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1.
Braz. j. biol ; 82: e236496, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1249245

RESUMO

Abstract Euphlyctis cyanophlyctis (the skittering frog) is one of the most widespread species in Pakistan. Present study was aimed to know the presence of Euphlyctis cyanophlyctis in urban and rural areas of Lower Dir, the North-western Pakistan. A total of 33 frogs were collected, including 15 from rural and 18 from urban areas. The frogs were caught by hands covered with gloves instead of using nets. The collection was managed from August to October 2016 and from April to May 2018. Morphometric analysis, coloration as well as photographs of the frogs have been provided in detail. Skittering frogs were seen frequent in swampy areas near the water bodies. These frogs were mostly seen after sunset.


Resumo Euphlyctis cyanophlyctis (a rã que desliza) é uma das espécies mais comuns no Paquistão. O presente estudo teve como objetivo conhecer a presença de Euphlyctis cyanophlyctis em áreas urbanas e rurais de Lower Dir, noroeste do Paquistão. Um total de 33 sapos foram coletados, incluindo 15 de áreas rurais e 18 de áreas urbanas. As rãs foram apanhadas com as mãos cobertas com luvas em vez de redes. A coleta foi gerenciada de agosto a outubro de 2016 e de abril a maio de 2018. Análises morfométricas, coloração e também fotografias das rãs foram fornecidas em detalhes. Rãs saltitantes foram vistas freqüentemente em áreas pantanosas próximas aos corpos d'água. Essas rãs eram vistas principalmente após o pôr do sol.

2.
Artigo em Inglês | VETINDEXEXPRESS | ID: vti-762571

RESUMO

Abstract Euphlyctis cyanophlyctis (the skittering frog) is one of the most widespread species in Pakistan. Present study was aimed to know the presence of Euphlyctis cyanophlyctis in urban and rural areas of Lower Dir, the North-western Pakistan. A total of 33 frogs were collected, including 15 from rural and 18 from urban areas. The frogs were caught by hands covered with gloves instead of using nets. The collection was managed from August to October 2016 and from April to May 2018. Morphometric analysis, coloration as well as photographs of the frogs have been provided in detail. Skittering frogs were seen frequent in swampy areas near the water bodies. These frogs were mostly seen after sunset.


Resumo Euphlyctis cyanophlyctis (a rã que desliza) é uma das espécies mais comuns no Paquistão. O presente estudo teve como objetivo conhecer a presença de Euphlyctis cyanophlyctis em áreas urbanas e rurais de Lower Dir, noroeste do Paquistão. Um total de 33 sapos foram coletados, incluindo 15 de áreas rurais e 18 de áreas urbanas. As rãs foram apanhadas com as mãos cobertas com luvas em vez de redes. A coleta foi gerenciada de agosto a outubro de 2016 e de abril a maio de 2018. Análises morfométricas, coloração e também fotografias das rãs foram fornecidas em detalhes. Rãs saltitantes foram vistas freqüentemente em áreas pantanosas próximas aos corpos d'água. Essas rãs eram vistas principalmente após o pôr do sol.

3.
New Microbes New Infect ; 42: 100882, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34094582

RESUMO

Anti-quorum sensing (QS) or quorum quenching (QQ) is known as a new anti-bacterial strategy to combat bacterial infection. One of the best candidates for this strategy is a natural plant or traditional herbal medicine. This review aimed to summarize and introduce Iranian medicinal plants with anti-QS properties. Biomedical databases (PubMed, Scopus, Google Scholar and Web of sciences) were investigated to retrieve all related manuscripts published in English and Persian. Out of 65 documents, 47 papers were published during 2010-2020. We categorized and summarized 19 papers that particularly presented the anti-QS activity of Iranian medicinal plants. Based on our results, different studies have been completed on the QQ effects of medicinal plants. We identified 106 plant species with different properties in medicine that have been evaluated for anti-QS activities in Iran. The QQ effects of herbal extracts were identified through different in vitro examinations on biosensor and clinical bacterial strains. Only 35 medicinal plants have shown these effects at sub-MICs. Our review summarizes Iranian medicinal plants with anti-QS properties. Some of these herbal extracts showed anti-QS activity against biosensors, standard and clinical bacterial strains. This result is very important because QS systems can be considered as a new target for the development of new remedial strategies and it is a good opportunity to perform QQ studies to effectively combat bacterial infections in the future.

4.
Braz J Biol ; 82: e236496, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34037074

RESUMO

Euphlyctis cyanophlyctis (the skittering frog) is one of the most widespread species in Pakistan. Present study was aimed to know the presence of Euphlyctis cyanophlyctis in urban and rural areas of Lower Dir, the North-western Pakistan. A total of 33 frogs were collected, including 15 from rural and 18 from urban areas. The frogs were caught by hands covered with gloves instead of using nets. The collection was managed from August to October 2016 and from April to May 2018. Morphometric analysis, coloration as well as photographs of the frogs have been provided in detail. Skittering frogs were seen frequent in swampy areas near the water bodies. These frogs were mostly seen after sunset.


Assuntos
Anuros , Animais , Paquistão
5.
Entropy (Basel) ; 22(6)2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-33286375

RESUMO

In this paper, we propose and study a new probability mass function by creating a natural discrete analog to the continuous Lindley distribution as a mixture of geometric and negative binomial distributions. The new distribution has many interesting properties that make it superior to many other discrete distributions, particularly in analyzing over-dispersed count data. Several statistical properties of the introduced distribution have been established including moments and moment generating function, residual moments, characterization, entropy, estimation of the parameter by the maximum likelihood method. A bias reduction method is applied to the derived estimator; its existence and uniqueness are discussed. Applications of the goodness of fit of the proposed distribution have been examined and compared with other discrete distributions using three real data sets from biological sciences.

6.
New Microbes New Infect ; 38: 100780, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33163200

RESUMO

Diarrhoea is a major health concern, especially in developing countries. Research has implicated diffusely adherent Escherichia coli (DAEC) strains as a cause of diarrhoea. In this study, we investigated the prevalence, adherence assay, virulence gene profiles and antimicrobial resistance of DAEC at a hospital in southern Iran. In this cross-sectional study, 309 infants and children under the age of 13 years with diarrhoea who had been referred to Shahid Dastgheib Hospital, Shiraz between October 2018 and May 2019 were recruited. Microbiological methods, PCR, HEp-2 adherence assay and antimicrobial susceptibility test were used. Of the 309 stool samples, 207 (66.9%) were found to contain E. coli by biochemical tests and culture. Molecular analysis of Afa/Dr and AIDA-I adhesin-encoding genes showed that 14 (6.7%) out of 207 E. coli isolates were DAEC. All DAEC isolates in HEp-2 cells showed a diffusely adherent pattern. The virulence genes sat, pet, sigA, pic, astA and fimH were found in 50%, 0%, 14.2%, 14.2%, 21.4% and 100% of DAEC isolates, respectively. The most effective antibiotic against the DAEC isolates was imipenem (92.8%) and the least effective was ampicillin (0%). Our findings expand the knowledge on DAEC prevalence and its characteristics in Iran. It also explains the role of virulence genes in DAEC pathogenesis. The results showed that although the prevalence of DAEC is low, these strains exhibit a high rate of antimicrobial resistance as well as high frequency for carrying virulence genes.

7.
New Microbes New Infect ; 38: 100769, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33194208

RESUMO

Today an alternative approach to control bacterial infections is the use of natural and traditional plant compounds to interfere with their quorum-sensing (QS) systems. In this study, antibacterial and anti-QS sensing activity of Syzygium aromaticum, Dionysia revoluta Boiss. and Eucalyptus camaldulensis Dehnh. were evaluated. These plants are local to the Middle East region and have since ancient times been used for their antibacterial activity. Plant compounds were extracted with n-hexane, methanol and 96% ethanol mixed solvent. Antibacterial activity of this herbal extracts against five Gram-negative and Gram-positive bacteria were assessed. The effective sub-minimum inhibitory concentration (MIC) of this extract on bacterial QS systems were investigated by a violacein quantification assay in the Chromobacterium violaceum CV026 biosensor strain, inhibition of exogenously QS signal molecules in Aeromonas veronii bv. Sobria strain BC88 and Pseudomonas aeruginosa isolated from a patient with cystic fibrosis in vitro. Results found that Syzygium aromaticum 0.39 to 0.048 mg/mL, Dionysia revoluta Boiss. 3.1 to 0.39 mg/mL and E. camaldulensis 0.78 to 0.097 mg/mL showed anti-QS activities by reducing the violacein formation depletion of QS signals produced in A. veronii and P. aeruginosa at sub-MICs. Regarding the anti-QS effects of these herbal extracts, their effective components may be candidates for use in combating bacterial infections at sub-MICs.

8.
Actas Urol Esp (Engl Ed) ; 44(7): 489-496, 2020 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32600878

RESUMO

OBJECTIVE: To evaluate the prevalence of preoperative anemia and its effect on oncological outcomes in patients undergoing radical cystectomy (RC) due to bladder cancer. MATERIAL AND METHODS: Retrospective single-center study with 176 RCs between May 2008 and July 2018. Anemia was defined according to the WHO classification (male<130mg/dL, female<120mg/dL). Kaplan-Meier test was used to estimate recurrence-free, cancer-specific and overall survival rates. Multivariate logistic regression was used to identify factors associated with overall mortality rates. RESULTS: Overall, 89 (50.6%) patients had preoperative anemia, and 44 of them (49.4%) received neoadjuvant chemotherapy. Anemic patients resulted in higher rates of ASA (ASA>2: 54.6 vs. 27.5%; P=.003), ectasia rate previous to RC (41.6 vs. 19.5%; P=.002), treatment with neoadjuvant chemotherapy (49.4 vs. 19.5%; P<.001), blood transfusion rate (25.8 vs. 11.5%; P=.015) and pathological stage (pT>2: 49.4 vs. 33.3%; P=.03) compared to non-anemic patients. Median follow-up was 27.2 months (IQR 11.12-72.28). Median overall survival (105 vs. 34 months, log-rank; P=.001), cancer-specific survival (89 vs. 61 months; P=.004) and recurrence-free survival (85 vs. 57 months; P=.002) were significantly lower in anemic patients compared to the non-anemic group. In multivariable Cox analysis, preoperative anemia, pT>2 and N≥1 were independently associated with overall mortality. CONCLUSION: Preoperative anemia was common in patients undergoing RC for bladder cancer, and it is related with a worse cancer prognosis. Anemia is a preoperative modifiable factor; we believe that the implementation of Patient Blood Management programs during prehabilitation may have a relevant role in improving the oncological outcomes in these patients.


Assuntos
Anemia/complicações , Cistectomia , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Anemia/epidemiologia , Cistectomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Neoplasias da Bexiga Urinária/mortalidade
9.
Carbohydr Polym ; 240: 116264, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32475554

RESUMO

Acetylated, propionylated and butyrylated rice and quinoa starches at different levels of modification and starch concentrations, were used to stabilize oil-in-water starch Pickering emulsions at 10% oil fraction. Short-chain fatty acid modified starch Pickering emulsions (SPEs) were characterized after emulsification and after 50 days of storage. The particle size distribution, microstructure, emulsion index, and stability were evaluated. An increase in starch concentration led to a decrease of emulsion droplet sizes. Quinoa starch has shown the capability of stabilizing Pickering emulsions in both the native and modified forms. The emulsifying capacity of SPEs was improved by increasing the chain length of SCFA. Modified quinoa starch with higher chain lengths (i.e. propionylated and butyrylated), at higher levels of modification, showed higher emulsion index (>71%) and stability over the entire 50 days storage. At optimized formulation, SCFA-starch particles have the potential in stabilizing emulsions for functional foods, pharmaceutical formulations, or industrial food applications.


Assuntos
Chenopodium quinoa/química , Emulsões/química , Ácidos Graxos Voláteis/química , Oryza/química , Amido/química , Tamanho da Partícula , Reologia
10.
Ann Ig ; 32(1): 72-80, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31713579

RESUMO

BACKGROUND: Clostridioides difficile a Gram-positive, obliged anaerobic, rod-shaped spore-former bacterium, causes a wide spectrum of diseases, ranging from mild, self-limiting diarrhoea to serious diarrhea. Chitosan, a natural polysaccharide, is largely known for its activity against a wide range of microorganisms. Chitosan, in the form of nanofibrils (nanofibrilated chitosan), consists of separated fibers which can be suspended easily in aqueous media. STUDY DESIGN: This paper, for the first time, aims to evaluate the antimicrobial activity of chitosan nanofibers against C. difficile isolates. METHODS: Chitosan nanofibers were characterized through scanning electron microscopy and atomic force microscopy. Minimum inhibitory concentration and minimum bactericidal concentration of chitosan nanofibers against toxigenic C. difficile isolates (with resistance gene: ermB, tetM and tetW) was determined by the standard broth microdilution method. RESULTS: The Miniumum Inhibitory Concentration of chitosan nanofibers for two toxigenic isolates with resistance genes ermB, tetM and tetW, two toxigenic isolates ermB+ tetM+ and the standard strain ATCC 700057 was similar and equal to 0.25 mg/mL. The minimum bactericidal concentration for all isolates was 0.5 mg/mL. CONCLUSIONS: The results demonstrated that chitosan nanofibers exhibit potent antimicrobial activities against multiple toxigenic C. difficile isolates, and the antibacterial effect of chitosan nanofibers against C. difficile isolates with ermB, tetM and tetW resistance genes indicates that interfering with the synthesis of proteins is not the mechanism of action of chitosan nanofibers.


Assuntos
Antibacterianos , Quitosana , Clostridioides difficile , Nanofibras , Proteínas de Bactérias/genética , Toxinas Bacterianas/genética , Clostridioides difficile/genética , Farmacorresistência Bacteriana/genética , Fezes/microbiologia , Humanos , Testes de Sensibilidade Microbiana , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Nanofibras/ultraestrutura
11.
Int J Oral Maxillofac Surg ; 48(2): 211-216, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30143350

RESUMO

Orthognathic surgery aims to correct dentoskeletal and facial discrepancies. Treatment usually requires a minimum of 18 months, necessitating that patients are adequately satisfied with the treatment provided. This study aimed to assess the determinants of patient satisfaction following treatment. One hundred and eighteen patients who had undergone orthognathic surgery were included prospectively. All participants completed a questionnaire regarding their reasons for undergoing treatment, treatment logistics, treatment outcomes, and satisfaction throughout their journey. Most patients were 'very satisfied' (71.2%) or 'satisfied' (19.5%) with the overall treatment. The majority wished to improve their smile (78.0%); post-treatment, 89.0% of patients reported an improved smile. Almost half of the patients (46.6%) stayed in hospital for only one night, and 41.5% took over 4 weeks off work or school post-surgery. People with postoperative breathing difficulties spent more days in hospital (P=0.021), but importantly, the duration of hospital stay did not differ between maxillary advancement, bilateral sagittal split osteotomy, and bimaxillary surgery (P=0.78). In conclusion, patient satisfaction was high following orthognathic treatment. The results highlight areas for improvement, such as information delivery to the patient throughout the treatment journey, and show that the presence of ongoing problems is an important predictor of patient satisfaction.


Assuntos
Procedimentos Cirúrgicos Ortognáticos , Satisfação do Paciente , Adulto , Feminino , Humanos , Masculino , Medição da Dor , Complicações Pós-Operatórias , Estudos Prospectivos , Inquéritos e Questionários , Resultado do Tratamento
12.
Herz ; 43(2): 140-145, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28144715

RESUMO

BACKGROUND: Sepsis is a systemic inflammatory response usually correlated with multi-organ failure. Myocardial dysfunction is one of the adverse outcomes in septic patients and results in high mortality rates. The aim of this study was to investigate the impact of irbesartan in attenuation of cardiac depression during polymicrobial sepsis via decreased activation of the phospho-p38MAPK/nuclear factor (NF)-κB signaling pathway. MATERIALS AND METHODS: A model of polymicrobial sepsis induced via cecal ligation and puncture (CLP) with 8- to 12-week-old albino mice was used. Mice were treated with i.p. irbesartan (3 mg/kg) 1 h before CLP. Using a micro-tipped transducer catheter, the following hemodynamic parameters were evaluated after CLP: heart rate, ejection fraction, left ventricular (LV) end-diastolic pressure, LV systolic pressure, and cardiac output. Plasma levels of proinflammatory cytokines, including tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6, monocyte chemoattractant protein-1 (MCP-1), and cardiac troponin I (cTn-I), were measured via ELISA analysis. The degree of p38MAPK and NF-κB phosphorylation was assessed via Western blotting. RESULTS: Mice treated with irbesartan displayed improvement in LV function (ejection fraction: 42.4 ± 1.1% vs. 27.8 ± 3% in CLP mice). The attenuation of cardiac depression in irbesartan-treated mice was associated with lower levels of MCP-1 in plasma and a reduction in the levels of TNF-alpha, IL-1beta, and IL-6. Furthermore, irbesartan-treated mice displayed lower expression levels of p38-MAPK and NF-κB phosphorylation. CONCLUSION: Irbesartan can attenuate cardiac dysfunction during polymicrobial sepsis possibly via a reduction of proinflammatory cytokines through decreased activation of the p38MAPK/NF-κB pathways.


Assuntos
Cardiotônicos/farmacologia , Coinfecção/tratamento farmacológico , Irbesartana/farmacologia , NF-kappa B/antagonistas & inibidores , Sepse/tratamento farmacológico , Transdução de Sinais/efeitos dos fármacos , Proteínas Quinases p38 Ativadas por Mitógeno/antagonistas & inibidores , Animais , Coinfecção/sangue , Citocinas/sangue , Modelos Animais de Doenças , Ativação Enzimática/efeitos dos fármacos , Hemodinâmica/efeitos dos fármacos , Injeções Intraperitoneais , Camundongos , Pré-Medicação , Sepse/sangue
13.
Cell Mol Biol (Noisy-le-grand) ; 63(9): 115-121, 2017 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-28980931

RESUMO

The present study aimed to determine the bacteriological etiology and antibiotic susceptibility pattern of sepsis in HIV infected and HIV uninfected patients, and related risk factors to introduce an appropriate therapy. This cross-sectional study was conducted from January 2014 to January of 2015 enrolling patients with sepsis associated with or without HIV infection admitted to Shiraz teaching hospitals, South of Iran. Blood and urine cultures were performed and standard microbiological methods were followed for isolation and identification of the bacteria. HIV antibody testing and CD4+ lymphocyte count were done for HIV-infected patients. Antimicrobial susceptibility tests were performed using the disk diffusion method in accordance with CLSI recommendations. Totally, 140 patients with sepsis including 30 HIV-positive, and 110 HIV-negative were enrolled. Our finding showed 26.7% and 20% blood and urine culture positivity in HIV-positive and 20.9% and 14.5% positivity in HIV-negative patients. Staphylococcus aureus, Salmonella spp. and coagulase-negative staphylococci (CoNS) each with frequency of 25% were detected as the most prevalent isolates in samples of HIV patients. In contrast, the main etiology for sepsis in HIV-negative patients was CoNS (47.8%), followed by Escherichia coli (17.4%). The median of CD4+ lymphocyte count and viral load in HIV patients were estimated 10.15 cells/mm3 and 68019.48 copies/mL, respectively. The results of the present study revealed that the main cause of sepsis in the studied hospitals was nosocomial pathogens. These findings highlighted the importance of infection control policies for preventing the emergence and spread of nosocomial infections.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Infecções por HIV/complicações , Sepse/complicações , Sepse/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Escherichia coli/efeitos dos fármacos , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Infecções por HIV/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Salmonella/efeitos dos fármacos , Infecções por Salmonella/complicações , Infecções por Salmonella/tratamento farmacológico , Infecções por Salmonella/epidemiologia , Infecções por Salmonella/microbiologia , Sepse/epidemiologia , Sepse/microbiologia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos
14.
Circ Heart Fail ; 5(6): 778-85, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23087402

RESUMO

BACKGROUND: Right ventricular (RV) dysfunction frequently occurs and independently prognosticates in left-sided heart failure. It is not clear which RV afterload measure has the greatest impact on RV function and prognosis. We examined the determinants, prognostic role, and response to treatment of pulmonary arterial capacitance (PAC, ratio of stroke volume over pulmonary pulse pressure), in relation to pulmonary vascular resistance (PVR) in heart failure. METHODS AND RESULTS: We reviewed 724 consecutive patients with heart failure who underwent right heart catheterization between 2000 and 2005. Changes in PAC were explored in an independent cohort of 75 subjects treated for acute decompensated heart failure. PAC showed a strong inverse relation with PVR (r=-0.64) and wedge pressure (r=-0.73), and provides stronger prediction of significant RV failure than PVR (area under the curve ROC 0.74 versus 0.67, respectively, P=0.003). During a mean follow-up of 3.2±2.2 years, both lower PAC (P<0.0001) and higher PVR (P<0.0001) portend more adverse clinical events (all-cause mortality and cardiac transplantation). In multivariate analysis, PAC (but not PVR) remains an independent predictor (Hazard ratio=0.92 [95% CI: 0.84-1.0, P=0.037]). Treatment of heart failure resulted in a decrease in PVR (270±165 to 211±88 dynes·s(-1)·cm(-5), P=0.002), a larger increase in PAC (1.65±0.64 to 2.61±1.42 mL/mm Hg, P<0.0001), leading to an increase in pulmonary arterial time constant (PVR×PAC) (0.29±0.12 to 0.37±0.15 second, P<0.0001). CONCLUSIONS: PAC bundles the effects of PVR and left-sided filling pressures on RV afterload, explaining its strong relation with RV dysfunction, poor long-term prognosis, and response to therapy.


Assuntos
Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Artéria Pulmonar/fisiopatologia , Índice de Gravidade de Doença , Capacitância Vascular/fisiologia , Adulto , Idoso , Estudos de Coortes , Feminino , Hemodinâmica/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Volume Sistólico/fisiologia , Resistência Vascular/fisiologia , Disfunção Ventricular Direita/fisiopatologia
15.
Clin Ter ; 163(4): 287-91, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23007811

RESUMO

BACKGROUND: Anaemia is a global health problem including Malaysia. In adults, anaemia may affect work productivity. Iron deficiency anaemia and thalassaemia are common causes of anaemia in Malaysia. However, there is scarcity of data on national prevalence of iron deficiency anaemia and thalassaemia, especially in young adults. This cross sectional study was performed to determine the prevalence of iron deficiency anaemia and thalassaemia among medical students of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). MATERIALS AND METHODS: Blood samples collected in EDTA tubes were analyzed for haemoglobin level and red cell parameters such as MCV, MCH and red cell counts. Samples with abnormal red cell indices were sent for analysis of RBC morphology, iron status, haemoglobin analysis and DNA analysis. RESULTS: A total of 400 samples were available for this study. Fifty-eight (14.5%) students had hypochromic microcytic red cell indices in which 44 (11%) showed thalassaemia red cell indices while 14 (3.5%) had iron deficiency red cell indices which were finally confirmed by serum iron/TIBC analysis. Amongst those suspected to have thalassaemia, 12 (27.3%) were confirmed as alpha thalassaemia trait (αα/--(SEA)), 11 (25%) as Haemoglobin-E trait, 8 (18.2%) as beta thalassaemia trait and 2 (4.5%) as Haemoglobin Constant Spring (αα/α(CS)α). However, eleven students (25%) with thalassaemia red cell indices could not be confirmed with the common thalassaemia primers available, thus causes have yet to be established. CONCLUSION: Our prevalence of thalassaemia was high and thus we opine that better screening methods should be adopted.


Assuntos
Anemia Ferropriva/epidemiologia , Talassemia/epidemiologia , Estudos Transversais , Feminino , Humanos , Malásia , Masculino , Prevalência , Estudantes de Medicina , Adulto Jovem
16.
Clin Biomech (Bristol, Avon) ; 27(2): 111-6, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21924805

RESUMO

BACKGROUND: Up to now, plain radiographs are not well suited to assess spinal fusion. Radiostereometric analysis performed for two postures may deliver more reliable results. However, it is unknown, which postures are most suitable for this procedure. METHODS: In a finite element study, spinal fusion at the level L4-5 was simulated assuming a posterior approach and the implantation of two cages and a spinal fixation device. The change of the distance between markers in vertebrae adjacent to the cages was calculated for moving from one of the following postures standing, flexion, extension, axial rotation, lying, and extension in a lying position to another. The changes of marker distances were calculated for the intact model, as well as for the situations: directly after surgery before fusion started, in the early-fusion-phase and in the late-fusion-phase. Differences in the marker motion between two postoperative situations were also calculated. FINDINGS: The most anteriorly placed markers showed the greatest motion between two postures. The greatest differences in marker motions between the two situations before-fusion and early-fusion-phase (0.54 mm) as well as between early-fusion-phase and late-fusion-phase (0.34 mm) were found for the two postures flexion while standing and extension in a lying position. INTERPRETATION: Pairs of X-rays taken while standing with maximum flexed upper body and while lying with maximum extended trunk are most suited for the assessment of spinal fusion when using radiostereometric analysis.


Assuntos
Vértebras Lombares , Modelos Biológicos , Postura , Análise Radioestereométrica/métodos , Fusão Vertebral/métodos , Articulação Zigapofisária/fisiopatologia , Articulação Zigapofisária/cirurgia , Artrografia/métodos , Simulação por Computador , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiopatologia , Vértebras Lombares/cirurgia , Região Lombossacral , Avaliação de Resultados em Cuidados de Saúde/métodos , Exame Físico/métodos , Resultado do Tratamento
17.
Eur Spine J ; 21(4): 666-73, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22012215

RESUMO

PURPOSE: Pedicle-screw-based dynamic implants are intended to preserve intervertebral mobility while releasing certain spinal structures. The aim of the study was to determine the as yet unknown optimal stiffness value of the longitudinal rods that fulfils best these opposing tasks. METHODS: A finite element model of the lumbar spine was used which includes the posterior implant at level L4/5. More than 250 variations of this model were generated by varying the diameter of the longitudinal rods between 6 and 12 mm and their elastic modulus between 10 MPa and 200 MPa. The loading cases flexion, extension, lateral bending and axial rotation were simulated. Evaluated optimization criteria were the ranges of motion, forces in the facet joints, posterior bulgings of the intervertebral disc and the intradiscal pressures. Various objective functions were evaluated. RESULTS: The results show that the objective values depend more on the axial stiffness of the rods than on bending and torsional stiffness, rod diameter and elastic modulus. The optimal stiffness value for most of the investigated objective functions is approximately 50 N/mm and is achieved, e.g. using a rod diameter of 6 mm and an elastic modulus of 50 MPa. The design with the least axial stiffness was the best one with regard to the mobility. The forces in the facet joints and the intradiscal pressures were reduced mostly by an implant with the highest axial stiffness. When minimal posterior disc bulging was the criterion, the optimal axial stiffness was also approximately 50 N/mm. CONCLUSIONS: The optimal axial stiffness of a pedicle-screw-based motion preservation implant for the lumbar spine is approximately 50 N/mm.


Assuntos
Parafusos Ósseos , Módulo de Elasticidade/fisiologia , Vértebras Lombares/fisiologia , Vértebras Lombares/cirurgia , Próteses e Implantes , Amplitude de Movimento Articular/fisiologia , Fusão Vertebral/instrumentação , Fenômenos Biomecânicos , Pinos Ortopédicos , Simulação por Computador , Análise de Elementos Finitos , Humanos , Modelos Biológicos , Fusão Vertebral/métodos
18.
Biomed Tech (Berl) ; 56(6): 327-31, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22103650

RESUMO

Abstract Posterior disc bulging may lead to nerve root compression and radicular pain, and in extreme cases to a local pressure on the dural sac and thus to back pain. Compared to when standing, posterior disc bulging is increased during extension and decreased during flexion, in an uninstrumented spine. The aim of this study was to determine the effect of a pedicle-screw-based dynamic implant on posterior disc bulging. A finite element model of the lumbosacral spine was used to calculate posterior disc bulging before and after implantation of a dynamic implant for different loading cases. The elastic modulus of the longitudinal rod was varied, and the influence of distraction of the bridged segment on disc bulging was also determined. In addition, the centre of rotation (CoR) was determined. Due to a dynamic implant, the magnitude of posterior disc bulging was reduced compared to that for "standing without an implant" during extension, lateral bending, and axial rotation. During flexion, however, disc bulging was usually increased. With increasing stiffness of the dynamic implant, the CoR moved towards the longitudinal rod. This posterior shift of the CoR led to a compression of the entire intervertebral disc during flexion and thus to an increase of disc bulging.


Assuntos
Parafusos Ósseos/efeitos adversos , Deslocamento do Disco Intervertebral/etiologia , Deslocamento do Disco Intervertebral/fisiopatologia , Disco Intervertebral/fisiopatologia , Vértebras Lombares/fisiopatologia , Vértebras Lombares/cirurgia , Modelos Biológicos , Movimento , Postura , Simulação por Computador , Humanos
19.
Coron Artery Dis ; 22(8): 553-8, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21934609

RESUMO

BACKGROUND: A non-negligible proportion of patients with chest pain with negative cardiac troponin may harbor a disrupted coronary plaque. A marker of plaque rupture upstream from myocardial necrosis may help identify high-risk patients among this patient population. The purpose of this study was to investigate the correlation of plasma myeloperoxidase (MPO) concentration and angiographic coronary disease among patients with suspected troponin-negative coronary syndromes. PATIENTS AND METHODS: Patients presenting with chest pain and negative cardiac troponin-T concentration and undergoing coronary angiography were enrolled in our study. Plasma MPO concentration was measured using a single blood sample collected prior to cardiac catheterization. The primary angiographic endpoint was the presence of at least one coronary stenosis causing a 70% or more diameter reduction; secondary endpoints were number of diseased vessels, presence of coronary thrombus, and lesion ulceration. The main clinical endpoint was coronary revascularization. RESULTS: Three hundred and eighty-nine patients were enrolled. Presence of coronary stenosis causing a 70% or more diameter reduction increased with increasing quartiles of myeloperoxidase concentration (P<0.0001), as did the presence of coronary thrombus (P<0.0001) and plaque ulceration (P<0.0001). The need for percutaneous coronary revascularization also increased with increasing quartiles of systemic myeloperoxidase levels (P<0.0001). Coronary surgical revascularization did not differ among myeloperoxidase quartiles. CONCLUSION: Among patients with chest pain without troponin elevation, a single measurement of plasma MPO concentration can help identify patients with a higher risk of having significant coronary stenoses and high-risk angiographic features.


Assuntos
Angina Pectoris/diagnóstico , Estenose Coronária/diagnóstico , Peroxidase/sangue , Troponina T/sangue , Idoso , Angina Pectoris/sangue , Angina Pectoris/etiologia , Angina Pectoris/terapia , Angioplastia Coronária com Balão , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Angiografia Coronária , Ponte de Artéria Coronária , Estenose Coronária/sangue , Estenose Coronária/complicações , Estenose Coronária/terapia , Feminino , Humanos , Líbano , Masculino , Pessoa de Meia-Idade , Razão de Chances , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença
20.
J Clin Pharmacol ; 51(10): 1418-28, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21148049

RESUMO

The authors assessed the impact of CYP2C9*2, CYP2C9*3, and/or VKORC1-1639G>A/1173C>T single-nucleotide polymorphisms on oral anticoagulants in a Lebanese population. This study recruited 231 Lebanese participants on long-term warfarin or acenocoumarol maintenance therapy with an international normalized ratio (INR) monitored at the American University of Beirut Medical Center. CYP2C9 and VKORC1 variant alleles were screened by real-time PCR. Plasma R- and S-warfarin and R- and S-acenocoumarol levels were assayed using high-performance liquid chromatography. The variant allele frequencies of CYP2C9*2, CYP2C9*3, and VKORC1 -1639G>A/1173C>T were 15.4%, 7.8%, and 52.4%, respectively. Fifty-five participants were excluded from analysis because of nontherapeutic INR values at recruitment, leaving 43 participants taking warfarin and 133 taking acenocoumarol. There was a significant decrease in the weekly maintenance dose of both drugs with CYP2C9 and VKORC1 variants when compared with wild-type patients. CYP2C9*2 had the least impact on the response to both drugs. The concentrations of R- and S-warfarin in plasma were significantly correlated with CYP2C9 genotypes. For acenocoumarol, time to reach target INR was more prolonged in patients carrying any CYP2C9 variant allele but failed to reach statistical significance because of low numbers of patients. There was no association between allelic variants and bleeding events. This is the first pharmacogenetic study of oral anticoagulants in Arabs. The authors showed that both CYP2C9 and VKORC1 polymorphisms are common in Lebanon and influence warfarin and acenocoumarol dose requirements, with the CYP2C9*2 polymorphism having less effect on acenocoumarol, the most commonly used oral anticoagulant in Lebanon.


Assuntos
Acenocumarol/farmacocinética , Hidrocarboneto de Aril Hidroxilases/genética , Oxigenases de Função Mista/genética , Polimorfismo Genético , Varfarina/farmacocinética , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/farmacocinética , Citocromo P-450 CYP2C9 , Feminino , Genótipo , Humanos , Coeficiente Internacional Normatizado , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Trombose/epidemiologia , Trombose/prevenção & controle , Vitamina K Epóxido Redutases
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