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1.
Artigo em Inglês | MEDLINE | ID: mdl-38808374

RESUMO

While certain animal species are sensitive to heat stress, poultry particularly modern breeds, are more susceptible to high ambient temperatures. This has major implications for the poultry industry, as heat stress causes large financial losses. These economic losses will probably increase as a consequence of a predicted rise in global temperatures. Heat stress adversely affects various aspects of poultry, including physiological responses, growth and production performance, meat quality, egg quality, and reproductive activities. These effects occur through specific molecular and metabolic pathways. To mitigate the impacts of heat stress, it is crucial to go beyond administrative practices and implement dietary interventions during high ambient temperature. Such interventions aim to optimize the development of stressed bird species in terms of performance, health, and profitability. Essential oils have shown promising in mitigating the negative effects of heat stress and improved antioxidant status, growth and yield performance, as well as meat and egg quality in poultry. They actively participate in certain metabolic and molecular pathways that help to counteract the effects of heat stress. The article discusses the impacts of essential oil supplementation on the relationships between antioxidant enzyme activity, these molecular, and metabolic pathways, as well as various parameters such as growth and yield performance, and product quality heat-stressed poultry.

2.
Medicina (Kaunas) ; 60(6)2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38929508

RESUMO

Background and Objectives: Carbon monoxide (CO) intoxication is one of the most common causes of poisoning-related deaths and complications. Myocardial injury is an important complication of CO poisoning. In our study, we aimed to evaluate the relationship between the presence and prevalence of fragmented QRS (fQRS) and myocardial injury in patients with CO intoxication. Materials and Methods: We retrospectively evaluated patients who presented to the emergency department of our tertiary care center with CO intoxication between January 2020 and December 2023. In our study, we performed subgroup analyses according to the presence of myocardial injury and fQRS. We evaluated the parameters and risk factors associated with myocardial injury. Results: Myocardial injury was detected in 44 patients, and fQRS was detected in 38 patients. In the myocardial injury (+) group, the fQRS rate was 38.6%, and the median number of leads with fQRS was 3 (2-6) and was significantly higher than in the myocardial injury (-) group (p < 0.001). We found that carboxyhemoglobin had a significant positive correlation with troponin (p = 0.001) and pro-B-type natriuretic peptide (proBNP) (p = 0.009). As a result of multivariate analysis, we determined that age, creatinine, proBNP, fQRS, and ≥3 leads with fQRS are independent risk factors for myocardial injury. Conclusions: Myocardial injury in CO intoxication patients is associated with proBNP, the presence of fQRS, and the number of leads with fQRS. Age, creatinine level, proBNP, the presence of fQRS, and ≥3 leads with fQRS are independent risk factors for myocardial injury in patients with CO intoxication.


Assuntos
Intoxicação por Monóxido de Carbono , Eletrocardiografia , Humanos , Intoxicação por Monóxido de Carbono/complicações , Intoxicação por Monóxido de Carbono/fisiopatologia , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Eletrocardiografia/métodos , Adulto , Idoso , Fatores de Risco , Peptídeo Natriurético Encefálico/sangue , Peptídeo Natriurético Encefálico/análise , Carboxihemoglobina/análise , Troponina/sangue , Troponina/análise
3.
Bioinformatics ; 38(Suppl 1): i143-i152, 2022 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-35758787

RESUMO

MOTIVATION: Database fingerprinting has been widely used to discourage unauthorized redistribution of data by providing means to identify the source of data leakages. However, there is no fingerprinting scheme aiming at achieving liability guarantees when sharing genomic databases. Thus, we are motivated to fill in this gap by devising a vanilla fingerprinting scheme specifically for genomic databases. Moreover, since malicious genomic database recipients may compromise the embedded fingerprint (distort the steganographic marks, i.e. the embedded fingerprint bit-string) by launching effective correlation attacks, which leverage the intrinsic correlations among genomic data (e.g. Mendel's law and linkage disequilibrium), we also augment the vanilla scheme by developing mitigation techniques to achieve robust fingerprinting of genomic databases against correlation attacks. RESULTS: Via experiments using a real-world genomic database, we first show that correlation attacks against fingerprinting schemes for genomic databases are very powerful. In particular, the correlation attacks can distort more than half of the fingerprint bits by causing a small utility loss (e.g. database accuracy and consistency of SNP-phenotype associations measured via P-values). Next, we experimentally show that the correlation attacks can be effectively mitigated by our proposed mitigation techniques. We validate that the attacker can hardly compromise a large portion of the fingerprint bits even if it pays a higher cost in terms of degradation of the database utility. For example, with around 24% loss in accuracy and 20% loss in the consistency of SNP-phenotype associations, the attacker can only distort about 30% fingerprint bits, which is insufficient for it to avoid being accused. We also show that the proposed mitigation techniques also preserve the utility of the shared genomic databases, e.g. the mitigation techniques only lead to around 3% loss in accuracy. AVAILABILITY AND IMPLEMENTATION: https://github.com/xiutianxi/robust-genomic-fp-github.


