Functional and epigenetic phenotypes of humans and mice with DNMT3A Overgrowth Syndrome

Germline mutations in the DNMT3A gene can cause an overgrowth syndrome associated with behavioural and hematopoietic phenotypes. Here the authors describe a mouse model of this syndrome that recapitulates many of these features, including conserved alterations in DNA methylation in the blood cells of both species

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Uso intraluminal de stent de nitinol Dual para colapso completo de tráquea en un maltés: reporte de caso

Anamnesis: Canine patient, Maltese, female, castrated, 4 years old and 5 Kg. of weight. The main reason for consultation was cough and severe respiratory distress. Clinical and laboratory findings: During the clinical evaluation the patient presented cyanosis, severe inspiratory and expiratory stridor, goose-honking especially after an emotion. An examination was performed through a bronchoscopy, revealing a dynamic decrease in the diameter of the tracheal lumen, severe collapse in the cervical and thoracic portions. Treatmen approach: Due to the severity of the tracheal collapse, the implantation of a nitinol stent was decided. The choice of the stent is fundamental; It was necessary to make a measurement of the tracheal diameter and length, to minimize side effects and rejections. The trachea presented variability of the diameter at thoracic level for this reason it was decided to use a dual stent, the stent was placed on direct observation using a pediatric bronchoscope. Conclusion: We present a case where a dual stent was used, indicated in cases where the diameter of the trachea varies, yielding excellent results since it was adjusted to the different tracheal diameters that the patient presented at the cervical and thoracic levels.Anamnesis: paciente canino, maltés, femenino, castrado, 4 años y 5 Kg. de peso El motivo principal de consulta fue tos y dificultad respiratoria grave. Hallazgos clínicos y de laboratorio: Durante la evaluación clínica, el paciente presentó cianosis, estridor inspiratorio y espiratorio severo, tos en graznido especialmente después de una emoción. Se realizó un examen a través de una broncoscopia, que reveló una disminución dinámica en el diámetro de la luz traqueal, un colapso severo en las porciones cervicales y torácicas. Enfoque de tratamiento: Debido a la gravedad del colapso traqueal, se decidió la implantación de un stent de nitinol. La elección del stent es fundamental; Fue necesario realizar una medición del diámetro y la longitud de la tráquea para minimizar los efectos secundarios y los rechazos. La tráquea presentó variabilidad del diámetro a nivel torácico por esta razón se decidió utilizar un stent dual, el stent se colocó en observación directa utilizando un broncoscopio pediátrico. Conclusión: Presentamos un caso en el que se usó un stent dual, indicado en casos en que el diámetro de la tráquea varía, obteniendo excelentes resultados ya que se ajustó a los diferentes diámetros traqueales que el paciente presentó en los niveles cervical y torácico

Use of biomarkers as prognostic indicators in dogs with natural heartworm

Heartworm disease is a parasitic illness caused by the Dirofilaria immitis nematode. In its developed form, remains in the pulmonary artery and right side of the heart, resulting in pulmonary thromboembolism, myocarditis, and inflammation. A retrospective study was made in which was evaluated the usefulness of the Dimer-D, troponin I and C-reactive protein in sick dogs naturally infected with heartworm. There were evaluated the concentrations of D-Dimer, troponin I and C-reactive protein in 23 dogs, analyzed hematological variables, the presence or absence of microfilariae, the pulmonary hypertension and clinical signs. The respiratory problems were the most frequent clinical signs including dyspnea (74%), cough (30%), pulmonary hypertension (57%), and other signs of inflammation or pulmonary thromboembolism. Hematological changes were not found. Elevations of the Dimer-D were found in 73.9% of cases, where the patients with microfilariae (69.6%) showed higher values compared to amicrofilaremics (30.4%); males had a higher average (3,857.83 ng ml-1) compared to females (1,714.0 ng ml-1). Troponin I and C-reactive protein had elevations in 21.7 - 39.1% of cases without significant changes compared to sex or microfilariae. The measurement of Dimer-D, troponin I and C-reactive protein complements for the diagnosis, prognosis and therapeutic control in patients with D. immitis indicated inflammation, pulmonary thromboembolism and/or myocarditis

Use of biomarkers as prognostic indicators in dogs with natural heartworm

Heartworm disease is a parasitic illness caused by the Dirofilaria immitis nematode. In its developed form, remains in the pulmonary artery and right side of the heart, resulting in pulmonary thromboembolism, myocarditis, and inflammation. A retrospective study was made in which was evaluated the usefulness of the Dimer-D, troponin I and C-reactive protein in sick dogs naturally infected with heartworm. There were evaluated the concentrations of D-Dimer, troponin I and C-reactive protein in 23 dogs, analyzed hematological variables, the presence or absence of microfilariae, the pulmonary hypertension and clinical signs. The respiratory problems were the most frequent clinical signs including dyspnea (74%), cough (30%), pulmonary hypertension (57%), and other signs of inflammation or pulmonary thromboembolism. Hematological changes were not found. Elevations of the Dimer-D were found in 73.9% of cases, where the patients with microfilariae (69.6%) showed higher values compared to amicrofilaremics (30.4%); males had a higher average (3,857.83 ng ml-1) compared to females (1,714.0 ng ml-1). Troponin I and C-reactive protein had elevations in 21.7 - 39.1% of cases without significant changes compared to sex or microfilariae. The measurement of Dimer-D, troponin I and C-reactive protein complements for the diagnosis, prognosis and therapeutic control in patients with D. immitis indicated inflammation, pulmonary thromboembolism and/or myocarditis

Tundra Trait Team : A database of plant traits spanning the tundra biome

Motivation The Tundra Trait Team (TTT) database includes field-based measurements of key traits related to plant form and function at multiple sites across the tundra biome. This dataset can be used to address theoretical questions about plant strategy and trade-offs, trait-environment relationships and environmental filtering, and trait variation across spatial scales, to validate satellite data, and to inform Earth system model parameters. Main types of variable contained Spatial location and grain The database contains 91,970 measurements of 18 plant traits. The most frequently measured traits (> 1,000 observations each) include plant height, leaf area, specific leaf area, leaf fresh and dry mass, leaf dry matter content, leaf nitrogen, carbon and phosphorus content, leaf C:N and N:P, seed mass, and stem specific density. Measurements were collected in tundra habitats in both the Northern and Southern Hemispheres, including Arctic sites in Alaska, Canada, Greenland, Fennoscandia and Siberia, alpine sites in the European Alps, Colorado Rockies, Caucasus, Ural Mountains, Pyrenees, Australian Alps, and Central Otago Mountains (New Zealand), and sub-Antarctic Marion Island. More than 99% of observations are georeferenced. Time period and grain Major taxa and level of measurement All data were collected between 1964 and 2018. A small number of sites have repeated trait measurements at two or more time periods. Trait measurements were made on 978 terrestrial vascular plant species growing in tundra habitats. Most observations are on individuals (86%), while the remainder represent plot or site means or maximums per species. Software format csv file and GitHub repository with data cleaning scripts in R; contribution to TRY plant trait database (www.try-db.org) to be included in the next version release.Peer reviewe