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1.
Phys Rev Lett ; 132(11): 113401, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38563934

RESUMO

We explore the dynamics of a tuneable box-trapped Bose gas under strong periodic forcing in the presence of weak disorder. In absence of interparticle interactions, the interplay of the drive and disorder results in an isotropic nonthermal momentum distribution that shows subdiffusive dynamic scaling, with sublinear energy growth and the universal scaling function captured well by a compressed exponential. We explain that this subdiffusion in momentum space can naturally be understood as a random walk in energy space. We also experimentally show that for increasing interaction strength, the gas behavior smoothly crosses over to wave turbulence characterized by a power-law momentum distribution, which opens new possibilities for systematic studies of the interplay of disorder and interactions in driven quantum systems.

2.
Ann Plast Surg ; 87(6): 676-680, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34176895

RESUMO

INTRODUCTION: Successful minimally invasive repair of pectus excavatum relies on a pectus bar that closely conforms to the desired shape of the sternum and ribs to produce optimal elevation and remodeling. However, the present method of empirical intraoperative bar shaping is tedious and risks trauma to surrounding structures. To overcome this, we devised a technique using a life-sized computed tomography (CT) printout of the patient's chest wall to guide preoperative bar bending. METHODS: A 5-cm-wide polymethylmethacrylate block placed on the sternum as the patient underwent chest CT was used as a marker to guide scaling of an axial screenshot of the patient's chest to life-size. This life-size image was printed and the planned correction of the patient's chest wall was traced onto it. The pectus bar was bent according to this template. Patient demographics, Haller index, surgical indications, operative technique, complications, aesthetic and functional improvements, and overall satisfaction were assessed. RESULTS: Thirty patients (4 women) underwent primary minimally invasive repair of pectus excavatum with a single pectus bar shaped preoperatively over an 8-year period. The average age and Haller index was 20.6 years and 5.4, respectively. The mean operative time was 66.4 minutes. Satisfactory sternal elevation was attained with a single attempt at bar insertion in all cases. Two patients had pneumothoraxes that resolved without intervention. The mean follow-up period was 50.1 months. There were no cases of bar migration or recurrence of deformity after bar removal. On a 5-point Likert scale, all patients indicated an improvement in aesthetic appearance (4.6), and patients with physical symptoms (10) reported an improvement in function (4.4). The overall satisfaction score was 4.7. CONCLUSIONS: This technique of CT-guided preoperative pectus bar shaping is straightforward, eliminates the need for intraoperative revisions to bar shape, and achieves effective correction of the pectus excavatum deformity. All patients were satisfied with the aesthetic, functional, and overall outcomes.


Assuntos
Tórax em Funil , Parede Torácica , Feminino , Tórax em Funil/diagnóstico por imagem , Tórax em Funil/cirurgia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos Retrospectivos , Esterno/diagnóstico por imagem , Esterno/cirurgia , Parede Torácica/diagnóstico por imagem , Parede Torácica/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
3.
Int J Mol Sci ; 22(7)2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33805910

RESUMO

Long urethral strictures are often treated with autologous genital skin and buccal mucosa grafts; however, risk of hair ingrowth and donor site morbidity, restrict their application. To overcome this, we introduced a tissue-engineered human urethra comprising adipose-derived stem cell (ASC)-based self-assembled scaffold, human urothelial cells (UCs) and smooth muscle cells (SMCs). ASCs were cultured with ascorbic acid to stimulate extracellular matrix (ECM) production. The scaffold (ECM) was stained with collagen type-I antibody and the thickness was measured under a confocal microscope. Results showed that the thickest scaffold (28.06 ± 0.59 µm) was achieved with 3 × 104 cells/cm2 seeding density, 100 µg/mL ascorbic acid concentration under hypoxic and dynamic culture condition. The biocompatibility assessment showed that UCs and SMCs seeded on the scaffold could proliferate and maintain the expression of their markers (CK7, CK20, UPIa, and UPII) and (α-SMA, MHC and Smootheline), respectively, after 14 days of in vitro culture. ECM gene expression analysis showed that the ASC and dermal fibroblast-based scaffolds (control) were comparable. The ASC-based scaffold can be handled and removed from the plate. This suggests that multiple layers of scaffold can be stacked to form the urothelium (seeded with UCs), submucosal layer (ASCs only), and smooth muscle layer (seeded with SMCs) and has the potential to be developed into a fully functional human urethra for urethral reconstructive surgeries.