Assuntos
Algoritmos , Genômica , Bases de Dados Factuais
4.
Anim Biotechnol ; 34(7): 2766-2777, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36052972

RESUMO

This study was carried out to evaluate the impact of cumin essential oil (CEO) supplementation on levels of certain gene expression related to antioxidant, apoptotic, detoxific, and heat shock mechanisms in the breast meat and ileum of heat-stressed broilers. The study was conducted on a 2 × 6 factorial design (heat stress + feed additive) on 600 day-old male broiler chicks for a period of 42 days. From day 7 to 42, although broilers in heat stress groups (HT) were exposed to constant chronic heat stress (36 °C), others were housed at thermoneutral ambient temperature (TN). The chicks in both conditions were fed with 6 experimental diets: C0 (basal diet with no additive), ANTIB (basal diet + 100 mg/kg chloramphenicol), VITE (basal diet + 50 IU α-tocopherol), C2 (basal diet + 200 mg/kg CEO), C4 (basal diet + 400 mg/kg CEO), C6 (basal diet+ 600 mg/kg CEO). The results showed that heat stress upregulated (except for Bcl-2) the genes related to antioxidant, apoptosis, detoxification, and heat shock mechanism. However, cumin essential oil increased the dose-dependently positive effect on certain genes in tissues of the heat-stressed broilers and downregulated (except for Bcl-2) these genes.


Assuntos
Antioxidantes , Cuminum , Animais , Masculino , Antioxidantes/farmacologia , Antioxidantes/metabolismo , Galinhas/genética , Galinhas/metabolismo , Cuminum/genética , Cuminum/metabolismo , Suplementos Nutricionais , Dieta/veterinária , Resposta ao Choque Térmico/genética , Temperatura Alta , Apoptose , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Ração Animal
5.
Vascular ; 31(3): 467-472, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35000519

RESUMO

OBJECTIVE: The aim of this study was to investigate the association between blood groups and severity of peripheral artery disease (PAD) using TASC II classification. METHODS: The patients who were diagnosed with PAD were retrospectively analyzed. The patients with 50% or more stenosis in the aorto-iliac or femoro-popliteal region detected by conventional or CT angiography were included in the study. These patients were divided into TASC II A, B, C, and D groups considering the severity of PAD. All patients' blood groups were recorded and compared between TASC II groups. RESULTS: While 38% of the study population was O blood group, 61% were non-O group. On the other hand, 90% of the entire study population were RH positive and 10% were RH negative. Non-O blood ratio was found to be significantly higher in patients with higher TASC II groups. (TASC IIA 51.6% vs. TASC IIB 57.9% vs. TASC IIC 61.3% vs. TASC IID 76.6%, p< .001) However, the frequencies of Rh types were similar in all groups. Multiple logistic regression analysis was applied for determining the predictors of severity and complexity of PAD (TASC II C and TASC II D lesions). CONCLUSIONS: Our study results revealed a clear association between ABO blood groups and severity of peripheral arterial disease. Non-O blood group was found to be the independent predictor of severe and complex PAD.


