Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 26
Filtrar
1.
Hernia ; 28(1): 17-24, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37676569

RESUMO

PURPOSE: Unstructured data are an untapped source for surgical prediction. Modern image analysis and machine learning (ML) can harness unstructured data in medical imaging. Incisional hernia (IH) is a pervasive surgical disease, well-suited for prediction using image analysis. Our objective was to identify optimal biomarkers (OBMs) from preoperative abdominopelvic computed tomography (CT) imaging which are most predictive of IH development. METHODS: Two hundred and twelve rigorously matched colorectal surgery patients at our institution were included. Preoperative abdominopelvic CT scans were segmented to derive linear, volumetric, intensity-based, and textural features. These features were analyzed to find a small subset of OBMs, which are maximally predictive of IH. Three ML classifiers (Ensemble Boosting, Random Forest, SVM) trained on these OBMs were used for prediction of IH. RESULTS: Altogether, 279 features were extracted from each CT scan. The most predictive OBMs found were: (1) abdominopelvic visceral adipose tissue (VAT) volume, normalized for height; (2) abdominopelvic skeletal muscle tissue volume, normalized for height; and (3) pelvic VAT volume to pelvic outer aspect of body wall skeletal musculature (OAM) volume ratio. Among ML prediction models, Ensemble Boosting produced the best performance with an AUC of 0.85, accuracy of 0.83, sensitivity of 0.86, and specificity of 0.81. CONCLUSION: These OBMs suggest increased intra-abdominopelvic volume/pressure as the salient pathophysiologic driver and likely mechanism for IH formation. ML models using these OBMs are highly predictive for IH development. The next generation of surgical prediction will maximize the utility of unstructured data using advanced image analysis and ML.


Assuntos
Hérnia Incisional , Humanos , Hérnia Incisional/diagnóstico por imagem , Hérnia Incisional/etiologia , Hérnia Incisional/cirurgia , Herniorrafia/métodos , Tomografia Computadorizada por Raios X/métodos , Biomarcadores , Estudos Retrospectivos
2.
Hernia ; 2023 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-37755523

RESUMO

INTRODUCTION: Transversus abdominis release (TAR) may provide an optimal plane for mesh placement for large ventral hernias requiring medial myofascial flap advancement. Long-term outcomes of TAR for large ventral hernia repair (VHR) remains under-studied. This study aims to assess longitudinal clinical outcomes and quality of life (QoL) following large VHR with TAR and resorbable biosynthetic mesh. METHODS: Retrospective review of clinical outcomes and prospective QoL was performed for patients undergoing VHR with poly-4-hydroxybutyrate mesh and TAR from 2016 to 2021. Patients with ≤ 24 months of follow-up, defects ≤ 150 cm2, and parastomal hernias were excluded. Cost-related data was collected for each patient's hospital course. QoL was compared using paired Wilcoxon signed-rank tests. RESULTS: Twenty-nine patients met inclusion criteria. Median age and BMI were 61 years (53.2-68.1 years) and 31.4 kg/m2 (26.1-35.3 kg/m2). Average hernia defect was 390cm2 ± 152.9 cm2. All patients underwent previous abdominal surgery and were primarily Ventral Hernia Working Group 2 (58.6%). Two hernia recurrences (6.9%) occurred over the median follow-up period of 63.1 months (IQR 43.7-71.3 months), with no cases of mesh infection or explantation. Delayed healing and seroma occurred in 27 and 10.3% of patients, respectively. QoL analysis identified a significant improvement in postoperative QoL (p < 0.005), that continued throughout the 5-year follow-up period, with a 41% overall improvement. Cost analysis identified the hospital revenue generated was approximately equal to the direct costs of patient care. Higher costs were associated with ASA class and length of stay (p < 0.05). CONCLUSION: Large VHR with resorbable biosynthetic mesh and TAR can be performed safely, with a low recurrence and complication rate, acceptable hospital costs, and significant improvement in disease-specific QoL at long-term follow-up.

