Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 61
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
Small ; : e2402266, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38847571

RESUMO

This work reports a novel 3D printed grid reservoir-integrated mesoporous carbon coordinated silicon oxycarbide hybrid composite (3DP-MPC-SiOC) to establish the zincophile interphase for controlling the dendrite formation. The customized 3D printed grid patterned structure inhibits Zn dendrite growth and achieves long-term stability with reduced voltage polarization due to homogeneous electric field distribution. The hybrid composite consisting of SiOC interpenetrated within carbon constructs a high zinc nucleation interphase, hence promoting uniform Zn2+ deposition and enhancing ionic diffusion with dendrite-free growth and a reduced nucleation energy barrier. As a result, the 3DP-MPC-SiOC@Zn symmetrical cell affords a highly reversible Zn plating/stripping and dendrite-free structure over 198 h with an ultra-low voltage polarization. These inspiring performances endow the 3DP anode with a 3DP-VO cathode as a full battery, which shows a retention capacity of 78.8 mAh g-1 (Coulombic efficiency: 94.04%) at 0.1 A g-1 and a large energy density of 41 Wh kg-1 at a power density of 1.2 W kg-1 (based on the total mass of electrode) after 120 cycles. This newly developed 3D printing of hybrid composite as an electrode is straightforward and scalable and provides a novel concept for realizing dendrite-free and stable rechargeable Zn-ion batteries.

2.
Environ Res ; 258: 119419, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38879107

RESUMO

Nano-zerovalent iron (nZVI) is a promising material for the removal of both organic and inorganic pollutants from contaminated water. This study investigates the potential of a novel composite of nZVI on a polymer-derived supporting ceramic (nZVI-PDC) synthesized via the liquid-phase reduction method for the simultaneous adsorption and Fenton-type reduction of bromate anion (BrO3-) in water. The nZVI nanoparticles were effectively anchored onto the PDC by impregnating high-yield carbon in a ferrous sulfate solution. The PDC facilitated the uniform dispersion of nZVI nanoparticles due to its multiple active sites distributed within mesocarbon cavities. The developed nZVI-PDC composite exhibited a high specific surface area of 837 m2 g-1 and an ordered mesoporous structure with a pore volume of 0.37 cm3 g-1. As an adsorbent, the nZVI-PDC composite exhibited a maximum adsorption capacity (qe) of 842 mg g-1 and a partition coefficient (KH) of 10.2 mg g-1 µM-1, as calculated by the pseudo-second-order model. As a catalyst, the composite demonstrated a reaction kinetic rate of 43.5 µmol g-1 h-1 within 6 h at pH 4, using a dosage of 60 mg L-1 nZVI-PDC and a concentration of 0.8 mmol L-1 H2O2. Comparatively, PDC exhibited a qe of 408 mg g-1, KH of 1.67 mg g-1 µM-1, and a reaction rate of 20.8 µmol g-1 h-1, while nZVI showed a qe of 456 mg g-1, KH of 2.30 mg g-1 µM-1, and a reaction rate of 27.2 µmol g-1 h-1. The modelling indicated that the nZVI-PDC composite followed pseudo-second-order kinetics. The remarkable removal efficiency of the nZVI-PDC composite was attributed to the synergistic effects between PDC and nZVI, where PDC facilitated charge transfer, promoting Fe2+ generation and the Fe3+/Fe2+ cycle. Overall, this work introduces a promising adsorption technology for the efficient removal of BrO3- from contaminated aqueous solutions, highlighting the significant potential of the nZVI-PDC composite in water purification applications.

3.
Small ; 19(12): e2206550, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36587964

RESUMO

Current electrical contact models are occasionally insufficient at the nanoscale owing to the wide variations in outcomes between 2D mono and multi-layered and bulk materials that result from their distinctive electrostatics and geometries. Contrarily, devices based on 2D semiconductors present a significant challenge due to the requirement for electrical contact with resistances close to the quantum limit. The next generation of low-power devices is already hindered by the lack of high-quality and low-contact-resistance contacts on 2D materials. The physics and materials science of electrical contact resistance in 2D materials-based nanoelectronics, interface configurations, charge injection mechanisms, and numerical modeling of electrical contacts, as well as the most pressing issues that need to be resolved in the field of research and development, will all be covered in this review.

4.
Small ; 19(27): e2207879, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37009995

RESUMO

Human beings have a greater need to pursue life and manage personal or family health in the context of the rapid growth of artificial intelligence, big data, the Internet of Things, and 5G/6G technologies. The application of micro biosensing devices is crucial in connecting technology and personalized medicine. Here, the progress and current status from biocompatible inorganic materials to organic materials and composites are reviewed and the material-to-device processing is described. Next, the operating principles of pressure, chemical, optical, and temperature sensors are dissected and the application of these flexible biosensors in wearable/implantable devices is discussed. Different biosensing systems acting in vivo and in vitro, including signal communication and energy supply are then illustrated. The potential of in-sensor computing for applications in sensing systems is also discussed. Finally, some essential needs for commercial translation are highlighted and future opportunities for flexible biosensors are considered.


Assuntos
Técnicas Biossensoriais , Dispositivos Eletrônicos Vestíveis , Humanos , Materiais Biocompatíveis , Inteligência Artificial , Próteses e Implantes
5.
BMC Health Serv Res ; 23(1): 1305, 2023 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-38012758

RESUMO

BACKGROUND: Considering the high maternal mortality rate, the government of Pakistan has deployed Community Midwives (CMWs) in rural areas of Pakistan. This relatively new cadre of community-based skilled birth attendants has previously reported to experience several challenges in providing maternal and child healthcare. However, what barriers they experience in providing basic emergency obstetric and newborn care needs to be further studied. METHODS: This was a cross-sectional study conducted in twelve districts in Sindh province, Pakistan, with poor maternal and child health indicators. A total of 258 CMWs participated in this study and completed the questionnaire on a pretested, validated tool in their community-based stations. The trained data collectors completed the questionnaires from the respondents. The problems identified were categorized into three major issues: financial, and transport and security related; and were analyzed accordingly. Ethical approval was obtained from the institutional review board (IRB) of Health Services Academy (HSA) Islamabad, Pakistan. RESULTS: The majority (90%) of 258 CMWs had formal training in maternal and neonatal care from the recognized institutions. Financial difficulties faced by CMWs were identified as the most frequent barriers and others were transport, security, and other issues. In univariate analysis, 38.1% and 61.9% of the community midwives who faced financial difficulties had completed a graduation or intermediate level of education, respectively (p = 0.006). Round-the-clock availability for emergencies was inversely associated with having financial difficulties, i.e., 71.4%, in contrast to 28.4% who had financial difficulties were available round-the-clock for emergency calls in their community clinics (p = 0.008). Formal training (p = 0.001), work experience (p = 0.015), longer duration of work (p = 0.003), and liaison with health workers and posting district (p = 0.001) had statistically significantly higher transport related issues. Security difficulties faced by CMWs and a set of correlates such as formal training (p = 0.019), working experience (p = 0.001), longer duration of work (p = 0.023), 24 h of availability on call (p = 0.004), liaison with traditional birth attendants (TBAs) in the community (p = 0.002), and district of posting (p = 0.001) were statistically significantly different. Other issues like working experience (p = < 0.001) and Liaison with TBAs in the community (p = < 0.001) were found statistically significant. CONCLUSION: Financial, transportation and security related barriers were commonly reported by community midwives in the delivery of basic emergency obstetric and newborn care in rural Pakistan.


Assuntos
Serviços de Saúde Materna , Tocologia , Gravidez , Feminino , Recém-Nascido , Criança , Humanos , Paquistão , Estudos Transversais , Instituições de Assistência Ambulatorial , População Rural
6.
Toxicol Ind Health ; 38(8): 470-480, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35700117

RESUMO

The objective of the present research was to determine if dibutyl phthalate (DBP) and di-(2-ethylhexyl) phthalate (DEHP) alone and combined exposure induced pathological alterations in laboratory reared albino mice. Adult male mice were equally divided (n = 10) into Control, corn oil (CO), DBP, DEHP, and DBP+DEHP treated groups. Dibutyl phthalate (250 mg/kg), DEHP (300 mg/kg), and DBP+DEHP (250+300 mg/kg), respectively, were administered by oral gavage mixed in corn oil (0.2 mL) for 28 days. All animals were sacrificed following 28 days of treatment and blood was collected for serum lipid profiles and liver function tests. Liver samples were also collected for observation of histological changes. Microphotographs of hematoxylin and eosin-stained sections were used for computer-based micrometry. CO, DBP, DEHP, and DBP+DEHP treatment resulted in a significant increase in the mean body and liver weights as compared with the Control group. Histological examination of the livers with DBP and/or DEHP treatment showed marked alterations leading to hepatic hypertrophy. In the treated groups, a significant increase in the mean number of mononucleated, binucleated cells, and oval cells per unit area was noticed with disorganized trabecular arrangement as compared with the Control group. Treatment with DBP and/or DEHP resulted in large regeneration zones in the liver and an increased relative nucleo-cytoplasmic index of mononuclear shepatocytes when compared with the Control group. All treatments caused a significant increases in the liver enzymes and proteins as well as altered serum cholesterol, triglycerides, LDL, and VLDL levels. The histopathological and serological findings confirmed the toxic potentials to hepatic tissue of DBP and DEHP either given alone or in combination.


Assuntos
Dietilexilftalato , Ácidos Ftálicos , Animais , Óleo de Milho , Dibutilftalato/toxicidade , Dietilexilftalato/toxicidade , Fígado/metabolismo , Masculino , Camundongos
7.
Nanotechnology ; 32(38)2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34139684

RESUMO

High energy-density supercapacitors (SCs) with long operating life, cost-effective, and competitive cycling performance is attracted great research attention to competing in the requirements of the modern age. However, despite these benefits, SC hampers inadequate rate-capability and structural deterioration, which primarily affects its commercialization. Herein, ultra-thin two-dimensional (2D) ZnCo2O4nanosheets arein situanchored on the conductive surface of nickel foam (denoted as ZCO@NF) by hydrothermal process. The binder-free ZCO@NF is employed as an electrode for SCs and shows impressive charge storage properties. ZCO@NF electrode exhibited a high capacitance of 1250 (750) and 733 F g-1(440 C g-1) at 2.5 and 20 A g-1, respectively, demonstrating the outstanding rate-capability of 58.6% even at 8 times larger current density. Furthermore, the ZCO@NF electrode exhibits admirable capacitance retention of 96.5% after 10 000 cycles. This impressive performance of the ZCO@NF electrode is attributed to the high surface area which gives a short distance for ion/electron transfer, a high conductivity with extensive electroactive cities, and strong structural stability. The binder-free approach provides a strong relationship between the current collector and the active material, which turns into improved electrochemical operation as an electrode material for SCs.

8.
Environ Res ; 181: 108955, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791708

RESUMO

2,4-Dichlorophenol (2,4-DCP) is a hazardous chlorinated organic chemical derived from phenol that exerts serious effects on living organisms. In the present study, SnO2 templated with grapefruit peel carbon as a nanocomposite (SnO2@GPC) was designed via ball-milling, and its mechanism of 2,4-DCP adsorption in aqueous solution was determined. Batch adsorption experiments revealed that the maximum adsorption efficiency of SnO2@GPC occurred at 6.0 pH, 3 mg L-1 initial adsorbate concentration, 2 h contact time, and 293 K temperature. The SnO2@GPC nanocomposite and its non-tin-bearing counterpart, grapefruit derived char (@GPC), showed maximum adsorption capacities (QL) of 45.95 and 22.09 mg g-1 and partition coefficients of 41.77 and 10.83 mg g-1 µM-1, respectively. The adsorption of 2,4-DCP was best described by the Redlich-Peterson model followed by the Langmuir model with high correlation coefficients (R2 ≥ 0.96), and the adsorption kinetic data best fitted the pseudo-second-order model (R2 ≥ 0.98). The thermodynamic parameters indicated that the reaction was spontaneous, exothermic, and involved high affinity between SnO2@GPC and 2,4-DCP. The high desorption efficiency obtained (>80%) demonstrated the recyclability of the adsorbent. The enhanced QL of SnO2@GPC was due to the effective combination of GPC and SnO2. A thin porous layer of GPC on SnO2 nanoparticles provided effective channels, a large surface area, and an abundance of active sites for 2,4-DCP adsorption. Thus, the SnO2@GPC nanocomposite could potentially be used as a low-cost adsorbent to remove 2,4-DCP from water.


Assuntos
Clorofenóis/química , Nanocompostos , Compostos de Estanho/análise , Poluentes Químicos da Água , Purificação da Água , Adsorção , Biomassa , Concentração de Íons de Hidrogênio , Cinética , Fenóis , Termodinâmica
9.
J Environ Manage ; 213: 109-118, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-29482091

RESUMO

Here, we report a pyrolyzed guinea fowl manure-derived biochar (GFM-BC) and cattle manure-derived biochar (CTM-BC) and their use as adsorbent for the removal of divalent copper from aqueous media was evaluated. The BCs physical and chemical properties were characterized by Scanning electron microscopy (SEM), Elemental dispersive x-ray analysis (EDX), Fourier transform infrared microscopy (FTIR) and thermo gravimetric analysis (TGA). The results presented that the BCs obtained higher content were quite effective for Cu (II) removal with maximum capacities of 43.60 and 44.50 mg g-1 for GFM-BC and CTM-BC, respectively. From simulation of experimental data with different adsorption isotherms and kinetics models it was found that the adsorption of both BCs was adequately fitted by Freundlich adsorption model and pseudo-second order kinetic model, respectively. Thermodynamic parameters suggested that the adsorption of Cu (II) onto both BCs was feasible, spontaneous and exothermic under evaluated parameters. Thus, the biomass used in this study proved to be effective adsorbents for the removal of Cu (II) from aqueous media.


Assuntos
Carvão Vegetal , Cobre/isolamento & purificação , Esterco , Adsorção , Animais , Bovinos , Concentração de Íons de Hidrogênio , Cinética , Microscopia Eletrônica de Varredura , Espectroscopia de Infravermelho com Transformada de Fourier , Termodinâmica , Poluentes Químicos da Água
10.
Pak J Med Sci ; 34(4): 864-868, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30190743

RESUMO

BACKGROUND & OBJECTIVE: Pakistan like many Asian countries is investing in medical education to address increased societal needs and to meet the requirement of national and international accrediting bodies. Establishing medical education departments is part of this investment. The research question was "What are the expectations of faculty from medical education department?" The objective of this study was to explore the Faculty's perception about the roles of medical education department and their suggestions for its future endeavors. METHODS: A qualitative case study design was chosen for this study. Heterogeneous group of faculty members from basic and clinical sciences departments of University College of Medicine, Lahore were invited for this study. They represented a variety of disciplines, and seniority levels. They were queried about their perception of the roles of medical education department and were encouraged to give suggestions for better functioning of department. Data was collected by audio recording through focus group interviews. Data analysis was done using NVIVO 11 software. RESULTS: Initially 55 nodes/codes emerged which were then condensed to 35 nodes. Out of these three main themes emerged. The three emergent themes were: Knowledge about the roles of medical education department.Interactions with the medical education department.Future Prospects of the medical education department. Roles of medical education department identified by the faculty were mainly related to faculty development, curriculum planning and implementation, student support, policy making for student induction, improving teaching strategies, student assessment, quality assurance and accreditation of the medical college. Faculty development not only encompassed faculty training but also provision of opportunities for research and curriculum development. Student support was found to be a neglected role and faculty members suggested it to be an important area to be looked upon by medical education departments. CONCLUSION: Institutions must ensure consultation with faculty members and should take proactive measures to sustain change, including giving ownership and team building among the faculty members.

11.
Stroke ; 47(8): 2010-6, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27338926

RESUMO

BACKGROUND AND PURPOSE: Autopsy studies suggest that cerebral amyloid angiopathy (CAA) is associated with cognitive impairment and risk for dementia. We analyzed neuropsychological test data from a prospective cohort study of patients with CAA to identify the prevalence of cognitive impairment and its associations with brain magnetic resonance imaging features and the apolipoprotein E genotype. METHODS: Data were analyzed from 34 CAA, 16 Alzheimer's disease, 69 mild cognitive impairment, and 27 ischemic stroke participants. Neuropsychological test results were expressed as z scores in relation to normative data provided by the test manuals and then grouped into domains of memory, executive function, and processing speed. RESULTS: Mean test scores in CAA participants were significantly lower than norms for memory (-0.44±1.03; P=0.02), executive function (-1.14±1.07; P<0.001), and processing speed (-1.06±1.12; P<0.001). Twenty-seven CAA participants (79%) had mild cognitive impairment based on low cognitive performance accompanied by cognitive concerns. CAA participants had similarly low executive function scores as Alzheimer's disease, but relatively preserved memory. CAA participants' scores were lower than those of ischemic stroke controls for executive function and processing speed. Lower processing speed scores in CAA were associated with higher magnetic resonance imaging white matter hyperintensity volume. There were no associations with the apolipoprotein E ε4 allele. CONCLUSIONS: Mild cognitive impairment is very prevalent in CAA. The overall cognitive profile of CAA is more similar to that seen in vascular cognitive impairment rather than Alzheimer's disease. White matter ischemic lesions may underlie some of the impaired processing speed in CAA.


Assuntos
Encéfalo/diagnóstico por imagem , Angiopatia Amiloide Cerebral/complicações , Cognição/fisiologia , Disfunção Cognitiva/etiologia , Função Executiva/fisiologia , Idoso , Idoso de 80 Anos ou mais , Alelos , Apolipoproteínas E/genética , Angiopatia Amiloide Cerebral/diagnóstico por imagem , Angiopatia Amiloide Cerebral/genética , Angiopatia Amiloide Cerebral/psicologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/genética , Disfunção Cognitiva/psicologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos Prospectivos
12.
Ann Neurol ; 77(2): 251-61, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25428654

RESUMO

OBJECTIVE: Decline in cognitive function begins by the 40s, and may be related to future dementia risk. We used data from a community-representative study to determine whether there are age-related differences in simple cognitive and gait tests by the 40s, and whether these differences were associated with covert cerebrovascular disease on magnetic resonance imaging (MRI). METHODS: Between 2010 and 2012, 803 participants aged 40 to 75 years in the Prospective Urban Rural Epidemiological (PURE) study, recruited from prespecified postal code regions centered on 4 Canadian cities, underwent brain MRI and simple tests of cognition and gait as part of a substudy (PURE-MIND). RESULTS: Mean age was 58 ± 8 years. Linear decreases in performance on the Montreal Cognitive Assessment, Digit Symbol Substitution Test (DSST), and Timed Up and Go test of gait were seen with each age decade from the 40s to the 70s. Silent brain infarcts were observed in 3% of 40- to 49-year-olds, with increasing prevalence up to 18.9% in 70-year-olds. Silent brain infarcts were associated with slower timed gait and lower volume of supratentorial white matter. Higher volume of supratentorial MRI white matter hyperintensity was associated with slower timed gait and worse performance on DSST, and lower volumes of the supratentorial cortex and white matter, and cerebellum. INTERPRETATION: Covert cerebrovascular disease and its consequences on cognitive and gait performance and brain atrophy are manifest in some clinically asymptomatic persons as early as the 5th decade of life.


Assuntos
Encéfalo/patologia , Doenças de Pequenos Vasos Cerebrais/diagnóstico , Doenças de Pequenos Vasos Cerebrais/fisiopatologia , Cognição/fisiologia , Marcha/fisiologia , Adulto , Idoso , Atrofia/patologia , Canadá/epidemiologia , Doenças de Pequenos Vasos Cerebrais/psicologia , Diagnóstico Precoce , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Vigilância da População/métodos , Estudos Prospectivos
13.
Stroke ; 45(7): 2115-7, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24923720

RESUMO

BACKGROUND AND PURPOSE: Incidental magnetic resonance diffusion-weighted imaging (DWI)-positive lesions, considered to represent small acute infarcts, have been detected in patients with cerebral small vessel diseases or cognitive impairment, but the prevalence in the community population is unknown. METHODS: DWI sequences collected in 793 participants in the Prospective Urban Rural Epidemiological (PURE) study were reviewed for DWI lesions consistent with small acute infarcts. RESULTS: No DWI-positive lesions were detected (0%, 95% confidence interval, 0-0.5). CONCLUSIONS: DWI-positive lesions are rare in an asymptomatic community population. The prevalence of DWI-positive lesions in the community seems to be lower than in patients with cerebral amyloid angiopathy, intracerebral hemorrhage, or cognitive impairment.


Assuntos
Infarto Cerebral/epidemiologia , Imagem de Difusão por Ressonância Magnética/estatística & dados numéricos , Adulto , Idoso , Canadá/epidemiologia , Infarto Cerebral/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos
14.
Cureus ; 16(1): e52386, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38361702

RESUMO

Acute kidney injury (AKI) frequently occurs in hospitalized individuals with liver cirrhosis and represents a significant risk factor for early in-hospital mortality, holding crucial clinical and prognostic importance. The objective of this meta-analysis was to assess the risk factors associated with AKI in hospitalized individuals with cirrhosis. This systematic review and meta-analysis was conducted in concordance with guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Two independent researchers systematically searched major databases, including MEDLINE/PubMed, Web of Science, and EMBASE, from January 2015 until December 2023. A total of 14 studies were included in this meta-analysis, of which six were prospective, and the remaining were retrospective. Of the 9,659 cirrhosis patients in the 14 included studies, 3,968 had developed AKI with a pooled incidence of 41% (95% confidence interval = 34-47%). Our findings showed that a high Model for End-Stage Liver Disease (MELD) score, infection, high Child-Pugh-Turcotte stage score, high serum creatinine, high serum bilirubin, and low serum albumin were significantly associated with high incidence of AKI in liver cirrhosis patients. The results emphasize the importance of vigilant monitoring in cirrhosis patients to detect any indications of AKI, followed by meticulous and attentive management.

15.
Cureus ; 16(2): e53784, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38465175

RESUMO

Acute myocardial infarction (AMI) is a significant global cause of mortality, necessitating the exploration of innovative treatments against the condition. Angiotensin receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor-neprilysin inhibitors (ARNIs) such as sacubitril/valsartan have demonstrated promise in managing acute heart failure (HF). However, despite favorable evidence from clinical trials for the use of sacubitril/valsartan in AMI, its overall efficacy remains a subject of debate. Hence, we conducted this review and meta-analysis, by adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and aligned with European Society of Cardiology recommendations, to compare sacubitril/valsartan with traditional ACEI/ARB treatments for AMI. We employed Review Manager 5.4 for statistical analysis, the Risk of Bias Tool 2.0 was utilized for quality assessment, and publication bias was assessed using a funnel plot. A p-value <0.05 was considered statistically significant. Eight randomized controlled trials (RCTs) were included in this meta-analysis. Our findings revealed that participants treated with sacubitril experienced significantly improved outcomes in terms of HF (OR=0.79; 95% CI: 0.66-0.95; p=0.01; I2=23%), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (MD = -1.58; 95% CI: -1.78 to -1.37, p<0.00001; I2=97%), and major adverse cardiovascular events (MACE) (OR=0.84; 95% CI: 0.72-0.99; p=0.03; I2=44%). However, left ventricular ejection fraction (LVEF) (MD=3.68; 95% CI: 3.35-4.01, p<0.00001; I2=71%) showed greater improvement in the control group compared to the experimental group. Our meta-analysis suggests that sacubitril offers a favorable balance between safety and effectiveness. Sacubitril significantly improved outcomes in terms of HF, MACE, and NT-proBNP levels when compared to the control group. However, improvement in LVEF was notably higher in the control group over the sacubitril/valsartan group.

16.
Cureus ; 16(1): e53057, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38410306

RESUMO

Individuals with depression face an elevated stroke risk, marked by an unfavorable prognosis. This meta-analysis aims to determine the impact of depression on stroke risk. The current meta-analysis was conducted using the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We selected studies through a systematic review of electronic databases, including PubMed, EMBASE, and CINAHL from January 2011 to January 2023. Google Scholar was utilized to identify supplementary studies. Furthermore, we scrutinized citation lists of reported articles for additional potential studies. Only English-language articles were included in the review. A total of 15 studies were included in this meta-analysis. The pooled sample size was 744,179. Sample size of the included studies ranged from 560 to 487,377. The pooled estimate of 15 studies showed that the risk of stroke was 1.47 times higher in individuals with depression compared to the individuals without depression, and the difference is statistically significant (RR: 1.47, 95% CI: 1.30 to 1.66, p-value<0.001). Age and hypertension emerged as significant predictors of stroke risk in depressed individuals identified through meta-regression. These findings underscore the importance of targeted preventive strategies for depression-related stroke risk, especially considering age-specific considerations and associated factors.

17.
Stroke ; 44(10): 2782-6, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23920014

RESUMO

BACKGROUND AND PURPOSE: We investigated the sensitivity and reliability of MRI susceptibility-weighted imaging (SWI) compared with routine MRI T2*-weighted gradient-recalled echo (GRE) for cerebral microbleed (CMB) detection. METHODS: We used data from a prospective study of cerebral amyloid angiopathy (n=9; mean age, 71±8.3) and healthy non-cerebral amyloid angiopathy controls (n=22; mean age, 68±6.3). Three raters (labeled 1, 2, and 3) independently interpreted the GRE and SWI sequences (using the phase-filtered magnitude image) blinded to clinical information. RESULTS: In 9 cerebral amyloid angiopathy cases, the raters identified 1146 total CMBs on GRE and 1432 CMBs on SWI. In 22 healthy control subjects, the raters identified ≥1 CMBs in 6/22 on GRE (total 9 CMBs) and 5/22 on SWI (total 19 CMBs). Among cerebral amyloid angiopathy cases, the reliability between raters for CMB counts was good for SWI (intraclass correlation coefficient, 0.87) but only moderate for GRE (intraclass correlation coefficient, 0.52). In controls, agreement on the presence or absence of CMBs in controls was moderate to good on both SWI (κ coefficient ranged from 0.57 to 0.74 across the 3 combinations of rater pairs) and GRE (κ range, 0.31 to 0.70). A review of 114 hypointensities identified as possible CMBs indicated that increased detection and reliability on SWI was related to both increased contrast and higher resolution, allowing better discrimination of CMBs from the background and better anatomic differentiation from pial vessels. CONCLUSIONS: SWI confers greater reliability as well as greater sensitivity for CMB detection compared with GRE, and should be the preferred sequence for quantifying CMB counts.


Assuntos
Angiopatia Amiloide Cerebral/diagnóstico por imagem , Hemorragia Cerebral/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Imagem Ecoplanar/métodos , Idoso , Idoso de 80 Anos ou mais , Angiopatia Amiloide Cerebral/complicações , Hemorragia Cerebral/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Sensibilidade e Especificidade
18.
J Pak Med Assoc ; 63(1): 28-31, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23865128

RESUMO

OBJECTIVE: To determine the accuracy of Doppler ultrasound in the diagnosis of endometrial carcinoma in patients presenting with post-menopausal bleeding while taking histopathological findings as the gold standard. METHODS: The cross-sectional study was done at the Department of Radiology, Bahawal Victoria Hospital, Bahawalpur, from April 1 to September 30, 2009, and comprised 128 patients above 50 years of age having history of post-menopausal bleeding and who were referred to the department. Name, age and hospital registration number were recorded on a proforma. Doppler ultrasound was performed and endometrial thickness and uterine artery resistive index were recorded on transabdominal ultrasonography. Patients with endometrial thickness of more than 5 mm and uterine artery resistive index of less than 0.7 were considered to be having endometrial carcinoma. Histopathology findings were also recorded using the hospital registration number of the patient. The findings of Doppler ultrasound scan were validated with the findings of histopathology. RESULTS: Of the 128 patients, 48 (37.5%) were between the ages of 51 and 55 years; 46 (35.93%) were in the 56-60 age group; and 34 (26.57%) were over 65 years. On the basis of Doppler ultrasound findings, 106 (82.8%) patients were diagnosed as having endometrial carcinoma, while 22 (17.19%) were declared negative. Ultrasonography results were compared with histopathology findings. The percentages of true positive, true negative, false positive and false negative were calculated. There were 103 (80.47%) true positive; 12 (9.37%) false positive; 10 (7.81%) true negative; and 3 (2.35%) false negative. Specificity, sensitivity, positive predictive value and negative predictive value were found to be 97.16%, 76%, 89.56% and 76.92% respectively. CONCLUSION: The use of Doppler ultrasonography in non-invasive diagnosis of endometrial carcinoma in patients presenting with post-menopausal bleeding was quite useful with good sensitivity, specificity, as well as positive and negative predictive values. There were no procedural complications.


Assuntos
Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/patologia , Pós-Menopausa , Ultrassonografia Doppler em Cores , Idoso , Carcinoma/complicações , Estudos Transversais , Neoplasias do Endométrio/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Paquistão , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Artéria Uterina , Hemorragia Uterina/diagnóstico por imagem , Hemorragia Uterina/etiologia , Hemorragia Uterina/patologia , Resistência Vascular
19.
Cureus ; 15(5): e39634, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37388583

RESUMO

Cancer screening techniques aim to detect premalignant lesions and enable early intervention to delay the onset of cancer while keeping incidence constant. Technology advancements have led to the development of powerful tools such as microfluidic technology, artificial intelligence, machine learning algorithms, and electrochemical biosensors to aid in early cancer detection. Non-invasive cancer screening methods like virtual colonoscopy and endoscopic ultrasonography have also been developed to provide comprehensive pictures of organs and detect cancer early. This review article provides an overview of recent advances in cancer screening in microfluidic technology, artificial intelligence, and biomarkers through a narrative literature search. Microfluidic devices enable easy handling of sub-microliter volumes and have become a promising tool for cancer detection, drug screening, and modeling angiogenesis and metastasis in cancer research. Machine learning and artificial intelligence have shown high accuracy in oncology-related diagnostic imaging, reducing the manual steps in lesion detection and providing standardized and accurate results, with potential for global standardization in areas like colon polyps, breast cancer, and primary and metastatic brain cancer. A biomarker-based cancer diagnosis is promising for early detection and effective therapy, and electrochemical biosensors integrated with nanoparticles offer multiplexing and amplification capabilities. Understanding these advanced technologies' basics, achievements, and challenges is crucial for advancing their use in oncology.

20.
Cureus ; 15(5): e39440, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37362511

RESUMO

Pylephlebitis is a rare but serious condition caused by intra-abdominal or pelvic infections that can lead to septic thrombophlebitis of the portal veins. While laparoscopic cholecystectomy is considered a safe and effective treatment option, it is not without its risks, and pylephlebitis following this procedure is an extremely rare occurrence. Here, we present the case of a 73-year-old male who presented with lower abdominal pain for the last two weeks. He had undergone laparoscopic cholecystectomy for symptomatic cholelithiasis four weeks prior with an unremarkable follow-up. Laboratory tests revealed leukocytosis and blood culture showed Streptococcus constellatus. A CT scan revealed portal vein thrombosis causing diffuse periportal edema throughout the liver. The patient was treated with antibiotics and anticoagulation for pylephlebitis.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA