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1.
Braz. j. biol ; 83: e248910, 2023. tab, graf
Artigo em Inglês | LILACS-Express | MEDLINE, LILACSEXPRESS | ID: biblio-1339342

RESUMO

Abstract This study determines the associations among serum lipid profiles, risk of cardiovascular disease, and persistent organic pollutants. Using Gas chromatography technique, the intensity of toxic pollutant residues in serum samples of Hypertensive patients were measured. Based on statistical analysis, the effects of different covariates namely pesticides, age, systolic blood pressure, diastolic blood pressure, and lipid profile duration was checked using the logistic regression model. Statistical computation was performed on SPSS 22.0. The P-values of F-Statistic for each lipid profile class are greater than 0.01 (1%), therefore we cannot reject the null hypothesis for all cases. The estimated coefficients, their standard errors, Wald Statistic, and odds ratio of the binary logistic regression model for different lipid profile parameters indicate if pesticides increase then the logit value of different lipid profile parameters changes from -0.46 to -0.246 except LDL which increases by 0.135. The study reports a significantly increased threat of cardiovascular disease with increased concentrations of toxic pollutants.


Resumo Este estudo determina as associações entre o perfil lipídico sérico, o risco de doença cardiovascular e os poluentes orgânicos persistentes. Por meio da técnica de cromatografia gasosa, mediu-se a intensidade dos resíduos de poluentes tóxicos em amostras de soro de pacientes hipertensos. Com base na análise estatística, os efeitos de diferentes covariáveis ​​- ou seja, pesticidas, idade, pressão arterial sistólica, pressão arterial diastólica e duração do perfil lipídico - foram verificados usando o modelo de regressão logística. O cálculo estatístico foi realizado no SPSS 22.0. Os valores P da estatística F para cada classe de perfil lipídico são maiores que 0,01 (1%), portanto não podemos rejeitar a hipótese nula para todos os casos. Os coeficientes estimados, seus erros padrão, estatística de Wald e odds ratio do modelo de regressão logística binária para diferentes parâmetros do perfil lipídico indicam se os pesticidas aumentam, então o valor logit de diferentes parâmetros do perfil lipídico muda de -0,46 para -0,246, exceto LDL, que aumenta em 0,135. O estudo relata um aumento significativo da ameaça de doença cardiovascular com aumento das concentrações de poluentes tóxicos.

2.
Braz. j. biol ; 83: e250373, 2023. tab, graf
Artigo em Inglês | LILACS-Express | MEDLINE, LILACSEXPRESS | ID: biblio-1339376

RESUMO

Abstract Honey is a suitable matrix for the evaluation of environmental contaminants including organochlorine insecticides. The present study was conducted to evaluate residues of fifteen organochlorine insecticides in honey samples of unifloral and multifloral origins from Dir, Pakistan. Honey samples (5 g each) were extracted with GC grade organic solvents and then subjected to Rotary Evaporator till dryness. The extracts were then mixed with n-Hexane (5 ml) and purified through Column Chromatography. Purified extracts (1μl each) were processed through Gas Chromatograph coupled with Electron Capture Detector (GC-ECD) for identification and quantification of the insecticides. Of the 15 insecticides tested, 46.7% were detected while 53.3% were not detected in the honey samples. Heptachlor was the most prevalent insecticide with a mean level of 0.0018 mg/kg detected in 80% of the samples followed by β-HCH with a mean level of 0.0016 mg/kg detected in 71.4% of the honey samples. Honey samples from Acacia modesta Wall. were 100% positive for Heptachlor with a mean level of 0.0048 mg/kg followed by β-HCH with a mean level of 0.003 mg/kg and frequency of 83.3%. Minimum levels of the tested insecticides were detected in the unifloral honey from Ziziphus jujuba Mill. Methoxychlor, Endosulfan, Endrin and metabolites of DDT were not detected in the studied honey samples. Some of the tested insecticides are banned in Pakistan but are still detected in honey samples indicating their use in the study area. The detected levels of all insecticides were below the Maximum Residue Levels (MRLs) and safe for consumers. However, the levels detected can cause mortality in insect fauna. The use of banned insecticides is one of the main factors responsible for the declining populations of important insect pollinators including honeybees.


Resumo O mel é uma matriz adequada para a avaliação de contaminantes ambientais, incluindo inseticidas organoclorados. O presente estudo foi conduzido para avaliar resíduos de 15 inseticidas organoclorados em amostras de mel de origem unifloral e multifloral de Dir, Paquistão. Amostras de mel (5 g cada) foram extraídas com solventes orgânicos de grau GC e, em seguida, submetidas ao evaporador rotativo até a secura. Os extratos foram então misturados com n-hexano (5 ml) e purificados por cromatografia em coluna. Os extratos purificados (1μl cada) foram processados através de cromatógrafo gasoso acoplado a detector de captura de elétrons (GC-ECD) para identificação e quantificação dos inseticidas. Dos 15 inseticidas testados, 46,7% foram detectados enquanto 53,3% não foram detectados nas amostras de mel. O heptacloro foi o inseticida mais prevalente com um nível médio de 0,0018 mg / kg detectado em 80% das amostras, seguido por β-HCH com um nível médio de 0,0016 mg / kg detectado em 71,4% das amostras de mel. Amostras de mel da parede de Acacia modesta foram 100% positivos para heptacloro com um nível médio de 0,0048 mg / kg seguido por β-HCH com um nível médio de 0,003 mg / kg e frequência de 83,3%. Níveis mínimos dos inseticidas testados foram detectados no mel unifloral de Ziziphus jujuba da usina. Metoxicloro, Endosulfan, Endrin e metabólitos do DDT não foram detectados nas amostras de mel estudadas. Alguns dos inseticidas testados são proibidos no Paquistão, mas ainda são detectados em amostras de mel, indicando seu uso na área de estudo. Os níveis detectados de todos os inseticidas estavam abaixo dos Níveis Máximos de Resíduos (MRLs) e seguros para os consumidores. No entanto, os níveis detectados podem causar mortalidade na fauna de insetos. O uso de inseticidas proibidos é um dos principais fatores responsáveis pelo declínio das populações de importantes insetos polinizadores, incluindo as abelhas.

3.
Braz. j. biol ; 83: e251958, 2023. tab, graf
Artigo em Inglês | LILACS-Express | MEDLINE, LILACSEXPRESS | ID: biblio-1339380

RESUMO

Abstract Odonates are important biological control agents for the control of insect pests and insect disease vectors of medical and veterinary importance. The present study was conducted to evaluate the odonate fauna of Swat, Pakistan from March to October 2019. A total of 200 specimens of odonates were collected from diverse habitats. The collected specimens of the order Odonata belonged to 5 families, three families of suborder Anisoptera namely Libellulidae, Gomphidae and Aeshnidae while two families of suborder Zygoptera (Chlorocyphidae and Coenagrionidae). The specimens were categorized into 12 genera and 22 species. Libellulidae was the dominant family (n = 138) accounting for 69% of the odonate fauna. Orthetrum was the dominant genus (n = 73) of suborder Anisoptera accounting for 36.5% of the odonate fauna. The least dominant genera were Anax, Paragomphus and Rhyothemis (n = 5 each) accounting each for 2.5% of the odonate fauna. In Zygoptera, the dominant genus was Ceriagrion (12.5%) and the least dominant genus was Ischnura (6%). Pantala flavescens (Fabricius, 1798) was the most abundant odonate species in the study area recorded from all surveyed habitats. Shannon Diversity Index (H) was 2.988 and Simpson Diversity Index (D) was 0.95 for the collected odonate fauna. The highest abundance of Odonata was recorded in August, September and May while no odonate species were recorded in January, February, November and December. Lotic water bodies were the most suitable habitats with abundant odonate fauna. Anax immaculifrons (Rambur, 1842) was the largest sized odonate species having a wingspan of 53.2±1.63 mm and body length of 56.3 ± 0.4 mm. The present study shows the status of odonate fauna of Swat, Pakistan in diverse habitats and seasonsonal variation throughout the year. Further work is recommended to bridge the gaps in the existing literature.


Resumo Odonatos são importantes agentes de controle biológico para o controle de insetos-praga e vetores de doenças de insetos de importância médica e veterinária. O presente estudo foi conduzido para avaliar a fauna de odonatos de Swat, Paquistão, de março a outubro de 2019. Um total de 200 espécimes de odonatos foi coletado em diversos habitats. Os espécimes coletados da ordem Odonata pertenciam a cinco famílias, três famílias da subordem Anisoptera, a saber, Libellulidae, Gomphidae e Aeshnidae, enquanto duas famílias eram da subordem Zygoptera (Chlorocyphidae e Coenagrionidae). Os espécimes foram classificados em 12 gêneros e 22 espécies. Libellulidae foi a família dominante (n = 138), respondendo por 69% da fauna de odonatos. Orthetrum foi o gênero dominante (n = 73) da subordem Anisoptera, responsável por 36,5% da fauna de odonatos. Os gêneros menos dominantes foram Anax, Paragomphus e Rhyothemis (n = 5 cada), representando cada um 2,5% da fauna de odonatos. Em Zygoptera, o gênero dominante foi Ceriagrion (12,5%), e o gênero menos dominante foi Ischnura (6%). Pantala flavescens (Fabricius, 1798) foi a espécie de odonato mais abundante na área de estudo, registrada em todos os habitats pesquisados. O Índice de Diversidade de Shannon (H) foi de 2,988, e o Índice de Diversidade de Simpson (D) foi de 0,95 para a fauna de odonatos coletados. A maior abundância de Odonata foi registrada em agosto, setembro e maio, enquanto nenhuma espécie de Odonata foi registrada em janeiro, fevereiro, novembro e dezembro. Corpos d'água lóticos foram os habitats mais adequados, com abundante fauna de odonatos. Anax imaculifrons (Rambur, 1842) foi a espécie de odonato de maior tamanho, com envergadura de 53,2 ± 1,63 mm e comprimento do corpo de 56,3 ± 0,4 mm. O presente estudo mostrou o status da fauna de odonatos de Swat, Paquistão, em diversos habitats e variação sazonal ao longo do ano. Recomenda-se trabalho adicional para preencher as lacunas na literatura existente.

4.
Braz J Biol ; 84: e253613, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34730702

RESUMO

Soybean meal is an inexpensive plant origin protein which has been used in practical diets as a replacement of animal protein such as fish meal or chicken meal, due to the uneconomical price of animal protein diets. Consequently, a research study was conducted on some commercial species of Indian major carps i.e. Catla (Cattla cattla), Rohu (Labeo rohita) and Mrigala (Cirhinus mrigala) (Hamilton, 1822) to estimate optimum dietary protein requirement of soy bean meal in diet in an intensive polyculture. Three different diets (SBM I, SBM II and SBM III) were formulated by 80%, 50% and 20% replacement of fish meal with soybean meal from a 45% fish meal diet (control).Highest monthly mean weight gain was obtained by SBM II (with 35% CP and about 50% substitution of fish meal), while SBM III (45% Crude Protein and about 20% substitution of fish meal) was stood second. All tested diets respond enormously by producing high yield as compare to control diet, though SBM II generated highest yield among all. On the bases of the following research, it was revealed that the SBM can surrogate even50% fish meal without any augmentation of other amino acids in the diet of Indian major carps.


Assuntos
Carpas , Cyprinidae , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Alimentos Marinhos , Soja
5.
Braz J Biol ; 83: e251958, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34614127

RESUMO

Odonates are important biological control agents for the control of insect pests and insect disease vectors of medical and veterinary importance. The present study was conducted to evaluate the odonate fauna of Swat, Pakistan from March to October 2019. A total of 200 specimens of odonates were collected from diverse habitats. The collected specimens of the order Odonata belonged to 5 families, three families of suborder Anisoptera namely Libellulidae, Gomphidae and Aeshnidae while two families of suborder Zygoptera (Chlorocyphidae and Coenagrionidae). The specimens were categorized into 12 genera and 22 species. Libellulidae was the dominant family (n = 138) accounting for 69% of the odonate fauna. Orthetrum was the dominant genus (n = 73) of suborder Anisoptera accounting for 36.5% of the odonate fauna. The least dominant genera were Anax, Paragomphus and Rhyothemis (n = 5 each) accounting each for 2.5% of the odonate fauna. In Zygoptera, the dominant genus was Ceriagrion (12.5%) and the least dominant genus was Ischnura (6%). Pantala flavescens (Fabricius, 1798) was the most abundant odonate species in the study area recorded from all surveyed habitats. Shannon Diversity Index (H) was 2.988 and Simpson Diversity Index (D) was 0.95 for the collected odonate fauna. The highest abundance of Odonata was recorded in August, September and May while no odonate species were recorded in January, February, November and December. Lotic water bodies were the most suitable habitats with abundant odonate fauna. Anax immaculifrons (Rambur, 1842) was the largest sized odonate species having a wingspan of 53.2±1.63 mm and body length of 56.3 ± 0.4 mm. The present study shows the status of odonate fauna of Swat, Pakistan in diverse habitats and seasonsonal variation throughout the year. Further work is recommended to bridge the gaps in the existing literature.


Assuntos
Odonatos , Animais , Paquistão
6.
Braz J Biol ; 83: e248910, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34550288

RESUMO

This study determines the associations among serum lipid profiles, risk of cardiovascular disease, and persistent organic pollutants. Using Gas chromatography technique, the intensity of toxic pollutant residues in serum samples of Hypertensive patients were measured. Based on statistical analysis, the effects of different covariates namely pesticides, age, systolic blood pressure, diastolic blood pressure, and lipid profile duration was checked using the logistic regression model. Statistical computation was performed on SPSS 22.0. The P-values of F-Statistic for each lipid profile class are greater than 0.01 (1%), therefore we cannot reject the null hypothesis for all cases. The estimated coefficients, their standard errors, Wald Statistic, and odds ratio of the binary logistic regression model for different lipid profile parameters indicate if pesticides increase then the logit value of different lipid profile parameters changes from -0.46 to -0.246 except LDL which increases by 0.135. The study reports a significantly increased threat of cardiovascular disease with increased concentrations of toxic pollutants.


Assuntos
Poluentes Ambientais , Praguicidas , Humanos , Lipídeos , Lipoproteínas , Poluentes Orgânicos Persistentes
7.
Braz J Biol ; 83: e250373, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34550295

RESUMO

Honey is a suitable matrix for the evaluation of environmental contaminants including organochlorine insecticides. The present study was conducted to evaluate residues of fifteen organochlorine insecticides in honey samples of unifloral and multifloral origins from Dir, Pakistan. Honey samples (5 g each) were extracted with GC grade organic solvents and then subjected to Rotary Evaporator till dryness. The extracts were then mixed with n-Hexane (5 ml) and purified through Column Chromatography. Purified extracts (1µl each) were processed through Gas Chromatograph coupled with Electron Capture Detector (GC-ECD) for identification and quantification of the insecticides. Of the 15 insecticides tested, 46.7% were detected while 53.3% were not detected in the honey samples. Heptachlor was the most prevalent insecticide with a mean level of 0.0018 mg/kg detected in 80% of the samples followed by ß-HCH with a mean level of 0.0016 mg/kg detected in 71.4% of the honey samples. Honey samples from Acacia modesta Wall. were 100% positive for Heptachlor with a mean level of 0.0048 mg/kg followed by ß-HCH with a mean level of 0.003 mg/kg and frequency of 83.3%. Minimum levels of the tested insecticides were detected in the unifloral honey from Ziziphus jujuba Mill. Methoxychlor, Endosulfan, Endrin and metabolites of DDT were not detected in the studied honey samples. Some of the tested insecticides are banned in Pakistan but are still detected in honey samples indicating their use in the study area. The detected levels of all insecticides were below the Maximum Residue Levels (MRLs) and safe for consumers. However, the levels detected can cause mortality in insect fauna. The use of banned insecticides is one of the main factors responsible for the declining populations of important insect pollinators including honeybees.


Assuntos
Mel , Inseticidas , Resíduos de Praguicidas , Animais , Abelhas , Endossulfano/análise , Biomarcadores Ambientais , Mel/análise , Inseticidas/toxicidade , Resíduos de Praguicidas/análise , Resíduos de Praguicidas/toxicidade
8.
Cureus ; 12(7): e9170, 2020 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-32802607

RESUMO

Background Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition where a tortuous arteriole, most commonly in the stomach, may bleed and lead to significant gastrointestinal hemorrhage. Limited epidemiological data exist on patient characteristics and the annual number of hospitalizations associated with such lesions. The aim of our study is to determine the inpatient burden of Dieulafoy's lesion. Methods We analyzed the National Inpatient Sample (NIS) database for all subjects with a discharge diagnosis of Dieulafoy's lesion of the stomach, duodenum, and colon using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 537.84 and 569.86 as the primary or secondary diagnosis during the period from 2002 to 2011. Statistical significance of variation in the number of hospital discharges and demographics during the study period was achieved using the Cochrane-Armitage trend test. Results In 2002, there were 1,071 admissions with a discharge diagnosis of Dieulafoy's lesion as compared to 7,414 in 2011 (p < 0.0001). Dieulafoy's lesion was found to be most common in the age group of 65-79 years (p < 0.0001). Overall, it was found to be more common in males as compared to females (p = 0.0261). The white race was most commonly affected amongst all the races. The average cost of care per hospitalization increased from $14,992 in 2002 to $25,594 in 2011 (p < 0.0001). Conclusion There has been a steady rise in the number of inpatient admissions with Dieulafoy's lesions. Advances in diagnostic techniques likely play a key role in the higher detection rates along with the possible involvement of other unknown factors. Men, in the age group of 65 to 79 years, and Whites were found to have significantly higher admission rates than all other groups, with a significant increase in the cost of care.

9.
Cureus ; 11(9): e5652, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31700754

RESUMO

Background Gastrointestinal bleeding (GIB) has been reported to be more common in patients with chronic renal failure and end-stage renal disease requiring hemodialysis with higher mortality than in the general population. Limited epidemiological data exist on the annual number of hospitalizations, demographic variation, cost of care, and outcomes for GIB in patients with acute kidney injury (AKI) requiring and not requiring hemodialysis (HD). The main objective of this study was to analyze the trends of GIB in patients with AKI requiring HD and those not requiring HD during hospitalization. Methods and Results We analyzed the National (Nationwide) Inpatient Sample (NIS) database for all subjects with a discharge diagnosis of AKI as the primary or secondary diagnosis during the period from 2001 to 2011. Subjects with a discharge diagnosis of hemodialysis and GIB were then identified from the pool and trends were analyzed. A significant rise in the annual number of hospitalizations with AKI was found with a greater proportion being discharged without HD. From 2001 to 2011, there were 19,393,811 hospitalizations with a discharge diagnosis of AKI of which 1,424,692 (7.3%) received HD (HD group), whereas 17,969,119 (92.7%) did not receive HD (non-HD group) (p < 0.0001). The male gender was more commonly affected by GIB than the female gender in both groups (p < 0.0001). The cost of care per hospitalization for GIB patients in the HD group increased over the study period with average found to be $61,463 (adjusted for inflation, p < 0.0001), whereas for GIB patients in the non-HD group, it showed a slight decrease in trend with the average found to be $28,419 (p < 0.0001). All-cause mortality was higher for GIB patients in the HD group (38.1%) than in the non-HD group (25.1%) (p < 0.0001). Conclusions GIB is more common and associated with higher all-cause inpatient mortality in patients receiving HD in comparison to non-HD patients.

10.
Rhinology ; 55(3): 202-210, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28501885

RESUMO

The first European Rhinology Research Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held in the Royal Academy of Medicine in Brussels on 17th and 18th November 2016, in collaboration with the European Rhinologic Society (ERS) and the Global Allergy and Asthma European Network (GA2LEN). One hundred and thirty participants (medical doctors from different specialties, researchers, as well as patients and industry representatives) from 27 countries took part in the multiple perspective discussions including brainstorming sessions on care pathways and research needs in rhinitis and rhinosinusitis. The debates started with an overview of the current state of the art, including weaknesses and strengths of the current practices, followed by the identification of essential research needs, thoroughly integrated in the context of Precision Medicine (PM), with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key principles for improving current clinical practices. This report provides a concise summary of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2016.


Assuntos
Asma/terapia , Hipersensibilidade/terapia , Rinite/terapia , Sinusite/terapia , Europa (Continente) , Humanos , Médicos , Medicina de Precisão , Pesquisa
12.
Int J Tuberc Lung Dis ; 20(6): 844-7, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27155191

RESUMO

Assessing treatment adherence and quantifying exposure to anti-tuberculosis drugs among children is challenging. We undertook a 'proof of concept' study to assess the drug concentrations of isoniazid (INH) in hair as a therapeutic drug monitoring tool. Children aged <12 years initiated on a thrice-weekly treatment regimen including INH (10 mg/kg) for newly diagnosed tuberculosis were enrolled. INH concentrations in hair were measured using liquid chromatography-tandem mass spectrometry at 1, 2, 4 and 6 months after initiating anti-tuberculosis treatment. We found that INH hair concentrations in all children on thrice-weekly INH were detectable and displayed variability across a dynamic range.


Assuntos
Antituberculosos/análise , Cabelo/química , Isoniazida/análise , Tuberculose/tratamento farmacológico , Antituberculosos/uso terapêutico , Criança , Pré-Escolar , Cromatografia Líquida , Monitoramento de Medicamentos , Feminino , Humanos , Isoniazida/uso terapêutico , Estudos Longitudinais , Masculino , Cooperação do Paciente , Estudo de Prova de Conceito , Estudos Prospectivos , Espectrometria de Massas em Tandem , Tuberculose/diagnóstico
13.
Br J Radiol ; 88(1047): 20140778, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25587917

RESUMO

OBJECTIVE: To evaluate current UK practice of periprocedural haematological management for image-guided procedures in relation to Cardiovascular and Interventional Radiological Society guidelines, which provide recommendations according to bleeding risk of procedures from Category 1 (lowest) to 3 (highest). METHODS: Survey of practice in UK radiology departments conducted over a 1-year period RESULTS: 48 radiology departments responded. The percentage of departments that stop antithrombotics pre-procedurally are as follows (for Category 1, 2 and 3, respectively): aspirin (31.3%, 43.8%, 54.2%); clopidogrel (54.2%, 68.8%, 72.9%); therapeutic low-molecular-weight heparin (56.3%, 77.1%, 75.0%). The percentage of departments that perform pre-procedural laboratory testing are as follows (for Category 1, 2 and 3, respectively): international normalized ratio (INR; 81.3%, 95.8%, 93.8%); activated partial thrombin time ratio (APTTR; 60.4%, 75.0%, 93.8%); platelet (77.1%, 91.7%, 95.7%); haemoglobin (70.8%, 85.4%, 87.5%). Mean threshold (standard deviation) of laboratory results for conducting procedures (Level 1, 2 and 3, respectively) are as follows: INR [1.53 (0.197), 1.47 (0.186), 1.47 (0.188)]; APTTR [1.50 (0.392), 1.50 (0.339), 1.48 (0.344)]; platelet count (x10(3) cells per microlitre) [74.4 (28.7), 79.9 (29.1), 80.5 (29.3)]; haemoglobin (grams per decilitre) [9.05 (1.40), 9.00 (1.33), 8.92 (1.21)]. No department practices conformed to current recommendations for (1) pre-procedural cessation of antithrombotics and (2) pre-procedural laboratory testing. Two (4.2%) department practices conformed to recommendations for thresholds of haematological parameters. CONCLUSION: Current peri-procedural haematological management is variable and often does not conform to existing recommendations. Further research into the impact of this variation in practice on patient outcome is required. ADVANCES IN KNOWLEDGE: This study demonstrates wide variation in practice in haematological management for image-guided procedures.


Assuntos
Fibrinolíticos/uso terapêutico , Cuidados Pré-Operatórios/métodos , Cirurgia Assistida por Computador , Terapia Trombolítica/métodos , Trombose/prevenção & controle , Feminino , Humanos , Masculino , Contagem de Plaquetas , Prognóstico , Trombose/sangue
14.
J Laryngol Otol ; 127(12): 1238-41, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24125173

RESUMO

OBJECTIVE: We report the rare case of a 55-year-old woman with an asymptomatic left sphenoid sinus pseudomeningocele mimicking a mucocele. CASE REPORT: A 55-year-old woman was found to have an incidental mass in the left sphenoid sinus on computed tomography. Magnetic resonance imaging confirmed the presence of a mucocele. A left endoscopic sphenoidotomy was performed to drain the mucocele. Despite an anatomical puncture through a stenosed sphenoid ostium, alarmingly, the opening leaked cerebrospinal fluid. A dehiscent lateral wall was identified with a dural opening communicating with the sphenoid sinus. This was immediately repaired with a free nasal septal mucosal graft. Six months post-operatively, the patient remained free from cerebrospinal fluid leakage. CONCLUSION: Pseudomeningoceles are extremely rare in the absence of trauma or iatrogenic injury. Surgeons should be alert to their presence as they can mimic a unilateral mucocele or nasal polyp. Endoscopic management lends itself to a single-stage repair.


Assuntos
Mucocele/diagnóstico , Cirurgia Endoscópica por Orifício Natural , Seio Esfenoidal/anormalidades , Seio Esfenoidal/diagnóstico por imagem , Meios de Contraste , Diagnóstico Diferencial , Drenagem/efeitos adversos , Drenagem/métodos , Feminino , Humanos , Achados Incidentais , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Mucocele/diagnóstico por imagem , Mucocele/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Seio Esfenoidal/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
15.
Eye (Lond) ; 26(11): 1431-6, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22975654

RESUMO

INTRODUCTION: In long-standing facial palsy, muscles on the normal side overcontract causing difficulty in articulation, eating, drinking, cosmetic embarrassment, and psychological effects as patients lack confidence in public. METHODS: We injected botulinum toxin A (BTXA) into the normal contralateral smile muscles to weaken them and restore symmetry to both active and passive movements by neutralising these overacting muscles. RESULTS: A total of 14 patients received BTXA (79% women, median age 47 years, average length of palsy 8 years). They were all difficult cases graded between 2 and 6 (average grade 3 House-Brackmann). All 14 patients reported improved facial symmetry with BTXA (dose altered in some to achieve maximum benefit). Average dose was 30 units, but varied from 10 to 80 units. Average time to peak effect was 6 days; average duration of effect was 11 weeks. Three patients had increased drooling (resolved within a few days). CONCLUSION: The improvement in symmetry was observed by both patient and examining doctor. Patients commented on increased confidence, being more likely to allow photographs taken of themselves, and families reported improved legibility of speech. Younger patients have more muscle tone than older patients; the effect is more noticeable and the benefit greater for them. BTXA improves symmetry in patients with facial palsy, is simple and acceptable, and provides approximately 4 months of benefit. The site of injection depends on the dynamics of the muscles in each individual patient.


Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Assimetria Facial/tratamento farmacológico , Expressão Facial , Músculos Faciais/efeitos dos fármacos , Paralisia Facial/tratamento farmacológico , Fármacos Neuromusculares/uso terapêutico , Adolescente , Adulto , Idoso , Criança , Eletromiografia , Assimetria Facial/fisiopatologia , Músculos Faciais/fisiopatologia , Paralisia Facial/fisiopatologia , Feminino , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
17.
CJEM ; 12(1): 39-44, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20078917

RESUMO

OBJECTIVE: We compared pain severity and time to resumption of activities in patients with cervical strains treated with a nonsteroidal anti-inflammatory drug (NSAID), a centrally acting muscle relaxant or both. METHODS: We performed a double-blinded, randomized controlled trial of adults with cervical strains from motor vehicle collisions or from falls who presented to a suburban academic emergency department (ED). Patients were randomly assigned to receive ibuprofen 800 mg, cyclobenzaprine 5 mg or both, 3 times daily as needed for up to 7 days. Outcome measures included a pain score on a 100-mm visual analog scale, pain relief scores, the time to resumption of normal activities, the use of rescue medications, and adverse outcomes. We used repeated-measures analysis of variance to compare pain relief over time. Our sample size of 20 patients in each group had a power of 80% to detect a difference of 15 mm in pain relief scores between the highest and lowest groups. RESULTS: We randomly assigned 61 patients to receive ibuprofen (n = 20), cyclobenzaprine (n = 21) or both (n = 20). Mean (standard deviation) age was 34 (11) years; 58% were women and 72% were white. Although pain scores improved over time in all groups, there were no significant differences between the groups in any of the outcome measures. The rate of adverse events was also similar between groups. CONCLUSION: Our study suggests that there is little benefit to routinely using or adding cyclobenzaprine to NSAIDs for ED patients with acute cervical strain.


Assuntos
Amitriptilina/análogos & derivados , Anti-Inflamatórios não Esteroides/uso terapêutico , Ibuprofeno/uso terapêutico , Relaxantes Musculares Centrais/uso terapêutico , Entorses e Distensões/tratamento farmacológico , Adulto , Amitriptilina/administração & dosagem , Amitriptilina/uso terapêutico , Anti-Inflamatórios não Esteroides/administração & dosagem , Relação Dose-Resposta a Droga , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Ibuprofeno/administração & dosagem , Masculino , Relaxantes Musculares Centrais/administração & dosagem , Medição da Dor , Estudos Prospectivos , Entorses e Distensões/diagnóstico , Centros de Traumatologia , Resultado do Tratamento
19.
J Laryngol Otol ; 123(9): 1035-8, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19063771

RESUMO

AIM: Bone-anchored hearing aids are well established, implanted devices. We present two patients who suffered mixed hearing loss and who underwent titanium implant placement in the temporal bone to enable attachment of bone-anchored hearing aids. Osseointegration is necessary for such implants to function. We report these two cases to highlight how such osseointegration may be disrupted. METHOD: Attached tissue from the explanted or removed titanium implants was examined by transmission electron microscopy and histopathological analysis. RESULTS: Attached tissue from both implants showed the presence of keratinocytes at the titanium implant and living bone interface. This was confirmed by histopathological analysis. In one case, there was frank keratinocyte proliferation, which had led to osseointegration failure; in the other case, such proliferation was present but not so advanced. CONCLUSION: These findings suggest that, in the cases reported, keratinocytes implanted between the titanium and the living bone, leading to disruption of osseointegration.


Assuntos
Implante Coclear/efeitos adversos , Implantes Cocleares/efeitos adversos , Perda Auditiva Condutiva-Neurossensorial Mista/cirurgia , Queratinócitos/fisiologia , Osseointegração/fisiologia , Idoso , Implantes Cocleares/microbiologia , Humanos , Masculino , Microscopia Eletrônica , Otite Média Supurativa/microbiologia , Falha de Prótese
20.
Rhinology ; 45(1): 83-8, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17432077

RESUMO

OBJECTIVE: To investigate the outcomes from nasal fracture reduction performed under local anaesthesia (LA) and general anaesthesia (GA). METHOD: A randomised multi-centred prospective trial and cohort analysis. Patients were randomised into two groups, 74 (53%) underwent closed reduction under LA, 65 (47%) patients underwent closed reduction under GA. MAIN OUTCOME MEASURES: Pain scores and patient toleration of local or general nasal manipulation was noted. RESULTS: The pain score ranged from 0 (no pain) to 10 (unbearable pain). The mean pain score in the LA group was 3, compared to 2 in the GA group. LA manipulation was tolerated equally well as GA manipulation by 85% of the patients in each group. The number of patients requiring a septorhinoplasty was compared between LA 19/74 (26%), and GA 21/65 (32%). This failed to demonstrate a significant difference with a p value of 0.50. The absolute risk difference was 5% with a 95% confidence interval of (20% to -10%). CONCLUSION: This trial clearly shows LA to be as effective as GA in the first line management of nasal fractures. The degree of septal displacement and presence of nasal tip deviation were associated with persistent nasal deformity following nasal fracture reduction.


Assuntos
Anestesia Geral , Anestesia Local , Osso Nasal/lesões , Fraturas Cranianas/terapia , Adolescente , Adulto , Idoso , Anestésicos Locais/administração & dosagem , Estudos de Coortes , Feminino , Humanos , Lidocaína/administração & dosagem , Masculino , Manipulação Ortopédica , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Septo Nasal/patologia , Nariz/patologia , Deformidades Adquiridas Nasais/etiologia , Medição da Dor , Satisfação do Paciente , Complicações Pós-Operatórias , Estudos Prospectivos
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