4.
Int J Tuberc Lung Dis ; 26(12): 1170-1176, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36447322

RESUMO

BACKGROUND: We examined patterns in care for individuals treated for latent TB infection (LTBI) in the US Food and Drug Administration´s Sentinel System.METHODS: Using administrative claims data, we identified patients who filled standard LTBI treatment prescriptions during 2008-2019. In these cohorts, we assessed LTBI testing, clinical management, and treatment duration.RESULTS: Among 113,338 patients who filled LTBI prescriptions, 80% (90,377) received isoniazid (INH) only, 19% (21,235) rifampin (RIF) only, and 2% (1,726) INH + rifapentine (RPT). By regimen, the proportion of patients with documented prior testing for TBI was 79%, 54%, and 91%, respectively. Median therapy duration was 84 days (IQR 35-84) for the 3-month once-weekly INH + RPT regimen, 60 days (IQR 30-100) for the 6- to 9-month INH regimen, and 30 days (IQR 2-60) for the 4-month RIF regimen.CONCLUSIONS: Among the cohorts, INH-only was the most commonly prescribed LTBI treatment. Most persons who filled a prescription for LTBI treatment did not have evidence of completing recommended treatment duration. These data further support preferential use of shorter-course regimens such as INH + RPT.


Assuntos
Antituberculosos , Prescrições de Medicamentos , Tuberculose , Humanos , Isoniazida/administração & dosagem , Estados Unidos , United States Food and Drug Administration , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Antituberculosos/administração & dosagem , Rifampina/administração & dosagem , Prescrições de Medicamentos/estatística & dados numéricos
5.
Front Plant Sci ; 12: 670201, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34135925

RESUMO

Pearl millet [Pennisetum glaucum (L.) R. Br.] is grown under both arid and semi-arid conditions in India, where other cereals are hard to grow. Pearl millet cultivars, hybrids, and OPVs (open pollinated varieties) are tested and released by the All India Coordinated Research Project on Pearl Millet (AICRP-PM) across three zones (A1, A, and B) that are classified based on rainfall pattern. Except in locations with extreme weather conditions, hybrids dominate pearl millet growing areas, which can be attributed to hybrid vigor and the active role of the private sector. The importance of OPVs cannot be ruled out, owing to wider adaptation, lower input cost, and timely seed availability to subsidiary farmers cultivating this crop. This study was conducted to scrutinize the presently used test locations for evaluation of pearl millet OPVs across India, identify the best OPVs across locations, and determine the variation in grain Fe and Zn contents across locations in these regions. Six varieties were evaluated across 20 locations in A1 and A (pooled as A) and B zones along with three common checks and additional three zonal adapted checks in the respective zones during the 2019 rainy season. Recorded data on yield and quality traits were analyzed using genotype main effects and genotype × environment interaction biplot method. The genotype × environment (G × E) interaction was found to be highly significant for all the grain yield and agronomic traits and for both micronutrients (iron and zinc). However, genotypic effect (G) was four (productive tillers) to 49 (grain Fe content) times that of G × E interaction effect for various traits across zones that show the flexibility of OPVs. Ananthapuramu is the ideal test site for selecting pearl millet cultivars effectively for adaptation across India, while Ananthapuramu, Perumallapalle, and Gurugram can also be used as initial testing locations. OPVs MP 599 and MP 600 are identified as ideal genotypes, because they showed higher grain and fodder yields and stability compared with other cultivars. Iron and zinc concentration showed highly significant positive correlation (across environment = 0.83; p < 0.01), indicating possibility of simultaneous effective selection for both traits. Three common checks were found to be significantly low yielders than the test entries or zonal checks in individual zones and across India, indicating the potential of genetic improvement through OPVs.

6.
Clin Radiol ; 76(6): 436-442, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33820639

RESUMO

AIM: To determine the prevalence of pleural abnormalities and describe the computed tomography (CT) features observed in a well-characterised population of patients with pleural infection. MATERIALS AND METHODS: A retrospective study of a subgroup of patients from the Second Multi-centre Intra-pleural Sepsis Trial (MIST 2) trial was carried out. Patients were diagnosed with pleural infection on robust clinical criteria. CT examinations were assessed by three observers independently for the presence of predefined features. Planned subgroup comparisons of patients with and without evidence of parenchymal infection were performed. RESULTS: Eighty-one patients were included. Parietal pleural thickening and enhancement were seen in 98.7% of patients. Visceral pleural changes were observed in most, including several previously undescribed features. Consolidation was observed in 61.7% of patients and there was a significant association of parenchymal consolidation with CT evidence of small airways infection (p<0.001) and visceral pleural thickening and enhancement (p<0.05). Features of parenchymal infection were absent in one third of patients. CONCLUSION: This study provides a comprehensive account of the parietal pleural, visceral pleural, and parenchymal changes of pleural infection on CT. Parenchymal infection is absent in a significant proportion of patients with pleural infection, suggesting that a pneumonic process may not be necessary for the development of pleural infection.


Assuntos
Doenças Pleurais/diagnóstico por imagem , Sepse/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pleura/diagnóstico por imagem , Estudos Retrospectivos
7.
Eur J Radiol ; 101: 82-86, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29571806

RESUMO

INTRODUCTION: Although nodule volumetry is a recognized biomarker of malignancy in pulmonary nodules (PNs), caution is needed in its interpretation because of variables such as respiratory volume variation and inter-scan variability of up to 25%. CT Texture Analysis (CTTA) is a potential independent biomarker of malignancy but inter-scan variability and respiratory volume variation has not been assessed. METHODS: In this prospective cohort study, 40 patients (20 with an indeterminate PN and 20 with pulmonary metastases) underwent two LDCTs within a 60-min period (the "Coffee-break") with the aim of assessing the repeatability of CTTA and semi-automated volume measurements. Texture features were extracted from each automatic contoured region surrounding the PN. Patients were also randomized to two inspiratory control groups: normal breath hold, and controlled lung volume to study the influence of inspiratory control on these measurements. RESULTS: The mean difference in volume between the two scans was 6.3%,SD:29.9%. The textural features displayed 95% CI below ±17.8%, and were less variable than nodule volume (95%CI ±â€¯28.9%). All features had high repeatability, calculated by the concordance correlation coefficient, (0.84 ≤ CCC ≤ 0.99). All measurements were more repeatable for the controlled lung volume group than the normal breath-hold group. CONCLUSION: CTTA repeatability was comparable to automatic volumetric measurements, and appears to be improved using controlled volume breath holding.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Suspensão da Respiração , Estudos de Coortes , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Nódulos Pulmonares Múltiplos/patologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Respiração , Nódulo Pulmonar Solitário/patologia , Tempo , Carga Tumoral
8.
Respir Med ; 124: 88-99, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28233652

RESUMO

Pleural disease is common. Radiological investigation of pleural effusion, thickening, masses, and pneumothorax is key in diagnosing and determining management. Conventional chest radiograph (CXR) remains as the initial investigation of choice for patients with suspected pleural disease. When abnormalities are detected, thoracic ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) can each play important roles in further investigation, but appropriate modality selection is critical. US adds significant value in the identification of pleural fluid and pleural nodularity, guiding pleural procedures and, increasingly, as "point of care" assessment for pneumothorax, but is highly operator dependent. CT scan is the modality of choice for further assessment of pleural disease: Characterising pleural thickening, some pleural effusions and demonstration of homogeneity of pleural masses and areas of fatty attenuation or calcification. MRI has specific utility for soft tissue abnormalities and may have a role for younger patients requiring follow-up serial imaging. MRI and PET/CT may provide additional information in malignant pleural disease regarding prognosis and response to therapy. This article summarises existing techniques, highlighting the benefits and applications of these different imaging modalities and provides an up to date review of the evidence.