Assuntos
Sistema ABO de Grupos Sanguíneos , Doença Arterial Periférica , Humanos , Fatores de Risco , Resultado do Tratamento , Estudos Retrospectivos , Doença Arterial Periférica/diagnóstico por imagem , Artéria Femoral , Artéria Poplítea , Grau de Desobstrução Vascular , Stents
6.
Perfusion ; 38(1): 186-192, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-34590527

RESUMO

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is considered a major risk factor for postoperative complications after transcatheter aortic valve implantation (TAVI). To date, there is no clear consensus on the best anesthesia management for these patients. We aimed to investigate the effects of types of anesthesia on clinical outcomes in patients with severe COPD undergoing TAVI. METHODS: This is a single-center, retrospective study comparing conscious sedation (CS) versus general anesthesia (GA) in 72 patients with severe COPD who underwent TAVI. The primary endpoints were 30-day all-cause mortality and postoperative pulmonary complications. RESULTS: The main outcome of interest of this study was that the frequency of pulmonary complications was statistically higher in the GA group (21.4% vs 3.3%, p = 0.038). These differences are most likely attributed to the GA because of prolonged mechanical ventilation, and longer ICU stay (2 (1.2-3) vs 2.5 (2-4) days, p = 0.029) associated with an increased risk of nosocomial infections. There were no significant differences in procedure complications and 30-day mortality between the two groups (GA; 19% vs CS; 13.3%, p = 0.521). One-year survival rates, compared by Kaplan-Meier analysis, were similar between groups (log-rank p = 0.733). CONCLUSION: In aortic stenosis patients with severe COPD undergoing TAVI, the use of GA compared with CS was associated with higher incidences of respiratory-related complications, and longer ICU length of stay. CS is a safe and viable option for these patients and should be considered the favored approach.


Assuntos
Estenose da Valva Aórtica , Doença Pulmonar Obstrutiva Crônica , Substituição da Valva Aórtica Transcateter , Humanos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/métodos , Sedação Consciente/efeitos adversos , Sedação Consciente/métodos , Estudos Retrospectivos , Resultado do Tratamento , Anestesia Geral/efeitos adversos , Anestesia Geral/métodos , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/cirurgia , Fatores de Risco , Doença Pulmonar Obstrutiva Crônica/complicações , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Valva Aórtica/cirurgia
7.
IEEE Trans Dependable Secure Comput ; 20(4): 2939-2953, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38384377

RESUMO

Database fingerprinting is widely adopted to prevent unauthorized data sharing and identify source of data leakages. Although existing schemes are robust against common attacks, their robustness degrades significantly if attackers utilize inherent correlations among database entries. In this paper, we demonstrate the vulnerability of existing schemes by identifying different correlation attacks: column-wise correlation attack, row-wise correlation attack, and their integration. We provide robust fingerprinting against these attacks by developing mitigation techniques, which can work as post-processing steps for any off-the-shelf database fingerprinting schemes and preserve the utility of databases. We investigate the impact of correlation attacks and the performance of mitigation techniques using a real-world database. Our results show (i) high success rates of correlation attacks against existing fingerprinting schemes (e.g., integrated correlation attack can distort 64.8% fingerprint bits by just modifying 14.2% entries in a fingerprinted database), and (ii) high robustness of mitigation techniques (e.g., after mitigation, integrated correlation attack can only distort 3% fingerprint bits). Additionally, the mitigation techniques effectively alleviate correlation attacks even if (i) attackers have access to correlation models directly computed from the original database, while the database owner uses inaccurate correlation models, (ii) or attackers utilizes higher order of correlations than the database owner.

8.
Environ Monit Assess ; 195(11): 1290, 2023 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-37821723

RESUMO

Proper disposal of solid waste is crucial for the protection of natural resources and human health. However, increasing population and changes in consumption habits have led to a global increase in solid waste production. Therefore, a site selection process for solid waste management that takes into account environmental, economic, and social factors is needed. The number of open-source GIS (geographic information system) software programs used in site selection analysis is increasing day by day. QGIS software is an open-source GIS software developed by free software developers, with its popularity increasing with each new version and allowing for the development of plugins with the Python programming language. The shareability of plugins developed with QGIS software brings together open-source GIS users around the world for common goals. In this study, a plugin called "LANDFILL SITE SELECTION (LFSS)" was developed in the QGIS software environment for solid waste landfill site selection and a suitability map was created for solid waste landfill site selection in Tokat, Turkey, using this plugin. For this purpose, 14 evaluation criteria and 8 exclusion criteria were selected, the importance levels of criteria and sub-criteria were determined using the AHP method, and a solid waste landfill site selection suitability map was created using the developed plugin.


