Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 389
Filtrar
Mais filtros

Base de dados
Tipo de documento
Intervalo de ano de publicação
1.
Proc Natl Acad Sci U S A ; 116(6): 2130-2137, 2019 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-30670643

RESUMO

Voluntary sustainability standards (VSS) are stakeholder-derived principles with measurable and enforceable criteria to promote sustainable production outcomes. While institutional commitments to use VSS to meet sustainable procurement policies have grown rapidly over the past decade, we still have relatively little understanding of the (i) direct environmental benefits of large-scale VSS adoption; (ii) potential perverse indirect impacts of adoption; and (iii) implementation pathways. Here, we illustrate and address these knowledge gaps using an ecosystem service modeling and scenario analysis of Bonsucro, the leading VSS for sugarcane. We find that global compliance with the Bonsucro environmental standards would reduce current sugarcane production area (-24%), net tonnage (-11%), irrigation water use (-65%), nutrient loading (-34%), and greenhouse gas emissions from cultivation (-51%). Under a scenario of doubled global sugarcane production, Bonsucro adoption would further limit water use and greenhouse gas emissions by preventing sugarcane expansion into water-stressed and high-carbon stock ecosystems. This outcome was achieved via expansion largely on existing agricultural lands. However, displacement of other crops could drive detrimental impacts from indirect land use. We find that over half of the potential direct environmental benefits of Bonsucro standards under the doubling scenario could be achieved by targeting adoption in just 10% of global sugarcane production areas. However, designing policy that generates the most environmentally beneficial Bonsucro adoption pathway requires a better understanding of the economic and social costs of VSS adoption. Finally, we suggest research directions to advance sustainable consumption and production.

2.
Eur J Neurol ; 27(11): 2176-2184, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32558040

RESUMO

BACKGROUND AND PURPOSE: Basilar artery occlusion (BAO) leads to high rates of morbidity and mortality, despite successful recanalization. The discordance between flow restoration and long-term functional status clouds clinical decision-making regarding further aggressive care. We sought to develop and validate a practical, prognostic tool for the prediction of 3-month favorable outcome after acute reperfusion therapy for BAO. METHODS: This retrospective, multicenter, observational study was conducted at four high-volume stroke centers in the USA and Europe. Multivariate regression analysis was performed to identify predictors of favorable outcome (90-day modified Rankin scale scores 0-2) and derive a clinically applicable prognostic model (the Pittsburgh Outcomes after Stroke Thrombectomy-Vertebrobasilar (POST-VB) score). The POST-VB score was evaluated and internally validated with regard to calibration and discriminatory ability. External validity was assessed in patient cohorts at three separate centers. RESULTS: In the derivation cohort of 59 patients, independent predictors of favorable outcome included smaller brainstem infarct volume on post-procedure magnetic resonance imaging (P < 0.01) and younger age (P = 0.01). POST-VB score was calculated as: age + (10 × brainstem infarct volume). POST-VB score demonstrated excellent discriminatory ability [area under the receiver-operating characteristic curve (AUC) = 0.91] and adequate calibration (P = 0.88) in the derivation cohort (Center A). It performed equally well across the three external validation cohorts (Center B, AUC = 0.89; Center C, AUC = 0.78; Center D, AUC = 0.80). Overall, a POST-VB score < 49 was associated with an 88% likelihood of favorable outcome, as compared to 4% with a score ≥ 125. CONCLUSIONS: The POST-VB score effectively predicts 3-month functional outcome following acute reperfusion therapy for BAO and may aid in guiding post-procedural care.


Assuntos
Procedimentos Endovasculares , Acidente Vascular Cerebral , Insuficiência Vertebrobasilar , Artéria Basilar/diagnóstico por imagem , Europa (Continente) , Humanos , Reperfusão , Estudos Retrospectivos , Resultado do Tratamento
3.
Anaesthesist ; 68(11): 733-741, 2019 11.
Artigo em Alemão | MEDLINE | ID: mdl-31324931

