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1.
Radiat Oncol ; 19(1): 86, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38956685

RESUMEN

PURPOSE: To apply an independent GPU-accelerated Monte Carlo (MC) dose verification for CyberKnife M6 with Iris collimator and evaluate the dose calculation accuracy of RayTracing (TPS-RT) algorithm and Monte Carlo (TPS-MC) algorithm in the Precision treatment planning system (TPS). METHODS: GPU-accelerated MC algorithm (ArcherQA-CK) was integrated into a commercial dose verification system, ArcherQA, to implement the patient-specific quality assurance in the CyberKnife M6 system. 30 clinical cases (10 cases in head, and 10 cases in chest, and 10 cases in abdomen) were collected in this study. For each case, three different dose calculation methods (TPS-MC, TPS-RT and ArcherQA-CK) were implemented based on the same treatment plan and compared with each other. For evaluation, the 3D global gamma analysis and dose parameters of the target volume and organs at risk (OARs) were analyzed comparatively. RESULTS: For gamma pass rates at the criterion of 2%/2 mm, the results were over 98.0% for TPS-MC vs.TPS-RT, TPS-MC vs. ArcherQA-CK and TPS-RT vs. ArcherQA-CK in head cases, 84.9% for TPS-MC vs.TPS-RT, 98.0% for TPS-MC vs. ArcherQA-CK and 83.3% for TPS-RT vs. ArcherQA-CK in chest cases, 98.2% for TPS-MC vs.TPS-RT, 99.4% for TPS-MC vs. ArcherQA-CK and 94.5% for TPS-RT vs. ArcherQA-CK in abdomen cases. For dose parameters of planning target volume (PTV) in chest cases, the deviations of TPS-RT vs. TPS-MC and ArcherQA-CK vs. TPS-MC had significant difference (P < 0.01), and the deviations of TPS-RT vs. TPS-MC and TPS-RT vs. ArcherQA-CK were similar (P > 0.05). ArcherQA-CK had less calculation time compared with TPS-MC (1.66 min vs. 65.11 min). CONCLUSIONS: Our proposed MC dose engine (ArcherQA-CK) has a high degree of consistency with the Precision TPS-MC algorithm, which can quickly identify the calculation errors of TPS-RT algorithm for some chest cases. ArcherQA-CK can provide accurate patient-specific quality assurance in clinical practice.


Asunto(s)
Algoritmos , Método de Montecarlo , Órganos en Riesgo , Radiocirugia , Dosificación Radioterapéutica , Planificación de la Radioterapia Asistida por Computador , Humanos , Radiocirugia/métodos , Radiocirugia/instrumentación , Planificación de la Radioterapia Asistida por Computador/métodos , Órganos en Riesgo/efectos de la radiación , Neoplasias/cirugía , Neoplasias/radioterapia , Radioterapia de Intensidad Modulada/métodos , Gráficos por Computador
2.
Cancer Invest ; 42(6): 527-537, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38965994

RESUMEN

Despite the emergence of various treatment strategies for rectal cancer based on neoadjuvant chemoradiotherapy, there is currently a lack of reliable biomarkers to determine which patients will respond well to neoadjuvant chemoradiotherapy. Through collecting hematological and biochemical parameters data of patients prior to receiving neoadjuvant chemoradiotherapy, we evaluated the predictive value of systemic inflammatory indices for pathological response and prognosis in rectal cancer patients. We found that baseline GRIm-Score was an independent predictor for MPR in rectal cancer patients. However, no association was observed between several commonly systemic inflammation indices and long-term outcome.