Assuntos
Eliminação de Resíduos , Resíduos Sólidos , Humanos , Eliminação de Resíduos/métodos , Turquia , Monitoramento Ambiental/métodos , Sistemas de Informação Geográfica , Instalações de Eliminação de Resíduos
9.
Artigo em Inglês | MEDLINE | ID: mdl-36342562

RESUMO

BACKGROUND AND AIM: Sodium-glucose co-transporter-2 (SGLT2) inhibitors added to optimal medical therapy have been shown to reduce the risk of cardiovascular death and recurrent heart failure (HF) hospitalization in HF patients. We aimed to evaluate the effect of SGLT2 inhibitors on the ventricular repolarization markers (VRM) in patients with HF with reduced ejection fraction (HFrEF). METHODS: 51 patients with HFrEF who had symptoms New York Heart Association (NYHA) class II-IV despite optimal medical treatment and were added SGLT2 inhibitors to their treatment were included in the study. Electrocardiography (ECG) and laboratory results obtained before the treatment and at the first-month follow-up visit were compared. QT, QTc (corrected by Bazett formula), QT dispersion (QTd), QTc dispersion (QTc-d), Tpeak to Tend (Tp-e) interval, Tp-e/QT, and Tp-e/QTc ratios were measured and defined as VRM. RESULTS: A significant decrease was observed in HR, QT, QTc intervals, and QTd compared to pre-treatment. While the mean Tp-e interval was 101.5 ± 11.7 ms before treatment, it decreased to 93.1 ± 12.7 ms after treatment (p < 0.001). There was a significant decrease in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels after treatment [2859 ± 681vs.1266 ± 763, respectively (p < 0.001)] and QTd, Tp-e interval, and Tp-e/QTc ratio was positively correlated with the change in NT-proBNP level. CONCLUSIONS: The addition of SGLT2 inhibitors to optimal medical therapy in HFrEF patients positively changes VRM (QT, QTc, QTd, Tp-e, and Tp-e/QTc).

10.
Neurosurg Rev ; 45(1): 357-364, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34432162

RESUMO

The sacroiliac joint is a diarthrodial synovial joint in the pelvis. Anatomically, it is described as a symphysis, its synovial joint characteristics being limited to the distal cartilaginous portion on the iliac side. It is a continuous ligamentous stocking comprising interconnecting ligamentous structures and surrounding fascia. Its ligaments, the primary source of its stability, include the anterior, interosseous and dorsal sacroiliac, the iliolumbar, sacrotuberous, and sacrospinous. Structural reinforcement is also provided by neighboring fascia and muscles. Lower back pain is a common presentation of sacroiliac joint disease, the best-established treatments being corticosteroid injections, bipolar radiofrequency ablation, and sacroiliac joint fusion.


Assuntos
Articulação Sacroilíaca , Sacro , Fenômenos Biomecânicos , Humanos , Ligamentos/cirurgia , Pelve , Articulação Sacroilíaca/diagnóstico por imagem , Articulação Sacroilíaca/cirurgia
11.
Clin Anat ; 35(3): 264-268, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34535923

RESUMO

We aimed to localize the pharyngeal branches of the pharyngeal plexus to preclude postoperative complications such as dysphagia resulting from injury to those branches. Cranial nerves IX and X and the sympathetic trunk were dissected on 10 sides in the necks of embalmed adult cadavers of European descent to identify the pharyngeal branches so that anatomical landmarks could be identified and injury thereby avoided. In all sides, the pharyngeal branches originated from the glossopharyngeal and vagus nerves and the superior cervical ganglion and entered the posterior pharyngeal wall at the C2-C4 levels within 10 mm medial to the greater horn of the hyoid bone. All pharyngeal branches were anterior to the alar fascia. Based on our anatomical study, vagus nerve branches to the pharyngeal muscles enter at the C3/C4 vertebral levels. Such knowledge might help decrease or allow surgeons to predict which patients are more likely to develop dysphagia after cervical spine surgery.