Assuntos
Adipócitos/citologia , Hipóxia Celular , Células-Tronco/citologia , Engenharia Tecidual/métodos , Uretra/citologia , Ácido Ascórbico/química , Materiais Biocompatíveis/química , Meios de Cultura , Matriz Extracelular/metabolismo , Fibroblastos/citologia , Perfilação da Expressão Gênica , Humanos , Microscopia Confocal , Miócitos de Músculo Liso/citologia , Fenótipo , Proteômica , Alicerces Teciduais/química , Urotélio/citologia , Urotélio/metabolismo
4.
J Emerg Med ; 56(6): 666-673, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31031069

RESUMO

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has several applications as a resuscitative intervention, including extracorporeal cardiopulmonary resuscitation (ECPR). ECPR is rarely initiated in the emergency department (ED) by emergency physicians outside regional academic institutions. OBJECTIVES: To evaluate whether ECPR improves clinical outcomes after cardiac arrest when initiated by emergency physicians (EPs) in a nonacademic hospital. METHODS AND MATERIALS: We performed a retrospective analysis of prospectively identified consecutive EP-initiated ECMO subjects from a single community hospital over a 7-year period. Logistic regression and propensity models tested the association between ECPR and survival to hospital discharge compared with concurrent ECPR-eligible control subjects. RESULTS: Over 7 years (2010-2017), EPs initiated ECMO on 58 subjects; 44 (76%) were venoarterial cases (43 ECPR) initiated in the ED. Of those, 11 (25%) survived to discharge (n = 9 with cerebral performance category score 1) and most were still alive after 5 years (66%). Adjusting for known covariates, ECPR subjects were more likely than concurrent controls to survive to discharge (odds ratio 8.4; 95% confidence interval 1.2-60.4). Propensity analysis revealed a favorable trend toward survival to discharge after ECPR (odds ratio 2.0; 95% confidence interval 0.51-7.8). CONCLUSIONS: Emergency physicians initiated ECMO with promising clinical outcomes. Prospective trials are needed to define the efficacy, safety, and cost-effectiveness of EP-initiated ECMO.


Assuntos
Medicina de Emergência/métodos , Oxigenação por Membrana Extracorpórea/métodos , Padrões de Prática Médica/tendências , Ressuscitação/métodos , Medicina de Emergência/tendências , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Modelos Logísticos , Pontuação de Propensão , Estudos Prospectivos , Ressuscitação/tendências , Estudos Retrospectivos , Sobreviventes/estatística & dados numéricos , Fatores de Tempo , Resultado do Tratamento
5.
Acc Chem Res ; 50(10): 2589-2597, 2017 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-28930430

