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1.
Memory ; 31(9): 1218-1231, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37646087

RESUMO

Border control officers may be on the lookout for wanted people while they verify that travellers match their passport photos. We developed a novel experimental paradigm to investigate whether people are more likely to report that someone is wanted if they also believe that person is using a fraudulent passport. In two experiments, undergraduate students assumed the role of a border control officer and completed multiple "shifts" of a face matching task designed to simulate a passport verification check. Before each shift participants viewed posters of wanted people and were instructed to report any sightings if a wanted person appeared in any of the images during the passport check. Participants were more likely to say an individual was wanted if they also believed the person did not match their passport image. In addition, the accuracy of wanted person sightings was reduced for trials with nonmatching passports compared to trials with matching passports. This suggests wanted people with matching passports were easier to spot because participants had an additional image to compare with their memory of the person in the wanted poster.


Assuntos
Memória Episódica , Humanos , Estudos Prospectivos , Estudantes
2.
Law Hum Behav ; 47(4): 463-483, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37471013

RESUMO

OBJECTIVE: The risk of mistaken identification for innocent suspects in lineups can be estimated by correcting the overall error rate by the number of people in the lineup. We compared this nominal size correction to a new effective size correction, which adjusts the error rate for the number of plausible lineup members. HYPOTHESES: We hypothesized that (a) increasing lineup bias would increase misidentifications of a designated innocent suspect; (b) with the effective size correction, increasing lineup bias would also increase the estimate of innocent-suspect misidentifications; and (c) with the nominal size correction, lineup bias would have no effect on the estimate of innocent-suspect misidentifications. METHOD: In a reanalysis of previous literature, we obtained 10 data sets from Open Science Framework. In three new experiments (Ns = 686, 405, and 1,531, respectively), participants observed a staged crime and completed a fair or biased lineup. RESULTS: In the reanalysis of previous literature, less than four of six lineup members were identified frequently enough to be classified as plausible, M = 3.78, 95% confidence interval [CI: 2.20, 5.36]. In the new experiments, increasing lineup bias increased mistaken identifications of a designated innocent suspect, odds ratio (OR) = 5.50, 95% CI [2.77, 10.95] and also increased the effective size-corrected estimate of innocent-suspect misidentifications, OR = 3.04, 95% CI [2.13, 4.33]. With the nominal size correction, lineup bias had no effect on the estimate of innocent-suspect misidentifications, OR = 0.84, 95% CI [0.60, 1.18]. CONCLUSIONS: Most lineups include a combination of plausible and implausible lineup members. Contrary to the nominal size correction, which ignores implausible lineup members, the effective size correction is sensitive to implausible lineup members and accounts for lineup bias when estimating the risk of innocent suspect misidentifications. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Rememoração Mental , Reconhecimento Psicológico , Humanos , Direito Penal/métodos , Crime
3.
J Pediatr Orthop ; 42(5): e409-e413, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35200217

RESUMO

BACKGROUND: The Pavlik harness (PH) is commonly used to treat infantile dislocated hips. However, significant variability exists in the duration of brace treatment after successful reduction of the dislocated hip. The purpose of this study was to evaluate the effect of prescribed time in brace on acetabular index (AI) at two years of age using a prospective, international, multicenter database. METHODS: We retrospectively studied prospectively enrolled infants with at least 1 dislocated hip that were initially treated with a PH and had a recorded AI at 2-year follow-up. Subjects were treated at 1 of 2 institutions. Institution 1 used the PH until they observed normal radiographic acetabular development. Institution 2 followed a structured shorter brace treatment protocol. Hip dislocation was defined as <30% femoral head coverage at rest on the pretreatment ultrasound or International Hip Dysplasia Institute (IHDI) grade III or IV on the pretreatment radiograph. RESULTS: Fifty-three hips met our inclusion criteria. Hips from Institution 1 were treated with a brace ×3 longer than hips from institution 2 (adjusted mean 8.9±1.3 vs. 2.6±0.2 mo) (P<0.001). Institution 1 had an 88% success rate and institution 2 had an 85% success rate at achieving hip reduction (P=0.735). At 2-year follow-up, we observed no significant difference in AI between Institution 1 (adjusted mean 25.6±0.9 degrees) compared with Institution 2 (adjusted mean 23.5±0.8 degrees) (P=0.1). However, 19% of patients from Institution 1 and 44% of patients from Institution 2 were at or below the 50th percentile of previously published age-matched and sex-matched AI normal data (P=0.049). Also, 27% (7/26) of hips from Institution 1 had significant acetabular dysplasia (more than 2 SD from the mean), compared with a 22% (6/27) from Institution 2 (P=0.691). We found no correlation between age at initiation of bracing and AI at 2-year follow-up (P=0.071). CONCLUSIONS: The PH brace can successfully treat dislocated infant hips, however, prolonged brace treatment was not found to result in improved acetabular development at 2-year follow-up. LEVEL OF EVIDENCE: Level III.