Assuntos
Transtornos de Deglutição , Adulto , Cadáver , Vértebras Cervicais/cirurgia , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/prevenção & controle , Nervo Glossofaríngeo/anatomia & histologia , Nervo Glossofaríngeo/cirurgia , Humanos , Pescoço , Músculos Faríngeos
12.
Arch Orthop Trauma Surg ; 142(7): 1359-1366, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33484305

RESUMO

INTRODUCTION: Salvage of joint destruction of the tibiotalar and subtalar joint with necrosis or infection of the talus in compromised hosts is a challenging problem. In these cases, tibiocalcaneal arthrodesis using the Ilizarov external fixator represents a possible alternative to amputation. This retrospective study presents the results and complications of this salvage procedure. MATERIALS AND METHODS: Between 2005 and 2015, 19 patients were treated with tibiocalcaneal arthrodesis using the Ilizarov external fixator. Ten patients received tibiocalcaneal arthrodesis due to an acute or chronic infection with joint destruction. The other nine patients presented posttraumatic necrosis of the talus or Charcot arthropathy. In addition to demographic data, the time spent in the fixator, the major and minor complications and the endpoint of the consolidation were evaluated retrospectively. Furthermore, clinical outcomes were measured using the modified American Orthopedic Foot and Ankle Society (AOFAS) score. RESULTS: The average time spent in the fixator was 22 (range 14-34) weeks. The average follow-up in 17 patients was 116 (range 4-542) weeks. Two patients were lost to follow-up. Complete osseous consolidation was achieved in 14 out of 19 patients. One patient presented partial consolidation, and in four patients, pseudarthrosis could be detected. The mean modified AOFAS score at the final follow-up was 53 out of 86 possible points. CONCLUSION: Tibiocalcaneal arthrodesis using the Ilizarov fixator is a possible salvage procedure even in compromised hosts. However, the healing rates are below the rates reported in the literature for tibiotalar arthrodesis in comparable clinical situations.


Assuntos
Artropatia Neurogênica , Técnica de Ilizarov , Articulação do Tornozelo/cirurgia , Artrodese/métodos , Artropatia Neurogênica/cirurgia , Humanos , Necrose , Estudos Retrospectivos , Resultado do Tratamento
13.
Medicina (Kaunas) ; 58(8)2022 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-36013595

RESUMO

Background and Objectives: In addition to left ventricular (LV) functions, right ventricular (RV) functions and pulmonary arterial stiffness (PAS) may be adversely affected in patients with heart failure with reduced ejection fraction (HFrEF). Sodium-glucose co-transporter-2 (SGLT2) inhibitor therapy positively affects LV functions as well as having functional and symptomatic benefits in HFrEF patients. In this study, we aimed to evaluate the effects of SGLT2 inhibitor treatment on RV function and PAS in HFrEF patients. Materials andMethods: 168 HFrEF patients with New York Heart Association (NYHA) class ≥2 symptoms despite optimal medical treatment and who were started on SGLT2 inhibitor therapy were included in this retrospective study. NYHA classification, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, Minnesota Living with Heart Failure Questionnaire (MLWHFQ) scores, laboratory tests, and transthoracic echocardiography (TTE) measurements were recorded before treatment and at the end of the 6-month follow-up. Results: The mean age of the patients was 62.7 ± 11.4 years, and 38 (22.6%) were women. RV function (RV fractional area change (FAC) (33.8 ± 6.4% vs. 39.2 ± 7.3%, p < 0.001); tricuspid annular plane systolic excursion (TAPSE) (18.4 ± 3.8 mm vs. 19.6 ± 3.6 mm, p < 0.001); RV S' (10 (8 − 13) cm/s vs. 13 (10 − 16) cm/s, p < 0.001); RV myocardial performance index (RV MPI) (0.68 ± 0.12 vs. 0.59 ± 0.11, p < 0.001); mean pulmonary artery pressure (mPAP) (39.6 ± 7.8 mmHg vs. 32 ± 6.8 mmHg, p = 0.003)) and PAS (24.2 ± 4.6 kHz/ms vs. 18.6 ± 3.1 kHz/ms, p < 0.001) values at the 6-month follow-up after SGLT2 inhibitor therapy significantly improved. It was found that SGLT2 inhibitor treatment provided significant improvement in NYHA classification, MLWHFQ scores, and NT-proBNP levels (2876 ± 401 vs. 1034 ± 361, p < 0.001), and these functional and symptomatic positive changes in HFrEF patients were significantly correlated with positive changes in LVEF, PAS, and RV functional status. Conclusions: SGLT2 inhibitor treatment results in symptomatic and functional well-being in HFrEF patients, as well as positive changes in RV function and PAS.


Assuntos
Insuficiência Cardíaca , Inibidores do Transportador 2 de Sódio-Glicose , Rigidez Vascular , Disfunção Ventricular Esquerda , Disfunção Ventricular Direita , Idoso , Feminino , Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Artéria Pulmonar , Estudos Retrospectivos , Sódio , Transportador 2 de Glucose-Sódio , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Volume Sistólico/fisiologia , Disfunção Ventricular Direita/tratamento farmacológico , Função Ventricular Direita/fisiologia
14.
Eur J Orthop Surg Traumatol ; 32(6): 1063-1070, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34327546

RESUMO

PURPOSE: Treatment of joint destruction of the tibiotalar and subtalar joints caused by acute or chronic infections in compromised hosts is a challenging problem. In these cases, simultaneous septic arthrodesis with the use of the Ilizarov external fixator represents a possible alternative to amputation. This case series presents the results and complications of patients with acute or chronic infection of the tibiotalar and subtalar joints. METHODS: Between 2005 and 2015, 13 patients with acute or chronic infections were treated by simultaneous single-stage debridement/arthrodesis of the tibiotalar and subtalar joints. In seven patients, there was a florid infection with fistula formation and soft tissue defects, and in six patients, there was chronic osteomyelitis with closed soft tissue. In addition to the demographic data, the time spent in the fixator, the major and minor complications and the endpoint of consolidation were reviewed. RESULTS: The mean time spent in the fixator was 18 (min 15, max 26) weeks. The mean follow-up time for nine patients was 100 (min 3, max 341) weeks. Complete osseous consolidation of both the tibiotalar and subtalar joints was achieved in 10 patients (77%). In three (23%) patients, there was complete consolidation of one of the joints and partial consolidation of the other joint. CONCLUSION: The Ilizarov external fixator allows for simultaneous arthrodesis of the tibiotalar and subtalar joints in septic joint destruction. However, the healing rates are below the rates reported in the literature for isolated tibiotalar or tibiocalcaneal arthrodesis in comparable clinical situations.


Assuntos
Osteomielite , Articulação Talocalcânea , Articulação do Tornozelo/cirurgia , Artrodese/efeitos adversos , Artrodese/métodos , Fixadores Externos , Humanos , Osteomielite/etiologia , Osteomielite/cirurgia , Estudos Retrospectivos , Articulação Talocalcânea/cirurgia , Resultado do Tratamento
15.
Int J Clin Pract ; 75(8): e14267, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33893709

RESUMO

BACKGROUND: This study aimed to investigate the relationship between the experience level of physicians initially making the clinical diagnosis of ST-segment elevation myocardial infarction in the emergency department and door-to-balloon time (DBT). MATERIAL AND METHODS: The study group comprised 522 patients with ST-elevation myocardial infarction who were immediately treated in the catheter laboratory. Information about DBT, the experience level of the physicians who initially clinically diagnosed the patients and clinical benefit parameters were collected. The experience level of the physicians was divided into three groups: medical practitioner (no emergency training; n = 351), assistant physician (undergoing emergency medicine training; n = 111) and emergency medicine specialist (n = 60). DBT was compared among these groups. RESULTS: The average DBT was 80.3 ± 83.2 minutes for medical practitioners, 77.5 ± 74.7 minutes for assistant physicians and 53.6 ± 28.1 minutes for emergency medicine specialists. The difference in DBT between the emergency medicine specialist group and others was statistically significant (P = .046). CONCLUSIONS: DBT decreased as the experience level of the emergency physician increased, but randomisation is required to determine the clinical benefit of this effect.


Assuntos
Angioplastia Coronária com Balão , Infarto do Miocárdio , Médicos , Eletrocardiografia , Serviço Hospitalar de Emergência , Humanos , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/terapia , Fatores de Tempo
16.
Neurosurg Rev ; 44(1): 309-315, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31974822

RESUMO

The lateral lumbar interbody fusion technique for lumbar arthrodesis is gaining popularity and being added as an option to traditional posterior and anterior approaches. In light of this, we analyzed the literature to identify the 25 most cited articles regarding lateral lumbar interbody fusion. The Thomson Reuters Web of Science was systematically searched to identify papers pertaining to lateral lumbar interbody fusion. The results were sorted in order to identify the top cited 25 articles. Statistical analysis was applied to determine metrics of interest, and observational studies were further classified. A search of all databases in the Thomson Reuters Web of Science identified 379 articles pertaining to lateral lumbar interbody fusion, with a total of 3800 citations. Of the 25 most cited articles, all were case series, reporting on a total of 2981 patients. These 25 articles were cited 2232 times in the literature and total citations per article ranged from 29 to 433. The oldest article was published in 2006, whereas the most recent article was published in 2015. The most cited article, by Ozgar et al., was cited 433 times, and the journal Spine published 7 of the 25 most cited articles. Herein, we report and analyze the 25 most cited articles on lateral lumbar interbody fusion, which include 25 cases series reporting a variety of data on a total of 2513 patients. Such data might assist in the design and interpretation of future studies pertaining to this topic.


Assuntos
Vértebras Lombares/cirurgia , Publicações Periódicas como Assunto/tendências , Fusão Vertebral/tendências , Humanos , Fusão Vertebral/métodos , Coluna Vertebral/cirurgia
17.
Neurosurg Rev ; 44(2): 763-772, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32318923

RESUMO

The pharyngeal plexus is an essential anatomical structure, but the contributions from the glossopharyngeal and vagus nerves and the superior cervical ganglion that give rise to the pharyngeal plexus are not fully understood. The pharyngeal plexus is likely to be encountered during various anterior cervical surgical procedures of the neck such as anterior cervical discectomy and fusion. Therefore, a detailed understanding of its anatomy is essential for the surgeon who operates in and around this region. Although the pharyngeal plexus is an anatomical structure that is widely mentioned in literature and anatomy books, detailed descriptions of its structural nuances are scarce; therefore, we provide a comprehensive review that encompasses all the available data from this critical structure. We conducted a narrative review of the current literature using databases like PubMed, Embase, Ovid, and Cochrane. Information was gathered regarding the pharyngeal plexus to improve our understanding of its anatomy to elucidate its involvement in postoperative spine surgery complications such as dysphagia. The neural contributions of the cranial nerves IX, X, and superior sympathetic ganglion intertwine to form the pharyngeal plexus that can be injured during ACDF procedures. Factors like surgical retraction time, postoperative hematoma, surgical hardware materials, and profiles and smoking are related to postoperative dysphagia onset. Thorough anatomical knowledge and lateral approaches to ACDF are the best preventing measures.


Assuntos
Transtornos de Deglutição/diagnóstico , Gânglios Simpáticos/anatomia & histologia , Nervo Glossofaríngeo/anatomia & histologia , Músculos Faríngeos/anatomia & histologia , Complicações Pós-Operatórias/diagnóstico , Nervo Vago/anatomia & histologia , Vértebras Cervicais/anatomia & histologia , Vértebras Cervicais/cirurgia , Transtornos de Deglutição/etiologia , Discotomia/efeitos adversos , Feminino , Gânglios Simpáticos/cirurgia , Nervo Glossofaríngeo/cirurgia , Humanos , Masculino , Músculos Faríngeos/inervação , Músculos Faríngeos/cirurgia , Complicações Pós-Operatórias/etiologia , Fusão Vertebral/efeitos adversos , Nervo Vago/cirurgia
18.
Neurosurg Rev ; 44(4): 2111-2118, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32851541

RESUMO

Vertebral osteomyelitis (VO) is a severe infection of the vertebral body and the adjacent disc space, where Staphylococcus aureus is most commonly isolated. The objective of this retrospective study was to determine risk factors for and compare outcome differences between de novo methicillin-resistant Staphylococcus aureus (MRSA) VO and methicillin-sensitive Staphylococcus aureus (MSSA) VO. A retrospective cohort study was performed by review of the electronic medical records of 4541 consecutive spine surgery patients. Among these 37 underwent surgical treatment of de novo MRSA and MSSA spinal infections. Patient demographics, pre- and postoperative neurological status (ASIA impairment score), surgical treatment, inflammatory laboratory values, nutritional status, comorbidities, antibiotics, hospital stay, ICU stay, reoperation, readmission, and complications were collected. A minimum follow-up (FU) of 12 months was required. Among the 37 patients with de novo VO, 19 were MRSA and 18 were MSSA. Mean age was 52.4 and 52.9 years in the MRSA and MSSA groups, respectively. Neurological deficits were found in 53% of patients with MRSA infection and in 17% of the patients with MSSA infection, which was statistically significant (p < 0.05). Chronic renal insufficiency and malnutrition were found to be significant risk factors for MRSA VO. Preoperative albumin was significantly lower in the MRSA group (p < 0.05). Patients suffering from spinal infection with chronic renal insufficiency and malnutrition should be watched more carefully for MRSA. The MRSA group did not show a significant difference with regard to final clinical outcome despite more severe presentation.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Antibacterianos/uso terapêutico , Humanos , Meticilina , Resistência a Meticilina , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus
19.
Vascular ; 29(3): 330-339, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32998666

RESUMO

OBJECTIVES: Malnutrition has been shown to be associated with survival in a variety of diseases. Our aim is to evaluate the prognostic value of objective nutritional indexes indicating malnutrition, in patients underwent endovascular aortic replacement. METHODS: We retrospectively evaluated 149 consecutive patients who underwent technically successful endovascular aortic replacement operation between October 2010 and August 2019. Objective nutritional indexes, prognostic nutritional index, geriatric nutritional risk index and controlling nutritional status, scores were calculated using the preoperative data. Optimal cut-off values were obtained by receiver operating characteristic analysis. According to the cut-off values, we investigated the relationship between indexes and the long-term all-cause mortality. RESULTS: During mean 48.0 ± 30.3 months follow-up duration, in 47 of patients (31.5%), all-cause mortality were documented. In mortality group, prognostic nutritional index (42.8 ± 7.1 vs 51.3 ± 5.2, p < 0.001) and geriatric nutritional risk index (100.7 ± 10.1 vs 107.6 ± 9.2, p < 0.001) were significantly lower, controlling nutritional status score (2.0 (1.0-4.0) vs 1.0 (0.0-2.0), p < 0.001) was higher when compared to survivor group. Kaplan-Meier curves presented higher mortality incidence in malnutrition patients evaluated with objective nutritional indexes (Log-rang test, for all three indexes p < 0.001). Besides Cox-proportional hazard analysis showed all three nutritional indexes may be a predictive marker for all-cause mortality, prognostic nutritional index introduced more valuable data than other two indexes. CONCLUSIONS: Malnutrition is associated with significant increase in postoperative long-term mortality in endovascular aortic replacement patients. Preoperatively calculated objective nutritional indexes especially prognostic nutritional index can be used as an important prognostic tool.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Desnutrição/fisiopatologia , Idoso , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/mortalidade , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/mortalidade , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/mortalidade , Feminino , Avaliação Geriátrica , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/mortalidade , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
20.
J Electrocardiol ; 64: 76-79, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33352333

RESUMO

BACKGROUND: Low iron storage is a common health problem around the world. Although the association of low iron storage with cardiovascular events and various electrocardiographic parameters has been investigated, its association with fragmented QRS (fQRS), Tpeak-Tend (Tp-e) interval, Tp-e/QT and Tp-e/QTc ratios, which are important criteria for repolarization, has not been studied in adults. METHODS: A total of 201 female patients in the 18-50 age group with no history of chronic and cardiac disease or anaemia were included in the study. Patients were divided into 3 groups based on their ferritin levels. Twelve lead EKGs were obtained from each patient, and fQRS, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were calculated manually. RESULTS: A total of 201 female patients with an average age of 37 ± 9 were included in the study. Group 1 (ferritin<15 ng/mL) consisted of 79 (39.3%) patients, Group 2 (ferritin 15-30 ng/mL) consisted of 64 patients (31.8%) and Group 3 (ferritin≥30 ng/mL) consisted of 58 (28.9%) patients. Tp-e interval was significantly higher in Group 1 compared to Group 2 and 3 (p < 0.001). A similar relationship was also observed between Tp-e/QT, Tp-e/QTc and fQRS (p < 0.001). A moderate, negative relationship was found in the correlation analysis of Tp-e, Tp-e/QT, Tp-e/QTc and fQRS with ferritin value [r = -0.519 (p = 0.001), r = -0.485 (p = 0.001), r = -0.540 (p = 0.001) and r = -0.345 (p = 0.001), respectively]. CONCLUSION: As a result of the study, it was found that low iron storage may increase arrhythmogenic susceptibility through increased fragmented QRS presence, increased Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in healthy women of childbearing age.


Assuntos
Anemia , Eletrocardiografia , Adulto , Arritmias Cardíacas , Feminino , Humanos , Ferro , Pessoa de Meia-Idade
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