Asunto(s)
Terapia Neoadyuvante , Neoplasias del Recto , Humanos , Neoplasias del Recto/patología , Neoplasias del Recto/terapia , Neoplasias del Recto/inmunología , Masculino , Femenino , Persona de Mediana Edad , Terapia Neoadyuvante/métodos , Anciano , Quimioembolización Terapéutica/métodos , Pronóstico , Resultado del Tratamiento , Adulto , Quimioradioterapia/métodos
3.
Environ Res ; 260: 119594, 2024 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-39002630

RESUMEN

1-Hexadecene has been detected at a level of mg/L in both influent and effluent of wastewater treatment plants situated in chemical/pharmaceutical industrial parks, which poses a potential threat to the environment. However, few reports are available on aerobic metabolic pathways and microorganisms involved in 1-Hexadecene degradation. In this study, a new strain of 1-Hexadecene-degrading bacteria, Bacillus sp. Hex-HIT36 (HIT36), was isolated from the activated sludge of a wastewater treatment plants located in an industrial park. The physicochemical properties and degradation efficacy of HIT36 were investigated. HIT36 was cultured on a medium containing 1-Hexadecene as a sole carbon source; it was found to remove ∼67% of total organic carbon as confirmed by mass spectrometric analysis of intermediate metabolites. Metabolomic and genomic analysis showed that HIT36 possesses various enzymes, namely, pyruvate dehydrogenase, dihydropolyhydroxyl dehydrogenase, and 2-oxoglutarate-2-oxoiron oxidoreductase (subunit alpha), which assist in the metabolization of readily available carbon source or long chain hydrocarbons present in the growth medium/vicinity. This suggests that HIT36 has efficient long-chain alkane degradation efficacy, and understanding the alkane degradation mechanism of this strain can help in developing technologies for the degradation of long-chain alkanes present in wastewater, thereby assisting in the bioremediation of environment.

5.
Cell ; 2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-38971152

RESUMEN

We identify a population of Protogenin-positive (PRTG+ve) MYChigh NESTINlow stem cells in the four-week-old human embryonic hindbrain that subsequently localizes to the ventricular zone of the rhombic lip (RLVZ). Oncogenic transformation of early Prtg+ve rhombic lip stem cells initiates group 3 medulloblastoma (Gr3-MB)-like tumors. PRTG+ve stem cells grow adjacent to a human-specific interposed vascular plexus in the RLVZ, a phenotype that is recapitulated in Gr3-MB but not in other types of medulloblastoma. Co-culture of Gr3-MB with endothelial cells promotes tumor stem cell growth, with the endothelial cells adopting an immature phenotype. Targeting the PRTGhigh compartment of Gr3-MB in vivo using either the diphtheria toxin system or chimeric antigen receptor T cells constitutes effective therapy. Human Gr3-MBs likely arise from early embryonic RLVZ PRTG+ve stem cells inhabiting a specific perivascular niche. Targeting the PRTGhigh compartment and/or the perivascular niche represents an approach to treat children with Gr3-MB.

6.
Environ Res ; 260: 119592, 2024 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-39002629

RESUMEN

Reactive oxygen species (ROS), substances with strong activity generated by oxygen during electron transfer, play a significant role in the decomposition of organic matter in various environmental settings, including soil, water and atmosphere. Although ROS has a short lifespan (ranging from a few nanoseconds to a few days), it continuously generated during the interaction between microorganisms and their environment, especially in environments characterized by strong ultraviolet radiation, fluctuating oxygen concentration or redox conditions, and the abundance of metal minerals. A comprehensive understanding of the fate of ROS in nature can provide new ideas for pollutant degradation and is of great significance for the development of green degradation technologies for organic pollutants. At present, the review of ROS generally revolves around various advanced oxidation processes, but lacks a description and summary of the fate of ROS in nature, this article starts with the definition of reactive oxidants species and reviews the production, migration, and transformation mechanisms of ROS in soil, water and atmospheric environments, focusing on recent developments. In addition, the stimulating effects of ROS on organisms were reviewed. Conclusively, the article summarizes the classic processes, possible improvements, and future directions for ROS-mediated degradation of pollutants. This review offers suggestions for future research directions in this field and provides the possible ROS technology application in pollutants treatment.

7.
Environ Res ; 260: 119593, 2024 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-39002634

RESUMEN

Both autotrophic and heterotrophic denitrification are known as important bioprocesses of microbe-mediated nitrogen cycle in natural ecosystems. Actually, mixotrophic denitrification co-driven by organic matter and reduced sulfur substances are also common, especially in hypoxic environments such as estuarine sediments. However, carbon, nitrogen and sulfur co-metabolism during mixotrophic denitrification in natural water ecosystems has rarely been reported in detail. Therefore, this study investigated the co-metabolism of carbon, nitrogen and sulfur using samples collected from four distinct natural water ecosystems. Results demonstrated that samples from various sources all exhibited the ability for co-metabolism of carbon, nitrogen and sulfur. Microbial community analysis showed that Pseudomonas and Paracoccus were dominant bacteria ranging from 65.6% to 75.5% in mixotrophic environment. Enterobacter sp. HIT-SHJ4, a mixotrophic denitrifying strain which owned the capacity for co-metabolism of carbon, nitrogen and sulfur, was isolated and reported here for the first time. The strain preferred methanol as its carbon source and demonstrated remarkable efficiency for removing sulfide and nitrate with below 100 mg/L sulfide. Under weak acid conditions (pH 6.5-7.0), it exhibited enhanced capability in converting sulfide to elemental sulfur. Its bioactivity was evident within a temperature from 25 °C to 40 °C and C/N ratios from 0.75 to 3. This study confirmed the widespread presence of microbial-mediated synergistic carbon, nitrogen and sulfur metabolism in natural aquatic ecosystems. HIT-SHJ4 emerges as a novel strain, shedding light on carbon, nitrogen and sulfur co-metabolism in natural water bodies. Furthermore, it also serves as a promising candidate microorganism for in-situ ecological remediation, particularly in dealing with contamination posed by nitrate, sulfide, and organic matter.

8.
Drug Alcohol Rev ; 2024 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-38982724

RESUMEN

INTRODUCTION: This study aimed to investigate the prevalence of different forms of harm from others' drinking (HFOD), predictors and the relationship with multi-dimensional quality of life among young adults in an emerging alcohol market in Asia-Taiwan. METHODS: Data were extracted from a 2018 household survey with national representativeness on substance use experiences. The analytic sample comprised 4901 participants aged 18-34. Eight items were used to measure HFOD experiences. Five-dimensional quality of life was assessed by the EQ-5D-5L. Multivariable regressions with complex survey analyses were performed to estimate the prevalence and risk association. RESULTS: Almost 4.2% of young adults experienced any form of HFOD; psychological harm occurred more prevalently than physical harm (3.7% and 1.5%, respectively). Those aged 25-29 and 30-34 had a two- to three-fold risk of HFOD compared with those aged 18-24. Both non-drunk drinking and drunk drinking were associated with an increased risk of psychological HFOD (adjusted odds ratio 2.36 and 5.89, respectively), whereas the risk of physical HFOD was related only to drunk drinking (adjusted odds ratio 7.8). Psychological HFOD victimisation emerged as the strongest predictor for deteriorated quality of life (adjusted b -0.14; 95% confidence interval -0.24, -0.04), especially in the dimensions of pain/discomfort and anxiety/depression. Among HFOD victims, only 33% sought help. DISCUSSION AND CONCLUSIONS: The HFOD among young adults, commonly exhibited in psychological form, was linked with deteriorated quality of life; nonetheless, young HFOD victims are under-recognised. When devising interventions for alcohol harm, developmental perspectives should be integrated into policies implemented in healthcare and community settings.

9.
Artículo en Inglés | MEDLINE | ID: mdl-38955498

RESUMEN

The development and maturation of follicles is a sophisticated and multistage process. The dynamic gene expression of oocytes and their surrounding somatic cells and the dialogs between these cells are critical to this process. In this study, we accurately classified the oocyte and follicle development into nine stages and profiled the gene expression of mouse oocytes and their surrounding granulosa cells and cumulus cells. The clustering of the transcriptomes showed the trajectories of two distinct development courses of oocytes and their surrounding somatic cells. Gene expression changes precipitously increased at Type 4 stage and drastically dropped afterward within both oocytes and granulosa cells. Moreover, the number of differentially expressed genes between oocytes and granulosa cells dramatically increased at Type 4 stage, most of which persistently passed on to the later stages. Strikingly, cell communications within and between oocytes and granulosa cells became active from Type 4 stage onward. Cell dialogs connected oocytes and granulosa cells in both unidirectional and bidirectional manners. TGFB2/3, TGFBR2/3, INHBA/B, and ACVR1/1B/2B of TGF-ß signaling pathway functioned in the follicle development. NOTCH signaling pathway regulated the development of granulosa cells. Additionally, many maternally DNA methylation- or H3K27me3-imprinted genes remained active in granulosa cells but silent in oocytes during oogenesis. Collectively, Type 4 stage is the key turning point when significant transcription changes diverge the fate of oocytes and granulosa cells, and the cell dialogs become active to assure follicle development. These findings shed new insights on the transcriptome dynamics and cell dialogs facilitating the development and maturation of oocytes and follicles.


Asunto(s)
Células de la Granulosa , Oocitos , Folículo Ovárico , Transcriptoma , Animales , Femenino , Oocitos/metabolismo , Oocitos/crecimiento & desarrollo , Oocitos/citología , Ratones , Células de la Granulosa/metabolismo , Células de la Granulosa/citología , Transcriptoma/genética , Folículo Ovárico/metabolismo , Folículo Ovárico/crecimiento & desarrollo , Folículo Ovárico/citología , Comunicación Celular/genética , Transducción de Señal/genética , Perfilación de la Expresión Génica/métodos , Metilación de ADN/genética , Oogénesis/genética
10.
Angew Chem Int Ed Engl ; : e202412283, 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-39011879

RESUMEN

Circularly polarized electroluminescence (CPEL) is highly promising in realm of 3D display and optical data storage. However, designing a groundbreaking chiral material with high comprehensive CPEL performance remains a formidable challenge. In this work, a pair of chiral polymers with self-assembled behavior is designed by integrating a chiral BN-moiety into polyfluorene backbone, named R-PBN and S-PBN, respectively. The chiral polymers show narrowband emission centered at 490 nm with full-width half maximum (FWHM) of 29 nm and high photoluminescence quantum yield (PLQY) of 79%. After thermal annealing treatment, the chiral polymers undergo self-assembly, exhibiting amplified circularly polarized luminescence (CPL) with asymmetry factor (|glum|) of up to 0.11. Moreover, the solution-processed nondoped CP-OLEDs based on the chiral polymers as emitting layers exhibit maximum external quantum efficiency (EQEmax) of 9.8%, intense CPEL activities with |gEL| of up to 0.07, and small FWHM of 36 nm, simultaneously. This represents the first case of self-assembled chiral polymers that combines high EQE, large gEL value and narrowband emission.

12.
J Clin Med ; 13(12)2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38930008

RESUMEN

Background: This study evaluated early childhood comorbidities of cerebral palsy (CP) in low birth weight (LBW) children and assessed the impact of maternal bio-psychosocial factors on CP risk in preterm infants of varying birth weights (BWs). Methods: Data from 15,181 preterm infants (2009-2013) and 151,810 controls were analyzed using Taiwan's National Health Insurance Research Database. CP prevalence and LBW-associated comorbidities were examined, and odds ratios (ORs) were calculated. Results: This study confirmed increasing prematurity and LBW rates in Taiwan, with LBW infants showing higher CP prevalence. Significant maternal risk factors included age extremes (<20 and >40 years). LBW infants exhibited higher risks for respiratory, circulatory, nervous system, and psycho-developmental comorbidities compared with controls, with the lowest BW having even higher ORs. Maternal factors such as family income, the number of hospital admissions, and length of hospital stay were remarkably correlated with BW and subsequent complications. Each additional gestational week crucially reduced the risk of complications in premature infants. Conclusions: LBW infants are at a higher risk for CP and various comorbidities, with maternal bio-psychosocial factors playing a critical role. Addressing these factors in prenatal care and interventions is essential to improve outcomes for premature infants.

13.
Ann Med ; 56(1): 2362872, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38913594

RESUMEN

RESULTS: Eventually, 108 consecutive patients received 174 surgeries were enrolled, experienced new or expanded infarction occured in 13 (7.47%) surgeries, which showed higher Suzuki stage on the non-operative side, more posterior cerebral artery (PCA) involvement, and more intraoperative hypotension compared to those without infarction(p < .05). The Suzuki stage on the non-operative side had the highest area under the curve (AUC) of 0.737, with a sensitivity of 0.692 and specificity of 0.783. Combination of the three factors showed better efficiency, with an AUC of 0.762, a sensitivity of 0.692, and a specificity of 0.907. CONCLUSIONS: Revascularization was a safe option for patients with MMD, higher Suzuki stage on the non-operative side, PCA involvement, and intraoperative hypotension might be the risk factors for new or expanded infarction after revascularization in patients with MMD.


Asunto(s)
Revascularización Cerebral , Enfermedad de Moyamoya , Humanos , Enfermedad de Moyamoya/cirugía , Enfermedad de Moyamoya/complicaciones , Masculino , Femenino , Factores de Riesgo , Revascularización Cerebral/efectos adversos , Revascularización Cerebral/métodos , Adulto , Persona de Mediana Edad , Adolescente , Adulto Joven , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Arteria Cerebral Posterior/cirugía , Estudios Retrospectivos , Niño , Hipotensión/etiología , Hipotensión/epidemiología , Infarto Cerebral/etiología , Infarto Cerebral/epidemiología
14.
Adv Sci (Weinh) ; : e2404400, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38845189

RESUMEN

Mitogen-activated protein kinase (MAPK) cascade is the center of plant signal transduction system that amplify immune signals into cellular responses by phosphorylating diverse substrates. The MAPK cascade consisting of MAPK kinase kinases (MAPKKKs), MAPK kinases (MAPKKs), and MAPKs is well characterized in plants, in which Raf-like kinases are generally regarded as MAPKKKs. However, it is rarely reported that Raf-like MAPKKKs function as middle regulators to link MAPK and its downstream transcription factors in plant immunity. Verticillium wilt, caused by the soil-borne vascular fungus Verticillium dahliae, is a serious disease in many plants, including cotton. The previous studies showed that GhMPK9 (a MAPK) is involved in the response to Verticillium wilt. Here, the Raf-like kinase GhRAF39_1 is reported as helper regulates the phosphorylation of WRKY transcription factor GhWRKY40a by GhMPK9. The phosphorylated GhWRKY40a can further activate the transcription of GhERF1b to up-regulate defense-related genes while inhibit the transcription of GhABF2 to regulate the stomatal opening, thus improving the resistance to Verticillium wilt in cotton. This study reveals a new signaling module of GhMPK9-GhRAF39_1-GhWRKY40a to regulate GhERF1b- and GhABF2-mediated defense responses, which triggers plant defense against Verticillium wilt.

15.
J Appl Clin Med Phys ; : e14409, 2024 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-38923699

RESUMEN

BACKGROUND: To investigate the effect of the Increment of gantry angle (Inc) parameter setting of the Monaco Treatment planning system (Monaco TPS) on the dosimetry and quality parameters of the volumetric modulated arc therapy (VMAT) program for rectal cancer. METHODS: A retrospective analysis was conducted on 50 patients with rectal cancer who underwent intensity modulated radiation therapy using the Monaco TPS system from 2020 to 2021. Under the same optimization function configuration and other parameter settings, the Inc parameters in the VMAT radiotherapy plan were set to 10°, 20°, 30°, and 40°. The dose-volume histogram (DVH) was used to evaluate the dose distribution of the target area and the radiation dose of the organs at risk (OAR). The differences in the dosimetry of the planning target volume (PTV) and OAR, as well as the gamma pass rate (GPR) were compared. RESULTS: In terms of target dose, D98, Dmin, HI, and conformity index (CI) of Inc10 group was significantly lower than those of Inc20, 30, and 40 groups (P < 0.05), and D2 of Inc10 group was significantly higher than that of Inc20 group (P = 0.009). We also found CI of Inc20 and 30 were significantly better than that of Inc40 (both P < 0.05). In terms of OAR dose, the study found that the Dmean, Dmin, V50%, V45%, and V40% for the bladder of the Inc10 group were lower than those of the other groups (all P < 0.05), the Dmean for femoral head of the Inc20 group was lower than that of the Inc30 group (P < 0.05), and Inc20 showed a better protective effect on the femoral head. The MUs tend to decrease as the Inc parameter setting is increased. The monitor unit (MU) in Inc10 group were significantly higher than those in Inc20, Inc30, and Inc40 groups, and the MU of Inc20 group was significantly higher than that of Inc40 group (both P < 0.05). We found that for the 3%/3 mm and 2%/2 mm standards, the GPRs of each plan were > 90%, which met clinical requirements. CONCLUSIONS: Different settings of Inc parameters have varying degrees of impact on target dose, OAR dose, and machine MU. It is important for doctors to choose different Inc parameters according to different clinical needs.

16.
Angew Chem Int Ed Engl ; : e202409020, 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38899789

RESUMEN

The strategy of integrating conformational isomerization donors and chiral acceptor in single molecule was proposed to construct white circularly polarized luminescence (WCPL) materials in this work. Consequently, a pair of dual-emission enantiomers, namely (R/S)-DO-PTZ, were designed and synthesized, which displayed white emission with blue and yellow dual-emission bands in solution and solid films at Commission Internationale de l'Eclairage (CIE) coordinates of (0.30, 0.33) and (0.33, 0.35), respectively. Meanwhile, (R/S)-DO-PTZ exhibited high PLQY of up to 67% in doped films and obvious mirror-image WCPL signals with |glum| value of 3.0 × 10-3. Moreover, white circularly polarized electroluminescence (WCPEL) based on organic light-emitting diodes (OLEDs) with (R/S)-DO-PTZ as emitters were also achieved with CIE coordinates of (0.32, 0.37) and EQEmax of 4.7%, representing the state-of-the-art level of white OLEDs based on single-molecule purely organic emitters. By optimizing the device structure, warm WCPEL devices were further obtained with |gEL| value of 2.8 × 10-3, CIE coordinates of (0.37, 0.48) and EQEmax of up to 15.6%. To our knowledge, this is the first report of CP-WOLEDs based on single-molecule purely organic emitters.

18.
Harm Reduct J ; 21(1): 109, 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38840179

RESUMEN

BACKGROUND: Drug-involved individuals who contact treatment services in Taiwan are mostly driven by criminal justice systems either as an alternative or adjunct to criminal sanctions for a drug offence. With a focus on justice-involved young female drug users, the present study examines the extent to which socioeconomic and motherhood characteristics are associated with receiving deferred prosecution, a scheme diverting drug offenders to community-based addiction treatment. METHODS: We identified a cohort of 5869 women under the age of 30 arrested for using Schedule II drugs (primarily amphetamine-like stimulants) from the 2011-2017 National Police Criminal Records in Taiwan. Information concerning socioeconomic characteristics, pregnancy and live birth history, and deferred prosecution was obtained through linkage with the 2006-2019 National Health Insurance, birth registration, and deferred prosecution datasets. Multinomial logistic regression was used to evaluate the association with stratification by recidivism status. RESULTS: Within six months of arrest, 21% of first-time offenders (n = 2645) received deferred prosecution and 23% received correction-based rehabilitation; the corresponding estimates for recidivists (n = 3224) were 6% and 15%, respectively. Among first-time offenders, low/unstable income was associated with lower odds of deferred prosecution (adjusted odds ratio [aOR] = 0.71; 95% CI: 0.58, 0.88). For recidivists, those with low/unstable income (aOR = 1.58) or unemployment (aOR = 1.58) had higher odds of correction-based rehabilitation; being pregnant at arrest was linked with reduced odds of deferred prosecution (aOR = 0.31, 95% CI: 0.13, 0.71) and correction-based rehabilitation (aOR = 0.50, 95% CI: 0.32, 0.77). CONCLUSIONS: For the young women arrested for drug offences, disadvantaged socioeconomic conditions were generally unfavored by the diversion to treatment in the community. Childbearing upon arrest may lower not only the odds of receiving medical treatment but also correctional intervention. The criminal prosecution policy and process should be informed by female drug offenders' need for treatment and recovery.


Asunto(s)
Factores Socioeconómicos , Humanos , Femenino , Taiwán/epidemiología , Adulto , Adulto Joven , Estudios Retrospectivos , Embarazo , Adolescente , Madres/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/rehabilitación , Reincidencia/estadística & datos numéricos , Consumidores de Drogas/estadística & datos numéricos , Consumidores de Drogas/legislación & jurisprudencia , Estudios de Cohortes , Servicios Comunitarios de Salud Mental/estadística & datos numéricos , Servicios Comunitarios de Salud Mental/legislación & jurisprudencia
19.
BMC Womens Health ; 24(1): 311, 2024 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-38811924

RESUMEN

INTRODUCTION: Perioperative urinary tract infections (PUTIs) are common in the United States and are a significant contributor to high healthcare costs. There is a lack of large studies on the risk factors for PUTIs after total hysterectomy (TH). METHODS: We conducted a retrospective study using a national inpatient sample (NIS) of 445,380 patients from 2010 to 2019 to analyze the risk factors and annual incidence of PUTIs associated with TH perioperatively. RESULTS: PUTIs were found in 9087 patients overall, showing a 2.0% incidence. There were substantial differences in the incidence of PUTIs based on age group (P < 0.001). Between the two groups, there was consistently a significant difference in the type of insurance, hospital location, hospital bed size, and hospital type (P < 0.001). Patients with PUTIs exhibited a significantly higher number of comorbidities (P < 0.001). Unsurprisingly, patients with PUTIs had a longer median length of stay (5 days vs. 2 days; P < 0.001) and a higher in-hospital death rate (from 0.1 to 1.1%; P < 0.001). Thus, the overall hospitalization expenditures increased by $27,500 in the median ($60,426 vs. $32,926, P < 0.001) as PUTIs increased medical costs. Elective hospitalizations are less common in patients with PUTIs (66.8% vs. 87.6%; P < 0.001). According to multivariate logistic regression study, the following were risk variables for PUTIs following TH: over 45 years old; number of comorbidities (≥ 1); bed size of hospital (medium, large); teaching hospital; region of hospital(south, west); preoperative comorbidities (alcohol abuse, deficiency anemia, chronic blood loss anemia, congestive heart failure, diabetes, drug abuse, hypertension, hypothyroidism, lymphoma, fluid and electrolyte disorders, metastatic cancer, other neurological disorders, paralysis, peripheral vascular disorders, psychoses, pulmonary circulation disorders, renal failure, solid tumor without metastasis, valvular disease, weight loss); and complications (sepsis, acute myocardial infarction, deep vein thrombosis, gastrointestinal hemorrhage, pneumonia, stroke, wound infection, wound rupture, hemorrhage, pulmonary embolism, blood transfusion, postoperative delirium). CONCLUSIONS: The findings suggest that identifying these risk factors can lead to improved preventive strategies and management of PUTIs in TH patients. Counseling should be done prior to surgery to reduce the incidence of PUTIs. THE MANUSCRIPT ADDS TO CURRENT KNOWLEDGE: In medical practice, the identification of risk factors can lead to improved patient prevention and treatment strategies. We conducted a retrospective study using a national inpatient sample (NIS) of 445,380 patients from 2010 to 2019 to analyze the risk factors and annual incidence of PUTIs associated with TH perioperatively. PUTIs were found in 9087 patients overall, showing a 2.0% incidence. We found that noted increased length of hospital stay, medical cost, number of pre-existing comorbidities, size of the hospital, teaching hospitals, and region to also a play a role in the risk of UTI's. CLINICAL TOPICS: Urogynecology.


Asunto(s)
Histerectomía , Complicaciones Posoperatorias , Infecciones Urinarias , Humanos , Femenino , Estudios Retrospectivos , Infecciones Urinarias/epidemiología , Infecciones Urinarias/etiología , Histerectomía/efectos adversos , Histerectomía/estadística & datos numéricos , Factores de Riesgo , Persona de Mediana Edad , Incidencia , Adulto , Complicaciones Posoperatorias/epidemiología , Estados Unidos/epidemiología , Anciano , Tiempo de Internación/estadística & datos numéricos , Periodo Perioperatorio/estadística & datos numéricos
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