RESUMO
The study of early embryo metabolism has fascinated researchers in the field for nearly a century. Herein, we give a brief account of the general features of embryo metabolism and some consideration of the research performed to reach such conclusions. It is becoming increasingly obvious that metabolism informs many fate decisions and outcomes beyond ATP generation, such as DNA methylation, Reactive Oxygen Species generation and cell signaling. We discuss the reasons for studying metabolism in the face of our current knowledge of the effect that the culture environment on the developing embryo and the downstream effects that can cause. The study of in vitro embryo metabolism can also give us insight into developmental perturbations in vivo. The strengths And limitations of the methods we use to study metabolism are reviewed with reference to species-specific fundamental biology and plasticity and we discuss what the future holds for metabolic studies and the unanswered questions that remain.
Assuntos
Feminino , Animais , Embrião de Mamíferos/metabolismo , Implantação do Embrião , Trifosfato de AdenosinaRESUMO
The study of early embryo metabolism has fascinated researchers in the field for nearly a century. Herein, we give a brief account of the general features of embryo metabolism and some consideration of the research performed to reach such conclusions. It is becoming increasingly obvious that metabolism informs many fate decisions and outcomes beyond ATP generation, such as DNA methylation, Reactive Oxygen Species generation and cell signaling. We discuss the reasons for studying metabolism in the face of our current knowledge of the effect that the culture environment on the developing embryo and the downstream effects that can cause. The study of in vitro embryo metabolism can also give us insight into developmental perturbations in vivo. The strengths And limitations of the methods we use to study metabolism are reviewed with reference to species-specific fundamental biology and plasticity and we discuss what the future holds for metabolic studies and the unanswered questions that remain.(AU)
Assuntos
Animais , Feminino , Embrião de Mamíferos/metabolismo , Trifosfato de Adenosina , Implantação do EmbriãoRESUMO
OBJECTIVES: To measure the proportion of attendees in a primary care setting consuming alcohol at levels which put them at risk of alcohol-related harm using the CAGE and AUDIT-C Screening tools. DESIGN AND METHODS: A cross-sectional study was used. The population consisted of all adults ≥18 years in a primary care setting. The CAGE and Alcohol Use Disorders Identification Test (AUDIT-C) screening tools were administered to 865 randomly selected participants. RESULTS: Of the 865 participants entered into this study, 514 participants drank alcoholic beverages. Furthermore, 142 (27.6%) were found to be CAGE positive (≥2) where more men (100, 11.5%) than women (42, 4.9%) were CAGE positive. A larger proportion of South-East Asians 60 (11.7%) were found to be CAGE positive than Africans 51 (9.9%) (ρ = 0.6221). For the AUDIT-C, 460 individuals participated with a response rate of 89.5%. With the score ≥ 4 in men, among the male drinkers 150 (32.6%) of the AUDIT-C screens were positive. For women, with the score ≥ 4, 100 (21.7%) of those who drank alcohol, screened positive. A larger proportion of South East Asians 101 (39.2%) were found to be AUDIT-C positive than Africans 105 (42%) (ρ = 0.7893). The Cronbach Alpha values for AUDIT-C and CAGE were 0.792 and 0.636 respectively. CONCLUSION: The CAGE screening tool identified 27.6% of the participants attending primary care facilities to be at risk of developing alcohol related disorders (ARDS). AUDIT-C identified 48.6% of participants to be at risk of developing an ARDS.
Assuntos
Alcoolismo , Atenção Primária à Saúde , Trinidad e Tobago , Estudos TransversaisRESUMO
BACKGROUND: Asthma causes significant morbidity and mortality in the developing world. It is thus important to identify modifiable risk factors. OBJECTIVES: To undertake a cross-sectional study to determine the prevalence of skin test reactivity to aeroallergens in Jamaican children and adults and the relationship of the diagnosis of asthma to the pattern of skin test positivity. METHODS: One hundred and sixty subjects without the sickle cell gene (genotype AA), eighty adults and eighty children, were recruited. Skin testing to seven aeroallergens was undertaken (atopy being diagnosed if there were at least one positive reaction). Asthma status was determined by a questionnaire and/or medical records. RESULTS: Twenty-seven (34%) of the children and forty-one (51%) of the adults were skin test positive to at least one aeroallergen. The most common positive responses in both age groups were to Dermatophagoides farinae, Dermatophagoides pteronyssinus and cockroach mix-(German and American). All adult asthmatics with current symptoms reacted to cockroach allergen. CONCLUSIONS: Appropriate steps to reduce cockroaches and cockroach sensitization might positively impact on asthma morbidity in Jamaica.
