with antibiotic alone, 21.3% with antibiotic plus T-H and 44.6% with T-H alone. A total of 55.3% of the sealings were performed in peritonitis caused by coagulase-negative staphylococci, 65.4% of which were sealed with T-H or antibiotic plus T-H (Table 1). Two of the peritonitis relapsed with conventional treatment (unsealed or sealed with antibiotic) and, after sealing the peritoneal catheter with T-H, no recurrence was observed. The catheter was removed from a patient with peritonitis plus S. aureus tunnelitis, a new catheter was placed deferred, but he had a new episode of peritonitis with S. aureus tunnelitis and the catheter was removed again; this patient's case is special as he has not maintained adequate hygiene measures in addition to lack of adherence to therapy. Conclusion Peritoneal catheter sealing, especially with T-H, appears to be effective in the treatment and prevention of relapsing peritonitis. In our case, we did not observe any recurrent peritonitis after its use. Despite its widespread use, there are hardly any studies on its use and the most recommendable guidelines for its use, which is why we believe that further studies should be conducted to establish guidelines and methods for its use.
Resumen Objetivos La microangiopatía trombótica (MAT) se define por trombocitopenia, anemia hemolítica microangiopática y daño de órganos diana. El embarazo está asociado con varias formas de MAT ...como preeclampsia (PE), síndrome de HELLP, púrpura trombótica trombocitopénica (PTT) y síndrome hemolítico urémico (SHU). Cuando SHU se produce por desregulación de la vía alternativa del complemento se denomina SHU atípico (SHUa). El diagnóstico diferencial es complejo, ya que comparten características clínicas, siendo importante realizarlo precozmente para instaurar tratamiento específico y mejorar el pronóstico. Caso clínico Primigesta de 43 años ingresa a la edad gestacional de 33 semanas, con diagnóstico de preeclampsia grave y sufrimiento fetal por lo que se realiza cesárea urgente. En el puerperio inmediato, presenta insuficiencia hepática aguda y fracaso renal anúrico en contexto de síndrome de HELLP, anemia, trombopenia, hipertensión arterial (HTA) y alteraciones neurológicas. Se realiza estudio de MAT y diagnóstico diferencial evidenciando además SHUa asociado al embarazo. Se inicia tratamiento con Eculizumab presentando buena respuesta y progresiva mejoría clínica y analítica. Conclusiones El SHUa es una enfermedad rara y multifactorial con elevada mortalidad antes de la aparición del Eculizumab. Debido al complejo diagnóstico, el laboratorio clínico tiene un papel clave en el diagnóstico diferencial y abordaje.
PDF
