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1.
J Appl Microbiol ; 131(1): 375-391, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33249672

RESUMO

AIMS: Compare and characterize Chaetomium strains with special regard to their potentialities as biocontrol agents. METHODS AND RESULTS: Twelve strains of the fungal genus Chaetomium from diverse ecological niches were identified as belonging to six different species. Large differences were observed between the strains with regard to temperature requirements for mycelial growth and pigmentation of culture filtrates. Culture filtrates and ethyl acetate extracts were assayed for fungicidal effects against important phytopathogens both on agar media and in multiwell plates. The samples from Chaetomium globosum were particularly active against Botrytis cinerea, Pyrenophora graminea and Bipolaris sorokiniana, while those from C. cochliodes and C. aureum were inhibitory towards Phytophthora infestans, and P. infestans and Fusarium culmorum respectively. To narrow down the active principle, the most promising extracts were separated by preparative HPLC and the resulting fractions tested in bioassays. Chaetoglobosins were identified as active compounds produced by C. globosum. CONCLUSIONS: The bioassays revealed C. aureum and C. cochliodes as promising candidates for use in biocontrol. Both showed remarkably good activity against the prominent plant pathogen P. infestans. SIGNIFICANCE AND IMPACT OF THE STUDY: We provide the first systematic study comparing six different Chaetomium species with regard to their use as biocontrol agents.


Assuntos
Antibiose , Antifúngicos/farmacologia , Agentes de Controle Biológico/farmacologia , Chaetomium/fisiologia , Fungos/crescimento & desenvolvimento , Antifúngicos/análise , Ascomicetos/efeitos dos fármacos , Ascomicetos/crescimento & desenvolvimento , Agentes de Controle Biológico/análise , Botrytis/efeitos dos fármacos , Botrytis/crescimento & desenvolvimento , Chaetomium/crescimento & desenvolvimento , Fungos/efeitos dos fármacos , Fusarium/efeitos dos fármacos , Fusarium/crescimento & desenvolvimento , Alcaloides Indólicos/análise , Alcaloides Indólicos/farmacologia , Fenótipo , Phytophthora infestans/efeitos dos fármacos , Phytophthora infestans/crescimento & desenvolvimento
2.
J Eur Acad Dermatol Venereol ; 35(3): 641-649, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32745330

RESUMO

BACKGROUND: Actinic keratosis (AK) is a common precancerous lesion of the skin that may be treated with chemical peelings. Despite their long-standing usage and clinical experience, no evidence-based recommendation regarding the efficacy and safety of chemical peelings for AK exists. OBJECTIVES: To systematically review and synthesize the current knowledge on chemically exfoliative peelings as interventions for AK. METHODS: We performed a systematic literature research in Medline, Embase and CENTRAL and hand-searched pertinent trial registers for eligible records until 5 August 2019. Results from individual studies were pooled using a random-effects model or described in a qualitative synthesis. The risk of bias was estimated with the tools provided by the Cochrane Collaboration (randomized and non-randomized trials) and the Evidence Project (single-arm trials). RESULTS: Four randomized controlled trials, two non-randomized controlled trials and two single-arm studies with a total sample size of n = 170 patients were included. Trichloroacetic acid (TCA) plus Jessner's solution showed significantly lower participant complete clearance (RR 0.36, 95% CI: 0.14-0.90, two studies, I2  = 0%, P = 0.03) and lower lesion clearance (RR 0.92, 95% CI: 0.85-0.99, one study, P = 0.03) compared to 5-fluorouracil (5-FU) 5% cream. TCA as monotherapy showed lower lesion complete clearance (RR 0.75, 95% CI: 0.69-0.82, two studies, I2  = 7%, P < 0.001) and lower mean lesion reduction per patient compared to conventional photodynamic therapy (cPDT) (MD -20.48, 95% CI: -31.55 to -9.41, two studies, I2  = 43%, P = 0.0003). Pain was more pronounced in patients treated with cPDT in comparison with TCA (MD -1.71 95% CI: -3.02 to -0.41, two studies, I2  = 55%, P = 0.01). In the single-arm studies, 5-FU plus glycolic acid showed 92% lesion clearance and phenol peeling 90.6% participant complete clearance. All studies showed a high risk for bias. CONCLUSIONS: Future high-quality studies and a standardization of peeling protocols are warranted to determine the value of chemical peelings in the treatment of AK.


Assuntos
Ceratose Actínica , Fotoquimioterapia , Fluoruracila/uso terapêutico , Humanos , Ceratose Actínica/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resorcinóis/uso terapêutico , Pele
3.
BMC Med Educ ; 17(1): 111, 2017 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-28693486

RESUMO

BACKGROUND: Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students. METHODS: All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making. RESULTS: International medical students scored significantly poorer than their local peers (p < .001; η2 = .042). Within the specific professional domains assessed, they showed poorer scores, with differences in conversational skills showing the highest effect (p < .001; η2 = .053). No differences emerged within the multiple-choice examination (p = .127). CONCLUSION: International students showed poorer results in clinical-practical exams in the field of psychosocial medicine, with conversational skills yielding the poorest scores. However, regarding factual and practical knowledge examined via a multiple-choice test, no differences emerged between international and local students. These findings have decisive implications for relationship building in the doctor-patient relationship.


Assuntos
Competência Clínica , Barreiras de Comunicação , Avaliação Educacional , Médicos Graduados Estrangeiros , Idioma , Exame Físico , Relações Médico-Paciente , Transtorno Bipolar/diagnóstico , Lista de Checagem , Tomada de Decisão Clínica , Demência/diagnóstico , Feminino , Médicos Graduados Estrangeiros/normas , Humanos , Masculino , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Ideação Suicida , Análise e Desempenho de Tarefas
4.
Schmerz ; 31(2): 108-114, 2017 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-27858221

RESUMO

BACKGROUND: The objectification of pain is essential for evaluation, treatment plan and follow-up; therefore, it is necessary to find reliable clinical parameters. OBJECTIVE: The goal of the study was the preoperative screening of a neuropathic component in patients with vertebral compression fracture (WKF), herniated disc (NPP) or spinal cord compression (SKS). MATERIAL AND METHODS: Depending on the preoperative condition on admittance, patients were classified into three groups: group 1 WKF, group 2 NPP and group 3 SKS. To characterize the pain we used the painDETECT questionnaire, the Oswestry questionnaire and further questionnaires. All patients were surgically treated according to the diagnosis, e.g. radiofrequency kyphoplasty, nucleotomy or spondylodesis. RESULTS: We evaluated the data from 139 patients (45% WKF, 34% NPP and 21% SKS). There were no differences in preoperative pain intensity (median ordinal scale 0-10) with a mean preoperative score of 7 for all groups. The total score of the painDETECT questionnaire showed significantly higher results in group 2 (median 18) and in group 3 (median 14) than in group 1 (median 9). There was even a significant difference between groups 2 and 3 (p = 0.03). The highest pain intensity was detected in group 1 with a median visual analog scale (VAS) of 71 mm. The total scores in the painDETECT questionnaire and the scores in the Oswestry questionnaire correlated in groups 2 and 3. CONCLUSION: The painDETECT questionnaire was shown to be a very suitable instrument for evaluating the neuropathic pain component in patients with dorsalgia. This could be very useful in planning further therapy.


Assuntos
Dor nas Costas/diagnóstico , Dor nas Costas/cirurgia , Fraturas por Compressão/diagnóstico , Fraturas por Compressão/cirurgia , Deslocamento do Disco Intervertebral/diagnóstico , Deslocamento do Disco Intervertebral/cirurgia , Programas de Rastreamento , Neuralgia/diagnóstico , Neuralgia/cirurgia , Cuidados Pré-Operatórios , Compressão da Medula Espinal/diagnóstico , Compressão da Medula Espinal/cirurgia , Fraturas da Coluna Vertebral/diagnóstico , Fraturas da Coluna Vertebral/cirurgia , Idoso , Idoso de 80 Anos ou mais , Dor nas Costas/psicologia , Discotomia Percutânea , Feminino , Fraturas por Compressão/psicologia , Humanos , Deslocamento do Disco Intervertebral/psicologia , Cifoplastia , Masculino , Pessoa de Meia-Idade , Neuralgia/psicologia , Medição da Dor/estatística & dados numéricos , Psicometria , Compressão da Medula Espinal/psicologia , Fraturas da Coluna Vertebral/psicologia , Fusão Vertebral , Inquéritos e Questionários
6.
Klin Padiatr ; 228(5): 251-6, 2016 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-27617761

RESUMO

BACKGROUND: Transition of care from pediatric to adult services is a complex process. Factors influencing the success of health care transition of adolescents with chronic neurological disorders are poorly understood. METHODS: Young adults with chronic neurological disorders who had been cared for in an Interdisciplinary Pediatric Center participated in this study. Using the Patient Satisfaction Questionnaire Short-form (PSQ-18) we investigated whether satisfaction of these patients with their medical care in adult services was depending on the severity and complexity of their condition. They were assigned to a group of severely disabled patients (group 1; intellectual disability or learning disability plus motor handicap or degree of disability≥80, n=11) or a group 2 of patients with milder impairment (N=39). We used descriptive and t-statistics to compare both groups. RESULTS: Patients of group 1 reported slightly lower satisfaction with their present medical care in adult services (M=3.25; 95%-KI=[2.96-3.55]) compared to patients of group 2 (M=3.59; 95%.KI=[3.37-3.81]; p=0.084). Satisfaction with transition was significantly lower in group 1 (M=2.65; 95% KI=[2.29-3.01]) than in group 2 (M=3.11; 95% KI=[2.89-3.33], p=0.045). The difference of mean values of 0.46 reflects a moderate effect size (Hedges' g=0.68). CONCLUSION: Health care transition of adolescent patients with chronic neurological disorders is significantly more successful in patients with minor impairment compared to patients with severe complex neurological conditions.


Assuntos
Doenças do Sistema Nervoso/terapia , Transição para Assistência do Adulto , Adolescente , Doença Crônica , Comorbidade , Pessoas com Deficiência , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/terapia , Comunicação Interdisciplinar , Colaboração Intersetorial , Deficiências da Aprendizagem/diagnóstico , Deficiências da Aprendizagem/terapia , Transtornos Motores/diagnóstico , Transtornos Motores/terapia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/psicologia , Satisfação do Paciente , Inquéritos e Questionários , Adulto Jovem
7.
Eur J Orthop Surg Traumatol ; 26(1): 67-75, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26482590

RESUMO

INTRODUCTION: Osteoporotic vertebral fractures are a frequent occurrence in geriatric traumatology. Differences in the achievement of pain reduction and restoration of the height of the vertebral body after balloon kyphoplasty (BKP) or radiofrequency-targeted vertebral augmentation (RF-TVA) were to be tested on a randomized population. METHODS: A total of 80 patients (f = 59; m = 21) with osteoporotic fractures of vertebral bodies were assigned to the groups BKP (n = 44) or RF-TVA (n = 36). The clinical analyses were compared peri- and postoperatively in a prospective study with an additional follow-up examination after 1 year. RESULTS: The operations for BKP were bipedicular in all cases; for RF-TVA, a bipedicular access was required in only five cases (14 %) (p>0.0001). There were confirmed differences with respect to the amount of cement used (ml) between the two groups (BKP = 4.9 ± 1 vs. RFTVA= 3.4 ± 1; p<0.001). In the BKP group, the angle of kyphosis was reduced by an average of 1.65° and in the RF-TVA group by an average of 2.8° by the operation. The analysis of the maximum VAS data showed a clear postoperative reduction in the intensity of pain of approximately 4.5 cm in each of the groups with no discernible difference. After 12 months, the majority of patients in both groups (BKP = 61 % vs. RF-TVA = 83 %) reported being free of pain when at rest without a significant difference(p = 0.05). CONCLUSIONS: A certain superiority of RF-TVA with respect to pain relief, amount of cement required, savings of operating time and personnel, and greater safety with respect to cement leakage noted in this study are consistent with other published literature. The differences between the two methods in the frequency of subsequent postoperative fractures and the secondary loss of high restoration were encouraging regarding RF-TVA.


Assuntos
Ablação por Cateter/métodos , Fraturas por Compressão/cirurgia , Cifoplastia/métodos , Fraturas por Osteoporose/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Idoso , Idoso de 80 Anos ou mais , Dor nas Costas/prevenção & controle , Feminino , Fraturas por Compressão/diagnóstico por imagem , Humanos , Masculino , Fraturas por Osteoporose/diagnóstico por imagem , Estudos Prospectivos , Radiografia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Resultado do Tratamento
8.
Intern Med J ; 45(8): 872-6, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26220030

RESUMO

Parathyroid hormone (PTH) is the predominant regulator of calcium/phosphate homeostasis in the human body. Beside this classical function, preclinical and clinical studies indicated a relevant role for PTH in mobilisation of bone marrow-derived cells into peripheral blood. In addition, recombinant PTH (teriparatide) was recently approved for the treatment of severe osteoporosis. Therefore, it was the aim of the present study to investigate the dynamics of haemopoietic stem cells and corresponding in peripheral blood of 13 patients with osteoporosis during treatment with teriparatide. We were able to show that administration of teriparatide is sufficient to mobilise haemopoietic stem cells into the bloodstream accompanied by an alteration of mobilising cytokines. In conclusion, teriparatide might be a useful tool in the context of stem cell mobilisation.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Mobilização de Células-Tronco Hematopoéticas/métodos , Células-Tronco Hematopoéticas/fisiologia , Osteoporose/tratamento farmacológico , Teriparatida/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
9.
Klin Monbl Augenheilkd ; 232(11): 1279-83, 2015 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-25927174

RESUMO

PURPOSE: Imaging of the optic nerve head and the nerve fibre layer are used in the diagnosis of glaucoma. We have investigated the diagnostic precision of nerve fibre layer imaging using a manually operated scanning laser ophthalmoscope and analysis of the optic nerve head using the Heidelberg Retina Tomograph II (HRT). PATIENTS AND METHODS: 42 patients with glaucoma, 16 patients with ocular hypertension (OHT) and 24 healthy control subjects were included in a clinical study. Nerve fibre layer imaging was performed using a scanning laser ophthalmoscope (SLO, Rodenstock Instr. argon laser 488 nm). Nerve fibre layer defects were analysed peripapillarily for every single degree (defect or no defect) at 1.7 mm (near) and at 3.4 mm (far) distance to the optic nerve head. Specificity and sensitivity of the HRT II were calculated using the Moorfields regression analysis (MRA). RESULTS: Patients with glaucoma were found to have 109 ± 92° (near) and 109 ± 92° (far) defects of the nerve fibre layer. Patients with OHT (8 ± 14° [far] and 6 ± 11° [near]) and control subjects (0 ± 0° [far] and 0 ± 1° [near]) showed significantly smaller defects (p < 0.0001). Sensitivity at > 90 % specificity for POAG and controls was 85.7 % (far) and 82.9 % (near). Sensitivity at > 90 % specifity for OHT and POAG was 85.7 % (far) und 82.9 % (near). Specificity of controls for the MRA was 83.3 % (borderline classified as normal). Specificity of OHT patients was 93.8 % (borderline classified normal). Sensitivity of the MRA for POAG was 80.9 % (borderline classified normal) and 90.5 % (borderline classified glaucoma). CONCLUSIONS: Nerve fiber layer imaging using a manually operated scanning laser ophthalmoscope was found to achieve a higher diagnostic precision as compared to optic disc evaluation using the HRT II.