Assuntos
Luxação Congênita de Quadril , Luxação do Quadril , Acetábulo/diagnóstico por imagem , Luxação Congênita de Quadril/diagnóstico por imagem , Luxação Congênita de Quadril/terapia , Humanos , Lactente , Aparelhos Ortopédicos , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
4.
Anesth Analg ; 133(2): 327-337, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-33481403

RESUMO

BACKGROUND: Intraoperative methadone, a long-acting opioid, is increasingly used for postoperative analgesia, although the optimal methadone dosing strategy in children is still unknown. The use of a single large dose of intraoperative methadone is controversial due to inconsistent reductions in total opioid use in children and adverse effects. We recently demonstrated that small, repeated doses of methadone intraoperatively and postoperatively provided sustained analgesia and reduced opioid use without respiratory depression. The aim of this study was to characterize pharmacokinetics, efficacy, and safety of a multiple small-dose methadone strategy. METHODS: Adolescents undergoing posterior spinal fusion (PSF) for idiopathic scoliosis or pectus excavatum (PE) repair received methadone intraoperatively (0.1 mg/kg, maximum 5 mg) and postoperatively every 12 hours for 3-5 doses in a multimodal analgesic protocol. Blood samples were collected up to 72 hours postoperatively and analyzed for R-methadone and S-methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidene (EDDP) metabolites, and alpha-1 acid glycoprotein (AAG), the primary methadone-binding protein. Peak and trough concentrations of enantiomers, total methadone, and AAG levels were correlated with clinical outcomes including pain scores, postoperative nausea and vomiting (PONV), respiratory depression, and QT interval prolongation. RESULTS: The study population included 38 children (10.8-17.9 years): 25 PSF and 13 PE patients. Median total methadone peak plasma concentration was 24.7 (interquartile range [IQR], 19.2-40.8) ng/mL and the median trough was 4.09 (IQR, 2.74-6.4) ng/mL. AAG concentration almost doubled at 48 hours after surgery (median = 193.9, IQR = 86.3-279.5 µg/mL) from intraoperative levels (median = 87.4, IQR = 70.6-115.8 µg/mL; P < .001), and change of AAG from intraoperative period to 48 hours postoperatively correlated with R-EDDP (P < .001) levels, S-EDDP (P < .001) levels, and pain scores (P = .008). Median opioid usage was minimal, 0.66 (IQR, 0.59-0.75) mg/kg morphine equivalents/d. No respiratory depression (95% Wilson binomial confidence, 0-0.09) or clinically significant QT prolongation (median = 9, IQR = -10 to 28 milliseconds) occurred. PONV occurred in 12 patients and was correlated with morphine equivalent dose (P = .005). CONCLUSIONS: Novel multiple small perioperative methadone doses resulted in safe and lower blood methadone levels, <100 ng/mL, a threshold previously associated with respiratory depression. This methadone dosing in a multimodal regimen resulted in lower blood methadone analgesia concentrations than the historically described minimum analgesic concentrations of methadone from an era before multimodal postoperative analgesia without postoperative respiratory depression and prolonged corrected QT (QTc). Larger studies are needed to further study the safety and efficacy of this methadone dosing strategy.


Assuntos
Analgésicos Opioides/administração & dosagem , Monitoramento de Medicamentos , Tórax em Funil/cirurgia , Metadona/administração & dosagem , Medição da Dor , Dor Pós-Operatória/prevenção & controle , Escoliose/cirurgia , Fusão Vertebral/efeitos adversos , Adolescente , Fatores Etários , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/sangue , Analgésicos Opioides/farmacocinética , Criança , Esquema de Medicação , Feminino , Humanos , Indiana , Masculino , Metadona/efeitos adversos , Metadona/sangue , Metadona/farmacocinética , Medição da Dor/efeitos adversos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/etiologia , Assistência Perioperatória , Náusea e Vômito Pós-Operatórios/induzido quimicamente , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Resultado do Tratamento
5.
Inj Prev ; 27(1): 55-60, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32152193

RESUMO

BACKGROUND: Recreational sports facilities with trampolines have become increasingly popular, and trampoline-related injuries incurred have been increasing. The goal of this study was to determine impact of recreational sports facilities on trampoline-associated injuries. METHODS: An epidemiological study was performed using data from the National Electronic Injury Surveillance System (NEISS). All patients in the NEISS database coded for trampoline injury were included. Statistical analyses were performed comparing home trampoline injuries (HTIs) and recreational sports facilities-related trampoline injuries (RSIs) for standard demographic variables using appropriated weighted statistical methods. RESULTS: There were an estimated 1 376 659 emergency department (ED) visits for trampoline related injuries from 1998 to 2017; 125 811 were RSIs and 1 227 881 were HTIs. Between 2004 and 2017, the number of RSIs increased rapidly, while HTIs decreased. RSIs more often presented to large hospitals and HTIs to smaller ones. Strain/sprains were more associated with RSIs, whereas HTIs sustained more internal organ injuries. Lower extremity fractures occurred more frequently in RSIs and upper extremity fractures in HTIs. There was a greater percentage of RSIs in 15-34 years old age group (28.2% vs 13.6%). There were no differences by gender and race between HTIs and RSIs. CONCLUSIONS: The rapid expansion in recreational sports facilities with trampolines coincided with increasing RSIs. RSIs differed from HTIs regarding changes over time, hospital size, diagnosis and injury location. Recreational sports facilities with trampolines pose a public health hazard.


Assuntos
Traumatismos em Atletas , Fraturas Ósseas , Traumatismos da Perna , Entorses e Distensões , Adolescente , Adulto , Traumatismos em Atletas/epidemiologia , Demografia , Serviço Hospitalar de Emergência , Fraturas Ósseas/epidemiologia , Humanos , Adulto Jovem
6.
J Res Natl Inst Stand Technol ; 126: 126048, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-38469443

RESUMO

We present a new paradigm for the primary standardization of radionuclide activity per mass of solution (Bq/g). Two key enabling capabilities are 4π decay-energy spectrometry using chip-scale sub-Kelvin microcalorimeters and direct realization of mass by gravimetric inkjet dispensing using an electrostatic force balance. In contrast to traditional traceability, which typically relies on chemical separation of single-radionuclide samples, 4π integral counting, and additional spectrometry methods to verify purity, the system described here has both 4π counting efficiency and spectroscopic resolution sufficient to identify multiple radionuclides in the same sample at once. This enables primary standardization of activity concentrations of mixed-radionuclide samples. A major benefit of this capability, beyond metrology, is in assay of environmental and forensics samples, for which the quantification of multiplenuclide samples can be achieved where presently inhibited by interferences. This can be achieved without the need for chemical separations or efficiency tracers, thereby vastly reducing time, radioactive waste, and resulting measurement uncertainty.

7.
J Pediatr Orthop ; 41(9): 531-536, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34325442

RESUMO

BACKGROUND: Congenital myopathies (CMs) are complex conditions often associated with early-onset scoliosis (EOS). The purpose of this study was to investigate radiographic outcomes in CM patients undergoing EOS instrumentation as well as complications. Secondarily, we sought to compare these patients to a population with higher prevalence, cerebral palsy (CP) EOS patients. METHODS: This is a retrospective study of a prospectively collected multicenter registry. The registry was queried for EOS patients with growth-sparing instrumentation (vertical expandable prosthetic titanium ribs, magnetically controlled growing rods, traditional growing rod, or Shilla) and a CM or CP diagnosis with minimum 2 years follow-up. Outcomes included major curve magnitude, T1-S1 height, kyphosis, and complications. RESULTS: Sixteen patients with CM were included. Six (37.5%) children with CM experienced 11 complications by 2 years. Mean major curve magnitude for CM patients was improved postoperatively and maintained at 2 years (P<0.01), with no significant increase in T1-S1 height or maximum kyphosis(P>0.05). Ninety-seven patients with CP EOS were included as a comparative cohort. Fewer CP patients required baseline respiratory support compared with CM patients (20.0% vs. 92.9%, P<0.01). Fifty-four (55.7%) CP patients experienced a total of 105 complications at 2 years. There was no evidence that the risk of complication or radiographic outcomes differs between cohorts at 2 years, though CP EOS patients experienced significant improvement in all measurements at 2 years. CONCLUSIONS: EOS CM children face a high risk of complication after growing instrumentation, with similar curve correction and risk of complication to CP patients. LEVEL OF EVIDENCE: Level III.