Assuntos
Alérgenos , Asma/imunologia , Hipersensibilidade Imediata/imunologia , Testes Cutâneos , Adolescente , Adulto , Animais , Antígenos de Dermatophagoides , Asma/diagnóstico , Asma/fisiopatologia , Criança , Baratas , Estudos Transversais , Dermatophagoides farinae , Dermatophagoides pteronyssinus , Poeira , Feminino , Humanos , Hipersensibilidade Imediata/fisiopatologia , Jamaica , Masculino , Ácaros , Prevalência , Rinite , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The active ingredients of marijuana may have beneficial properties in the treatment of chronic pain and inflammation and is being used by sufferers of chronic pain and arthritis in some settings. Anecdotally, marijuana is believed by some sickle cell disease (SCD) patients to improve their health. This study aimed to determine the prevalence of marijuana smoking in the Jamaica Sickle Cell Cohort Study (JSCCS) in the years 2000 and 2004. The perception that marijuana use ameliorated the complications of SCD was also investigated. METHODS: All patients in the JSCCS were invited to attend an annual review, and during the 2000 and 2004 reviews, participants with homozygous sickle cell (SS) disease and sickle cell haemoglobin-C (SC) disease were asked whether they smoked marijuana, and if they smoked, whether it was used for medicinal purposes related to SCD. The authors compared smoking prevalence by gender, disease, and year of review. The association of smoking with a measure of pain frequency was also examined. RESULTS: The prevalence of marijuana smoking was higher among men and among SC participants. The proportion of either gender reporting smoking of marijuana increased in 2004 compared to 2000, and this use was not related to a simple measure of clinical severity of SCD. CONCLUSIONS: Marijuana smoking is common in adults with SCD but its usage is unrelated to clinical severity of the disease.
ANTECEDENTES: Los ingredientes de la marihuana pueden tener propiedades beneficiosas para el tratamiento del dolor e inflamación crónicos, y en algunos lugares esta planta está siendo usada por enfermos que sufren de dolor y artritis de manera crónica. De forma anecdótica, se dice que algunos pacientes de la enfermedad de células falciformes (ECF) creen que la marihuana les mejora la salud. Este estudio se propuso determinar la prevalencia del hábito de fumar marihuana en el Estudio de Cohorte Jamaicano de Células Falciformes (ECJCF) en los años 2000 y 2004. Los autores también examinaron la creencia de que el uso de la marihuana guarda relación con la percepción de que la misma mejora los casos con complicaciones por ECF. MÉTODOS: A todos los pacientes en el ECJCF, se les invita a asistir a un examen anual, y durante los exámenes de los años 2000 y 2004, a los participantes con enfermedad de célula falciforme homocigótica (SS) y con la enfermad de célula falciforme hemoglobina C (SC), se les preguntó si fumaban marihuana, y si la usaban con fines medicinales en relación con la ECF. Los autores compararon la prevalencia por género, enfermedad, y año de examen. Asimismo, examinaron la asociación del hábito de fumar marihuana con una medida de frecuencia de dolor. RESULTADOS: La prevalencia del hábito de fumar marihuana fue más alta entre los hombres y entre los participantes SC. La proporción de ambos géneros que reportó hábito de fumar, aumentó en el año 2004 en comparación con el año 2000, y el uso de la marihuana no estuvo relacionado con una simple medida debida a la gravedad de la ECF. CONCLUSIONES: El hábito de fumar marihuana es común en adultos con ECF, pero su uso no guarda relación con la gravedad de la enfermedad.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Anemia Falciforme/fisiopatologia , Drogas Ilícitas , Fumar Maconha/epidemiologia , Anti-Inflamatórios , Anemia Falciforme/tratamento farmacológico , Dor/tratamento farmacológico , Dor/etiologia , Estudos Prospectivos , Fatores Etários , Inflamação/tratamento farmacológico , Inflamação/etiologia , Jamaica/epidemiologia , PrevalênciaRESUMO