Assuntos
Glaucoma/patologia , Fibras Nervosas/patologia , Oftalmoscopia/métodos , Nervo Óptico/patologia , Polarimetria de Varredura a Laser/métodos , Tomografia Óptica/métodos , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Retina/patologia , Sensibilidade e Especificidade
10.
Acta Psychiatr Scand ; 129(2): 143-55, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23590836

RESUMO

OBJECTIVE: To identify differences and similarities between immigrants of Turkish origin and native German patients in therapeutically relevant dimensions such as subjective illness perceptions and personality traits. METHOD: Turkish and native German mentally disordered in-patients were interviewed in three psychiatric clinics in Hessen, Germany. The Revised Illness Perception Questionnaire (IPQ-Revised) and the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) were used. Differences of scales and similarities by k-means cluster analyses were estimated. RESULTS: Of the 362 total patients, 227 (123 immigrants and 104 native Germans) were included. Neither demographic nor clinical differences were detected. Socioeconomic gradients and differences on IPQ-R scales were identified. For each ethnicity, the cluster analysis identified four different patient types based on NEO-FFI and IPQ-R scales. The patient types of each ethnicity appeared to be very similar in their structure, but they differed solely in the magnitude of the cluster means on included subscales according to ethnicity. CONCLUSION: When subjective illness perceptions and personality traits are considered together, basic patient types emerge independent of the ethnicity. Thus, the ethnical impact on patient types diminishes and a convergence was detected.


Assuntos
Atitude Frente a Saúde/etnologia , Comparação Transcultural , Transtornos Mentais/etnologia , Personalidade , Adulto , Estudos de Casos e Controles , Análise por Conglomerados , Emigrantes e Imigrantes , Feminino , Alemanha , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Percepção , Inventário de Personalidade , Autoimagem , Inquéritos e Questionários , Turquia/etnologia
11.
Eur J Orthop Surg Traumatol ; 24 Suppl 1: S131-43, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23771597

RESUMO

PURPOSE: For more than 30 years, minimally invasive surgical procedures have been available to stabilize the fractured vertebrae by cement augmentation leading to significant pain relief, a distinct improvement in quality of life and decreased mortality for patients suffering from osteoporotic vertebral compression fractures. This overview article is designed to provide information on the wide range of augmentation methods previously tested and clinically applied in surgery in an attempt to compile the clinically relevant information on safety and efficacy in the published literature. METHOD: Based on an extensive literature review on the topic of "vertebral fractures--surgical augmentation techniques" we summarized the results of published clinical trials and experimental testing which address clinically relevant questions. The selection of the publications in reference books and scientific journals covers the time period from the end of the 1970s until the present. RESULTS: The final selection of more than 50 publications with, in the opinion of the authors, clinically relevant data led to the following results, which can be of significance for clinical application. The prerequisites for the success of all augmentation methods include the earliest possible surgical intervention, optimal technical equipment and an experienced, interdisciplinary team, as well as thorough consideration of the situation of the individual patient. The selection of the material for vertebral augmentation depends on the surgical method. The material of choice remains polymethylmethacrylate (PMMA), and the best record of efficacy and safety is displayed by radiofrequency kyphoplasty with ultrahigh-viscosity cement. Regarding clinical efficacy and safety, there are many convincing documentations showing superiority of vertebroplasty and kyphoplasty in comparison with conservative therapeutic regimens. Initial results of clinical studies with additional implants indicate a trend toward further improvement in clinical success and suggest possible broader clinical possibilities of application. CONCLUSION: Modern, minimally invasive augmentation techniques represent a real alternative to conservative treatment of patients with vertebral fractures. Further technical and clinical development in this area should aim at optimizing procedural safety while continuing to achieve comparably good results to current methods. Minimizing damage to the remaining trabecular structures as well as to adjacent vertebral disks and vertebrae should be paramount of importance. SUMMARY: Options for the treatment of vertebral fractures: Reductions in bone density and pathological changes in bone structure are associated with an elevated risk of fractures, which can lead to decisive functional impairment, pain, and a host of further comorbidities. Vertebral augmentation can be considered as an alternative conservative treatment, in order to achieve immediate and lasting pain relief as well as improvement in functional impairment. To achieve greater safety, instrumentation for transpedicular access and incorporation of radiopacifiers in PMMA for vertebroplasty were developed in mid-eighties. Balloon kyphoplasty was introduced in the end nineties, and results of prospective, randomized clinical studies have confirmed the safety and efficacy; the destruction of the remaining native spongiosa structures during balloon expansion is viewed as a disadvantage of this method. The two step method of cavity creation followed by cement delivery known as kyphoplasty has been further refined and developed by and varied by technology/procedural developments. This includes most the radiofrequency kyphoplasty (DFINE Inc., San Jose, CA, USA), in which ultrahigh-viscosity cement is delivered at a controlled delivery rate, following producing a bone sparing size and side specific cavity which minimizes loss of spongiosa, allowing for mechanical stability upon interdigitation of cement into that remaining trabecular bone. This combination has been shown to preserve vertebral structures and reduces the risk of leakages. Finally, systems have been available in which cement augmentation of implants to enhance mechanical stability of the implants or the overall fracture is constructed by load sharing.


Assuntos
Fraturas por Compressão/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Anti-Inflamatórios não Esteroides/uso terapêutico , Cimentos Ósseos/uso terapêutico , Fraturas por Compressão/tratamento farmacológico , Humanos , Cifoplastia/métodos , Polimetil Metacrilato/uso terapêutico , Próteses e Implantes , Fraturas da Coluna Vertebral/tratamento farmacológico , Vertebroplastia/métodos
12.
Heredity (Edinb) ; 111(3): 200-9, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23632894

RESUMO

Chromosomal inversions are common in natural populations and are believed to be involved in many important evolutionary phenomena, including speciation, the evolution of sex chromosomes and local adaptation. While recent advances in sequencing and genotyping methods are leading to rapidly increasing amounts of genome-wide sequence data that reveal interesting patterns of genetic variation within inverted regions, efficient simulation methods to study these patterns are largely missing. In this work, we extend the sequential Markovian coalescent, an approximation to the coalescent with recombination, to include the effects of polymorphic inversions on patterns of recombination. Results show that our algorithm is fast, memory-efficient and accurate, making it feasible to simulate large inversions in large populations for the first time. The SMC algorithm enables studies of patterns of genetic variation (for example, linkage disequilibria) and tests of hypotheses (using simulation-based approaches) that were previously intractable.


Assuntos
Inversão Cromossômica , Genética Populacional , Modelos Genéticos , Algoritmos , Simulação por Computador , Desequilíbrio de Ligação , Recombinação Genética
13.
J Biomed Inform ; 46(3): 401-9, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23395682

RESUMO

Physiological processes in the human body can be predicted by mathematical models. Medical Decision Support Systems (MDSS) might exploit these predictions when optimizing therapy settings. In critically ill patients depending on mechanical ventilation, these predictions should also consider other organ systems of the human body. In a previously presented framework we combine elements of three model families: respiratory mechanics, cardiovascular dynamics and gas exchange. Computing combinations of moderately complex submodels showed to be computationally costly thus limiting the applicability of those model combinations in an MDSS. A decoupled computing approach was therefore developed, which enables individual evaluation of every submodel. Direct model interaction is not possible in separate calculations. Therefore, interface signals need to be substituted by estimates. These estimates are iteratively improved by increasing model detail in every iteration exploiting the hierarchical structure of the implemented model families. Simulation error converged to a minimum after three iterations. Maximum simulation error showed to be 1.44% compared to the original common coupled computing approach. Simulation error was found to be below measurement noise generally found in clinical data. Simulation time was reduced by factor 34 using one iteration and factor 13 using three iterations. Following the proposed calculation scheme moderately complex model combinations seem to be applicable for model based decision support.


Assuntos
Modelos Biológicos , Algoritmos , Sistemas de Apoio a Decisões Clínicas , Humanos
14.
Anaesthesist ; 62(8): 609-16, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23917894

RESUMO

BACKGROUND: This is a report on an international non-interventional study of patients exposed to fires with smoke development in closed rooms. The objective of the study was to document clinical symptoms, relevant laboratory values and blood cyanide concentrations from fire victims in order to confirm or rule out presumptive correlations between the individual parameters. MATERIALS AND METHODS: The study was conducted in five European countries with patients being included if they presented with the characteristic clinical signs, such as soot deposits and altered neurological status. Venous blood samples were taken from victims prior to administration of an antidote in all cases and determination of cyanide concentration was performed in a central laboratory using high performance liquid chromatography. RESULTS: Data from 102 patients (62 % male, average age 49 years) were included in the evaluation with no blood samples being available for analysis from 2 patients. In 25 patients the blood cyanide concentration was below the limit of detection of 1.2 µmol/l. Cyanide levels between 1.2 and 10 µmol/l were measured in 54 patients, 7 patients had values between 10 and 20 µmol/l, 4 patients between 20 and 40 µmol/l while levels above 40 µmol/l were determined in 10 patients. The results of the study could not demonstrate that the cyanide level was influenced either by the interval between smoke exposure and blood sampling or the duration presence at the fire scene. The following clinical signs or laboratory values were recorded as relevant for increased and possibly toxic cyanide levels: respiratory arrest, dyspnea, resuscitation requirement, tracheal intubation, respiratory support measures, low Glasgow coma scale (GCS) score and respiratory frequency. A correlation between cyanide concentration and the total amount of soot deposits on the face and neck, in the oral cavity and in expectoration was confirmed. A correlation between cyanide and carboxyhemoglobin (COHb) levels in the blood of fire victims was also confirmed. CONCLUSIONS: As long as it is not possible to immediately determine the blood cyanide concentration in patients exposed to fire with smoke development, a decreased GCS score, soot deposits particularly in expectoration, dyspnea and convulsions are to be regarded as risk markers for intoxication. In their presence immediate administration of hydroxocobalamin as an antidote is recommended.


Assuntos
Cianetos/sangue , Cianetos/intoxicação , Incêndios , Lesão por Inalação de Fumaça/diagnóstico , Lesão por Inalação de Fumaça/terapia , Antídotos/uso terapêutico , Biomarcadores , Dióxido de Carbono/sangue , Carboxihemoglobina/metabolismo , Cromatografia Líquida de Alta Pressão , Intervalos de Confiança , Serviços Médicos de Emergência , Meio Ambiente , Escala de Coma de Glasgow , Hematínicos/uso terapêutico , Humanos , Hidroxocobalamina/uso terapêutico , Oxigênio/sangue , Medição de Risco , Lesão por Inalação de Fumaça/sangue , Fuligem
15.
Int Psychogeriatr ; 24 Suppl 1: S25-34, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22784425

RESUMO

Experimental and clinical data suggest that the Ginkgo biloba standardized extract EGb 761® exerts beneficial effects in conditions which are associated with impaired cognitive function. However, the neurochemical correlates of these memory enhancing effects are not yet fully clarified. The aim of this study was to examine the effect of repeated oral administration of EGb 761® and some of its characteristic constituents on extracellular levels of dopamine (DA), noradrenaline (NA), serotonin (5-HT), acetylcholine (ACh) and the metabolites 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) in the medial prefrontal cortex (mPFC) of awake rats by use of in vivo microdialysis technique. Subacute (14 days, once daily), but not acute, oral treatment with EGb 761® (100 and 300 mg/kg) or the flavonoid fraction, which represents about 24% of the whole extract caused a significant and dose-dependent increase in extracellular DA levels in the mPFC. Repeated administration of EGb 761® also caused a modest but significant increase in the NA levels, whereas the concentrations of 5-HT and those of the metabolites DOPAC, HVA and 5-HIAA were not affected. The same treatment regimen was used in a subsequent study with the aim of investigating the effects of two Ginkgo-specific acylated flavonols, 3-O-(2''-O-(6'''-O-(p-hydroxy-trans-cinnamoyl)-ß-D-glucosyl)-α-L-rhamnosyl)quercetin (Q-ag) and 3-O-(2''-O-(6'''-O-(p-hydroxy-trans-cinnamoyl)-ß-D-glucosyl)-α-L-rhamnosyl)kaempferol (K-ag). Both compounds together represent about 4.5% of the whole extract. Repeated oral treatment with Q-ag (10 mg/kg) for 14 days caused a significant increase in extracellular DA levels of 159% and extracellular acetylcholine (ACh) levels of 151% compared to controls. Similarly, administration of K-ag (10 mg/kg) induced a significant rise of DA levels to 142% and ACh levels to 165% of controls, whereas treatment with isorhamnetin, an O-methylated aglycon component of EGb 761® flavonol glycosides had no effect. None of the tested flavonoids had a significant effect on extracellular DOPAC and HVA levels. The present findings provide evidence that the subacute treatment with EGb 761® and its flavonol constituents increases DA and ACh release in the rat mPFC, and suggest that the two Ginkgo-specific acylated flavonol glycosides Q-ag and K-ag are active constituents contributing to these effects. As seen for isorhamnetin, the effect on neurotransmitter levels seems not to be a general effect of flavonols but rather to be a specific action of acylated flavonol glycosides which are present in EGb 761®. The direct involvement of these two flavonol derivatives in the increase of dopaminergic and cholinergic neurotransmission in the prefrontal cortex may be one of the underlying mechanisms behind the reported effects of EGb 761® on the improvement of cognitive function.


Assuntos
Acetilcolina/análise , Cognição/efeitos dos fármacos , Dopamina/análise , Extratos Vegetais/farmacologia , Córtex Pré-Frontal/efeitos dos fármacos , Ácido 3,4-Di-Hidroxifenilacético/análise , Animais , Relação Dose-Resposta a Droga , Ginkgo biloba , Ácido Homovanílico/análise , Ácido Hidroxi-Indolacético/análise , Norepinefrina/análise , Córtex Pré-Frontal/química , Ratos , Serotonina/análise
16.
Commun Agric Appl Biol Sci ; 77(3): 297-309, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23878987

RESUMO

Despite the economic importance of covered kernel smut of sorghum (Sporisorium sorghi) in many African states and other parts of the world, only limited information is available on laboratory cultivation methods for this fungus and techniques for its diagnosis in plant tissue. When in the present study spores of S. sorghi were kept as intact sori at 5 degrees C, 80% of the spores germinated even after 24 months of storage. Spore germination on agar medium and production of mycelial dry weight in still culture were highest between 20 and 35 degrees C, with a peak at 30 degrees C. Both showed a steady increase from pH 4.5 to pH 7.5, followed by a decline at pH 8.5 and 9.5. In shake culture in different broth media the addition of 0.3% peptone from soybean caused an increase in fungal growth compared to the media alone. Of the media tested, mycelial production was highest in malt dextrose broth supplemented with peptone. When cultivated on different agar media, the morphology of single spore isolates differed both among isolates and depending on the agar medium. In greenhouse experiments, five short heighted, early maturing sorghum breeding accessions proved to be partially or fully resistant to covered kernel smut. Among the plant material tested, cv. 'Dorado' appeared to be the one best suited for greenhouse experiments with covered kernel smut. By microscopy of hand-cut sections stained with trypan-blue, hyphae of S. sorghi were seen in apical buds and in nodes of young sorghum plants. Diagnostic PCR amplified a 903 bp element comprising the internal region of the glyceraldehyde-3-phosphate dehydrogenase (GAPDH) encoding gene and enabled the detection of S. sorghi in both nodes and apical buds of infected sorghum seedlings. Both techniques, i.e. microscopy and diagnostic PCR have the potential to be used in studies for the identification of effective sorghum seed treatments already at the seedling stage.


Assuntos
Basidiomycota/fisiologia , Doenças das Plantas/microbiologia , Reação em Cadeia da Polimerase/métodos , Sorghum/microbiologia , Biomassa , Concentração de Íons de Hidrogênio , Micologia/métodos , Manejo de Espécimes , Esporos Fúngicos/fisiologia , Fatores de Tempo
17.
Knee Surg Sports Traumatol Arthrosc ; 19(6): 887-92, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20852843

RESUMO

PURPOSE: Computer-assisted surgery (CAS) for total knee arthroplasty (TKA) has become increasingly common over the last decade. There are several reports including meta-analyses that show improved alignment, but the clinical results do not differ. Most of these studies have used a bone referencing technique to size and position the prosthesis. The question arises whether CAS has a more pronounced effect on strict ligamentous referencing TKAs. METHODS: We performed a prospective cohort study comparing clinical outcome of navigated TKA (43 patients) with that of conventional TKA (122 patients). Patients were assessed preoperatively, and 2 and 12 months postoperatively by an independent study nurse using validated patient-reported outcome tools as well as clinical examination. RESULTS: At 2 months, there was no difference between the two groups. However, after 12 months, CAS was associated with significantly less pain and stiffness, both at rest and during activities of daily living, as well as greater overall patient satisfaction. CONCLUSION: The present study demonstrated that computer-navigated TKA significantly improves patient outcome scores such as WOMAC score (P=0.002) and Knee Society score (P=0.040) 1 year after surgery in using a ligament referencing technique. Furthermore, 91% were extremely or very satisfied in the CAS TKA group versus 70% after conventional TKA (P=0.007).


Assuntos
Artroplastia do Joelho/métodos , Prótese do Joelho , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular/fisiologia , Cirurgia Assistida por Computador/métodos , Idoso , Artroplastia do Joelho/efeitos adversos , Distribuição de Qui-Quadrado , Estudos de Coortes , Feminino , Seguimentos , Humanos , Instabilidade Articular/prevenção & controle , Tempo de Internação/tendências , Ligamentos Articulares/fisiologia , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Medição da Dor , Complicações Pós-Operatórias/fisiopatologia , Cuidados Pré-Operatórios/métodos , Estudos Prospectivos , Desenho de Prótese , Falha de Prótese , Cirurgia Assistida por Computador/efeitos adversos , Resultado do Tratamento
18.
Poult Sci ; 90(10): 2169-73, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21933997

RESUMO

The breeding of male layer chickens is currently considered to be highly uneconomical. In Germany alone, 40 to 50 million newly hatched male chickens were killed annually immediately after hatching. Therefore, it is necessary to find a method for sexing chickens early in the embryonic development, preferably before incubation. The genotypic sex of an egg can be determined using information found in the germinal disc, so knowledge of the exact position of the germinal disc is essential for further sexing, or for other actions such as the in ovo injection of agents. Previous studies have shown that the germinal disc is located somewhere on top of the yolk. However, no studies have yet been performed that investigate the influence of time spent in horizontal storage on the position of the germinal disc. Magnetic resonance imaging was chosen to determine this influence on the position of the germinal disc. It was found that eggs placed horizontally for long periods of time before scanning had significant changes in the positions of their germinal discs compared with those of eggs scanned minutes after positioning. The position of the germinal disc in eggs, minutes after horizontal positioning, deviated 14.7 ± 0.6 mm from the maximum vertical plane of the egg (zero position) in the z-direction; eggs scanned after 96 h of horizontal positioning showed a deviation of only 4.9 ± 1.6 mm. The x-axis also exhibited changes in the position of the germinal disc over time. Immediately after horizontal positioning, the eggs showed a deviation of 0.4 ± 0.4 mm in the x-direction, whereas the deviation after 96 h was 2.9 ± 0.5 mm. These results show that horizontal positioning of the egg hours before the measurement is necessary.


Assuntos
Blastodisco/anatomia & histologia , Embrião de Galinha/anatomia & histologia , Animais , Blastodisco/química , Cruzamento , Feminino , Imageamento por Ressonância Magnética , Masculino , Análise para Determinação do Sexo/métodos , Análise para Determinação do Sexo/veterinária , Fatores de Tempo
19.
Life Sci ; 264: 118682, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33127519

RESUMO

AIMS: Menthacarin is a herbal combination that is clinically used for the treatment of functional gastrointestinal disorders (FGIDs). In several clinical studies, Menthacarin reduced visceral hypersensitivity-related symptoms. Pathogenesis of visceral hypersensitivity is multifactorial. This involves several cell types and different transient receptor potential ion channels (TRPs); these ion channels are highly conductive for calcium ions. Since transient changes in cytosolic calcium levels are crucial for many functions of living cells, we investigated if Menthacarin can induce calcium influx in sensory, largely nociceptive, neurons from dorsal root ganglia (DRG), peritoneal macrophages (PMs) and colonic organoids. MAIN METHODS: We employed the calcium imaging technique on sensory neurons from DRG, PMs and colonic organoids isolated from mice. All cells were superfused by Menthacarin at several concentrations (600, 1200, 1800 µg/ml) during the experiments, followed by calcium ionophor ionomycin (Iono., 1 µM) as a positive control. KEY FINDINGS: Menthacarin induced concentration-dependent calcium ion influx in all investigated cell types. Furthermore, repeated applications of Menthacarin induced tachyphylaxis (desensitisation) of calcium responses in sensory neurons and colonic organoids. SIGNIFICANCE: Menthacarin-induced calcium influx into sensory neurons, macrophages and colonic organoids is probably related to its clinical desensitising effects in patients with FGIDs.


Assuntos
Canais de Cálcio/metabolismo , Colo/metabolismo , Macrófagos/metabolismo , Organoides/metabolismo , Preparações de Plantas/farmacologia , Células Receptoras Sensoriais/metabolismo , Animais , Colo/citologia , Colo/efeitos dos fármacos , Relação Dose-Resposta a Droga , Gânglios Espinais/efeitos dos fármacos , Gânglios Espinais/metabolismo , Macrófagos/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Óleos Voláteis/química , Óleos Voláteis/farmacologia , Técnicas de Cultura de Órgãos , Organoides/efeitos dos fármacos , Preparações de Plantas/química , Células Receptoras Sensoriais/efeitos dos fármacos
20.
Public Health ; 124(1): 39-48, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20036407

RESUMO

OBJECTIVES: To test the hypothesis that an inverse association exists between socio-economic position and all-cause mortality in a developing country in Latin America. STUDY DESIGN: Prospective cohort study carried out in Chile using data from a simple random sample of 920 apparently healthy subjects (weighted population 11,600 aged 30-89 years) followed for 8 years. METHODS: Education level (0-8 years, 9-12 years and > or = 13 years) and income quartiles were established at the outset of the study, along with behavioural and biological risk factors for chronic diseases: smoking, alcohol use, obesity, diabetes, hypertension, lipids and family history of death by cardiovascular disease. Relative risks of all-cause mortality were estimated using age-adjusted Cox regression models. RESULTS: During the follow-up period, 46 deaths were observed. Adjusting for age, gender, and behavioural and biological risk factors, the mortality risk for increasing categories of education after controlling for income was 1.0, 0.76 and 0.33 (P for trend<0.01). In contrast, the relative risk for increasing levels of income after controlling for education was 1.0, 0.98, 1.33 and 1.17 (P for trend=0.07). CONCLUSION: While education level had a protective effect on mortality risk of Chilean adults, income had a slightly unfavourable effect on survival. This finding is described as suggestive of a 'pauper-rich paradox', since the higher income quantiles in this study correspond with the lower income levels in most developed countries. Nevertheless, due to the small number of deaths, additional research is required to assess the validity of these findings.


Assuntos
Doença Crônica/mortalidade , Escolaridade , Renda/estatística & dados numéricos , Mortalidade , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Chile/epidemiologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Modelos de Riscos Proporcionais , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Distribuição por Sexo
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