RESUMO

Early recanalization of the closed cerebral arteries after acute ischemic stroke (AIS) is the only treatment to minimize long-term disability and to reduce the associated morbidity and mortality. For a long time the only proven causal treatment of AIS was intravenous thrombolysis; however, after the publication of a series of randomized prospective studies concerning endovascular mechanical thrombectomy using stent retriever systems after AIS, new guidelines were published. It was found that endovascular treatment (EVT) dramatically improves the outcome of eligible patients. The stent retriever enables high recanalization rates by clot removal from the cerebral arterial system by means of aspiration of the thrombus via the catheter and/or by entrapping it with a stent system. The management of anesthesia during the procedure is indispensable to prevent hypoxia and hemodynamic instability; however, which form of anesthesia (i.e. general anesthesia vs. conscious sedation) is advantageous for the patient during EVT is controversially discussed. In the first studies using retrospective data conscious sedation resulted in a better outcome compared to general anesthesia following EVT; however, in prospective studies this finding could not be confirmed. To obtain optimal neurological results after AIS and EVT with general anesthesia, it is of tremendous importance not to delay the EVT due to the anesthesiology procedure. Furthermore, hypotension, hypovolemia and hypocapnia should also be strictly avoided. Finally, the optimal anesthesiological approach should be guided by the current clinical state and pre-existing comorbidities of the patient.


Assuntos
Isquemia Encefálica/terapia , Procedimentos Endovasculares/métodos , Trombólise Mecânica/métodos , Acidente Vascular Cerebral/terapia , Anestesia Geral , Humanos , Stents , Resultado do Tratamento
4.
Chem Senses ; 43(8): 627-634, 2018 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-30219913

RESUMO

Autism Spectrum Disorders (ASDs) are characterized by atypical sensory functioning in the visual, tactile, and auditory systems. Although less explored, olfactory changes have been reported in ASD patients. To explore these changes on a neural level, 18 adults with ASD and 18 healthy neurotypical controls were examined in a 2-phase study. Participants were first tested for odor threshold and odor identification. Then, (i) structural magnetic resonance (MR) images of the olfactory bulb were acquired, and (ii) a functional MR imaging olfaction study was conducted. ASD patients exhibited decreased function for odor thresholds and odor identification; this was accompanied by a relatively decreased activation in the piriform cortex. In conclusion, these findings suggest, that the known alterations in olfaction in ASD are rooted in the primary olfactory cortex.


Assuntos
Transtorno Autístico/fisiopatologia , Odorantes , Córtex Olfatório/fisiopatologia , Percepção Olfatória/fisiologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Psicofísica , Limiar Sensorial/fisiologia
5.
Epidemiol Infect ; 145(7): 1409-1417, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28219463

RESUMO

We conducted a prospective cohort study between 1 January 2010 and 31 December 2012 at five adult and paediatric academic medical centres to identify factors associated with persistent methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Adults and children presenting to ambulatory settings with a MRSA skin and soft tissue infection (i.e. index cases), along with household members, performed self-sampling for MRSA colonisation every 2 weeks for 6 months. Clearance of colonisation was defined as two consecutive negative sampling periods. Subjects without clearance by the end of the study were considered persistently colonised and compared with those who cleared colonisation. Of 243 index cases, 48 (19·8%) had persistent colonisation and 110 (45·3%) cleared colonisation without recurrence. Persistent colonisation was associated with white race (odds ratio (OR), 4·90; 95% confidence interval (CI), 1·38-17·40), prior MRSA infection (OR 3·59; 95% CI 1·05-12·35), colonisation of multiple sites (OR 32·7; 95% CI 6·7-159·3). Conversely, subjects with persistent colonisation were less likely to have been treated with clindamycin (OR 0·28; 95% CI 0·08-0·99). Colonisation at multiple sites is a risk factor for persistent colonisation and may require more targeted decolonisation efforts. The specific effect of clindamycin on MRSA colonisation needs to be elucidated.


Assuntos
Staphylococcus aureus Resistente à Meticilina/fisiologia , Infecções Estafilocócicas/epidemiologia , Adolescente , Adulto , Idoso , Antibacterianos/farmacologia , Criança , Pré-Escolar , Clindamicina/uso terapêutico , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Meticilina/farmacologia , Pessoa de Meia-Idade , Pennsylvania/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Infecções Estafilocócicas/microbiologia , Adulto Jovem
6.
Br J Anaesth ; 117(1): 87-94, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27317707