BACKGROUND: Asthma causes significant morbidity and mortality in the developing world. It is thus important to identify modifiable risk factors. OBJECTIVES: To undertake a cross-sectional study to determine the prevalence of skin test reactivity to aeroallergens in Jamaican children and adults and the relationship of the diagnosis of asthma to the pattern of skin test positivity. METHODS: One hundred and sixty subjects without the sickle cell gene (genotype AA), eighty adults and eighty children, were recruited. Skin testing to seven aeroallergens was undertaken (atopy being diagnosed if there were at least one positive reaction). Asthma status was determined by a questionnaire and/or medical records. RESULTS: Twenty-seven (34) of the children and forty-one (51) of the adults were skin test positive to at least one aeroallergen. The most common positive responses in both age groups were to Dermatophagoides farinae, Dermatophagoides pteronyssinus and cockroach mix-(German and American). All adult asthmatics with current symptoms reacted to cockroach allergen. CONCLUSIONS: Appropriate steps to reduce cockroaches and cockroach sensitization might positively impact on asthma morbidity in Jamaica.
ANTECíENTES: El asma causa morbilidad y mortalidad significativas en el mundo en desarrollo. Por lo tanto, es importante identificar los factores de riesgo modificables. OBJETIVOS: Llevar a cabo un estudio transversal a fin de determinar la prevalencia de la reactividad de la prueba cutánea frente a los aeroalérgenos en niños y adultos jamaicanos, y la relación del diagnóstico del asma con el patrón de positividad de la prueba cutánea. MÉTODOS: Se reclutaron ciento sesenta sujetos AA (sin genes falciformes), ochenta adultos y ochenta niños. Se llevaron a cabo pruebas cutáneas frente a siete aeroalérgenos (diagnosticándose atopia si se producía al menos una reacción positiva). El estatus asmático se determinó mediante encuestas y/o historias clínicas. RESULTADOS: Veintisiete (34%) de los niños y cuarenta y uno (51%) de los adultos, resultaron positivos en la prueba cutánea, al menos a un aeroalérgeno. Las respuestas positivas más comunes en ambos grupos de edad fueron frente a Dermatophagoides farinae, Dermatophagoides pteronyssinus, y mezcla de cucarachas (alemanas y americanas). Todos los asmáticos adultos con síntomas usuales reaccionaron al alérgeno de la cucaracha. CONCLUSIONES: Medidas apropiadas a fin de reducir las cucarachas y la sensibilización a las cucarachas podría tener un impacto positivo en la morbilidad por asma en Jamaica.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Alérgenos , Asma/imunologia , Hipersensibilidade Imediata/imunologia , Testes Cutâneos , Animais , Antígenos de Dermatophagoides , Asma/diagnóstico , Asma/fisiopatologia , Baratas , Dermatophagoides farinae , Dermatophagoides pteronyssinus , Estudos Transversais , Hipersensibilidade Imediata/fisiopatologia , Jamaica , Poeira , Prevalência , Inquéritos e Questionários , Rinite , ÁcarosRESUMO
BACKGROUND: The active ingredients of marijuana may have beneficial properties in the treatment of chronic pain and inflammation and is being used by sufferers of chronic pain and arthritis in some settings. Anecdotally, marijuana is believed by some sickle cell disease (SCD) patients to improve their health. This study aimed to determine the prevalence of marijuana smoking in the Jamaica Sickle Cell Cohort Study (JSCCS) in the years 2000 and 2004. The perception that marijuana use ameliorated the complications of SCD was also investigated. METHODS: All patients in the JSCCS were invited to attend an annual review, and during the 2000 and 2004 reviews, participants with homozygous sickle cell (SS) disease and sickle cell haemoglobin-C (SC) disease were asked whether they smoked marijuana, and if they smoked, whether it was used for medicinal purposes related to SCD. The authors compared smoking prevalence by gender, disease, and year of review. The association of smoking with a measure of pain frequency was also examined. RESULTS: The prevalence of marijuana smoking was higher among men and among SC participants. The proportion of either gender reporting smoking of marijuana increased in 2004 compared to 2000, and this use was not related to a simple measure of clinical severity of SCD. CONCLUSIONS: Marijuana smoking is common in adults with SCD but its usage is unrelated to clinical severity of the disease.
Assuntos
Anemia Falciforme/fisiopatologia , Drogas Ilícitas , Fumar Maconha/epidemiologia , Adolescente , Adulto , Fatores Etários , Anemia Falciforme/tratamento farmacológico , Anti-Inflamatórios , Feminino , Humanos , Inflamação/tratamento farmacológico , Inflamação/etiologia , Jamaica/epidemiologia , Masculino , Dor/tratamento farmacológico , Dor/etiologia , Prevalência , Estudos ProspectivosRESUMO
BACKGROUND: Pulmonary complications are a major cause of morbidity and mortality in sickle cell disease (SCD). The relationship of asthma with SCD and acute chest syndrome (ACS) remains uncertain. A study was undertaken to test the hypotheses that asthma and bronchial hyperreactivity (BHR) are more common in children with SCD than in ethnic matched controls and that SCD children with atopic asthma are more likely to have recurrent episodes of ACS. METHODS: A modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was administered and skin prick tests undertaken in 80 children with SCD and 80 ethnic matched controls aged 5-10 years. BHR was assessed by measurement of forced expiratory volume in 1 second before and after a bronchodilator (albuterol 200 mug) or an exercise challenge. RESULTS: Asthma (48% v 22%, p = 0.002) and BHR (p = 0.02) but not atopy were more common in children with SCD than in controls. Atopy (66.6% v 29%, p = 0.007) and asthma (80% v 40%, p = 0.005), particularly atopic asthma (53% v 12%, p<0.001), were more common in children with SCD who had suffered recurrent episodes of ACS than in those who had suffered a single or no episode. CONCLUSIONS: Asthma and BHR are more common in children with SCD than in ethnic matched controls, and atopic asthma appears to be associated with recurrent ACS. Early and effective anti-asthma therapy might reduce the pulmonary morbidity associated with SCD.
Assuntos
Anemia Falciforme/complicações , Pneumopatias/complicações , Doença Aguda , Anemia Falciforme/fisiopatologia , Asma/complicações , Asma/fisiopatologia , Criança , Pré-Escolar , Feminino , Volume Expiratório Forçado/fisiologia , Humanos , Pneumopatias/fisiopatologia , Masculino , Síndrome , Capacidade Vital/fisiologiaRESUMO
BACKGROUND: Information about life expectancy of patients with homozygous sickle-cell disease is needed for research and patient counselling. Our aim was to study two Jamaican populations, one clinic-based and one birth cohort and, by careful consideration of data quality and statistical analysis, to identify ways to increase the chances of obtaining valid and generalisable results. METHODS: We investigated the survival experience of 3301 patients with homozygous sickle-cell disease attending the Jamaican sickle-cell clinic between Jan 1, 1987, and Dec 31, 1996. We applied and assessed a simulation technique for incorporating early life mortality using a birth cohort, and analysed the precision of this technique. Kaplan-Meier survival estimates are produced. FINDINGS: 290 of the 3301 patients died. Median survival calculated with the excess mortality rate simulation data was 53 years (95% CI 49.3-57.0) for men and 58.5 (55.1-67.5) for women. INTERPRETATION: Our simulation technique, with realistic assumptions based on empirical evidence, offers a new estimate of median survival for patients with homozygous sickle-cell disease. We present the precision of these survival estimates, which introduces an important level of uncertainty. The inherent biases of clinically ascertained populations of patients, and the assumptions underlying analysis techniques are crucial features of survival studies in sickle-cell disease, and can modify summary statistics substantially.