Assuntos
Pleura/diagnóstico por imagem , Doenças Pleurais/diagnóstico por imagem , Derrame Pleural Maligno/diagnóstico por imagem , Sistemas Automatizados de Assistência Junto ao Leito/normas , Humanos , Imageamento por Ressonância Magnética/métodos , Pleura/patologia , Doenças Pleurais/patologia , Derrame Pleural/diagnóstico por imagem , Derrame Pleural Maligno/patologia , Pneumotórax/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons/métodos , Prognóstico , Radiografia Torácica/métodos , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodos
9.
Clin Radiol ; 72(2): 177.e1-177.e8, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27908443

RESUMO

AIM: To estimate the probability of malignancy in small pulmonary nodules (PNs) based on clinical and radiological characteristics in a non-screening population that includes patients with a prior history of malignancy using three validated models. MATERIALS AND METHODS: Retrospective data on clinical and radiological characteristics was collected from the medical records of 702 patients (379 men, 323 women; range 19-94 years) with PNs ≤12 mm in diameter at a single centre. The final diagnosis was compared to the probability of malignancy calculated by one of three models (Mayo, VA, and McWilliams). Model accuracy was assessed by receiver operating characteristics (ROC). The models were calibrated by comparing predicted and observed rates of malignancy. RESULTS: The area under the ROC curve (AUC) was highest for the McWilliams model (0.82; 95% confidence interval [CI]: 0.78-0.91) and lowest for the Mayo model (0.58; 95% CI: 0.55-0.59). The VA model had an AUC of (0.62; 95% CI: 0.47-0.64). Performance of the models was significantly lower than that in the published literature. CONCLUSIONS: The accuracy of the three models is lower in a non-screening population with a high prevalence of prior malignancy compared to the papers that describe their development. To the authors' knowledge, this is the largest study to validate predictive models for PNs in a non-screening clinically referred patient population, and has potential implications for the implementation of predictive models.


Assuntos
Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Tomografia Computadorizada Multidetectores/métodos , Modelos de Riscos Proporcionais , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/epidemiologia , Adulto , Idoso , Institutos de Câncer/estatística & dados numéricos , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores/estatística & dados numéricos , Prevalência , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco/métodos , Sensibilidade e Especificidade , Centros de Atenção Terciária/estatística & dados numéricos , Reino Unido/epidemiologia , Adulto Jovem
10.
Indian J Physiol Pharmacol ; 56(3): 279-83, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23734444

RESUMO

Maximal oxygen uptake (VO2max) during a graded maximal exercise test is the objective method to assess cardiorespiratory fitness. Maximal oxygen uptake testing is limited to only a few laboratories as it requires trained personnel and strenuous effort by the subject. At the population level, submaximal tests have been developed to derive VO2max indirectly based on heart rate based nomograms or it can be calculated using anthropometric measures. These heart rate based predicted standards have been developed for western population and are used routinely to predict VO2max in Indian population. In the present study VO2max was directly measured by maximal exercise test using a bicycle ergometer and was compared with VO2max derived by recovery heart rate in Queen's College step test (QCST) (PVO2max I) and with VO2max derived from Wasserman equation based on anthropometric parameters and age (PVO2max II) in a well defined age group of healthy male adults from New Delhi. The values of directly measured VO2max showed no significant correlation either with the estimated VO2max with QCST or with VO2max predicted by Wasserman equation. Bland and Altman method of approach for limit of agreement between VO2max and PVO2max I or PVO2max II revealed that the limits of agreement between directly measured VO2max and PVO2max I or PVO2max II was large indicating inapplicability of prediction equations of western population in the population under study. Thus it is evident that there is an urgent need to develop nomogram for Indian population, may be even for different ethnic sub-population in the country.


Assuntos
Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Oxigênio/metabolismo , Adulto , Povo Asiático , Teste de Esforço/métodos , Humanos , Índia , Masculino , Nomogramas , Consumo de Oxigênio/fisiologia
11.
Int J STD AIDS ; 21(6): 446-8, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20606229

RESUMO

The Buschke-Löwenstein tumour is an extremely rare, slow-growing, locally destructive, cauliflower-like mass, also known as giant condyloma acuminatum. We report a case of a 42-year-old man who presented to the department of surgery with a two-year history of a perineal tumour. The mass was painless initially but had become painful more recently. After histopathological confirmation, the tumour was removed surgically, as it was resistant to medical treatment. There has been considerable debate regarding the exact nature, aetiology and treatment of these lesions.


Assuntos
Condiloma Acuminado/cirurgia , Períneo/patologia , Adulto , Condiloma Acuminado/patologia , Humanos , Masculino
12.
Psychiatr Danub ; 22(2): 266-9, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20562759

RESUMO

INTRODUCTION: Little research has been done to ascertain how patients and families of South Asian origin access and use early intervention mental health services today. The aim of this retrospective study is to gain a better understanding of how well South Asian patients engage with standard psycho-social interventions. SUBJECTS AND METHODS: In June 2003 an audit was conducted amongst 75 patients from different ethnic groups in Luton. Measures of engagement with mental health services included; number of missed outpatient appointments over one year and compliance with medication regimes. RESULTS: The results of this audit showed that South Asian patients are more likely to miss appointments and refuse to take medication in comparison to their Caucasian or Afro- Caribbean counter-parts. Further analysis revealed that the Bangladeshi subgroup had missed more appointments and had a greater proportion of medication refusal in comparison to the other Asian subgroups. CONCLUSIONS: These results support the pioneering work by Dr Robin Pinto in the 1970s he observed that Asian patients perceive and utilise mental health services in a different way compared to the Caucasian population. The observations from our study depict the difficulties in engaging ethnic minority patients into existing services. Hence we argue that future interventions should be adapted and tailored to overcome cultural and language barriers with patients and their families.


Assuntos
Agendamento de Consultas , Povo Asiático/psicologia , Comparação Transcultural , Emigrantes e Imigrantes/psicologia , Adesão à Medicação/etnologia , Cooperação do Paciente/etnologia , Transtornos Psicóticos/etnologia , Adolescente , Adulto , Assistência Ambulatorial/psicologia , Assistência Ambulatorial/estatística & dados numéricos , Ásia/etnologia , Povo Asiático/estatística & dados numéricos , População Negra/psicologia , População Negra/estatística & dados numéricos , Auditoria Clínica/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Inglaterra , Feminino , Humanos , Masculino , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/terapia , População Branca/psicologia , População Branca/estatística & dados numéricos , Adulto Jovem
13.
J Commun Dis ; 42(2): 81-90, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22471167

RESUMO

Human Immune Deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) has posed different set of challenges towards the country's growth and has also changed the strategic approach of Public Health for containing the further growth of the disease. HIV/AIDS is considered as more of a social problem than a medical problem alone. National AIDS Control Program (NACP) though its three phases have tried to design & implement evidence based strategies including Targeted Interventions (TI) based on the lessons learnt in the past. It has been a long journey for more than a decade which has brought innovations & effectiveness into the program and is showing some preliminary results in positive direction in limiting the HIV infection among HRGs. In the present communication few of the salient features of the entire approach and possible impacts in the future have been discussed.


Assuntos
Síndrome da Imunodeficiência Adquirida/prevenção & controle , Programas Nacionais de Saúde , Síndrome da Imunodeficiência Adquirida/epidemiologia , Humanos , Índia/epidemiologia , Saúde Pública
14.
Int J STD AIDS ; 20(6): 437-9, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19451336

RESUMO

Acquired lymphoedema of the vulva is induced by impaired lymph flow. We present the case of a 35-year-old woman having lymphoedema of the vulva following pulmonary tuberculosis, which she had developed four years back for which she had taken a full course of antitubercular treatment for nine months from the Chest and Tuberculosis department. The biopsy taken from the perianal swellings showed hyperkeratosis and acanthosis with multiple dilated lymph specs.


Assuntos
Linfedema/etiologia , Tuberculose dos Genitais Femininos/etiologia , Tuberculose Pulmonar/complicações , Doenças da Vulva/etiologia , Adulto , Antituberculosos/uso terapêutico , Feminino , Humanos , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/microbiologia
15.
Surg Endosc ; 19(7): 902-4, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15868252

RESUMO

BACKGROUND: Endoscopic retrograde cholangio pancreatography (ERCP) is a technically challenging procedure. Glyceryl trinitrate (GTN) has been shown to reduce tone in the sphincter of Oddi (SO), cannulation of which is a rate-limiting factor. A double-blind randomized control trial was performed to assess whether topical GTN on the SO would facilitate cholangiography and/or bile duct cannulation. METHODS: 104 patients requiring ERCP for biliary symptoms were randomized into two groups, 52 controls pretreated with 5 ml 0.9% normal saline (NS) and 52 pretreated with 5 ml GTN (concentration 1 mg/ml). RESULTS: There was no significant between the control group and the GTN group in primary cannulation rate (p = 0.76), time taken to cholangiography (p = 0.58), or time to cannulation (p = 0.43). CONCLUSION: Topically administered GTN to the SO does not aid in obtaining a cholangiogram or cannulation during an ERCP.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Nitroglicerina/administração & dosagem , Esfíncter da Ampola Hepatopancreática , Vasodilatadores/administração & dosagem , Administração Tópica , Neoplasias do Ducto Colédoco/diagnóstico , Método Duplo-Cego , Feminino , Cálculos Biliares/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade
16.
Indian J Med Sci ; 56(12): 607-12, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14514244

RESUMO

Flow volume loop and its various indices can be used to diagnose UAO. Change in posture from sitting to horizontal position per se causes a decrease in effort dependent inspiratory and expiratory flow rates but no significant change in upper airway obstruction indices. Thus, measurement of FVL in supine posture may be used to detect UAO as it may be missed if spirometry is performed in sitting posture.


Assuntos
Postura/fisiologia , Mecânica Respiratória/fisiologia , Adulto , Peso Corporal/fisiologia , Volume Expiratório Forçado/fisiologia , Humanos , Masculino , Curvas de Fluxo-Volume Expiratório Máximo/fisiologia
17.
Med J Armed Forces India ; 57(3): 197-202, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27365603

RESUMO

Endocervical swabs from 315 patients were screened for chlamydial infection by using Enzyme Immuno Assay technique for antigen detection. Of these, 190 patients were of infertility and 125 patients were with history suggestive of pelvic inflammatory disease (PID). 100 age matched controls were also screened for the detection of chlamydial antigen by using EIA. The overall incidence of chlamydial infection in this study group was 15.2%. 21 (11.05%) of the infertility patients and 27 (21.6%) of the pelvic inflammatory disease cases were found to be positive for chlamydial antigen. The prevalence rate was found to be high in the age group of 31-40 years in both study groups i.e. infertility group (14.7%) and PID group (50%). All the ELISA positive cases (48) and randomly selected (10) age matched controls were screened by tissue culture using McCoy cell line. In the tissue culture, 44 of the 48 samples were found to be positive and none of the controls groups were found positive. 4 samples showed discordant results possibly due to the presence of non-viable organism or inhibitory material present at the sample site. The sensitivity and specificity of ELISA with respect to tissue culture are 100% and 71% respectively. The positive predictive value and the negative predictive value of the ELISA are 91.6% and 100% respectively. The efficiency of the test was found to be 93.1%.