RESUMO

BACKGROUND: Surgical site infections (SSIs) can have devastating consequences for children who undergo spinal instrumentation. Prospective evaluations of prophylactic cefazolin in this population are limited. The purpose of this study was to describe the pharmacokinetics and skeletal muscle disposition of prophylactic cefazolin in a paediatric population undergoing complex spinal surgery. METHODS: This prospective pharmacokinetic study included 17 children with adolescent idiopathic scoliosis undergoing posterior spinal fusion, with a median age of 13.8 [interquartile range (IQR) 13.4-15.4] yr and a median weight of 60.6 (IQR 50.8-66.0) kg. A dosing strategy consistent with published guidelines was used. Serial plasma and skeletal muscle microdialysis samples were obtained during the operative procedure and unbound cefazolin concentrations measured. Non-compartmental pharmacokinetic analyses were performed. The amount of time that the concentration of unbound cefazolin exceeded the minimal inhibitory concentration for bacterial growth for selected SSI pathogens was calculated. RESULTS: Skeletal muscle concentrations peaked at a median of 37.6 (IQR 26.8-40.0) µg ml(-1) within 30-60 min after the first cefazolin 30 mg kg(-1) dose. For patients who received a second 30 mg kg(-1) dose, the peak concentrations reached a median of 40.5 (IQR 30.8-45.7) µg ml(-1) within 30-60 min. The target cefazolin concentrations for SSI prophylaxis for meticillin-sensitive Staphylococcus aureus (MSSA) and Gram-negative pathogens were exceeded in skeletal muscle 98.9 and 58.3% of the intraoperative time, respectively. CONCLUSIONS: For children with adolescent idiopathic scoliosis undergoing posterior spinal fusion, the cefazolin dosing strategy used in this study resulted in skeletal muscle concentrations that were likely not to be effective for intraoperative SSI prophylaxis against Gram-negative pathogens.


Assuntos
Antibacterianos/farmacocinética , Cefazolina/farmacocinética , Músculo Esquelético/metabolismo , Escoliose/cirurgia , Fusão Vertebral , Infecção da Ferida Cirúrgica/prevenção & controle , Adolescente , Antibacterianos/sangue , Antibacterianos/metabolismo , Cefazolina/sangue , Cefazolina/metabolismo , Feminino , Humanos , Masculino , Pediatria , Estudos Prospectivos
7.
Rhinology ; 54(4): 374-381, 2016 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-27421303

RESUMO

BACKGROUND: Individuals with hyposmia, or the partial loss of smell, represent a large sector (15 %) of the population that is likely to grow with the current aging population; however, our understanding to how hyposmics centrally process odors is still not clear. One popular non-invasive tool for in vivo imaging of biological activity among human brains has been function magnetic resonance imaging (fMRI) which uses blood-oxygenation level dependent (BOLD) signal as an indirect measurement. Therefore, the aim of this study was to understand differences in olfaction processing between patients with hyposmia and healthy controls using functional magnetic resonance imaging (fMRI). METHODOLOGY: Eleven hyposmic and 12 healthy, normosmic subjects were exposed to two different food-related odors (coffee and peach) during a block-designed fMRI session. Additionally, odor perception qualities were rated for each odor throughout the scanning session. RESULTS: The activations of the normosmic group were localized in typical olfactory areas (insula, orbitofrontal cortex [OFC], limbic system and amygdala). The hyposmic group showed similar regions of activation (insula, OFC, limbic system), however, less activation was found in the amygdala, left anterior cingulate and right OFC, but higher activation was shown in the right parahippocampal and both the left and right posterior cingulate gyrus which are assumed to play an important role in the processing and remembrance of memories. CONCLUSIONS: These results indicate similar central olfactory processing among groups, yet subjects with partial loss may attempt to compensate smell impairment with odor memory or higher motivation to smell.


Assuntos
Encéfalo/fisiopatologia , Transtornos do Olfato/fisiopatologia , Adulto , Idoso , Tonsila do Cerebelo/diagnóstico por imagem , Tonsila do Cerebelo/fisiopatologia , Encéfalo/diagnóstico por imagem , Estudos de Casos e Controles , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiopatologia , Feminino , Neuroimagem Funcional , Voluntários Saudáveis , Humanos , Sistema Límbico/diagnóstico por imagem , Sistema Límbico/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico por imagem , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/fisiopatologia
8.
Neuroimage ; 113: 365-73, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25797832