Assuntos
Cifose , Doenças Musculares , Escoliose , Criança , Seguimentos , Humanos , Estudos Retrospectivos , Costelas , Escoliose/diagnóstico por imagem , Escoliose/epidemiologia , Escoliose/cirurgia , Coluna Vertebral , Resultado do Tratamento
8.
Memory ; 28(3): 309-322, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31918628

RESUMO

Repeated events are common in everyday life, but relatively neglected as a topic within memory psychology. In two samples of adults, we investigated memory for repeated, schema-establishing simple events (operationalised as structured word-lists), and the effects of deviations within those events. We focused on the effects of deviations from two core dimensions of schema: content and order. Across three successive word-list events, we established and reinforced a basic list schema by always presenting three content categories in the same order. These expectations were violated in a fourth and final word-list. We measured the effects on memory of both the violating and the schema-establishing lists in multiple recall attempts over a period of one month. We measured correct recall, misattribution errors, metacognitive awareness of list-organisation and deviations, and recall organisation. Across all delays and across all word-lists (not only the final one), content changes increased recall, whereas order changes decreased recall. Participants were also more aware of content changes than order changes. These disparate effects suggest that the two types of schema-deviations may have qualitatively different effects on memory for specific instances of a repeated generic event. Cognitive processes underlying memory for typical and exceptional instances of repeated events are discussed.


Assuntos
Conscientização , Cognição/fisiologia , Rememoração Mental/fisiologia , Adulto , Feminino , Humanos , Masculino
9.
Int J Mol Sci ; 22(1)2020 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-33396420

RESUMO

Cadmium (Cd) is an anthropogenic as well as a naturally occurring toxicant associated with prediabetes and T2DM in humans and experimental models of Cd exposure. However, relatively few studies have examined the mechanism(s) of Cd-induced hyperglycemia. The purpose of this study was to examine the role of pancreatic islets in Cd-induced hyperglycemia. Male Sprague-Dawley rats were given daily subcutaneous doses of Cd at 0.6 mg/kg over 12 weeks. There was a resulting time-dependent increase in fasting blood glucose and altered insulin release in vitro. Islets isolated from control (saline-treated) and Cd-treated animals were incubated in low (0.5 mg/mL) or high (3 mg/mL) glucose conditions. Islets from 12 week Cd-treated animals had significantly less glucose-stimulated insulin release compared to islets from saline-treated control animals. The actual Cd content of isolated islets was 5 fold higher than the whole pancreas (endocrine + exocrine) and roughly 70% of that present in the renal cortex. Interestingly, islets isolated from Cd-treated animals and incubated in high glucose conditions contained significantly less Cd and zinc than those incubated in low glucose. These results show that within whole pancreatic tissue, Cd selectively accumulates in pancreatic islets and causes altered islet function that likely contributes to dysglycemia.


Assuntos
Glicemia/análise , Cádmio/análise , Cádmio/toxicidade , Hiperglicemia/patologia , Secreção de Insulina/efeitos dos fármacos , Ilhotas Pancreáticas/patologia , Animais , Hiperglicemia/induzido quimicamente , Hiperglicemia/metabolismo , Ilhotas Pancreáticas/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley
10.
Molecules ; 25(19)2020 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-33023027

RESUMO

Dimethyldioxirane epoxidizes 4,5-benzoxepin to form the reactive 2,3-epoxyoxepin intermediate followed by very rapid ring-opening to an o-xylylene that immediately isomerizes to the stable product 1H-2-benzopyran-1-carboxaldehyde. The present study demonstrates that separate incubations of 4,5-benzoxepin with three cytochrome P450 isoforms (2E1, 1A2, and 3A4) as well as pooled human liver microsomes (pHLM) also produce 1H-2-benzopyran-1-carboxaldehyde as the major product, likely via the 2,3-epoxyoxepin. The reaction of 4,5-benzoxepin with cerium (IV) ammonium nitrate (CAN) yields a dimeric oxidized molecule that is also a lesser product of the P450 oxidation of 4,5-benzoxepin. The observation that P450 enzymes epoxidize 4,5-benzoxepin suggests that the 2,3-epoxidation of oxepin is a major pathway for the ring-opening metabolism of benzene to muconaldehyde.


Assuntos
Benzeno/química , Sistema Enzimático do Citocromo P-450/metabolismo , Oxepinas/metabolismo , Benzoxepinas/química , Benzoxepinas/metabolismo , Cério/química , Compostos de Epóxi/metabolismo , Redes e Vias Metabólicas , Modelos Moleculares , Nitratos/química , Oxepinas/química , Oxirredução , Isoformas de Proteínas/metabolismo
11.
Law Hum Behav ; 43(1): 99-116, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30570277

RESUMO

When children report abuse, they often report that it occurred repeatedly. In most jurisdictions, children will be asked to report each instance of abuse with as many details as possible. In the current meta-analysis, we analyzed data from 31 experiments and 3099 children. When accuracy was defined as the number of correct details from the target instance (i.e., narrow definition), repeated-event children were less accurate than single-event children. However, we argue that defining accuracy as the number of reported details that were experienced across instances (i.e., broad definition) is more appropriate for repeated events. When a broad definition was applied, single- and repeated-event children were similarly accurate. Importantly, repeated-event children were less likely than single-event children to report details that had never been experienced and they were no more likely to say "I don't know." Overall, repeated-event children were more suggestible than single-event children, but this was moderated by length of delay to recall. In analyses of recognition data, single-event children's sensitivity score was higher than repeated-event children's, with no significant difference in response bias as a function of event frequency. We discuss these results in the context of how children's memory for repeated events is organized. We also consider the advantage of applying a broad definition of accuracy for victims of repeated abuse and charging repeated abuse as a continuous offense rather than discrete acts. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Maus-Tratos Infantis/psicologia , Comportamento Infantil/psicologia , Rememoração Mental , Reconhecimento Psicológico , Criança , Psicologia Forense , Humanos , Entrevistas como Assunto , Psicologia da Criança
12.
Law Hum Behav ; 42(1): 1-12, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29461076

RESUMO

The suspect in eyewitness lineups may be guilty or innocent. These possibilities are traditionally simulated in eyewitness identification studies using a dual-lineup paradigm: All witnesses observe the same perpetrator and then receive one of two lineups. In this paradigm, the suspect's guilt is manipulated by including the perpetrator in one lineup and an innocent suspect in the other. The lineup is then filled with people matched to either the suspect (resulting in different fillers in perpetrator-present and perpetrator-absent lineups) or to the perpetrator (resulting in the same fillers in each lineup). An inescapable feature of the dual-lineup paradigm is that the perpetrator-present and perpetrator-absent lineups differ not only in the suspect's guilt, but also in their composition. Here, we describe a single-lineup paradigm: Subjects observe one of two perpetrators and then all subjects receive the same lineup containing one of the perpetrators. This alternative paradigm allows manipulation of the suspect's guilt without changing the lineup's composition. In three experiments, we applied the single-lineup paradigm to explore suspect-filler similarity and consistently found that increasing similarity reduced perpetrator identifications but did little to prevent innocent suspect misidentifications. Conversely, when fillers were matched to the perpetrator using a dual-lineup paradigm, increasing similarity reduced identification of perpetrators and innocent suspects. This finding suggests that the effect of filler similarity may depend on the person to whom the fillers are matched. We suggest that the single-lineup paradigm is a more ecologically valid and better controlled approach to creating suspect-matched lineups in laboratory investigations of eyewitness memory than existing procedures. (PsycINFO Database Record


Assuntos
Crime , Direito Penal , Rememoração Mental , Reconhecimento Psicológico , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
13.
Psychol Public Policy Law ; 24(3): 307-325, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30100702

RESUMO

The medium used to present lineup members for eyewitness identification varies according to the location of the criminal investigation. Although in some jurisdictions live lineups remain the default procedure, elsewhere this practice has been replaced with photo or video lineups. This divergence leads to two possibilities: Either some jurisdictions are not using the lineup medium that best facilitates accurate eyewitness identification or the lineup medium has no bearing on the accuracy of eyewitness identification. Photo and video lineups are the more practical options, but proponents of live lineups believe witnesses make better identification decisions when the lineup members are physically present. Here, the authors argue against this live superiority hypothesis. To be superior in practice, the benefits of live presentation would have to be substantial enough to overcome the inherent difficulties of organizing and administering a live lineup. The review of the literature suggests that even in experimental settings, where these difficulties can be minimized, it is not clear that live lineups are superior. The authors conclude that live lineups are rarely the best option in practice and encourage further research to establish which nonlive medium provides the best balance between probative value and practical utility.

14.
J Comput Assist Tomogr ; 41(2): 195-198, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27560025

RESUMO

OBJECTIVE: We aimed to evaluate the use of 4-dimensional computed tomography (4DCT) for characterization of thyroid nodules. METHODS: Our study drew from 100 consecutive patients with primary hyperparathyroidism who underwent 4D parathyroid CT imaging for adenoma localization. Included subjects had tissue sampling of a thyroid nodule within 3 months of 4DCT. RESULTS: Twenty subjects (18 women and 2 men) had thyroid nodules that were pathologically confirmed. Precontrast nodule attenuation was significantly lower in malignant nodules when compared with benign nodules (36 vs 61 HU, P = 0.05). Arterial phase and delayed phase nodule attenuations were not significantly different in malignant and benign nodules (128 vs 144 HU, P = 0.7; 74 vs 98 HU, P = 0.3). CONCLUSIONS: Our initial experience with a small group of patients was unable to support the use of 4DCT for characterizing thyroid nodules; however, precontrast nodule attenuation was significantly lower in malignant nodules when compared with benign nodules.


Assuntos
Adenoma/diagnóstico por imagem , Tomografia Computadorizada Quadridimensional/métodos , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Adenoma/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hiperparatireoidismo Primário/complicações , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/complicações
15.
J Comput Assist Tomogr ; 41(3): 484-488, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27798445

RESUMO

BACKGROUND AND PURPOSE: Dental and periodontal diseases represent important but often overlooked causes of acute sinusitis. Our goal was to examine the prevalence of potential odontogenic sources of acute maxillary sinusitis according to immune status and their associations with sinusitis. MATERIALS AND METHODS: A retrospective review of maxillofacial computed tomography studies from 2013 to 2014 was performed. Each maxillary sinus and its ipsilateral dentition were evaluated for findings of acute sinusitis and dental/periodontal disease. RESULTS: Eighty-four patients (24 immunocompetent, 60 immunocompromised) had 171 maxillary sinuses that met inclusion criteria for acute maxillary sinusitis. Inspection of dentition revealed oroantral fistula in 1%, periapical lucencies in 16%, and projecting tooth root(s) in 71% of cases. Immunocompromised patients were more likely to have bilateral sinusitis than immunocompetent patients (67% vs 33%, P = 0.005). A paired case-control analysis in a subset of patients with unilateral maxillary sinusitis (n = 39) showed a higher prevalence of periapical lucency in association with sinuses that had an air fluid level-29% of sinuses with a fluid level had periapical lucency compared with 12% without sinus fluid (P = 0.033). CONCLUSIONS: Potential odontogenic sources of acute maxillary sinusitis are highly prevalent in both immunocompetent and immunocompromised patients, although the 2 patient populations demonstrate no difference in the prevalence of these potential odontogenic sources. Periapical lucencies were found to be associated with an ipsilateral sinus fluid level. Increased awareness of the importance of dental and periodontal diseases as key components of maxillofacial computed tomography interpretation would facilitate a more appropriate and timely treatment.


Assuntos
Imunocompetência/imunologia , Hospedeiro Imunocomprometido/imunologia , Sinusite Maxilar/diagnóstico por imagem , Doenças Periodontais/diagnóstico por imagem , Análise de Causa Fundamental/métodos , Tomografia Computadorizada por Raios X , Doenças Dentárias/diagnóstico por imagem , Doença Aguda , Ossos Faciais/diagnóstico por imagem , Humanos , Maxila/diagnóstico por imagem , Sinusite Maxilar/complicações , Sinusite Maxilar/imunologia , Doenças Periodontais/complicações , Doenças Periodontais/imunologia , Estudos Retrospectivos , Doenças Dentárias/complicações , Doenças Dentárias/imunologia
16.
Int J Neurosci ; 127(2): 135-144, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26892843

RESUMO

PURPOSE: Posterior reversible encephalopathy syndrome (PRES) is an acute neurotoxic syndrome that, although characteristically reversible, can be fatal or result in long-term disability in a subset of patients. Our aim was to identify factors associated with poor discharge outcome in PRES patients. MATERIALS AND METHODS: We retrospectively reviewed the clinical and radiological records of all patients with PRES admitted at our tertiary care medical center from 2007 to 2014. They were divided based their modified Rankin Score at discharge and compared for their baseline variables, clinical, laboratory and imaging features. Poor outcome was defined by a modified Rankin scale 2-6 and was subdivided based on the primary mechanism that led to poor outcome. RESULTS: Out of 100 PRES subjects, 36% had poor discharge outcomes. Factors associated with poor outcomes on univariate analysis were history of diabetes mellitus, coma, high Charlson comorbidity index, post-transplantation, autoimmune condition, lack of systolic or diastolic hypertension, elevated blood urea nitrogen and involvement of the corpus callosum. On multivariate analysis, only prior diabetes mellitus odd ratio (OR) = 6.8 (95% CI 1.1-42.1, p = 0.04), corpus callosum involvement (OR = 11.7; 95% CI 2.4-57.4, p = 0.00) were associated with poor outcome. Poor outcome also correlated with increased length of hospital stay (OR = 7.9; 95% CI 1.3-49.7, p = 0.03). CONCLUSION: Large prospective studies incorporating serial blood glucose values and advanced imaging studies are required to validate these findings.


Assuntos
Imageamento por Ressonância Magnética , Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem , Adulto , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes
17.
Law Hum Behav ; 41(6): 541-555, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28816467

RESUMO

We tested whether an alternative lineup procedure designed to minimize problematic influences (e.g., metacognitive development) on decision criteria could be effectively used by children and improve child eyewitness identification performance relative to a standard identification task. Five hundred sixteen children (6- to 13-year-olds) watched a video of a target reading word lists and, the next day, made confidence ratings for each lineup member or standard categorical decisions for 8 lineup members presented sequentially. Two algorithms were applied to classify confidence ratings into categorical decisions and facilitate comparisons across conditions. The classification algorithms produced accuracy rates for the confidence rating procedure that were comparable to the categorical procedure. These findings demonstrate that children can use a ratings-based procedure to discriminate between previously seen and unseen faces. In turn, this invites more nuanced and empirical consideration of ratings-based identification evidence as a probabilistic index of guilt that may attenuate problematic social influences on child witnesses' decision criteria. (PsycINFO Database Record


Assuntos
Crime/psicologia , Rememoração Mental , Reconhecimento Psicológico , Adolescente , Algoritmos , Criança , Tomada de Decisões , Feminino , Humanos , Masculino , Gravação de Videoteipe
18.
Epilepsy Behav ; 61: 97-101, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27337161

RESUMO

PURPOSE: Although seizures are common in patients with posterior reversible encephalopathy syndrome (PRES), epilepsy is rare. Our objective was to identify predictors and impact of seizures in patients with PRES. METHODS: A retrospective review of the clinical and radiological parameters of all patients diagnosed with PRES from 2007 to 2014 was performed. Patients were divided into two groups based on the occurrence of PRES-related seizures at presentation or during their hospital course. Univariate and multivariate analyses were performed to determine factors associated with the occurrence of PRES-related seizures. RESULTS: Of 100 patients, 70% experienced at least one seizure from PRES. On univariate analysis, the factors associated with seizures were the following: high Charlson comorbidity index (4.16±2.89 vs. 2.87±2.20, p=0.03), systemic malignancy (41.4% vs. 16.7%, p=0.02), occipital lobe involvement (97.1% vs. 83.3%, p=0.02), more lobes involved (4.6±1.48 vs. 3.9±1.32, p=0.03) but less likely in patients with visual disturbances (15.7% vs. 46.7%, p=0.005), and facial droop (12.9% vs. 16.7%, p=0.002). On multivariate analysis, only occipital lobe involvement was significantly (odds ratio: 9.63, 95% CI: 1.45-64.10, p=0.02) associated with the occurrence of PRES-related seizures. Despite the occurrence of seizures, they were less likely to require a nursing home placement upon hospital discharge (odds ratio: 0.17, 95% CI: 0.03-0.91, p=0.04). CONCLUSION: We conclude that seizures are common in patients with occipital lobe involvement from PRES.


Assuntos
Lobo Occipital/patologia , Síndrome da Leucoencefalopatia Posterior/diagnóstico , Convulsões/diagnóstico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome da Leucoencefalopatia Posterior/complicações , Prognóstico , Estudos Retrospectivos , Convulsões/etiologia
19.
Ann Surg Oncol ; 22 Suppl 3: S707-13, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26259757

RESUMO

BACKGROUND: This study aimed to determine the incidence and risk factors for emergency department (ED) visits and unplanned hospitalization after thyroid and parathyroid surgery. METHODS: A retrospective study of all patients who underwent thyroidectomy or parathyroidectomy from 2007 to 2014 was conducted to assess for ED visits or unplanned hospitalization within 30 days after surgery. Uni- and multivariate analyses were used to identify risk factors for ED visits and hospitalization. RESULTS: Of 864 patients who underwent thyroidectomy (n = 673) or parathyroidectomy (n = 191), 96 (11.1 %) had an ED visit and 41 (4.7 %) were hospitalized within 30 days after surgery. Univariate analysis showed hypocalcemia (p = 0.001), younger age (p = 0.02), total thyroidectomy (p = 0.01), and lack of private health insurance (p = 0.005) to be predictive of an ED visit and hypocalcemia (p = 0.0001), Hashimoto's thyroiditis (p = 0.049), total thyroidectomy (p = 0.005), and African American race (p = 0.03) were predictive of hospitalization after thyroidectomy. Multivariate analysis showed younger age (odds ratio [OR] 1.5 per 10-year decrease in age; p = 0.002; 95 % confidence interval [CI] 1.1-1.8) and Medicare insurance (OR 2.7; p = 0.01; 95 % CI 1.3-5.7) to be independently associated with an ED visit, and hypocalcemia (OR 4.7; p < 0.001; 95 % CI 2.2-11.0) was the only independent factor associated with hospitalization after thyroidectomy. Univariate analysis showed hypocalcemia, renal hyperparathyroidism, and multiglandular disease to be predictive of an ED visit and hospitalization after parathyroidectomy. The sample size for parathyroidectomy was too small for multivariate analysis. CONCLUSIONS: Targeted strategies for transitions of care for patients with postoperative hypocalcemia may help to reduce ED visits and hospitalization after thyroidectomy and parathyroidectomy.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Visita a Consultório Médico/estatística & dados numéricos , Paratireoidectomia/efeitos adversos , Readmissão do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias , Tireoidectomia/efeitos adversos , Feminino , Seguimentos , Humanos , Hipocalcemia/etiologia , Incidência , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias das Paratireoides/patologia , Neoplasias das Paratireoides/cirurgia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia
20.
Law Hum Behav ; 39(1): 62-74, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24955851

RESUMO

Eyewitness lineups typically contain a suspect (guilty or innocent) and fillers (known innocents). The degree to which fillers should resemble the suspect is a complex issue that has yet to be resolved. Previously, researchers have voiced concern that eyewitnesses would be unable to identify their target from a lineup containing highly similar fillers; however, our literature review suggests highly similar fillers have only rarely been shown to have this effect. To further examine the effect of highly similar fillers on lineup responses, we used morphing software to create fillers of moderately high and very high similarity to the suspect. When the culprit was in the lineup, a higher correct identification rate was observed in moderately high similarity lineups than in very high similarity lineups. When the culprit was absent, similarity did not yield a significant effect on innocent suspect misidentification rates. However, the correct rejection rate in the moderately high similarity lineup was 20% higher than in the very high similarity lineup. When choosing rates were controlled by calculating identification probabilities for only those who made a selection from the lineup, culprit identification rates as well as innocent suspect misidentification rates were significantly higher in the moderately high similarity lineup than in the very high similarity lineup. Thus, very high similarity fillers yielded costs and benefits. Although our research suggests that selecting the most similar fillers available may adversely affect correct identification rates, we recommend additional research using fillers obtained from police databases to corroborate our findings.


Assuntos
Crime , Prova Pericial , Rememoração Mental , Reconhecimento Psicológico , Adolescente , Feminino , Humanos , Masculino , Adulto Jovem
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