RESUMO

Growing concern with the environmental impact of CO2 emissions produced by combustion of fuels derived from fossil-based carbon resources has stimulated the search for renewable sources of carbon. Much of this focus has been on the development of methods for producing transportation fuels, the major source of CO2 emissions today, and to a lesser extent on the production of lubricants and chemicals. First-generation biofuels such as bioethanol, produced by the fermentation of sugar cane- or corn-based sugars, and biodiesel, produced by the transesterification reaction of triglycerides with alcohols to form a mixture of long-chain fatty esters, can be blended with traditional fuels in limited amounts and also arise in food versus fuel debates. Producing molecules that can be drop-in solutions for fossil-derived products used in the transportation sector allows for efficient use of the existing infrastructure and is therefore particularly interesting. In this context, the most viable source of renewable carbon is abundantly available lignocellulosic biomass, a complex mixture of lignin, hemicellulose, and cellulose. Conversion of the carbohydrate portion of biomass (hemicellulose and cellulose) to fuels requires considerable chemical restructuring of the component sugars in order to achieve the energy density and combustion properties required for transportation fuels-gasoline, diesel, and jet. A different set of constraints must be met for the conversion of biomass-sourced sugars to lubricants and chemicals. This Account describes strategies developed by us to utilize aldehydes, ketones, alcohols, furfurals, and carboxylic acids derived from C5 and C6 sugars, acetone-butanol-ethanol (ABE) fermentation mixtures, and various biomass-derived carboxylic acids and fatty acids to produce fuels, lubricants, and chemicals. Oxygen removal from these synthons is achieved by dehydration, decarboxylation, hydrogenolysis, and hydrodeoxygenation, whereas reactions such as aldol condensation, etherification, alkylation, and ketonization are used to build up the number of carbon atoms in the final product. We show that our strategies lead to high-octane components that can be blended into gasoline, C9-C22 compounds that possess energy densities and properties required for diesel and jet fuels, and lubricants that are equivalent or superior to current synthetic lubricants. Replacing a fraction of the crude-oil-derived products with such renewable sources can mitigate the negative impact of the transportation sector on overall anthropogenic greenhouse gas (GHG) emissions and climate change potential. While ethanol is a well-known fuel additive, there is significant interest in using ethanol as a platform molecule to manufacture a variety of valuable chemicals. We show that bioethanol can be converted with high selectivity to butanol or 1,3-butadiene, providing interesting alternatives to the current production from petroleum. Finally, we report that several of the strategies developed have the potential to reduce GHG emissions by 55-80% relative to those for petroleum-based processes.

6.
AJR Am J Roentgenol ; 209(5): W322-W332, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28929809

RESUMO

OBJECTIVE: The objective of this study was to investigate the impact of decreasing breast compression during digital mammography and breast tomosynthesis (DBT) on perceived pain and image quality. MATERIALS AND METHODS: In this two-part study, two groups of women with prior mammograms were recruited. In part 1, subjects were positioned for craniocaudal (CC) and mediolateral oblique (MLO) views, and four levels of compression force were applied to evaluate changes in breast thickness, perceived pain, and relative tissue coverage. No imaging was performed. In part 2, two MLO DBT images of one breast of each patient were acquired at standard and reduced compression. Blurring artifacts and tissue coverage were judged by three breast imaging radiologists, and compression force, breast thickness, relative tissue coverage, and perceived pain were recorded. RESULTS: Only the first reduction in force was feasible because further reduction resulted in inadequate breast immobilization. Mean force reductions of 48% and 47% for the CC and MLO views, respectively, resulted in a significantly reduced perceived pain level, whereas the thickness of the compressed breast increased by 0.02 cm (CC view) and 0.09 (MLO view, part 1 of the study) and 0.38 cm (MLO view, part 2 of the study), respectively, with no change in tissue coverage or increase in motion blurring. CONCLUSION: Mammography and DBT acquisitions may be possible using half of the compression force used currently, with a significant and substantial reduction in perceived pain with no clinically significant change in breast thickness and tissue coverage.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mamografia/métodos , Dor/prevenção & controle , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Mamografia/efeitos adversos , Pessoa de Meia-Idade , Variações Dependentes do Observador , Dor/etiologia , Pressão , Estresse Mecânico
7.
J Biol Chem ; 289(22): 15856-66, 2014 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-24753247

RESUMO

Allosteric modulators are an attractive approach to achieve receptor subtype-selective targeting of G protein-coupled receptors. Benzyl quinolone carboxylic acid (BQCA) is an unprecedented example of a highly selective positive allosteric modulator of the M1 muscarinic acetylcholine receptor (mAChR). However, despite favorable pharmacological characteristics of BQCA in vitro and in vivo, there is limited evidence of the impact of allosteric modulation on receptor regulatory mechanisms such as ß-arrestin recruitment or receptor internalization and endocytic trafficking. In the present study we investigated the impact of BQCA on M1 mAChR regulation. We show that BQCA potentiates agonist-induced ß-arrestin recruitment to M1 mAChRs. Using a bioluminescence resonance energy transfer approach to monitor intracellular trafficking of M1 mAChRs, we show that once internalized, M1 mAChRs traffic to early endosomes, recycling endosomes and late endosomes. We also show that BQCA potentiates agonist-induced subcellular trafficking. M1 mAChR internalization is both ß-arrestin and G protein-dependent, with the third intracellular loop playing an important role in the dynamics of ß-arrestin recruitment. As the global effect of receptor activation ultimately depends on the levels of receptor expression at the cell surface, these results illustrate the need to extend the characterization of novel allosteric modulators of G protein-coupled receptors to encapsulate the consequences of chronic exposure to this family of ligands.


Assuntos
Endocitose/fisiologia , Endossomos/metabolismo , Receptor Muscarínico M1/química , Receptor Muscarínico M1/metabolismo , Regulação Alostérica/fisiologia , Animais , Arrestinas/metabolismo , Células CHO , Vazamento de Resíduos Químicos , Cricetulus , Quinase 2 de Receptor Acoplado a Proteína G/metabolismo , Subunidades alfa Gq-G11 de Proteínas de Ligação ao GTP/metabolismo , Células HEK293 , Humanos , Ligantes , Transporte Proteico/fisiologia , Receptores Acoplados a Proteínas G/metabolismo , Transdução de Sinais/fisiologia , beta-Arrestinas
8.
Aging Male ; 18(2): 112-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25690022

RESUMO

AIM: The aim of study was to evaluate the influence of ageing, lifestyle, and co morbid illnesses on treatment outcome of nocturia among men with BPH. METHODS: Patients with BPH on medical therapy of least 6 months and up to 48 months were interviewed. Nocturia episodes, co morbid illnesses, beverage intake frequency, medications and work history were documented. Body Mass Index (BMI), waist circumference (WC), prostate volume, and prostate specific antigen (PSA) were recorded. Treatment failure is defined as persistent nocturia despite on medical therapy for BPH. RESULTS: In 156 patients, the prevalence of nocturia was 96.7% while nocturia of 2 or more was 85.9%. Factors associated with treatment failure was older age (p < 0.01), usage of diuretics (p = 0.03), and antimuscarinics (p < 0.01), while active working status (p < 0.01), use of desmopression (p = 0.01), and increased coffee intake (p = 0.02) were associated with nocturia improvement. Co-morbid illnesses, obesity, WC, alcohol intake, PSA, prostate volume, and use of BPH medical therapy did not influence treatment outcome. CONCLUSION: Advancing age has a significance negative outcome on nocturia treatment, while standard BPH medical therapy and co morbid illnesses have an insignificant impact. However, alleviation of bothersome symptoms is possible with the understanding of its patho-physiology and individual-based approach to treatment and expected outcome.


Assuntos
Envelhecimento/fisiologia , Estilo de Vida , Noctúria/tratamento farmacológico , Hiperplasia Prostática/tratamento farmacológico , Inibidores de 5-alfa Redutase/uso terapêutico , Antagonistas Adrenérgicos alfa/uso terapêutico , Idoso , Antidiuréticos/uso terapêutico , Constituição Corporal , Comorbidade , Estudos Transversais , Desamino Arginina Vasopressina/uso terapêutico , Combinação de Medicamentos , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas Muscarínicos/uso terapêutico , Fatores de Risco , Resultado do Tratamento
9.
Prev Med ; 67: 295-302, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25117523

RESUMO

OBJECTIVES: This study aims to compare health status and its risk factors between men and women who are from countries of different income status in Asia. METHOD: We have included 47 Asian countries and 2 regions in this study. Life expectancy, mortality rate from communicable disease, non-communicable disease and injuries, the prevalence of non-communicable diseases risk factors and their trends were extracted from the WHO and respective governmental database. Subgroup analysis was performed based on country income groups. RESULTS: Overall, men have shorter life expectancy and higher mortality rates compared to women. Men from higher-income countries lived longer compared to men from lower-income countries. There is a wide variation of male life expectancy in upper and lower middle income countries. The mean systolic blood pressure, fasting blood glucose and body mass index in Asia have also increased over the years. CONCLUSION: This study confirms that Asian men have poorer health compared to women besides the growing concerns on NCD risk factors. The findings from this study calls for a concerted effort to find solutions in addressing men's health problems in Asia.


Assuntos
Nível de Saúde , Expectativa de Vida , Saúde do Homem/estatística & dados numéricos , Ásia/epidemiologia , Povo Asiático , Glicemia/análise , Pressão Sanguínea , Índice de Massa Corporal , Doença Crônica/mortalidade , Doenças Transmissíveis/mortalidade , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Sexuais , Classe Social , Ferimentos e Lesões/mortalidade
11.
World J Surg Oncol ; 12: 88, 2014 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-24708809

RESUMO

Primary breast lymphomas (PBLs) represent less than 1% of all breast malignancies. Intravascular large B-cell lymphoma (ILBCL) is a rare, aggressive form of extranodal lymphoma. Breast involvement has only been described in the literature once previously. ILBCL is characterized by the proliferation of tumour cells within the lumen of small vessels of involved organs, resulting in their eventual occlusion. Clinical features are often vague, diagnosis is difficult and delayed, and prognosis is usually poor. We report the first ever case of synchronous ILBCL and invasive ductal carcinoma (IDC) of the breast in a patient presenting with pyrexia of unknown origin and altered mental status who underwent modified radical mastectomy and subsequent chemotherapy, and review the literature regarding intravascular large B-cell lymphoma, PBLs and synchronous carcinomas and lymphomas of the breast.


Assuntos
Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Linfoma Difuso de Grandes Células B/patologia , Neoplasias Primárias Múltiplas/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/terapia , Terapia Combinada , Feminino , Humanos , Linfoma Difuso de Grandes Células B/terapia , Mastectomia , Invasividade Neoplásica , Neoplasias Primárias Múltiplas/terapia , Prognóstico
12.
P T ; 39(12): 825-32, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25516692

RESUMO

Ceftolozane/tazobactam: a new option in the treatment of complicated gram-negative infections.

13.
JGH Open ; 8(1): e13020, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38268961

RESUMO

Background and Aim: Pediatric non-alcoholic fatty liver disease (NAFLD) is a progressive disorder that is increasing in incidence globally. The study aims to describe the clinical profile and longitudinal outcome, including the utility of vibration-controlled transient elastography (VCTE), in children with NAFLD at a single tertiary liver unit in Singapore. Methods: Retrospective review of patients aged 0-18 years referred for NAFLD from 2003 to 2020 was conducted. Diagnosis was based on persistent elevation of alanine transaminase ≥2× the upper limit of normal in at-risk patients, and/or radiologic detection of hepatic steatosis, with the exclusion of other etiologies. VCTE-derived liver stiffness measurements (LSMs) ≤7.0 , 7.1-9.0, and ≥9.1 kPa were used to differentiate normal (F0-F1), significant fibrosis (F2), and advanced fibrosis (F3-F4), respectively. Results: The study included 210 patients (72.4% male, mean age 11.6 years). New cases increased from 1.7/1000 referrals in 2003-2008 to 12.7 and 24.5/1000 referrals in 2009-2014 and 2015-2020, respectively. Significant proportion had dyslipidemia (41.4%), impaired glucose tolerance/diabetes (IGT/DM, 26.7%), and hypertension (17.1%). Only 6.2% had resolution of NAFLD after a mean follow-up of 3.7 years. Based on VCTE (n = 65), 41.5% had normal LSM, while 26.2% and 32.3% had increased likelihood of significant and advanced fibrosis, respectively. Age ≥16 years (odds ratio [OR] 8.9), IGT/DM (OR 6.5), and aspartate transaminase >70 U/L (OR 11.0) were independent risk factors associated with increased likelihood of advanced fibrosis. Conclusion: Incidence of pediatric NAFLD has increased dramatically in Singapore. Based on LSM estimation, pediatric NAFLD may be associated with an increased risk of developing advanced fibrosis by late adolescence.

14.
Plast Reconstr Surg Glob Open ; 12(4): e5752, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38645632

RESUMO

Background: The goals of reconstruction have progressed from filling a defect to enhancing function and aesthetic appearance. We aimed to achieve better aesthetic and functional outcomes in terms of shoe fitting and mobility. This is accomplished via a classification of the subunits and aesthetic considerations of the lower limb. Methods: Between April 2017 and December 2021, 66 cases of lower extremity free fasciocutaneous flap reconstruction cases were included in this retrospective study. Data parameters include age, sex, comorbidities, etiology of lower limb wounds, choice of free flap reconstruction, recipient arterial vessels, complications of flap reconstruction, and need for secondary debulking procedures. Physiotherapy records were also examined to determine the time to independent ambulation. Results: In total, 66 subjects were identified. The mean age was 48.6. An estimated 74.2% (n = 49) were men, 50% (n = 33) had diabetes, and 16.6% (n = 11) had peripheral vascular disease. Of the total wounds, 65.1% (n = 43) were caused by infection, whereas the remaining 34.9% (n = 23) were due to trauma. Of the cases, 72.7% (n = 48) had free anterolateral thigh flap reconstruction, 25.8% (n = 17) were reconstructed with superficial circumflex iliac artery perforator flaps, and 1.5% (n = 1) was reconstructed with medial sural artery perforator flaps. Cases that required secondary debulking procedures comprised 7.6% (n = 5). Conclusions: Free fasciocutaneous flaps are useful in lower extremity reconstruction. Based on the subunit principle and aesthetic considerations for lower limb reconstruction, it can aid in optimizing functional rehabilitation and decreasing secondary procedures.

15.
J Am Chem Soc ; 135(10): 3997-4006, 2013 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-23432136

RESUMO

5-(Hydroxymethyl)furfural (HMF) and levulinic acid production from glucose in a cascade of reactions using a Lewis acid (CrCl3) catalyst together with a Brønsted acid (HCl) catalyst in aqueous media is investigated. It is shown that CrCl3 is an active Lewis acid catalyst in glucose isomerization to fructose, and the combined Lewis and Brønsted acid catalysts perform the isomerization and dehydration/rehydration reactions. A CrCl3 speciation model in conjunction with kinetics results indicates that the hydrolyzed Cr(III) complex [Cr(H2O)5OH](2+) is the most active Cr species in glucose isomerization and probably acts as a Lewis acid-Brønsted base bifunctional site. Extended X-ray absorption fine structure spectroscopy and Car-Parrinello molecular dynamics simulations indicate a strong interaction between the Cr cation and the glucose molecule whereby some water molecules are displaced from the first coordination sphere of Cr by the glucose to enable ring-opening and isomerization of glucose. Additionally, complex interactions between the two catalysts are revealed: Brønsted acidity retards aldose-to-ketose isomerization by decreasing the equilibrium concentration of [Cr(H2O)5OH](2+). In contrast, Lewis acidity increases the overall rate of consumption of fructose and HMF compared to Brønsted acid catalysis by promoting side reactions. Even in the absence of HCl, hydrolysis of Cr(III) decreases the solution pH, and this intrinsic Brønsted acidity drives the dehydration and rehydration reactions. Yields of 46% levulinic acid in a single phase and 59% HMF in a biphasic system have been achieved at moderate temperatures by combining CrCl3 and HCl.


Assuntos
Ácidos/química , Frutose/química , Furaldeído/análogos & derivados , Glucose/química , Ácidos Levulínicos/síntese química , Catálise , Furaldeído/síntese química , Furaldeído/química , Ácidos Levulínicos/química , Simulação de Dinâmica Molecular , Água/química
16.
BJU Int ; 111(7): 1130-40, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23651425

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of long-acting i.m. testosterone undecanoate (TU) in Malaysian men with testosterone deficiency (TD). PATIENTS AND METHODS: A total of 120 men, aged 40-70 years, with TD (serum total testosterone [TT] ≤ 12 nmol/L) were randomised to receive either i.m. TU (1000 mg) or placebo. In all, 58 and 56 men in the placebo and treatment arm, respectively, completed the study. Participants were seen six times in the 48-week period and the following data were collected: physical examination results, haemoglobin, haematocrit, TT, lipid profile, fasting blood glucose, sex hormone-binding globulin, liver function test, prostate- specific antigen (PSA) and adverse events. RESULTS: The mean (sd) age of the participants was 53.4 (7.6) years. A significant increase in serum TT (P < 0.001), PSA (P = 0.010), haematocrit (P < 0.001), haemoglobin (P < 0.001) and total bilirubin (P = 0.001) were seen in the treatment arm over the 48-week period. Two men in the placebo arm and one man in the treatment arm developed myocardial infarction. Common adverse events observed in the treatment arm included itching/swelling/pain at the site of injection, flushing and acne. Overall, TU injections were well tolerated. CONCLUSIONS: TU significantly increases serum testosterone in men with TD. PSA, haemoglobin and haematocrit were significantly elevated but were within clinically safe limits. There was no significant adverse reaction that led to the cessation of treatment.


Assuntos
Envelhecimento/metabolismo , Androgênios/uso terapêutico , Testosterona/análogos & derivados , Testosterona/sangue , Adulto , Idoso , Androgênios/efeitos adversos , Androgênios/farmacologia , Bilirrubina/sangue , Glicemia/metabolismo , Método Duplo-Cego , Jejum/sangue , Hemoglobinas/metabolismo , Humanos , Injeções Intramusculares/efeitos adversos , Calicreínas/sangue , Lipídeos/sangue , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Exame Físico , Antígeno Prostático Específico/sangue , Globulina de Ligação a Hormônio Sexual/metabolismo , Testosterona/efeitos adversos , Testosterona/deficiência , Testosterona/farmacologia , Testosterona/uso terapêutico , Resultado do Tratamento
17.
Aging Male ; 16(3): 81-4, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23822757

RESUMO

Men's health has gained prominence over the past few years but it is still not on par with the attention or funding that women and child health is getting. In Asia, this issue is even more conspicuous. With westernization of lifestyle, Asian men's problems emulate their Western counterparts but there are certain issues unique to Asian men due to cultural differences. This review will discuss the health issues affecting Asian men and suggest measures that can be taken to overcome them.


Assuntos
Características Culturais , Saúde do Homem , Ásia , Educação em Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino
18.
Radiographics ; 33(4): E149-52, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23842981

RESUMO

The number of imaging-guided percutaneous breast biopsies performed has steadily increased as imaging techniques have improved. Percutaneous biopsy is becoming more commonplace and supplanting excisional biopsy as the preferred diagnostic tool. The radiologist's role in caring for patients who undergo breast biopsy extends beyond imaging to identifying lesions for biopsy and then performing the procedure. Radiologists must also be cognizant of radiologic-pathologic correlation to determine whether biopsy results are concordant with imaging findings and make management recommendations. Management of microcalcifications, masses, and areas of asymmetry begins with recognizing and characterizing the findings with the proper Breast Imaging Reporting and Data System (BI-RADS) lexicon. Determining concordance between imaging findings and histologic results is equally important. The decision to recommend surgical excision or short-term follow-up relies heavily on whether the histologic diagnosis correlates with the imaging findings, a determination that is part of the radiologist's responsibilities if he or she performs the biopsy. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.334125123/-/DC1.


Assuntos
Neoplasias da Mama/patologia , Mama/patologia , Calcinose/patologia , Biópsia Guiada por Imagem/métodos , Mamografia/métodos , Diagnóstico Diferencial , Feminino , Humanos
19.
J Paediatr Child Health ; 49(8): 629-34, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23750995

RESUMO

AIMS: There is a paucity of data on the pattern of intravenous immunoglobulin (IVIG) usage in the paediatric population. This study aimed to assess the prevalence, trends, indications and burden of cost of IVIG usage in the Singaporean paediatric population. METHODS: Pharmacy data of all IVIG prescriptions between 2000 and 2009 in the two major paediatric public hospitals in Singapore were retrospectively reviewed. Each prescription was cross-referenced with the patient's hospital records to confirm the administration of IVIG and indication of use. RESULTS: Over the 10-year period, a total 78,155 g of IVIG valued at an estimated $5.2 million was prescribed. There was an increasing trend of 445.6 g/year (P = 0.02) over this period. Analysis of patients showed that the most common indication for IVIG use was Kawasaki disease, both in terms of the proportion of patients (60%) and amount of IVIG used (34%). Kawasaki disease was also the only indication where there were significant increasing trends in both patient numbers (7.4 patients/year) and amount of IVIG used (247.5 g/year). The indications with the highest amount of IVIG used per patient were for conditions related to primary immunodeficiency diseases and stem cell transplantation, where repeat transfusions were required. More than 75% of indications were Food and Drug Administration approved. CONCLUSION: Albeit substantial and increasing, the use of IVIG in Singaporean children is mostly evidence based.


Assuntos
Uso de Medicamentos/estatística & dados numéricos , Imunoglobulinas Intravenosas/uso terapêutico , Adolescente , Criança , Pré-Escolar , Uso de Medicamentos/economia , Uso de Medicamentos/tendências , Feminino , Hospitais Pediátricos , Hospitais Públicos , Humanos , Imunoglobulinas Intravenosas/efeitos adversos , Imunoglobulinas Intravenosas/economia , Lactente , Masculino , Estudos Retrospectivos , Singapura
20.
Eur J Dent ; 17(3): 673-677, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36307115

RESUMO

OBJECTIVE: This study aimed to develop the Moyers' prediction equation to be used with tooth widths predicting app on smartphone. MATERIALS AND METHODS: Four equations were developed separately for sex and dental arches. Internal validation with Moyers' table was finished. External validation on 37 subjects with agreement test of both Moyers' prediction equations and Moyers' prediction tables was performed. STATISTICAL ANALYSIS: A general linear model procedure was used to create four prediction equations. Internal validation was evaluated using the coefficient of determination. External validation was performed using Bland and Altman (BA) test. RESULTS: Four equations were developed for OrthoAnalysis app on smartphone. The overall coefficient of determination of all equations and prediction table was 0.998 (p < 0.05) indicating good agreement of the two methods. The agreement test on the 37 subjects was that the BA test revealed the BA limits of agreement between the residuals of two predictions was -0.001 mm and ranged from -0.143 to 0.140 mm with almost all plots lying inside this difference interval. CONCLUSIONS: In summary, four novel estimation equations were developed and showed very low difference to the well accepted original Moyers' prediction tables. Therefore, the equations used in the orthodontic app for predicting unerupted tooth width were verified and valid for clinical use.

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