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2.
Phys Rev Lett ; 128(11): 112503, 2022 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-35363014

RESUMO

We have measured the 3d→2p transition x rays of kaonic ^{3}He and ^{4}He atoms using superconducting transition-edge-sensor microcalorimeters with an energy resolution better than 6 eV (FWHM). We determined the energies to be 6224.5±0.4(stat)±0.2(syst) eV and 6463.7±0.3(stat)±0.1(syst) eV, and widths to be 2.5±1.0(stat)±0.4(syst) eV and 1.0±0.6(stat)±0.3(stat) eV, for kaonic ^{3}He and ^{4}He, respectively. These values are nearly 10 times more precise than in previous measurements. Our results exclude the large strong-interaction shifts and widths that are suggested by a coupled-channel approach and agree with calculations based on optical-potential models.

3.
Biomed Pharmacother ; 145: 112436, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34813998

RESUMO

Disruption or loss of oligodendrocytes (OLs) and myelin has devastating effects on CNS function and integrity, which occur in diverse neurological disorders, including Multiple Sclerosis (MS), Alzheimer's disease and neuropsychiatric disorders. Hence, there is a need to develop new therapies that promote oligodendrocyte regeneration and myelin repair. A promising approach is drug repurposing, but most agents have potentially contrasting biological actions depending on the cellular context and their dose-dependent effects on intracellular pathways. Here, we have used a combined systems biology and neurobiological approach to identify compounds that exert positive and negative effects on oligodendroglia, depending on concentration. Notably, next generation pharmacogenomic analysis identified the PI3K/Akt modulator LY294002 as the most highly ranked small molecule with both pro- and anti-oligodendroglial concentration-dependent effects. We validated these in silico findings using multidisciplinary approaches to reveal a profoundly bipartite effect of LY294002 on the generation of OPCs and their differentiation into myelinating oligodendrocytes in both postnatal and adult contexts. Finally, we employed transcriptional profiling and signalling pathway activity assays to determine cell-specific mechanisms of action of LY294002 on oligodendrocytes and resolve optimal in vivo conditions required to promote myelin repair. These results demonstrate the power of multidisciplinary strategies in determining the therapeutic potential of small molecules in neurodegenerative disorders.


Assuntos
Cromonas/farmacologia , Morfolinas/farmacologia , Bainha de Mielina/efeitos dos fármacos , Oligodendroglia/efeitos dos fármacos , Animais , Diferenciação Celular/efeitos dos fármacos , Cromonas/administração & dosagem , Simulação por Computador , Relação Dose-Resposta a Droga , Sequenciamento de Nucleotídeos em Larga Escala , Camundongos , Camundongos Endogâmicos C57BL , Morfolinas/administração & dosagem , Bainha de Mielina/metabolismo , Farmacogenética , Transdução de Sinais/efeitos dos fármacos , Biologia de Sistemas
4.
Eur Phys J Plus ; 136(11): 1179, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34849324

RESUMO

This paper is devoted to a study of the fuzzy fractional mathematical model reviewing the transmission dynamics of the infectious disease Covid-19. The proposed dynamical model consists of susceptible, exposed, symptomatic, asymptomatic, quarantine, hospitalized, and recovered compartments. In this study, we deal with the fuzzy fractional model defined in Caputo's sense. We show the positivity of state variables that all the state variables that represent different compartments of the model are positive. Using Gronwall inequality, we show that the solution of the model is bounded. Using the notion of the next-generation matrix, we find the basic reproduction number of the model. We demonstrate the local and global stability of the equilibrium point by using the concept of Castillo-Chavez and Lyapunov theory with the Lasalle invariant principle, respectively. We present the results that reveal the existence and uniqueness of the solution of the considered model through the fixed point theorem of Schauder and Banach. Using the fuzzy hybrid Laplace method, we acquire the approximate solution of the proposed model. The results are graphically presented via MATLAB-17.

6.
Nanoscale Res Lett ; 16(1): 56, 2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33825981

RESUMO

Various concentrations (0.01, 0.03 and 0.05 wt ratios) of graphene oxide (GO) nanosheets were doped into magnesium oxide (MgO) nanostructures using chemical precipitation technique. The objective was to study the effect of GO dopant concentrations on the catalytic and antibacterial behavior of fixed amount of MgO. XRD technique revealed cubic phase of MgO, while its crystalline nature was confirmed through SAED profiles. Functional groups presence and Mg-O (443 cm-1) in fingerprint region was evident with FTIR spectroscopy. Optical properties were recorded via UV-visible spectroscopy with redshift pointing to a decrease in band gap energy from 5.0 to 4.8 eV upon doping. Electron-hole recombination behavior was examined through photoluminescence (PL) spectroscopy. Raman spectra exhibited D band (1338 cm-1) and G band (1598 cm-1) evident to GO doping. Formation of nanostructure with cubic and hexagon morphology was confirmed with TEM, whereas interlayer average d-spacing of 0.23 nm was assessed using HR-TEM. Dopants existence and evaluation of elemental constitution Mg, O were corroborated using EDS technique. Catalytic activity against methyl blue ciprofloxacin (MBCF) was significantly reduced (45%) for higher GO dopant concentration (0.05), whereas bactericidal activity of MgO against E. coli was improved significantly (4.85 mm inhibition zone) upon doping with higher concentration (0.05) of GO, owing to the formation of nanorods.

7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5761-5764, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019283

RESUMO

Nowadays objective and efficient assessment of Parkinson Disease (PD) with machine learning techniques is a major focus for clinical management. This work presents a novel approach for classification of patients with PD (PwPD) and healthy controls (HC) using Bidirectional Long Short-Term Neural Network (BLSTM). In this paper, the SensHand and the SensFoot inertial wearable sensors for upper and lower limbs motion analysis were used to acquire motion data in thirteen tasks derived from the MDS-UPDRS III. Sixty-four PwPD and fifty HC were involved in this study. One hundred ninety extracted spatiotemporal and frequency parameters were applied as a single input against each subject to develop a recurrent BLSTM to discriminate the two groups. The maximum achieved accuracy was 82.4%, with the sensitivity of 92.3% and specificity of 76.2%. The obtained results suggest that the use of the extracted parameters for the development of the BLSTM contributed significantly to the classification of PwPD and HC.


Assuntos
Doença de Parkinson , Humanos , Aprendizado de Máquina , Memória de Curto Prazo , Redes Neurais de Computação , Sensibilidade e Especificidade
8.
Public Health ; 189: 6-11, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33126120

RESUMO

OBJECTIVES: The impact of COVID-19 upon acute care admission rates and patterns are unknown. We sought to determine the change in rates and types of admissions to tertiary and specialty care hospitals in the COVID-19 era compared with pre-COVID-19 era. METHODS: Acute care admissions to the largest tertiary care referral hospital, designated national referral centers for cardiac, cancer and maternity hospital in the State of Qatar during March 2020 (COVID-19 era) and January 2020 and March 2019 (pre-COVID-19 era) were compared. We calculated total admissions, admissions for eight specific acute care conditions, in-hospital mortality rate, and length of stay at each hospital. RESULTS: A total of 18,889 hospital admissions were recorded. A sharp decline ranging from 9% to 75% was observed in overall admissions. A decline in both elective and non-elective surgeries was observed. A decline of 9%-58% was observed in admissions for acute appendicitis, acute coronary syndrome, stroke, bone fractures, cancer, and live births, whereas an increase in admissions due to respiratory tract infections was observed. Overall length of stay was shorter in the COVID-19 period possibly suggesting lesser overall disease severity, with no significant change in in-hospital mortality. Unadjusted mortality rate for Qatar showed marginal increase in the COVID-19 period. CONCLUSIONS: We observed a sharp decline in acute care hospital admissions, with a significant decline in admissions due to seven out of eight acute care conditions. This decline was associated with a shorter length of stay but not associated with a change in in-hospital mortality rate.


Assuntos
Doença Aguda/epidemiologia , COVID-19/epidemiologia , Mortalidade Hospitalar/tendências , Hospitalização/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , SARS-CoV-2 , Cuidados Críticos , Feminino , Humanos , Masculino , Catar/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos
9.
HIV Med ; 20(5): 317-329, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30924577

RESUMO

OBJECTIVES: The contribution of depression to mortality in adults with and without HIV infection is unclear. We hypothesized that depression increases mortality risk and that this association is stronger among those with HIV infection. METHODS: Veterans Aging Cohort Study (VACS) data were analysed from the first clinic visit on or after 1 April 2003 (baseline) to 30 September 2015. Depression definitions were: (1) major depressive disorder defined using International Classification of Diseases, Ninth Revision (ICD-9) codes; (2) depressive symptoms defined as Patient Health Questionnaire (PHQ)-9 scores ≥ 10. The outcome was all-cause mortality. Covariates were demographics, comorbid conditions and health behaviours. RESULTS: Among 129 140 eligible participants, 30% had HIV infection, 16% had a major depressive disorder diagnosis, and 24% died over a median follow-up time of 11 years. The death rate was 25.3 [95% confidence interval (CI) 25.0-25.6] deaths per 1000 person-years. Major depressive disorder was associated with mortality [hazard ratio (HR) 1.04; 95% CI 1.01, 1.07]. This association was modified by HIV status (interaction P-value = 0.02). In HIV-stratified analyses, depression was significantly associated with mortality among HIV-uninfected veterans but not among those with HIV infection. Among those with PHQ-9 data (n = 7372), 50% had HIV infection, 22% had PHQ-9 scores ≥ 10, and 28% died over a median follow-up time of 12 years. The death rate was 27.3 (95% CI 26.1-28.5) per 1000 person-years. Depressive symptoms were associated with mortality (HR 1.16; 95% CI 1.04, 1.28). This association was modified by HIV status (interaction P-value = 0.05). In HIV-stratified analyses, depressive symptoms were significantly associated with mortality among veterans with HIV infection but not among those without HIV infection. CONCLUSIONS: Depression was associated with all-cause mortality. This association was modified by HIV status and method of depression ascertainment.


Assuntos
Transtorno Depressivo Maior/epidemiologia , Infecções por HIV/mortalidade , Veteranos/psicologia , Adulto , Estudos de Casos e Controles , Feminino , Infecções por HIV/psicologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Mortalidade , Estudos Prospectivos , Estados Unidos/epidemiologia
10.
Front Med (Lausanne) ; 6: 334, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32010704

RESUMO

Inflammatory Bowel Diseases (IBD) are difficult to model as freshly acquired tissues are short-lived, provide data as a snapshot in time, and are not always accessible. Many patients with IBD are non-responders to first-line treatments, and responders are prone to developing resistance to treatment over time-resulting in reduced patient quality of life, increased time to remission, and potential relapse. IBD is heterogenous and we are yet to fully understand the mechanisms of disease; thus, our ability to diagnose and prescribe optimal treatment remains ineffective. Intestinal organoids are derived from patient tissues expanded in vitro. Organoids offer unique insight into individual patient disease and are a potential route to personalized treatments. However, organoid models do not contain functional microbial and immune cell components. In this review, we discuss immune cell subsets in the context of IBD, and the requirement of immune cell and microbial components in organoid models for IBD research.

11.
Biomed Eng Online ; 17(1): 168, 2018 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-30419916

RESUMO

BACKGROUND: The main objective of this paper is to develop and test the ability of the Leap Motion controller (LMC) to assess the motor dysfunction in patients with Parkinson disease (PwPD) based on the MDS-UPDRSIII exercises. Four exercises (thumb forefinger tapping, hand opening/closing, pronation/supination, postural tremor) were used to evaluate the characteristics described in MDS-UPDRSIII. Clinical ratings according to the MDS/UPDRS-section III items were used as target. For that purpose, 16 participants with PD and 12 healthy people were recruited in Ospedale Cisanello, Pisa, Italy. The participants performed standardized hand movements with camera-based marker. Time and frequency domain features related to velocity, angle, amplitude, and frequency were derived from the LMC data. RESULTS: Different machine learning techniques were used to classify the PD and healthy subjects by comparing the subjective scale given by neurologists against the predicted diagnosis from the machine learning classifiers. Feature selection methods were used to choose the most significant features. Logistic regression (LR), naive Bayes (NB), and support vector machine (SVM) were trained with tenfold cross validation with selected features. The maximum obtained classification accuracy with LR was 70.37%; the average area under the ROC curve (AUC) was 0.831. The obtained classification accuracy with NB was 81.4%, with AUC of 0.811. The obtained classification accuracy with SVM was 74.07%, with AUC of 0.675. CONCLUSIONS: Results revealed that the system did not return clinically meaningful data for measuring postural tremor in PwPD. In addition, it showed limited potential to measure the forearm pronation/supination. In contrast, for finger tapping and hand opening/closing, the derived parameters showed statistical and clinical significance. Future studies should continue to validate the LMC as updated versions of the software are developed. The obtained results support the fact that most of the set of selected features contributed significantly to classify the PwPD and healthy subjects.


Assuntos
Doença de Parkinson/diagnóstico por imagem , Processamento de Sinais Assistido por Computador , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Teorema de Bayes , Exercício Físico , Feminino , Dedos/fisiopatologia , Mãos , Humanos , Itália , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Movimento (Física) , Destreza Motora , Doença de Parkinson/classificação , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Software , Máquina de Vetores de Suporte , Tremor/fisiopatologia
12.
Aliment Pharmacol Ther ; 48(1): 35-43, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29797514

RESUMO

BACKGROUND: Chronic kidney disease (CKD) was a relative contraindication to hepatitis C virus (HCV) treatment in the interferon/ribavirin era. AIM: To determine the efficacy, tolerability and safety of sofosbuvir/ledipasvir (SOF/LDV) and paritaprevir/ritonavir/ombitasvir/dasabuvir (PrOD) regimens in persons with CKD. METHODS: We identified persons initiated on a SOF/LDV or PrOD regimen from October 30, 2014 to April 30, 2016. We excluded those with missing HCV genotype or eGFR values. We determined treatment completion and sustained virologic response (SVR) rates, and proportion developing worsening renal function or grade 3/4 haematologic toxicity. RESULTS: Among 13 663 persons on SOF/LDV±ribavirin, 14% and 1% persons had CKD Stage 3 and 4-5 respectively, 67.8% completed treatment, 98.2% achieved SVR. Treatment completion or SVR rates did not decline with advanced CKD or ribavirin administration. Among 3961 persons on PrOD±ribavirin, 9% and 3% persons had CKD Stage 3 and 4-5, respectively, 74.0% completed treatment and 98.2% achieved SVR. A decrease in treatment completion rates was seen in CKD stage 4-5 and those on ribavirin, but this did not impact SVR rates. A >10 mL/min/1.73 m2 drop in eGFR from baseline was observed in 30%-38% of persons with baseline eGFR ≥60 mL/min/1.73 m2 , but in only 0%-6% with CKD4-5. Grade 3/4 anaemia was more frequent in persons with CKD4-5, but ribavirin co-administration did not appear to affect this. CONCLUSIONS: SOF/LDV and PrOD achieved high SVR rates in CKD population. Treatment completion rates were lower than expected. A decline in eGFR and development of anaemia were observed in a substantial proportion of persons, but the clinical implications remain unclear.


Assuntos
Anilidas/administração & dosagem , Benzimidazóis/administração & dosagem , Carbamatos/administração & dosagem , Fluorenos/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Compostos Macrocíclicos/administração & dosagem , Insuficiência Renal Crônica/tratamento farmacológico , Ritonavir/administração & dosagem , Sulfonamidas/administração & dosagem , Uracila/análogos & derivados , Uridina Monofosfato/análogos & derivados , 2-Naftilamina , Idoso , Anilidas/efeitos adversos , Antivirais/uso terapêutico , Benzimidazóis/efeitos adversos , Carbamatos/efeitos adversos , Estudos de Casos e Controles , Ciclopropanos , Quimioterapia Combinada , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Fluorenos/efeitos adversos , Taxa de Filtração Glomerular/efeitos dos fármacos , Hepatite C Crônica/complicações , Hepatite C Crônica/epidemiologia , Humanos , Lactamas Macrocíclicas , Compostos Macrocíclicos/efeitos adversos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Prolina/análogos & derivados , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/virologia , Estudos Retrospectivos , Ritonavir/efeitos adversos , Sofosbuvir , Sulfonamidas/efeitos adversos , Resposta Viral Sustentada , Resultado do Tratamento , Uracila/administração & dosagem , Uracila/efeitos adversos , Uridina Monofosfato/administração & dosagem , Uridina Monofosfato/efeitos adversos , Valina
13.
J Viral Hepat ; 25(7): 825-833, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29478294

RESUMO

Recent preclinical studies have suggested an antifibrotic role for tricyclic antidepressants (TCA). Using the Electronically Retrieved Cohort of hepatitis C virus (HCV) Infected Veterans, we aimed to evaluate the impact of TCA use on fibrosis progression and development of hepatocellular carcinoma (HCC) among HCV-infected persons. Subjects were categorized according to use of TCAs, selective serotonin reuptake inhibitors (SSRI) or no antidepressants. TCAs or selective serotonin uptake inhibitors use was defined according to cumulative defined daily dose (cDDD), and categories were mutually exclusive. Subjects with HIV coinfection, hepatitis B surface antigen (HbsAg) positivity, cirrhosis or HCC at baseline were excluded. Outcomes were liver fibrosis progression measured by APRI scores and incident HCC. We utilized Cox proportional hazards regression to determine predictors of cirrhosis, defined as APRI > 2, and incident hepatocellular carcinoma (iHCC). Among 128 201 eligible HCV+ persons, 4% received TCAs, 43% received selective serotonin uptake inhibitors, and 53% received no antidepressants. Fewer TCAs users had drug abuse (34% and 43%) and alcohol abuse (32% vs 42%) compared to selective serotonin uptake inhibitor users. After adjusting for age, baseline APRI score, diabetes, hypertension, alcohol use, drug abuse and HCV RNA levels, TCAs use was associated with decreased risk of cirrhosis (hazard ratio [HR] = 0.77, 95% CI = 0.60, 0.99) and delayed time to development of cirrhosis, but not with decreased iHCC. In conclusion among a large cohort of HCV-positive Veterans, TCAs use was associated with decreased fibrosis progression and lower risk of developing cirrhosis. These data provide supportive evidence for the beneficial effects of TCAs on progression of liver fibrosis in patients with chronic HCV infection.


Assuntos
Antidepressivos Tricíclicos/uso terapêutico , Depressão/tratamento farmacológico , Hepatite C Crônica/complicações , Cirrose Hepática/epidemiologia , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/prevenção & controle , Coinfecção/complicações , Feminino , Infecções por HIV/complicações , Antígenos de Superfície da Hepatite B/sangue , Hepatite B Crônica/complicações , Humanos , Incidência , Cirrose Hepática/complicações , Cirrose Hepática/prevenção & controle , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco
14.
Surgeon ; 16(2): 82-88, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27908542

RESUMO

BACKGROUND: Informed consent is an essential component of medical practice, and especially so in procedural based specialties which entail varying degrees of risk. Breast cancer is one of the most common cancers in women, and as such is the focus of extensive research and significant media attention. Despite this, considerable misperception exists regarding the risk of developing breast cancer. AIMS: This study aims to examine the accuracy of risk perception of women attending a breast cancer family history clinic, and to explore the relationship between risk perception accuracy and health literacy. METHODS: A cross-sectional study of women attending a breast cancer family history clinic (n = 86) was carried out, consisting of a patient survey and a validated health literacy assessment. Patients' perception of personal and population breast cancer risk was compared to actual risk as calculated by a validated risk assessment tool. RESULTS: Significant discordance between real and perceived risks was observed. The majority (83.7%) of women overestimated their personal lifetime risk of developing breast cancer, as well as that of other women of the same age (89.5%). Health literacy was considered potentially inadequate in 37.2% of patients; there was a correlation between low health literacy and increased risk perception inaccuracy across both personal ten-year (rs = 0.224, p = 0.039) and general ten-year population estimations. (rs = 0.267, p = 0.013). CONCLUSION: Inaccuracy in risk perception is highly prevalent in women attending a breast cancer family history clinic. Health literacy inadequacy is significantly associated with this inaccuracy.


Assuntos
Neoplasias da Mama/psicologia , Doenças Genéticas Inatas/psicologia , Letramento em Saúde/estatística & dados numéricos , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Neoplasias da Mama/epidemiologia , Feminino , Doenças Genéticas Inatas/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Irlanda/epidemiologia , Percepção , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco
15.
Aliment Pharmacol Ther ; 47(3): 412-420, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29181838

RESUMO

BACKGROUND: Higher risk of hepatitis B reactivation (HBV-r) has been reported in patients with hepatitis C treated with newer directly acting antiviral agents (DAAs). AIM: To determine the proportion of persons who develop HBV-r and its clinical consequences among DAA treated vs pegylated interferon/ribavirin (PEG/RBV) treated persons. METHODS: We calculated the proportion of persons who developed HBV viral reactivation (HBV-r; new detectable HBV DNA or increase of >1 log10 ); serum alanine aminotransferase flare (>5 times baseline); all-cause mortality and hepatic decompensation in persons treated with a newer DAA regimen or PEG/RBV. Kaplan-Meier curves were used to demonstrate survival and hepatic decompensation by treatment group and HBV-r. RESULTS: In 34 632 persons treated with DAA and 23 475 treated with PEG/RBV, HBV-r rate per 1000 person-years was 30.04 (10.41, 49.67) and 25.42 (95% CI 17.23, 33.62) respectively (P = .8). When stratified by SVR or by baseline HBsAg status, HBV-r was not different between groups. Kaplan-Meier survival curves comparing each regimen stratified by presence or absence of HBV-r did not demonstrate a significant difference in incidence of hepatic decompensation over time. For overall survival, there was no difference between PEG/RBV treated persons with or without HBV-r. For DAA treated persons, those with HBV-r had a shortened survival, though the numbers at risk were small. CONCLUSIONS: HBV-r is relatively uncommon after DAA therapy and not higher than among those treated with a PEG/RBV regimen. The small numbers of persons treated with a DAA regimen who do develop HBV-r have a shortened survival compared to those without HBV-r.


Assuntos
Antivirais/uso terapêutico , Hepacivirus/efeitos dos fármacos , Vírus da Hepatite B/efeitos dos fármacos , Hepatite B/induzido quimicamente , Hepatite C/tratamento farmacológico , Ativação Viral/efeitos dos fármacos , Idoso , Coinfecção/tratamento farmacológico , Coinfecção/epidemiologia , Feminino , Hepatite B/complicações , Hepatite B/epidemiologia , Hepatite B/virologia , Vírus da Hepatite B/fisiologia , Hepatite C/complicações , Hepatite C/epidemiologia , Hepatite C/virologia , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/epidemiologia , Hepatite C Crônica/virologia , Humanos , Incidência , Interferon-alfa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ribavirina/uso terapêutico
16.
Aliment Pharmacol Ther ; 47(2): 246-258, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29105111

RESUMO

BACKGROUND: Proton pump inhibitors are among the most commonly prescribed medications in the United States. Their safety in cirrhosis has recently been questioned, but their overall effect on disease progression in noncirrhotic patients with chronic liver disease remains unclear. AIM: To determine the impact of proton pump inhibitors on the progression of liver disease in noncirrhotic patients with hepatitis C virus (HCV) infection. METHODS: Using the electronically retrieved cohort of HCV-infected veterans (ERCHIVES) database, we identified all subjects who received HCV treatment and all incident cases of cirrhosis, hepatic decompensation and hepatocellular carcinoma. Proton pump inhibitor use was measured using cumulative defined daily dose. Multivariate Cox regression analysis was performed after adjusting univariate predictors of cirrhosis and various indications for proton pump inhibitor use. RESULTS: Among 11 526 eligible individuals, we found that exposure to proton pump inhibitors was independently associated with an increased risk of developing cirrhosis (hazard ratio [HR]: 1.32; 95% confidence interval: [1.17, 1.49]). This association remained robust to sensitivity analysis in which only patients who achieved sustained virologic response were analysed as well as analysis excluding those with alcohol abuse/dependence. Proton pump inhibitor exposure was also independently associated with an increased risk of hepatic decompensation (HR: 3.79 [2.58, 5.57]) and hepatocellular carcinoma (HR: 2.01 [1.50, 2.70]). CONCLUSIONS: In patients with chronic HCV infection, increasing proton pump inhibitor use is associated with a dose-dependent risk of progression of chronic liver disease to cirrhosis, as well as an increased risk of hepatic decompensation and hepatocellular carcinoma.


Assuntos
Carcinoma Hepatocelular/epidemiologia , Hepatite C Crônica/tratamento farmacológico , Cirrose Hepática/epidemiologia , Falência Hepática/epidemiologia , Neoplasias Hepáticas/epidemiologia , Inibidores da Bomba de Prótons/uso terapêutico , Adulto , Idoso , Carcinoma Hepatocelular/etiologia , Estudos de Coortes , Bases de Dados Factuais , Progressão da Doença , Feminino , Hepacivirus/fisiologia , Hepatite C Crônica/complicações , Hepatite C Crônica/epidemiologia , Humanos , Cirrose Hepática/etiologia , Falência Hepática/etiologia , Neoplasias Hepáticas/etiologia , Masculino , Pessoa de Meia-Idade , Inibidores da Bomba de Prótons/efeitos adversos , Resposta Viral Sustentada , Estados Unidos/epidemiologia , Veteranos/estatística & dados numéricos
17.
Arq. bras. med. vet. zootec. (Online) ; 69(5): 1172-1180, set.-out. 2017. tab
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-877357

RESUMO

Fecal samples were collected from 120 domestic pigeons to determine the Attributable risk of Capillaria spp. The Capillaria spp. was observed in 64 out of 120 (51%) pigeons (70 males and 50 females) under this study. A total of 64 (39 males and 25 females) were found naturally infected with Capillaria spp. with infection percentage of 51% and 50% in males and females respectively. Qualitative examinations include the direct microscopy and faecal floatation while quantitative examination includes McMaster technique (worms load was calculated per gram of the faeces). Month wise Attributable risk showed that eggs of the worms were found to be abundant in the month of July during the present study (60% to 73%) because of high humidity. Very high and very low temperature is not suitable for the proper development of the eggs. Qualitative and quantitative examination revealed that Capillaria spp. was more prevalent in males (51%) than females (50%) but overall there was no significant difference (P>0.05) in the male and female because both individuals invest equal amount of energy in search of food and incubating the eggs. Different breeds of pigeons gave different Attributable risk in different months during the study. Groups of pigeons from different locations showed different variable Attributable risk. Areas with high humidity were more suitable for the development of eggs, which is the reason why higher Attributable risk was observed in Shahdara (75%) area of Lahore, Pakistan.(AU)


Amostras de fezes foram coletadas de 120 pombos domésticos para determinar os fatores de risco de Capillaria spp. Capillaria spp. foi observado em 64 de 120 (51%) pombos (70 machos e 50 fêmeas) neste estudo. Um total de 64 (39 machos e 25 fêmeas) foram naturalmente infectados com Capillaria spp. sendo 51% em machos e 50% em fêmeas. Exames qualitativos incluem microscopia direta e suspensão de fezes, e exames quantitativos incluem a técnica McMaster (vermes são calculados por grama de fezes). O risco por mês demonstrou que ovos dos vermes foram encontrados em abundância no mês de Julho durante o presente estudo (60% a 73%) por causa da alta umidade. Temperaturas muito altas e muito baixas não são adequadas para o desenvolvimento adequado de ovos. O exame qualitativo e quantitativo revelou que Capillaria spp. era mais prevalente em machos (51%) que em fêmeas (50%), mas no geral não houve diferença significativa (P>0.05) entre machos e fêmeas porque ambos investem a mesma energia na busca por alimento e incubação de ovos. Diferentes raças de pombos tem diferentes riscos em diferentes meses durante o estudo. Grupos de pombos de diferentes locais demonstraram risco diferenciado. Áreas com alta umidade eram mais propensas para o desenvolvimento de ovos, o motivo pelo qual maior risco foi observado em shahdara (75%).(AU)


Assuntos
Animais , Risco Atribuível , Capillaria , Columbidae/parasitologia , Paquistão
18.
Hepatol Int ; 11(5): 461-471, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28856540

RESUMO

BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is a progressive disease associated with rapid clinical worsening and high mortality. Early prediction of mortality and intervention can improve patient outcomes. We aimed to develop a dynamic prognostic model and compare it with the existing models. METHODS: A total of 1402 ACLF patients, enrolled in the APASL-ACLF Research Consortium (AARC) with 90-day follow-up, were analyzed. An ACLF score was developed in a derivation cohort (n = 480) and was validated (n = 922). RESULTS: The overall survival of ACLF patients at 28 days was 51.7%, with a median of 26.3 days. Five baseline variables, total bilirubin, creatinine, serum lactate, INR and hepatic encephalopathy, were found to be independent predictors of mortality, with AUROC in derivation and validation cohorts being 0.80 and 0.78, respectively. AARC-ACLF score (range 5-15) was found to be superior to MELD and CLIF SOFA scores in predicting mortality with an AUROC of 0.80. The point scores were categorized into grades of liver failure (Gr I: 5-7; II: 8-10; and III: 11-15 points) with 28-day cumulative mortalities of 12.7, 44.5 and 85.9%, respectively. The mortality risk could be dynamically calculated as, with each unit increase in AARC-ACLF score above 10, the risk increased by 20%. A score of ≥11 at baseline or persisting in the first week was often seen among nonsurvivors (p = 0.001). CONCLUSIONS: The AARC-ACLF score is easy to use, dynamic and reliable, and superior to the existing prediction models. It can reliably predict the need for interventions, such as liver transplant, within the first week.


Assuntos
Insuficiência Hepática Crônica Agudizada/mortalidade , Escores de Disfunção Orgânica , Humanos , Prognóstico , Sensibilidade e Especificidade , Análise de Sobrevida
19.
IEEE Int Conf Rehabil Robot ; 2017: 116-121, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28813804

RESUMO

The main goal of this study is to investigate the potential of the Leap Motion Controller (LMC) for the objective assessment of motor dysfunctioning in patients with Parkinson's disease (PwPD). The most relevant clinical signs in Parkinson's Disease (PD), such as slowness of movements, frequency variation, amplitude variation, and speed, were extracted from the recorded LMC data. Data were clinically quantified using the LMC software development kit (SDK). In this study, 16 PwPD subjects and 12 control healthy subjects were involved. A neurologist assessed the subjects during the task execution, assigning them a score according to the MDS/UPDRS-Section III items. Features of motor performance from both subject groups (patients and healthy controls) were extracted with dedicated algorithms. Furthermore, to find out the significance of such features from the clinical point of view, machine learning based methods were used. Overall, our findings showed the moderate potential of LMC to extract the motor performance of PwPD.


Assuntos
Mãos/fisiopatologia , Destreza Motora/fisiologia , Doença de Parkinson/fisiopatologia , Idoso , Algoritmos , Estudos de Casos e Controles , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/diagnóstico , Software , Extremidade Superior/fisiopatologia
20.
Am J Transplant ; 17(7): 1823-1832, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28497525

RESUMO

New federal regulations allow HIV-positive individuals to be live kidney donors; however, potential candidacy for donation is poorly understood given the increased risk of end-stage renal disease (ESRD) associated with HIV infection. To better understand this risk, we compared the incidence of ESRD among 41 968 HIV-positive participants of North America AIDS Cohort Collaboration on Research and Design followed for a median of 5 years with the incidence of ESRD among comparable HIV-negative participants of National Health and Nutrition Examination III followed for a median of 14 years. We used risk associations from multivariable Cox proportional hazards regression to derive cumulative incidence estimates for selected HIV-positive scenarios (no history of diabetes, hypertension, AIDS, or hepatitis C virus coinfection) and compared these estimates with those from similarly selected HIV-negative scenarios. For 40-year-old HIV-positive individuals with health characteristics that were similar to those of age-matched kidney donors, viral load <400 copies/mL, and CD4+ count ≥500 cells/µL, the 9-year cumulative incidence of ESRD was higher than that of their HIV-negative peers, yet still low: 2.5 versus 1.1 per 10 000 among white women, 3.0 versus 1.3 per 10 000 among white men, 13.2 versus 3.6 per 10 000 among black women, and 15.8 versus 4.4 per 10 000 among black men. HIV-positive individuals with no comorbidities and well-controlled disease may be considered low-risk kidney donor candidates.


Assuntos
Rejeição de Enxerto/epidemiologia , Infecções por HIV/complicações , Falência Renal Crônica/epidemiologia , Transplante de Rim/efeitos adversos , Doadores Vivos , Adulto , Estudos de Casos e Controles , Feminino , Seguimentos , Taxa de Filtração Glomerular , Rejeição de Enxerto/etiologia , Sobrevivência de Enxerto , Infecções por HIV/virologia , Soropositividade para HIV , HIV-1/fisiologia , Humanos , Incidência , Falência Renal Crônica/etiologia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Nefrectomia , América do Norte/epidemiologia , Prognóstico , Fatores de Risco , Carga Viral
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