RESUMO

A large family of vomeronasal receptors recognizes pheromone cues in many animals including most amphibia, reptiles, rhodents, and other mammals. Humans possess five vomeronasal-type 1 receptor genes (VN1R1-VN1R5), which code for proteins that are functional in recombinant expression systems. We used two different recombinant expression systems and identified Hedione as a ligand for the putative human pheromone receptor VN1R1 expressed in the human olfactory mucosa. Following the ligand identification, we employed functional magnetic resonance imaging (fMRI) in healthy volunteers to characterize the in vivo action of the VN1R1 ligand Hedione. In comparison to a common floral odor (phenylethyl alcohol), Hedione exhibited significantly enhanced activation in limbic areas (amygdala, hippocampus) and elicited a sex-differentiated response in a hypothalamic region that is associated with hormonal release. Utilizing a novel combination of methods, our results indicate that the putative human pheromone receptor VN1R1 is involved in extra-olfactory neuronal activations induced by the odorous substance Hedione. The activation of VN1R1 might play a role in gender-specific modulation of hormonal secretion in humans.


Assuntos
Ciclopentanos/farmacologia , Feromônios Humano/farmacologia , Olfato/fisiologia , Adulto , Sinalização do Cálcio/efeitos dos fármacos , Fatores Quimiotáticos/genética , Fatores Quimiotáticos/fisiologia , Feminino , Células HEK293 , Humanos , Hipotálamo/efeitos dos fármacos , Sistema Límbico/efeitos dos fármacos , Imageamento por Ressonância Magnética , Masculino , Mucosa Olfatória/efeitos dos fármacos , Mucosa Olfatória/metabolismo , Reação em Cadeia da Polimerase , Receptores de Feromônios/efeitos dos fármacos , Receptores de Feromônios/genética , Caracteres Sexuais , Transfecção , Adulto Jovem
9.
J Strength Cond Res ; 28(4): 1164-71, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23820560

RESUMO

Abnormal movement patterns have been identified as important prospective risk factors for lower extremity injury, including anterior cruciate ligament injury. Specifically, poor neuromuscular control during the early landing phase has been associated with increased injury risk. Although it is commonly assumed that higher division collegiate athletes generally exhibit better movement patterns than lower division athletes, few studies compare the biomechanical differences on basic tasks such as jump landing between various levels of athletic groups. The objective of this study was to evaluate jump-landing and fitness differences among college-aged Intramural, Competitive Club, and National Collegiate Athletic Association (NCAA) Division I level athletes. Two hundred seventy-seven student-athletes (222 men, 55 women; age 19.3 ± 0.8 years) categorized as NCAA Division I, Competitive Club, or Intramural level athletes were evaluated during a jump-landing task using the Landing Error Scoring System (LESS), a validated qualitative movement assessment. Fitness was measured using the Army Physical Fitness Test (APFT). Results showed no significant differences in landing errors between the levels of athletic group (F(2,267) = 0.36, p = 0.70). There was a significant difference in landing errors between genders (F(1,268) = 3.99, p = 0.05). Significant differences in APFT scores were observed between level of athletic group (F(2,267) = 11.14, p < 0.001) and gender (F(1,268) = 9.27, p = 0.003). There was no significant correlation between the APFT and LESS scores (p = 0.26). In conclusion, higher level athletes had better physical fitness as measured by the APFT but did not as a group exhibit better landing technique. The implications of this research suggest that "high-risk" movement patterns are prevalent in all levels of athletes.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Traumatismos do Joelho/etiologia , Educação Física e Treinamento/métodos , Aptidão Física/fisiologia , Esportes/fisiologia , Traumatismos em Atletas/prevenção & controle , Fenômenos Biomecânicos , Feminino , Humanos , Traumatismos do Joelho/prevenção & controle , Masculino , Militares , Movimento , Estudos Prospectivos , Estresse Mecânico , Estados Unidos , Adulto Jovem
10.
J Soc Psychol ; 154(1): 14-27, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24689334

RESUMO

We examine how three perspectives on relational devaluation relate to needs threat following ostracism. In two experiments with 179 first-year psychology students, distress was greatest when participants were ostracized without any prior throws, and distress decreased linearly with increasing prior inclusion. In Experiment 3, using 76 first-year psychology students, we manipulated expectations of exclusion and found expectations predicted distress following ostracism, suggesting ostracism's distress can be influenced by norm-based expectations of inclusion, and that progressive relational devaluation is not a necessary condition for ostracism's distress.


Assuntos
Afeto/fisiologia , Relações Interpessoais , Distância Psicológica , Rejeição em Psicologia , Isolamento Social/psicologia , Adulto , Feminino , Humanos , Masculino , Autoimagem , Estudantes/psicologia , Adulto Jovem
11.
J Healthc Qual Res ; 2024 May 13.
Artigo em Espanhol | MEDLINE | ID: mdl-38744586

RESUMO

INTRODUCTION AND OBJECTIVES: Healthcare organisations are highly complex entities that live with a high risk of instability. In order to minimise this instability, interactions and personal relationships play a major role and accordingly the figure of the leader gains full significance. The leadership style used can produce different reactions and lead to multiple outcomes, including job satisfaction. The aim of the present review is to correlate leadership style with job satisfaction in healthcare professionals. MATERIAL AND METHODS: A systematic review was carried out in BVS, Cochrane plus, CINAHL, ApaPsycinfo and Pubmed, selecting publications that mentioned leadership styles and job satisfaction in healthcare professionals. Publications search strategy were limited for the 5-10last years, full text availability and language of writing: English, French and Spanish. Review-type publications were excluded. Of the 1566 initial titles, 15 were selected for analysis. RESULTS AND CONCLUSIONS: The transformational style showed the highest number of positive correlations, followed by the authentic and transactional styles. On the other hand, the passive and laissez-faire styles showed a negative correlation regardless of the professional category to which they belonged. The results of this study provide a starting point for adopting effective leadership styles to optimise the recruitment and training processes of staff in management and coordination roles.

12.
Neuroimage ; 59(2): 1052-7, 2012 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-21967725

RESUMO

Both amygdala (AG) and hippocampus (HC) are integral parts of the olfactory system. The present study, including a large number of healthy subjects, was performed to compare HC and AG volumes, measured by manual tracing, in relation to specific olfactory functions, including odor threshold, discrimination, identification, and odor memory tasks. It also aimed to provide age-related normative data about the volume of the HC and AG. A total of 117 healthy volunteers participated (age range 19-77 years, mean age 37 years; 62 women, 55 men). Using the "Sniffin' Sticks", subjects received lateralized tests for odor threshold, and odor discrimination. In addition, an odor memory and an odor identification task were performed bilaterally. A Mini-Mental-State test excluded dementia. MR scans were performed using a 1.5 T scanner for later manual volumetric measurements. Volumetric measurements exhibited a good reproducibility. The average volume for the right HC was 3.29 cm(3) (SD 0.47), for the left HC it was 3.15 cm(3) (SD 0.47). The average right AG had a volume of 1.60 cm(3) (SD 0.31), left 1.59 cm(3) (SD 0.3). Increasing age was accompanied by a decrease of HC and AG volumes, which were much more pronounced for the right compared to the left side. Only the volume of the right HC showed a small but significant correlation with odor threshold (r(117)=0.21; p=0.02). Importantly, this correlation was not mediated by age as indicated by the significant partial correlation when controlling for age (r(114)=0.18; p=0.049). In conclusion, the present data obtained in a relatively large group of subjects demonstrates a small correlation between the volume of the HC, as an integral part of the olfactory system, and smell function. In addition, these data can be used as the basis for normative values of HC and AG volumes, separately for men, women and different age groups. This is of potential interest in diseases with acute or chronic impairment of olfactory function, in metabolic or neurodegenerative diseases or in disorders with damage of areas involved in adult neurogenesis.


Assuntos
Tonsila do Cerebelo/anatomia & histologia , Tonsila do Cerebelo/fisiologia , Hipocampo/anatomia & histologia , Hipocampo/fisiologia , Imageamento por Ressonância Magnética/métodos , Olfato/fisiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Limiar Sensorial/fisiologia , Estatística como Assunto
13.
Minerva Ginecol ; 64(6): 461-75, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23232531

RESUMO

Approximately 50% of males will develop cancer during their lifetime. In the past, oncologic therapies have largely been focused primarily on cure of the underlying malignancy. With improvements in both diagnostic modalities and treatments, pediatric and adult cancer patients are routinely surviving their disease. For this large group of patients, survivorship issues have become a major concern. Central among these survivorship issues is fertility. For males diagnosed with a malignancy, impaired reproductive potential is often noted even before any cancer therapy has been initiated. Furthermore, cancer treatments, in the form of chemotherapy, radiation therapy, and surgery, can all have potentially deleterious and lasting effects on male reproductive capability. For these reasons, a change in oncologic treatment paradigms has occurred. Now, the offer of fertility preservation to males diagnosed with cancer is a key component of comprehensive oncologic care.


Assuntos
Preservação da Fertilidade/métodos , Infertilidade Masculina/prevenção & controle , Adolescente , Adulto , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Azoospermia/fisiopatologia , Criança , Disfunção Erétil/etiologia , Disfunção Erétil/terapia , Previsões , Genitália Masculina/lesões , Genitália Masculina/fisiopatologia , Genitália Masculina/efeitos da radiação , Genitália Masculina/cirurgia , Humanos , Hipogonadismo/etiologia , Sistema Hipotálamo-Hipofisário/fisiopatologia , Sistema Hipotálamo-Hipofisário/efeitos da radiação , Sistema Hipotálamo-Hipofisário/cirurgia , Infertilidade Masculina/etiologia , Síndrome de Klinefelter/fisiopatologia , Masculino , Neoplasias/psicologia , Neoplasias/terapia , Traumatismos dos Nervos Periféricos/etiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Lesões por Radiação/etiologia , Lesões por Radiação/fisiopatologia , Radioterapia/efeitos adversos , Análise do Sêmen , Preservação do Sêmen , Bancos de Esperma , Espermatogênese/efeitos dos fármacos , Espermatogênese/fisiologia , Espermatogênese/efeitos da radiação , Sobreviventes/psicologia
14.
Radiography (Lond) ; 28(3): 823-830, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35135707

RESUMO

INTRODUCTION: Ionizing radiation can cause increased opacity of the lens and later lead to radiation-induced cataract. Therefore, the eye lens should be positioned outside of the direct radiation beam in cranial computed tomography (CCT). If this is not possible, protective measures must be taken, which includes the use of external lens protectors. In this study we assess whether direct radiation exposure of the eyes in CCT can be reduced by trained radiographers and whether the use of eye lens protectors improves after training. METHODS: First, we evaluated 763 non-enhanced CCT regarding direct radiation exposure of eyeballs and eye lenses and usage of lens shielding. Afterwards, we trained radiographers to avoid radiation exposure of the eyes by head adjustment and protectors and assessed the improvements in a subsequent study of 678 CCT. We tried to identify factors that influenced radiation exposure of the eye lens. RESULTS: After training, frequency of radiation exposure of lenses was significantly reduced by 5.9% (220/763 patients in pre- vs. 155/678 patients in post-training group, p = 0.01). The use of external lens protectors significantly increased after training by 9.8% (37/763 patients in pre- vs. 99/678 patients in post-training group, p < 0.001). The absence of tiltable headrest was a risk factor for increased eye lens radiation exposure in the pre-training group. The presence of cervical spine immobilizer was associated with more frequent radiation exposure of the lenses in the pre- and post-training group. CONCLUSIONS: Radiographer training and the use of tiltable headrest lead to reduction of radiation exposure to the eye lens. IMPLICATIONS FOR PRACTICE: Radiographer training is an effective method to reduce eye lens exposure in CCT. The usage of tiltable headrest minimizes the radiation exposure of the lenses.


Assuntos
Catarata , Cristalino , Exposição à Radiação , Lesões por Radiação , Humanos , Exposição à Radiação/prevenção & controle , Lesões por Radiação/etiologia , Lesões por Radiação/prevenção & controle , Tomografia Computadorizada por Raios X/efeitos adversos
15.
mBio ; 13(2): e0019522, 2022 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-35323040

RESUMO

Pediatric community-acquired pneumonia (CAP) is often treated with 10 days of antibiotics. Shorter treatment strategies may be effective and lead to less resistance. The impact of duration of treatment on the respiratory microbiome is unknown. Data are from children (n = 171), ages 6 to 71 months, enrolled in the SCOUT-CAP trial (NCT02891915). Children with CAP were randomized to a short (5 days) versus standard (10 days) beta-lactam treatment strategy. Throat swabs were collected at enrollment and the end of the study and used for shotgun metagenomic sequencing. The number of beta-lactam and multidrug efflux resistance genes per prokaryotic cell (RGPC) was significantly lower in children receiving the short compared to standard treatment strategy at the end of the study (Wilcoxon rank sum test, P < 0.05 for each). Wilcoxon effect sizes were small for beta-lactam (r: 0.15; 95% confidence interval [CI], 0.01 to 0.29) and medium for multidrug efflux RGPC (r: 0.23; 95% CI, 0.09 to 0.37). Analyses comparing the resistome at the beginning and end of the trial indicated that in contrast to the standard strategy group, the resistome significantly differed in children receiving the short course strategy. Relative abundances of commensals such as Neisseria subflava were higher in children receiving the standard strategy, and Prevotella species and Veillonella parvula were higher in children receiving the short course strategy. We conclude that children receiving 5 days of beta-lactam therapy for CAP had a significantly lower abundance of antibiotic resistance determinants than those receiving standard 10-day treatment. These data provide an additional rationale for reductions in antibiotic use when feasible. IMPORTANCE Antibiotic resistance is a major threat to public health. Treatment strategies involving shorter antibiotic courses have been proposed as a strategy to lower the potential for antibiotic resistance. We examined relationships between the duration of antibiotic treatment and its impact on resistance genes and bacteria in the respiratory microbiome using data from a randomized controlled trial of beta-lactam therapy for pediatric pneumonia. The randomized design provides reliable evidence of the effectiveness of interventions and minimizes the potential for confounding. Children receiving 5 days of therapy for pneumonia had a lower prevalence of two different types of resistance genes than did those receiving the 10-day treatment. Our data also suggest that children receiving longer durations of therapy have a greater abundance of antibiotic resistance genes for a longer period of time than do children receiving shorter durations of therapy. These data provide an additional rationale for reductions in antibiotic use.


Assuntos
Infecções Comunitárias Adquiridas , Microbiota , Pneumonia , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/tratamento farmacológico , Humanos , Lactente , Pneumonia/tratamento farmacológico , beta-Lactamas/uso terapêutico
16.
Am J Med Genet A ; 155A(8): 1981-6, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21744487

RESUMO

Subtelomeric deletions of chromosome 6q may result in a syndrome with brain malformations, comprising hydrocephalus and hypoplasia of the corpus callosum. Aplasia of the olfactory bulbs (OB) or anosmia has not been described in this syndrome. We describe a 3-year-old girl and a 25-year-old man with subtelomere 6q deletions. Both patients had aplastic OB and hydrocephalus. Subtelomeric 6q deletions might be underdiagnosed as anosmia can be the only symptom.


Assuntos
Anormalidades Múltiplas/genética , Deleção Cromossômica , Cromossomos Humanos Par 6/genética , Transtornos do Olfato/genética , Bulbo Olfatório/anormalidades , Anormalidades Múltiplas/diagnóstico , Adulto , Agenesia do Corpo Caloso , Pré-Escolar , Transtornos Cromossômicos/diagnóstico , Transtornos Cromossômicos/genética , Feminino , Humanos , Hidrocefalia/diagnóstico , Hidrocefalia/genética , Hibridização in Situ Fluorescente , Cariotipagem , Masculino , Transtornos do Olfato/diagnóstico , Síndrome
17.
Exp Brain Res ; 214(2): 285-91, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21842188

RESUMO

The olfactory bulb (OB) is considered to be the most important relay station in odor processing. The present study aimed to investigate the volumetric development of the human bulb and the olfactory function during childhood and youth. Furthermore, the present study aimed to investigate a possible correlation between OB volume and specific olfactory functions including odor threshold, odor discrimination and odor identification. A total of 87 subjects (46 boys, 41 girls), aged 1-17 years (mean age 8 years), participated in this study. None of them reported olfactory dysfunction or had signs of a dysfunctional sense of smell. Whenever possible, participants received a volumetric scan of the brain and lateralized olfactory tests. Volumetric measurements of the right and left OB were taken by manual segmentation of the coronal slices through the OB. Significant correlations between OB volumes and olfactory function were observed. Both, OB volumes and olfactory function increased with age, although the correlation between structure and function was not mediated by the subjects' age. In conclusion, for the first time, the present study showed a correlation between OB volume and olfactory functions in children.


Assuntos
Bulbo Olfatório/crescimento & desenvolvimento , Percepção Olfatória/fisiologia , Olfato/fisiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética/métodos , Masculino , Tamanho do Órgão , Limiar Sensorial/fisiologia
18.
Br J Oral Maxillofac Surg ; 59(3): 265-271, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33546846

RESUMO

The aim of this study was to evaluate the impact of orthognathic surgery on the quality of life (QoL) of patients with dentofacial deformity. This systematic review was performed through the survey of observational studies that had evaluated the impact of orthognathic surgery on the QoL of patients with dentofacial deformity. The article databases included PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and grey literature. The risk of bias was analysed according to the Newcastle-Ottawa Scale for quality assessment. The meta-analysis was performed considering the exposure before and after orthognathic surgery using the Oral Health Impact Profile (OHIP-14) versus the Orthognathic Quality of Life Questionnaire (OQLQ). A total of 2,263 articles were identified. Twelve studies remained in the qualitative synthesis and seven studies were included in the meta-analysis. The impact of QoL both preoperatively and postoperatively with the OHIP-14 questionnaire was 7.63 (95% confidence interval (CI) = 1.62 to 13.65; p = 0.01) and the OQLQ questionnaire was 20.53 (95% CI = 14.27 to 26.79; p < 0.0001). Overall impact of QoL was 16.01 (95% CI = 10.50 to 21.52; p < 0.0001), which showed that orthognathic surgery has an influence on the QoL. Orthognathic surgery generates positive impact on the QoL of patients with dentofacial deformity.


Assuntos
Deformidades Dentofaciais , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Deformidades Dentofaciais/cirurgia , Humanos , Qualidade de Vida , Inquéritos e Questionários
19.
Brain ; 132(Pt 11): 3096-101, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19773353

RESUMO

Differentiation of progenitor cells into neurons in the olfactory bulb depends on olfactory stimulation that can lead to an increase in olfactory bulb volume. In this study, we investigated whether the human olfactory bulb volume increases with increasing olfactory function due to treatment of chronic rhinosinusitis. Nineteen patients with chronic rhinosinusitis were investigated before and after treatment. For comparison, additional measurements were performed in 18 healthy volunteers. Volumetric measurements of the olfactory bulb were based on planimetric manual contouring of magnetic resonance scans. Olfactory function was evaluated separately for each nostril using tests for odour threshold, odour discrimination and odour identification. Measurements were performed on two occasions, 3 months apart. In healthy controls, the olfactory bulb volume did not change significantly between the two measurements. In contrast, the olfactory bulb volume in patients increased significantly from the initial 64.5 +/- 3.2 to 70.0 +/- 3.5 mm(3) on the left side (P = 0.02) and from 60.9 +/- 3.5 to 72.4 +/- 2.8 mm(3) on the right side (P < 0.001). The increase in olfactory bulb volume correlated significantly with an increase in odour thresholds (r = 0.60, P = 0.006, left side; r = 0.49, P = 0.03, right side), but not with changes in odour discrimination or odour identification. Results of this study support the idea that stimulation of olfactory receptor neurons impacts on the cell death in the olfactory bulb, not only in rodents but also in humans. To our knowledge, this is the first longitudinal study that describes an enlargement of the human olfactory bulb due to improvement of peripheral olfactory function.


Assuntos
Bulbo Olfatório , Sinusite , Olfato/fisiologia , Adulto , Idoso , Animais , Discriminação Psicológica/fisiologia , Feminino , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Odorantes , Bulbo Olfatório/anatomia & histologia , Bulbo Olfatório/patologia , Bulbo Olfatório/fisiologia , Neurônios Receptores Olfatórios/metabolismo , Tamanho do Órgão , Limiar Sensorial/fisiologia , Sinusite/patologia , Sinusite/terapia , Adulto Jovem
20.
J Chem Ecol ; 36(11): 1171-9, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20927640

RESUMO

Results of experiments conducted on ink recovered from the squid Sepioteuthis australis indicate that there is no epinephrine or protein naturally present in the ink as it would be ejected in vivo. Protein content was effectively zero when ink was syringed from the duct end of the ink sac of freshly killed animals. By contrast, there were proteins in samples collected from dead specimens where ink was collected by a stripping method. From these samples, a single large molecular weight protein was identified as having tyrosinase activity. Digestion of syringed ink did not yield signs of melanin-bound proteins. Analysis of supernatants after centrifugation of squid ink consistently revealed the presence of DOPA, dopamine, and taurine, whereas epinephrine and nor-epinephrine were recorded from what was believed to be contaminated ink. Histological investigations of the ink sac revealed a compartmentalised glandular structure distal to the duct end. Closer observation of the glandular tissue showed that compartments increased in size as they matured and moved further into the lumen. It was concluded that the presence of epinephrine and tyrosinase (or a related protein) in the ink of S. australis could be attributed to rupturing of basal glandular compartments or contamination from other sources during the extraction process.


Assuntos
Decapodiformes/química , Tinta , Animais , Di-Hidroxifenilalanina/química , Dopamina/química , Epinefrina/química , Espectrometria de Massas , Monofenol Mono-Oxigenase/metabolismo , Norepinefrina/química , Taurina/química
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA