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1.
J Mech Behav Biomed Mater ; 150: 106265, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38035644

RESUMO

This research presents the mechanical behavior of blood flow through capillary having smooth inner surface. In this study modelling of blood flow via permeable and lubricated capillary caused by nutrients re-absorption has been done by the help of laws of momentum and mass. The nutrients re-absorption is assumed to be constant and inner walls of the capillary are smooth and slippery therefore slip condition on the velocity and constant rate in vertical direction at the wall has considered. The Kelvin Voigt model is employed to simulate blood flow via capillaries, and results for pressure, blood flow pattern, and shear force necessary for blood flow are discovered by recursive approach. Numerical results for nutrient re-absorption from the blood and impact of smooth and slippery surfaces on blood flow are shown through graphs. The novelty of the research invents that the smoothness and slickness of capillary wall is a crucial presumption to examine the blood as non-Newtonian fluid via capillary.


Assuntos
Capilares , Modelos Cardiovasculares , Capilares/fisiologia , Velocidade do Fluxo Sanguíneo/fisiologia , Hemodinâmica , Estresse Mecânico , Simulação por Computador
2.
Heliyon ; 9(10): e20196, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37780778

RESUMO

In this work, tank drainage phenomena for in-compressible and isothermal fluid having unsteady fluid flow for third order fluid is studied. Analytical solution of the proposed problem is obtained using perturbation method subject to proper boundary conditions. No-slip condition is used because of fluid will have zero velocity relative to a solid boundary. Object of this work is to find out the velocity profile, flow rate, time required to empty a tank (time efflux) and mathematical relation of time and depth of the tank. Influence of different parameter over velocity profile, effect of radius of the tank over depth, effect of radius of piper over flow rate and effect of depth over flow rate are examined graphically using mathematica. Velocity profile of this model is compared with newtonian fluid's while assuming epsilon as a zero using graph and table from which it is clear that third order fluid posses greater velocity then Newtonian fluid.

3.
Sci Rep ; 13(1): 15075, 2023 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-37699974

RESUMO

Human Papillomavirus (HPV) is the most common cause of sexually transmitted diseases and causes a wide range of pathologies including cervical carcinoma. Integration of the HR-HPV DNA into the host genome plays a crucial role in cervical carcinoma. An alteration of the pRb pathways by the E7 proteins is one of the mechanisms that's account for the transforming capacity of high-risk papillomavirus. For the proper understanding of the underline mechanism of the progression of the disease, the present study investigate the correlation of concentration of host pRb protein, viral E7 oncoprotein and viral load in early and advanced stages of cervical carcinoma. It was found that the viral load in early stages (stage I and II) was less (log10 transformed mean value 2.6 and 3.0) compared to advanced stages (stage III and IV) (Log10 transformed value 5.0 and 5.8) having high expression of HPV E7 onco-protein and reduced level of pRb protein, signifying the role of viral load and expression level of E7 oncoprotein in the progression of cervical cancer.


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Humanos , Feminino , Papillomavirus Humano , Infecções por Papillomavirus/complicações , Carga Viral , Proteínas E7 de Papillomavirus/genética
4.
Ann Pharm Fr ; 81(4): 653-666, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36529284

RESUMO

OBJECTIVES: Among infectious diseases, bloodstream infection (BSI) caused by gram-negative bacteria (E. coli) is the leading cause of death worldwide. However, the bacteria have produced resistance to many of these antibiotics. Thus, the present study aimed to develop silver nanoparticles (AgNPs) loaded with Emilia sonchifolia (ES) extract (ES-AgNPs) to treat BSI efficiently. METHODS: AgNPs were synthesized by reduction of silver nitrate (AgNO3) solution by ES extract. Furthermore, these ES-AgNPs were characterized for particle size and zeta potential, crystallinity by powder X-ray diffraction (P-XRD) technique, in vitro antibacterial activity, time-kill assay, film bio adhesion, and fluorescence assay. RESULTS: Surface plasmon resonance (SPR) has been used to confirm the formation of AgNPs by seeing a shift in colour to dark-brown. The ES-AgNPs displayed a mean particle size of 137±3nm (PDI of 0.168±0.02) and zeta potential of 18.2±0.8mV. Furthermore, according to P-XRD results, the developed AgNPs are highly crystalline. The ES-AgNPs showed effective antibacterial action against E. coli with minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of 0.4±0.02µg/mL and 0.8±0.03µg/mL, respectively. In addition, ES-AgNPs inhibited biofilm formation and bacterial adhesion in a dose-dependent manner with 100% inhibition obtained in 48h at MBC. CONCLUSIONS: Present research work revealed that the ES-AgNPs obtained by green synthesis holds a prominent antibacterial activity in the treatment of BSIs caused by E. coli and they may be used as a competent substitute for current treatments. However, further, in vivo antibacterial studies are required to establish its efficacy in the treatment of BSIs.


Assuntos
Escherichia coli , Nanopartículas Metálicas , Nanopartículas Metálicas/química , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Química Verde , Prata/farmacologia , Testes de Sensibilidade Microbiana , Antibacterianos/farmacologia , Antibacterianos/química
5.
Morphologie ; 107(357): 268-269, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36526575

RESUMO

The third part of the axillary artery has an intimate relationship with the cords of the brachial plexus. The subscapular artery, the largest branch of the axillary artery, arises from its third part. The radial nerve is a branch of the posterior cord of the brachial plexus and its supplies the extensors of the arm, forearm and dorsum of the hand. During routine undergraduate dissection of the axilla of a formalin-fixed cadaver of about 70 years, the subscapular artery was found sandwiched between two divisions of the radial nerve. These anterior and posterior divisions of the radial nerve arose immediately after the formation of the radial nerve and encircled the subscapular artery and fused to form a single nerve subsequently. This variant anatomy can lead to conditions like subscapular entrapment causing ischemia of the scapular region and radial nerve compression causing weakness of the extensors of the upper limb. Injury to the nerve and vessel can occur while performing diagnostic and therapeutic procedures in the area. Knowledge of these variations provides a precautious approach by surgeons and other interventionists while working on this area.


Assuntos
Plexo Braquial , Nervo Radial , Humanos , Nervo Radial/anatomia & histologia , Artéria Axilar/anatomia & histologia , Plexo Braquial/cirurgia , Plexo Braquial/anatomia & histologia , Axila , Extremidade Superior , Cadáver
6.
AJNR Am J Neuroradiol ; 43(11): 1615-1620, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36229166

RESUMO

BACKGROUND AND PURPOSE: Flow diversion has gradually become a standard treatment for intracranial aneurysms of the anterior circulation. Recently, the off-label use of the flow diverters to treat posterior circulation aneurysms has also increased despite initial concerns of rupture and the suboptimal results. This study aimed to explore the change in complication rates and treatment outcomes across time for posterior circulation aneurysms treated using flow diversion and to further evaluate the mechanisms and variables that could potentially explain the change and outcomes. MATERIALS AND METHODS: A retrospective review using a standardized data set at multiple international academic institutions was performed to identify patients with ruptured and unruptured posterior circulation aneurysms treated with flow diversion during a decade spanning January 2011 to January 2020. This period was then categorized into 4 intervals. RESULTS: A total of 378 procedures were performed during the study period. Across time, there was an increasing tendency to treat more vertebral artery and fewer large vertebrobasilar aneurysms (P = .05). Moreover, interventionalists have been increasingly using fewer overlapping flow diverters per aneurysm (P = .07). There was a trend toward a decrease in the rate of thromboembolic complications from 15.8% in 2011-13 to 8.9% in 2018-19 (P = .34). CONCLUSIONS: This multicenter experience revealed a trend toward treating fewer basilar aneurysms, smaller aneurysms, and increased usage of a single flow diverter, leading to a decrease in the rate of thromboembolic and hemorrhagic complications.


Assuntos
Embolização Terapêutica , Procedimentos Endovasculares , Aneurisma Intracraniano , Humanos , Procedimentos Endovasculares/métodos , Curva de Aprendizado , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Resultado do Tratamento , Estudos de Coortes , Estudos Retrospectivos , Embolização Terapêutica/métodos , Stents
7.
AJNR Am J Neuroradiol ; 43(11): 1550-1558, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35618427

RESUMO

Embolization of the middle meningeal artery has gained substantial interest as a therapy for chronic subdural hematomas. For the results of the currently running chronic subdural hematoma trials to inform clinical practice, sufficient accuracy and matching definitions are necessary. We summarized the current practice in chronic subdural hematoma evaluation and derived suggestions on reporting standards using the {Nested} Knowledge AutoLit living review platform. On the basis of the most commonly reported data elements, we suggested a set of standardized image-based study end points for chronic subdural hematoma evaluation for future trials. The measurement methods and reporting standards as proposed in this article have been derived from published best practices and are endorsed by the European Society of Minimally Invasive Neurological Therapy's research committee. The standardization of radiologic outcome measures and measurement techniques in chronic subdural hematoma embolization trials would increase the impact and implication of each trial as well as facilitate data pooling for increased statistical power and, therefore, translation to clinical practice.


Assuntos
Embolização Terapêutica , Hematoma Subdural Crônico , Humanos , Hematoma Subdural Crônico/diagnóstico por imagem , Hematoma Subdural Crônico/terapia , Artérias Meníngeas , Embolização Terapêutica/métodos
8.
Vacunas ; 23: S26-S32, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34512220

RESUMO

Objective: The objective of this study was to assess the attitude and hesitancy toward vaccine against COVID-19 in a Pakistani Population. Materials and methods: A mix-method, prospective study was conducted and adults (aged ≥18 years) residing in Pakistan were invited to participate. The questionnaire was prepared, hosted in Google Forms and circulated through electronic platforms and was also available to be done in in-person. Data was compiled from 15th September to 30th November 2020. Results: The response rate was 80%. A total of 1003 participants were included in the final analysis. Of them, 75% completed survey questionnaire online, while remaining 25% responded in-person. The mean age of the participants was 29.62 ± 10.47 years. The majority of participants were females; 60.9% (n = 611). 57.02% (n = 572) of the participants were employed at the time of survey. Overall, 70.68% (n = 709) of the participants had previous experience of vaccines such as the flu vaccine Only 4.9% (n = 49) participants thought that they will be seriously ill from COVID-19 within six months and 39% (n = 392) participants were confident that they will get COVID-19. A total of 71.29% of the participants reported they would consider getting vaccinated once available. There was statistical association between gender and getting vaccinated (P < 0.001). Conclusion: This study demonstrated that majority of the participants showed positive attitude toward considering COVID-19 vaccine. However awareness with informed knowledge of efficacy, possible adverse effects and cost would be of added great value to increase the real response of Pakistani population toward COVID-19 vaccination.


Objetivo: El objetivo de este estudio fue evaluar la actitud y la renuencia hacia la vacuna frente a la COVID-19 en una población paquistaní. Materiales y métodos: Se realizó un estudio prospectivo de método mixto, invitándose a participar a personas adultas (edad ≥18 años) residentes en Paquistán. Se preparó el cuestionario, que se alojó en Google Forms y se hizo circular a través de plataformas electrónicas, pudiendo realizarse también de manera personal. Los datos se recopilaron desde el 15 de septiembre al 30 de noviembre de 2020. Resultados: La tasa de respuesta fue del 80%. El análisis final incluyó un total de 1.003 participantes, de los cuales el 75% completó el cuestionario-encuesta online, mientras que el 25% respondió en persona. La edad media de los participantes fue de 29,62 ± 10,47 años. La mayoría de los participantes eran mujeres: el 60,9% (n = 611). El 57,02% (n = 572) de los participantes tenía empleo en el momento de la encuesta. En general, el 70,68% (n = 709) de los participantes tenía experiencia previa sobre vacunas tales como la vacuna frente a la gripe. Solo el 4,9% (n = 49) de los participantes pensaba que padecerían la COVID-19 de forma grave en el plazo de seis meses, y el 39% (n = 392) de los participantes estaba seguro de que se contagiaría de dicha enfermedad. El 71,29% de los participantes reportó que consideraría recibir la vacuna una vez que se dispusiera de la misma. Existió una asociación estadística entre el sexo y el ser vacunado (P< 0,001). Conclusión: Este estudio demostró que la mayoría de los participantes mostró una actitud positiva hacia la consideración de la vacuna frente a la COVID-19. Sin embargo, la concienciación sobre el conocimiento informado de la vacuna, los posibles efectos adversos y el coste supondrían un gran valor añadido al incremento de la respuesta real de la población paquistaní hacia la vacuna frente a la COVID-19.

9.
AJNR Am J Neuroradiol ; 42(10): 1898-1903, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34353785

RESUMO

BACKGROUND AND PURPOSE: Coloboma of the eye, Heart defects, Atresia of the choanae, Retardation of growth and/or development, Genital and/or urinary abnormalities, Ear abnormalities and deafness (CHARGE) syndrome is an autosomal dominant genetic disorder with evolving clinical diagnostic criteria. Recently, a number of additional anomalies have been described in this syndrome, which may aid in early diagnosis, particularly in incomplete phenotypes or atypical cases. The persistent trigeminal artery is an embryonic carotid-vertebral anastomosis, rarely seen in the healthy population, with a reported prevalence of 0.4%. Because we had observed the persistent trigeminal artery in patients with CHARGE syndrome, this study aimed to explore the prevalence of the persistent trigeminal artery in this syndrome. MATERIALS AND METHODS: A retrospective study was performed at our tertiary center. MR imaging studies, clinical records, and genetic results were reviewed for patients diagnosed with CHARGE syndrome between 2006 and 2019. The prevalence of the persistent trigeminal artery in patients with CHARGE syndrome was recorded and compared with other established diagnostic criteria. RESULTS: Twenty-five patients with CHARGE syndrome were included. The persistent trigeminal artery was demonstrated on MR imaging in 14/25 (56%) patients and was seen more frequently than 4 of 9 other established diagnostic criteria in our cohort. When individual major or minor diagnostic criteria were absent, the persistent trigeminal artery was still demonstrated on MR imaging in 52%-67% of these patients with CHARGE syndrome. CONCLUSIONS: The prevalence of the persistent trigeminal artery in CHARGE syndrome of 56% is higher than that of some other established diagnostic criteria and much higher than that in the general population. The persistent trigeminal artery may be a useful addition to the expanding phenotype of CHARGE syndrome, supplementing other diagnostic criteria. Radiologists should be aware of this novel finding demonstrable on MR imaging.


Assuntos
Síndrome CHARGE , Coloboma , Artérias , Síndrome CHARGE/diagnóstico por imagem , Síndrome CHARGE/genética , Humanos , Imageamento por Ressonância Magnética , Estudos Retrospectivos
10.
Theory Biosci ; 140(3): 249-263, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34218412

RESUMO

This theoretical analysis considers a biomechanical model in which the Carreau fluid model characterizes the viscoelastic nature of growing human embryo and secreted fluid. This model incorporates transport mechanisms that involve the swaying motions of ciliary cells, peristaltic contractions of smooth muscle cells and pressure gradient at the ampullar region entrance. Series form solutions of the resulting partial differential equations are obtained using the regular perturbation method. A theoretical estimate of effects of the condition of pressure gradient, geometric parameters and fluid model parameters on the flow variables that have relevance to the problem of growing embryo transport in the human fallopian tube is presented through the discussion of graphs. Furthermore, an analogy between the linearly viscous fluid, and the shear thinning and shear thickening characteristics of the Carreau fluid model is also presented. The pertinence of the obtained results with growing embryo transport in the human fallopian tube revealed that when shear thickening characteristics of the Carreau fluid model are considered then complete mitotic divisions take place properly with an estimated appropriate residue time about 3-4 days. Smaller size trapped boluses of the secreted fluid make the smooth forwarding of the growing embryo in the human fallopian tube when shear thinning characteristics of the Carreau fluid model are taken into account. Key modulators: progesterone ([Formula: see text] and estradiol ([Formula: see text]), prostaglandin [Formula: see text] ([Formula: see text]) and prostaglandin [Formula: see text] ([Formula: see text]) constraint the growing embryo transport.


Assuntos
Miócitos de Músculo Liso , Feminino , Humanos , Movimento (Física)
13.
Clin Radiol ; 76(5): 391.e19-391.e31, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33648757

RESUMO

Paediatric posterior fossa lesions can have much overlap in their clinical and radiological presentation. There are, however, a number of key imaging features that can help the reading radiologist to distinguish tumours from important tumour mimics which are often inflammatory or metabolic entities. This pictorial review provides a number of important cases that proved challenging on imaging and illustrates some common pitfalls when interpreting lesions in the posterior fossa in children. Not everything that is abnormal will be a tumour, but often other causes are overlooked and misinterpreted as tumours, leading to great morbidity for that child. This article highlights some lesions that were mistaken as tumours and will introduce the reader to less commonly seen pathologies which are important to consider on a differential list for this location.


Assuntos
Encefalopatias/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Neoplasias Infratentoriais/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Criança , Diagnóstico Diferencial , Humanos
14.
AJNR Am J Neuroradiol ; 42(4): 774-781, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33602745

RESUMO

BACKGROUND AND PURPOSE: Head motion causes image degradation in brain MR imaging examinations, negatively impacting image quality, especially in pediatric populations. Here, we used a retrospective motion correction technique in children and assessed image quality improvement for 3D MR imaging acquisitions. MATERIALS AND METHODS: We prospectively acquired brain MR imaging at 3T using 3D sequences, T1-weighted MPRAGE, T2-weighted TSE, and FLAIR in 32 unsedated children, including 7 with epilepsy (age range, 2-18 years). We implemented a novel motion correction technique through a modification of k-space data acquisition: Distributed and Incoherent Sample Orders for Reconstruction Deblurring by using Encoding Redundancy (DISORDER). For each participant and technique, we obtained 3 reconstructions as acquired (Aq), after DISORDER motion correction (Di), and Di with additional outlier rejection (DiOut). We analyzed 288 images quantitatively, measuring 2 objective no-reference image quality metrics: gradient entropy (GE) and MPRAGE white matter (WM) homogeneity. As a qualitative metric, we presented blinded and randomized images to 2 expert neuroradiologists who scored them for clinical readability. RESULTS: Both image quality metrics improved after motion correction for all modalities, and improvement correlated with the amount of intrascan motion. Neuroradiologists also considered the motion corrected images as of higher quality (Wilcoxon z = -3.164 for MPRAGE; z = -2.066 for TSE; z = -2.645 for FLAIR; all P < .05). CONCLUSIONS: Retrospective image motion correction with DISORDER increased image quality both from an objective and qualitative perspective. In 75% of sessions, at least 1 sequence was improved by this approach, indicating the benefit of this technique in unsedated children for both clinical and research environments.


Assuntos
Artefatos , Neuroimagem , Adolescente , Encéfalo/diagnóstico por imagem , Criança , Pré-Escolar , Humanos , Imageamento por Ressonância Magnética , Movimento (Física) , Estudos Retrospectivos
15.
AJNR Am J Neuroradiol ; 42(1): 57-64, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33243895

RESUMO

BACKGROUND AND PURPOSE: Clot perviousness in acute ischemic stroke is a potential CT imaging biomarker for mechanical thrombectomy efficacy. We investigated the association among perviousness, clot cellular composition, and first-pass effect. MATERIALS AND METHODS: In 40 mechanical thrombectomy-treated cases of acute ischemic stroke, we calculated perviousness as the difference in clot density on CT angiography and noncontrast CT. We assessed the proportion of fibrin/platelet aggregates, red blood cells, and white blood cells on clot histopathology. We tested for linear correlation between histologic components and perviousness, differences in components between "high" and "low" pervious clots defined by median perviousness, and differences in perviousness/composition between cases that did and did not achieve a first-pass effect. RESULTS: Perviousness significantly positively and negatively correlated with the percentage of fibrin/platelet aggregates (P = .001) and the percentage of red blood cells (P = .001), respectively. Higher pervious clots had significantly greater fibrin/platelet aggregate content (P = .042). Cases that achieved a first-pass effect (n = 14) had lower perviousness, though not significantly (P = .055). The percentage of red blood cells was significantly higher (P = .028) and the percentage of fibrin/platelet aggregates was significantly lower (P = .016) in cases with a first-pass effect. There was no association between clot density on NCCT and clot composition or first-pass effect. Receiver operating characteristic analysis indicated that clot composition was the best predictor of first-pass effect (area under receiver operating characteristic curve: percentage of fibrin/platelet aggregates = 0.731, percentage of red blood cells = 0.706, perviousness = 0.668). CONCLUSIONS: Clot perviousness on CT is associated with a higher percentage of fibrin/platelet aggregate content. Histologic data and, to a lesser degree, perviousness may have value in predicting first-pass outcome. Imaging metrics that more strongly reflect clot biology than perviousness may be needed to predict a first-pass effect with high accuracy.


Assuntos
AVC Isquêmico/diagnóstico por imagem , AVC Isquêmico/cirurgia , Trombose/diagnóstico por imagem , Resultado do Tratamento , Idoso , Plaquetas/patologia , Angiografia por Tomografia Computadorizada/métodos , Feminino , Fibrina/análise , Humanos , AVC Isquêmico/patologia , Masculino , Trombectomia/métodos , Trombose/patologia
16.
Biomech Model Mechanobiol ; 20(2): 569-584, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33128659

RESUMO

In this paper, we have discussed the flow of a Newtonian fluid through a slit filled with porous medium and linearly reabsorbing porous walls. The study is motivated by fluid flow in diseased renal tubules in a kidney. Due to diseases, some fibrous material, fatty substances and solid waste particles, etc., may get suspended in tubule channel as well as on the pores of the wall, resulting in the porous filling in the slit and biofouling, respectively. In this study, the absorption at the wall is assumed to follow a linear pattern and the fluid is assumed to be entering the channel at a prescribed initial flow rate. The problem of the two-dimensional fluid flow is formulated using stream function, and inverse solution method is applied to obtain an exact solution of the fourth-order compatibility equation. Some special cases are also deduced from the obtained results and compared with available results from literature. Expressions for various physically relevant quantities like fluid velocities, volume flow rate, fractional reabsorption, leakage flux and pressure distribution are obtained. The results are used to demonstrate how medium porosity and biofouling parameter may affect average pressure differences in the renal tubules of a rat kidney. Finally, the results are presented graphically and effects of changing various parameters on the flow are analysed. We have also deduced some special cases when the wall reabsorption is uniform, and when there is no medium porosity. We have shown these special cases match with the already present results in the literature.


Assuntos
Túbulos Renais/patologia , Túbulos Renais/fisiopatologia , Reologia , Animais , Modelos Biológicos , Porosidade , Pressão , Ratos , Estresse Mecânico
17.
Blood Cells Mol Dis ; 85: 102482, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32745939

RESUMO

BACKGROUND: Post-transplant maintenance provides progression-free survival benefit in multiple myeloma (MM). Here we report our institution's experience with elotuzumab-based maintenance following autologous stem cell transplant. METHODS: We retrospectively evaluated the outcomes of MM patients who were started on elotuzumab-based maintenance (elotuzumab/lenalidomide/dexamethasone, elotuzumab/bortezomib/dexamethasone, or elotuzumab/bortezomib/methylprednisolone) following transplant (N = 7). Baseline characteristics, treatment response, survival, and adverse events were reviewed. RESULTS: Median age was 68 (56-81) years at the time of transplant, and median lines of induction therapy was 2 (1-6). Three patients (42.9%) had high-risk cytogenetics and five (71.4%) had stage II or greater disease at diagnosis. At a median follow-up of 24 months (12-50), five patients (71.4%) had improvement of quality of response, with a combined CR or VGPR rate increasing from 57.1% to 100% (CR = 3, VGPR = 4). All patients were alive without relapse or progression at the time of this analysis. Grade 3-4 adverse events were observed in three (42.9%) patients. None of the patients discontinued the treatment due to intolerance. CONCLUSIONS: Our study demonstrates that elotuzumab-based maintenance may deepen response post-transplant in MM and can be safely administered even in older patients. Given its unique action and rare side effects, further studies of elotuzumab in the post-transplant setting are warranted.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Mieloma Múltiplo/terapia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/patologia , Estudos Retrospectivos , Transplante de Células-Tronco , Transplante Autólogo , Resultado do Tratamento
18.
Theory Biosci ; 139(3): 235-251, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32488752

RESUMO

Swimming of spermatozoa through couple stress fluid in an asymmetric human cervical canal is investigated in the present theoretical analysis. A couple of fourth-order partial differential equations arising from the mathematical modelling of the proposed model is solved analytically. Flow variables like pressure gradient, propulsive velocity, mucus velocity and time mean flow rate are analysed for the pertinent parameters. Conspicuous features of the pumping characteristics are explored. It is found that pressure rise facilitates the motion of spermatozoa to fertilize an ovum in the female reproductive tract, whereas pressure drop by inverting the direction of spermatozoa controls the probability of pregnancy. Maximal propulsive velocity of the spermatozoa is reported in the absence of travelling waves along the cervical walls. Minute impact of phase difference on propulsive velocity is evident. An analogy of the current analysis with the existing literature is also made.


Assuntos
Colo do Útero/anormalidades , Colo do Útero/metabolismo , Espermatozoides/metabolismo , Muco do Colo Uterino , Feminino , Fertilização , Células Caliciformes , Humanos , Masculino , Modelos Biológicos , Modelos Teóricos , Movimento (Física) , Muco , Pressão , Reologia , Espermatozoides/fisiologia , Viscosidade
19.
Eur J Neurol ; 27(6): 1039-1047, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32149450

RESUMO

BACKGROUND AND PURPOSE: We investigated the effectiveness of intravenous thrombolysis (IVT) in acute ischaemic stroke (AIS) patients with large vessel or distal occlusions and mild neurological deficits, defined as National Institutes of Health Stroke Scale scores < 6 points. METHODS: The primary efficacy outcome was 3-month functional independence (FI) [modified Rankin Scale (mRS) scores 0-2] that was compared between patients with and without IVT treatment. Other efficacy outcomes of interest included 3-month favorable functional outcome (mRS scores 0-1) and mRS score distribution at discharge and at 3 months. The safety outcomes comprised all-cause 3-month mortality, symptomatic intracranial hemorrhage (ICH), asymptomatic ICH and severe systemic bleeding. RESULTS: We evaluated 336 AIS patients with large vessel or distal occlusions and mild stroke severity (mean age 63 ± 15 years, 45% women). Patients treated with IVT (n = 162) had higher FI (85.6% vs. 74.8%, P = 0.027) with lower mRS scores at hospital discharge (P = 0.034) compared with the remaining patients. No differences were detected in any of the safety outcomes including symptomatic ICH, asymptomatic ICH, severe systemic bleeding and 3-month mortality. IVT was associated with higher likelihood of 3-month FI [odds ratio (OR), 2.19; 95% confidence intervals (CI), 1.09-4.42], 3-month favorable functional outcome (OR, 1.99; 95% CI, 1.10-3.57), functional improvement at discharge [common OR (per 1-point decrease in mRS score), 2.94; 95% CI, 1.67-5.26)] and at 3 months (common OR, 1.72; 95% CI, 1.06-2.86) on multivariable logistic regression models adjusting for potential confounders, including mechanical thrombectomy. CONCLUSIONS: Intravenous thrombolysis is independently associated with higher odds of improved discharge and 3-month functional outcomes in AIS patients with large vessel or distal occlusions and mild stroke severity. IVT appears not to increase the risk of systemic or symptomatic intracranial bleeding.


Assuntos
Isquemia Encefálica , Acidente Vascular Cerebral , Administração Intravenosa , Idoso , Isquemia Encefálica/tratamento farmacológico , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Hemorragias Intracranianas , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acidente Vascular Cerebral/tratamento farmacológico , Trombectomia , Terapia Trombolítica , Resultado do Tratamento
20.
AJNR Am J Neuroradiol ; 41(2): 206-212, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31948951

RESUMO

BACKGROUND AND PURPOSE: Brain CTP is used to estimate infarct and penumbra volumes to determine endovascular treatment eligibility for patients with acute ischemic stroke. We aimed to assess the accuracy of a Bayesian CTP algorithm in determining penumbra and final infarct volumes. MATERIALS AND METHODS: Data were retrospectively collected for 105 patients with acute ischemic stroke (55 patients with successful recanalization [TICI 2b/2c/3] and large-vessel occlusions and 50 patients without interventions). Final infarct volumes were calculated using DWI and FLAIR 24 hours following CTP imaging. RAPID and the Vitrea Bayesian CTP algorithm (with 3 different settings) predicted infarct and penumbra volumes for comparison with final infarct volumes to assess software performance. Vitrea settings used different combinations of perfusion maps (MTT, TTP, CBV, CBF, delay time) for infarct and penumbra quantification. Patients with and without interventions were included for assessment of predicted infarct and penumbra volumes, respectively. RESULTS: RAPID and Vitrea default setting had the most accurate final infarct volume prediction in patients with interventions ([Spearman correlation coefficient, mean infarct difference] default versus FLAIR: [0.77, 4.1 mL], default versus DWI: [0.72, 4.7 mL], RAPID versus FLAIR: [0.75, 7.5 mL], RAPID versus DWI: [0.75, 6.9 mL]). Default Vitrea and RAPID were the most and least accurate in determining final infarct volume for patients without an intervention, respectively (default versus FLAIR: [0.76, -0.4 mL], default versus DWI: [0.71, -2.6 mL], RAPID versus FLAIR: [0.68, -49.3 mL], RAPID versus DWI: [0.65, -51.5 mL]). CONCLUSIONS: Compared with RAPID, the Vitrea default setting was noninferior for patients with interventions and superior in penumbra estimation for patients without interventions as indicated by mean infarct differences and correlations with final infarct volumes.


Assuntos
Algoritmos , Interpretação de Imagem Assistida por Computador/métodos , Neuroimagem/métodos , Imagem de Perfusão/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/patologia , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acidente Vascular Cerebral/patologia , Tomografia Computadorizada por Raios X/métodos
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