18.
Indian J Physiol Pharmacol ; 44(1): 33-42, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10919093

RESUMO

Rats were treated with intraperitoneal injections of morphine (10 mg/kg) followed by glutamic acid (20 mg/kg.) and ketamine. (5 mg/kg). Pain thresholds were recorded as tail flick latencies for a period of 23 days and the mean area under curves calculated. Glutamic acid and ketamine, partially blocked the analgesic effects of morphine. Two types of effects were observed. In 4 animals, there was a partial blockade of the response, and in 2 animals there was a complete blockade followed by reversal in both the groups. It is suggested that two different mechanisms one excitatory and one inhibitory may be operating for the interaction of NMDA receptors with the opioid analgesic systems for modulating nociceptive responses.


Assuntos
Analgésicos Opioides/farmacologia , Antagonistas de Aminoácidos Excitatórios/farmacologia , Ácido Glutâmico/farmacologia , Ketamina/farmacologia , Morfina/farmacologia , Medição da Dor/efeitos dos fármacos , Animais , Área Sob a Curva , Interações Medicamentosas , Microinjeções , Limiar da Dor/efeitos dos fármacos , Sistema Nervoso Periférico/efeitos dos fármacos , Ratos , Ratos Wistar , Tempo de Reação/efeitos dos fármacos
19.
Jpn J Physiol ; 50(2): 227-34, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10880879

RESUMO

The present study was undertaken to evaluate the effects of hypoxia and hypercapnia on circulatory parameters during acute normovolemic hemodilution. Cats anesthetized with a mixture of alpha-chloralose and urethane were maintained by positive pressure ventilation. Muscles were paralysed by intramuscular vecuronium (0.1 mg/kg) to eliminate reflex respiratory movements. Cats were exposed to hypoxia (12% O(2) and 7% O(2)) and hypercapnia (4% CO(2) and 7% CO(2)) at normal hematocrit (Ht 40.1 +/- 2.8%) and then at graded levels of normovolemic hemodilution (Ht 24.0 +/- 2.0% and Ht 13.0 +/- 1.5%, respectively). Left ventricular pressure (LVP), LV dP/dt(max), arterial blood pressure (ABP), heart rate (HR), and right atrial pressure (RAP) were recorded on a polygraph. Cardiac output (CO) was measured using a cardiac output computer. Hemodilution per se did not produce any significant change in ABP, RAP or LV dP/dt(max), however, it produced a significant rise in HR and a significant fall in total peripheral resistance (TPR). Exposure to hypoxic gas mixtures caused significant increases in HR and CO at control Ht; but after hemodilution it caused the reverse effects. Hypercapnia did not produce any significant effect on ABP, LV dP/dt(max) or RAP either at control Ht or after hemodilution. Hypercapnia produced a fall in HR, CO and stroke volume (SV) at normal Ht and percent fall in HR response was enhanced following hemodilution. The reversal of chronotropic response to hypoxia and enhanced bradycardia response to hypercapnia, under conditions of acute normovolemic hemodilution would be deleterious as the tissues would become more hypoxic. Such a response may be attributed to altered control mechanisms under such conditions of severe stress.


Assuntos
Hemodiluição , Hemodinâmica , Hipercapnia/fisiopatologia , Hipóxia/fisiopatologia , Animais , Gatos
20.
J R Army Med Corps ; 146(1): 37-8, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15241984

RESUMO

Hepatic Abscesses have been reported in association with Crohn's disease (CD). They either occur as a complication of known CD, or as in this case, are the presentation of undiagnosed disease. The management of the CD associated with liver abscesses is a matter of debate. We report a case of CD presenting with hepatic abscesses, review the literature and discuss the management options.


Assuntos
Doença de Crohn/complicações , Doença de Crohn/diagnóstico , Abscesso Hepático/diagnóstico , Abscesso Hepático/microbiologia , Infecções Estreptocócicas/diagnóstico , Doença de Crohn/terapia , Humanos , Abscesso Hepático/terapia , Masculino , Pessoa de Meia-Idade , Infecções Estreptocócicas/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA