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1.
J Clin Periodontol ; 50(11): 1420-1443, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37608638

RESUMO

AIM: To determine the accuracy of biomarker combinations in gingival crevicular fluid (GCF) and saliva through meta-analysis to diagnose periodontitis in systemically healthy subjects. METHODS: Studies on combining two or more biomarkers providing a binary classification table, sensitivity/specificity values or group sizes in subjects diagnosed with periodontitis were included. The search was performed in August 2022 through PUBMED, EMBASE, Cochrane, LILACS, SCOPUS and Web of Science. The methodological quality of the articles selected was evaluated using the QUADAS-2 checklist. Hierarchical summary receiver operating characteristic modelling was employed to perform the meta-analyses (CRD42020175021). RESULTS: Twenty-one combinations in GCF and 47 in saliva were evaluated. Meta-analyses were possible for six salivary combinations (median sensitivity/specificity values): IL-6 with MMP-8 (86.2%/80.5%); IL-1ß with IL-6 (83.0%/83.7%); IL-1ß with MMP-8 (82.7%/80.8%); MIP-1α with MMP-8 (71.0%/75.6%); IL-1ß, IL-6 and MMP-8 (81.8%/84.3%); and IL-1ß, IL-6, MIP-1α and MMP-8 (76.6%/79.7%). CONCLUSIONS: Two-biomarker combinations in oral fluids show high diagnostic accuracy for periodontitis, which is not substantially improved by incorporating more biomarkers. In saliva, the dual combinations of IL-1ß, IL-6 and MMP-8 have an excellent ability to detect periodontitis and a good capacity to detect non-periodontitis. Because of the limited number of biomarker combinations evaluated, further research is required to corroborate these observations.


Assuntos
Interleucina-6 , Periodontite , Humanos , Quimiocina CCL3 , Metaloproteinase 8 da Matriz , Periodontite/diagnóstico , Biomarcadores/análise , Interleucina-1beta , Líquido do Sulco Gengival/química , Saliva/química
2.
Tissue Antigens ; 83(2): 82-93, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24400773

RESUMO

The human leukocyte antigen-E (HLA-E) locus is a human major histocompatibility complex (MHC) gene associated with immune-modulation and suppression of the immune response by the interaction with specific natural killer (NK) and T cell receptors (TCRs). It is considered one of the most conserved genes of the human MHC; however, this low nucleotide variability seems to be a consequence of the scarce number of studies focusing on this subject. In this manuscript we assessed the nucleotide variability at the HLA-E coding and 3' untranslated regions (3'UTRs) in Brazil and in the populations from the 1000Genomes Consortium. Twenty-eight variable sites arranged into 33 haplotypes were detected and most of these haplotypes (98.2%) are encoding one of the two HLA-E molecules found worldwide, E*01:01 and E*01:03. Moreover, three worldwide spread haplotypes, associated with the coding alleles E*01:01:01, E*01:03:01 and E*01:03:02, account for 85% of all HLA-E haplotypes, suggesting that they arose early before human speciation. In addition, the low nucleotide diversity found for the HLA-E coding and 3'UTR in worldwide populations suggests that the HLA-E gene is in fact a conserved gene, which might be a consequence of its key role in the modulation of the immune system.


Assuntos
Regiões 3' não Traduzidas , Haplótipos , Antígenos de Histocompatibilidade Classe I/classificação , Antígenos de Histocompatibilidade Classe I/genética , Fases de Leitura Aberta , Polimorfismo Genético , Alelos , Sequência de Bases , Brasil , Sequência Conservada , Especiação Genética , Antígenos de Histocompatibilidade Classe I/imunologia , Humanos , Dados de Sequência Molecular , Filogenia , Antígenos HLA-E
3.
Cardiooncology ; 10(1): 8, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38365812

RESUMO

BACKGROUND: This article provides an up-to-date overview of pericardial effusion in oncological practice and a guidance on its management. Furthermore, it addresses the question of when malignancy should be suspected in case of newly diagnosed pericardial effusion. MAIN BODY: Cancer-related pericardial effusion is commonly the result of localization of lung and breast cancer, melanoma, or lymphoma to the pericardium via direct invasion, lymphatic dissemination, or hematogenous spread. Several cancer therapies may also cause pericardial effusion, most often during or shortly after administration. Pericardial effusion following radiation therapy may instead develop after years. Other diseases, such as infections, and, rarely, primary tumors of the pericardium complete the spectrum of the possible etiologies of pericardial effusion in oncological patients. The diagnosis of cancer-related pericardial effusion is usually incidental, but cancer accounts for approximately one third of all cardiac tamponades. Drainage, which is mainly attained by pericardiocentesis, is needed when cancer or cancer treatment-related pericardial effusion leads to hemodynamic impairment. Placement of a pericardial catheter for 2-5 days is advised after pericardial fluid removal. In contrast, even a large pericardial effusion should be conservatively managed when the patient is stable, although the best frequency and timing of monitoring by echocardiography in this context are yet to be established. Pericardial effusion secondary to immune checkpoint inhibitors typically responds to corticosteroid therapy. Pericardiocentesis may also be considered to confirm the presence of neoplastic cells in the pericardial fluid, but the yield of cytological examination is low. In case of newly found pericardial effusion in individuals without active cancer and/or recent cancer treatment, a history of malignancy, unremitting or recurrent course, large effusion or presentation with cardiac tamponade, incomplete response to empirical therapy with nonsteroidal anti-inflammatory, and hemorrhagic fluid at pericardiocentesis suggest a neoplastic etiology.

4.
Ann Nucl Med ; 35(10): 1136-1146, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34273103

RESUMO

BACKGROUND: Non-ST-elevation myocardial infarction (NSTEMI) and unstable angina (UA) are caused often by destabilization of non-flow limiting inflamed coronary artery plaques. 18F-fluorodeoxyglucose (FDG) uptake with positron emission tomography/computed tomography (PET/CT) reveals plaque inflammation, while intracoronary optical coherence tomography (OCT) reliably identifies morphological features of coronary instability, such as plaque rupture or erosion. We aimed to prospectively compare these two innovative biotechnologies in the characterization of coronary artery inflammation, which has never been attempted before. METHODS: OCT and FDG PET/CT were performed in 18 patients with single vessel coronary artery disease, treated by percutaneous coronary intervention (PCI) with stent implantation, divided into 2 groups: NSTEMI/UA (n = 10) and stable angina (n = 8) patients. RESULTS: Plaque rupture/erosion recurred more frequently [100% vs 25%, p = 0.001] and FDG uptake was greater [TBR median 1.50 vs 0.87, p = 0.004] in NSTEMI/UA than stable angina patients. FDG uptake resulted greater in patients with than without plaque rupture/erosion [1.2 (0.86-1.96) vs 0.87 (0.66-1.07), p = 0.013]. Among NSTEMI/UA patients, no significant difference in FDG uptake was found between ruptured and eroded plaques. The highest FDG uptake values were found in ruptured plaques, belonging to patients with NSTEMI/UA. OCT and PET/CT agreed in 72% of patients [p = 0.018]: 100% of patients with plaque rupture/erosion and increased FDG uptake had NSTEMI/UA. CONCLUSION: For the first time, we demonstrated that the correspondence between increased FDG uptake with PET/CT and morphology of coronary plaque instability at OCT is high.


Assuntos
Placa Aterosclerótica , Idoso , Humanos , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia de Coerência Óptica
5.
Trials ; 21(1): 192, 2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32066489

RESUMO

BACKGROUND: Ticagrelor is a reversibly binding, direct-acting, oral, P2Y12 antagonist used for the prevention of atherothrombotic events in patients with coronary artery disease (CAD). Ticagrelor blocks adenosine reuptake through the inhibition of equilibrative nucleoside transporter 1 (ENT-1) on erythrocytes and platelets, thereby facilitating adenosine-induced physiological responses such as an increase in coronary blood flow velocity. Meanwhile, adenosine plays an important role in triggering ischemic preconditioning through the activation of the A1 receptor. Therefore, an increase in ticagrelor-enhanced adenosine bioavailability may confer beneficial effects through mechanisms related to preconditioning activation and improvement of coronary microvascular dysfunction. METHODS: To determine whether ticagrelor can trigger ischemic preconditioning and influence microvascular function, we designed this prospective, open-label, pilot study that enrolled patients with stable multivessel CAD requiring staged, fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI). Participants will be randomized in 1:1 ratios either to ticagrelor (loading dose (LD) 180 mg, maintenance dose (MD) 90 mg bid) or to clopidogrel (LD 600 mg, MD 75 mg) from 3 to 1 days before the scheduled PCI. The PCI operators will be blinded to the randomization arm. The primary endpoint is the delta (difference) between ST segment elevations (in millimeters, mm) as assessed by intracoronary electrocardiogram (ECG) during the two-step sequential coronary balloon inflation in the culprit vessel. Secondary endpoints are 1) changes in coronary flow reserve (CFR), index of microvascular resistance (IMR), and FFR measured in the culprit vessel and reference vessel at the end of PCI, and 2) angina score during inflations. This study started in 2018 with the aim of enrolling 100 patients. Based on the rate of negative FFR up to 30% and a drop-out rate up to 10%, we expect to detect an absolute difference of 4 mm among the study arms in the mean change of ST elevation following repeated balloon inflations. All study procedures were reviewed and approved by the Ethical Committee of the Catholic University of Sacred Heart. DISCUSSION: Ticagrelor might improve ischemia tolerance and microvascular function compared to clopidogrel, and these effects might translate to better long-term clinical outcomes. TRIAL REGISTRATION: EudraCT No. 2016-004746-28. No. NCT02701140.  TRIAL STATUS: Information provided in this manuscript refers to the definitive version (n. 3.0) of the study protocol, dated 31 October 2017, and includes all protocol amendments. Recruitment started on 18 September 2018 and is currently ongoing. The enrollment is expected to be completed by the end of 2019. TRIAL SPONSOR: Fondazione Policlinico Universitario A. Gemelli - Roma, Polo di Scienze Cardiovascolari e Toraciche, Largo Agostino Gemelli 8, 00168 Rome, Italy.


Assuntos
Doença da Artéria Coronariana/cirurgia , Precondicionamento Isquêmico Miocárdico/métodos , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Intervenção Coronária Percutânea/efeitos adversos , Ticagrelor/administração & dosagem , Adolescente , Adulto , Idoso , Ensaios Clínicos Fase II como Assunto , Ensaios Clínicos Fase III como Assunto , Clopidogrel/administração & dosagem , Vasos Coronários/efeitos dos fármacos , Feminino , Reserva Fracionada de Fluxo Miocárdico/efeitos dos fármacos , Humanos , Masculino , Microvasos/efeitos dos fármacos , Pessoa de Meia-Idade , Traumatismo por Reperfusão Miocárdica/etiologia , Projetos Piloto , Cuidados Pré-Operatórios/métodos , Antagonistas do Receptor Purinérgico P2Y/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Resistência Vascular/efeitos dos fármacos , Adulto Jovem
6.
Coral Reefs ; 28(3): 727-733, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22833700

RESUMO

Due to the importance of preserving the genetic integrity of populations, strategies to restore damaged coral reefs should attempt to retain the allelic diversity of the disturbed population; however, genetic diversity estimates are not available for most coral populations. To provide a generalized estimate of genetic diversity (in terms of allelic richness) of scleractinian coral populations, the literature was surveyed for studies describing the genetic structure of coral populations using microsatellites. The mean number of alleles per locus across 72 surveyed scleractinian coral populations was 8.27 (±0.75 SE). In addition, population genetic datasets from four species (Acropora palmata, Montastraea cavernosa, Montastraea faveolata and Pocillopora damicornis) were analyzed to assess the minimum number of donor colonies required to retain specific proportions of the genetic diversity of the population. Rarefaction analysis of the population genetic datasets indicated that using 10 donor colonies randomly sampled from the original population would retain >50% of the allelic diversity, while 35 colonies would retain >90% of the original diversity. In general, scleractinian coral populations are genetically diverse and restoration methods utilizing few clonal genotypes to re-populate a reef will diminish the genetic integrity of the population. Coral restoration strategies using 10-35 randomly selected local donor colonies will retain at least 50-90% of the genetic diversity of the original population.

8.
Minerva Cardioangiol ; 56(1): 35-42, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18432167

RESUMO

AIM: Drug eluting stents (DES) have been shown to reduce restenosis compared with bare metal stents in bifurcated lesions. The aim of this study was to evaluate the long-term clinical outcomes of patients with bifurcated lesions treated by 3 different DES. METHODS: Consecutive patients with symptomatic coronary artery disease on one bifurcated lesion with SB>2.25 mm (on visual estimation) undergoing at the Department of Cardiology of the Catholic University of Rome, Italy were screened. Patients treated with Sirolimus-eluting stent (Cypher Select; SES Group), Tacrolimus-eluting stent (Taxus-Libertè; TA Group) and Zotarolimus-eluting stent (Endeavor Driver; ZOT Group) were enrolled in the study. Clinical and angiographic characteristics of all patients were prospectively recorded. Major adverse clinical events (MACE), including death, acute myocardial infarction (MI) or target lesion revascularization (TVR) by either percutaneous coronary intervention (PCI) or coronary surgery were recorded during the follow-up. Incidence of definite or probable stent thrombosis was calculated according to the ARC criteria. RESULTS: Two hundred and forty-one consecutive patients were enrolled (89 Group CY, 98 Group TA and 54 Group EN). Length of follow-up was 235+/-60 days. Baseline clinical and angiographic characteristic were similar across the groups. The adopted technique for stent implantation was provisional stenting (73.4%), T-stenting technique (7%), crush (7%) and V-stenting (2.6%). The rate of patients finally treated with two stents was similar among groups. The cumulative rate of MACE (9% SES, 12% TA, 11% ZOT: P=0.7) and of TVR (2% SES, 9% TA, 7% ZOT) was similar among groups. No definite stent thrombosis was observed during follow-up, while 1 probable stent thrombosis was observed in TA group. CONCLUSION: The clinical outcome of bifurcated lesions using DES and mainly a technique of single stent implantation is good. In the present observational study, clinical adverse events did not differ in patients with bifurcated lesions treated by Cypher, Taxus or Endeavor stent implantation.


Assuntos
Doença da Artéria Coronariana/terapia , Stents Farmacológicos , Imunossupressores/administração & dosagem , Sirolimo/análogos & derivados , Sirolimo/administração & dosagem , Tacrolimo/administração & dosagem , Idoso , Angioplastia Coronária com Balão/métodos , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/patologia , Reestenose Coronária/prevenção & controle , Vasos Coronários/patologia , Quimioterapia Combinada , Stents Farmacológicos/efeitos adversos , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/terapia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Cidade de Roma , Resultado do Tratamento
9.
Int J Cardiol ; 109(1): 53-8, 2006 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-16084611

RESUMO

BACKGROUND: Distal protection devices are increasingly used to prevent embolization during percutaneous coronary interventions (PCI) in saphenous vein grafts (SVG) and native coronary arteries (NV). During interventions with the Filterwire device we have observed reduced flow that is reversible following removal of the filter (filter no reflow, FNR), which might be erroneously interpreted as true no reflow and might be associated with reduced capture efficiency of the basket. METHODS: We analyzed the incidence of FNR in 58 patients (60 lesions) at high risk of embolization undergoing PCI of either a SVG or a NV using the Filterwire (Boston Scientific, Natick, MA). Qualitative and quantitative angiographic analysis was performed, and the volume of collected debris was estimated using a photographic technique. RESULTS: In our population, about 1/3 of the cases showed FNR, which was associated with angiographically visible filling defects within the basket, indicating macroembolism. However some patients (especially those undergoing vein graft interventions) showed filling defects without FNR, and some others FNR without filling defects. Thus we tried to understand the predictors of FNR: FNR was associated with higher amount of collected debris (36.97 +/- 42.98 mm(3) vs. 11.31 +/- 18.47 mm(3), p = 0.005), was neither prevented by abciximab, nor predicted by high thrombotic burden, increasing stent volume or need for predilatation. When patient with and without angiographically evident macroembolisation were separately analyzed, a linear correlation of FNR with the quantity of debris was only apparent in the macroembolization group. CONCLUSIONS: Interventionalists should be aware of the "Filter No Reflow", a common but reversible angiographic complication when the Filterwire device is used. Reduced flow seen during these procedures should be treated conservatively. Mechanical obstruction of the filter, but also other mechanisms (pharmacologically active debris? platelet aggregates?) play a role in this phenomenon.


Assuntos
Angioplastia Coronária com Balão/métodos , Doença das Coronárias/terapia , Embolia/prevenção & controle , Abciximab , Idoso , Angioplastia Coronária com Balão/instrumentação , Anticorpos Monoclonais/uso terapêutico , Constrição Patológica , Angiografia Coronária , Desenho de Equipamento , Feminino , Filtração/instrumentação , Humanos , Fragmentos Fab das Imunoglobulinas/uso terapêutico , Masculino , Microcirculação , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/uso terapêutico , Estudos Retrospectivos , Veia Safena/transplante
10.
Water Sci Technol ; 54(8): 37-46, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17163011

RESUMO

Developed for tertiary nitrification, this biofilter also removed carbonaceous BOD (cBOD) and (SS). Because the biofilter is expanded, it cannot clog, and therefore does not require backflushing; yet, it removed a significant proportion of the influent SS. This unanticipated capability was due to the activities of heterotrophic bacteria, protozoa, and metazoa (nematode and oligochaete worms). The expanded bed is an intensified process, which is based on natural immobilization of microbes to small support particles. Using glassy coke as the support material, an attached layer of microbes develops, forming particulate biofilms having a superficial surface area of 1 800 m2 m(-3)(expandedbed). Autotrophic nitritifiers (Nitrosomonas spp.) were detected in the biofilm using rRNA-based molecular methods and were likely responsible, at least in part, for reducing the ammonia concentration by up to 99% (to 0.1 mg L(-1)), while the other organisms reduced cBOD and SS by up to 56% and 62%, respectively. Furthermore, the influent concentrations of Escherichia coli, coliform and heterotrophic bacteria were reduced by over 80%. It thereby provides a single process solution for combined tertiary nitrification and solids removal. Operating the process to consistently achieve < 0.5mg NH3N L(-1) and at the same time removing a significant fraction of cBOD and SS, it can replace processes such as SAFs or NTFs followed by a sandfilter.


Assuntos
Biofilmes , Reatores Biológicos , Nitrogênio/metabolismo , Eliminação de Resíduos Líquidos/instrumentação , Amônia/análise , Amônia/metabolismo , Biodegradação Ambiental , Escherichia coli/metabolismo , Filtração/instrumentação , Nitritos/metabolismo , Nitrosomonas/metabolismo , Eliminação de Resíduos Líquidos/métodos
11.
Aust Dent J ; 60(1): 65-72, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25721280

RESUMO

BACKGROUND: Dentine hypersensitivity (DH) occurs on exposed dentine and is dependent on the patency of dentinal tubules. This study compared the effectiveness of red propolis extract (RPE), calcium sodium phosphosilicate (Novamin) and arginine-calcium carbonate (ACC) in occluding dentine tubules. METHODS: Eighty dentine discs from extracted human molars were randomly divided into four groups (n=20): Group 1--RPE; Group 2--Novamin; Group 3--ACC; Group 4--saline. The discs were etched with 37.5% phosphoric acid and treated with the test agents. Ten treated discs from each group were then exposed to 6% citric acid challenge. The extent of tubule occlusion was assessed using scanning electron microscopy (SEM). Three blinded assessors scored each SEM image on the degree of tubule occlusion. Differences in occlusion were tested using ANOVA and Tukey adjustment. RESULTS: Discs treated with ACC demonstrated more tubule occlusion, followed by RPE and Novamin, and were greater in statistical significance when compared to discs treated with saline. Following acid challenge, RPE treated discs maintained more occlusion, followed by ACC and Novamin. CONCLUSIONS: All three agents demonstrated tubule occlusion. Although ACC showed more occlusion following treatment, RPE demonstrated a higher degree of occlusion following acid challenge.


Assuntos
Dessensibilizantes Dentinários/farmacologia , Dentina/efeitos dos fármacos , Arginina/farmacologia , Carbonato de Cálcio/farmacologia , Ácido Cítrico/efeitos adversos , Dentina/ultraestrutura , Sensibilidade da Dentina/fisiopatologia , Fluoretos/farmacologia , Vidro , Humanos , Teste de Materiais , Microscopia Eletrônica de Varredura , Fosfatos/farmacologia , Ácidos Fosfóricos/química , Própole/farmacologia , Cremes Dentais/farmacologia
12.
Eur Rev Med Pharmacol Sci ; 19(8): 1461-79, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25967723

RESUMO

OBJECTIVE: Periprocedural management of warfarin remains challenging in patients requiring electrophysiological device surgery. For patients at high risk of thromboembolic events, guidelines recommend bridging therapy with heparin; however, this strategy is associated with a high risk of pocket hematoma. This paper systematically reviews studies appraising the risk of pocket hematoma with different perioperative anticoagulation strategies. METHODS: All relevant studies identified in MEDLINE/PubMed, The Cochrane Collaboration CENTRAL, clinicaltrials.org and in bibliographies of key articles. Estimates were combined using a fixed effects model. Heterogeneity was assessed by p values of χ2 statistics and I2. Publication bias was assessed by visual examination of funnel plots and by Egger test. Fifteen studies enrolling 5911 patients met all inclusion criteria and were included in this review. RESULTS: Heparin bridging compared with no heparin was associated with increased risk of pocket hematoma (OR = 4.47, 95% CI 3.21-6.23, p < 0.00001), and prolonged hospital stay (9.13 ± 1.9 days vs. 5.11 ± 1 .39 days, p < 0.00001). Warfarin continuation was not associated with increased pocket hematoma compared to warfarin discontinuation (p = 0.38), but was associated with reduced risk of pocket hematoma compared with heparin bridging (OR = 0.37, 95% CI 0.2-0.69, p = 0.002). Thromboembolic complications were reduced with heparin bridging vs. no heparin (0.50% vs.1.07%, p = 0.02), and no significant differences were reported between heparin bridging vs. warfarin continuation (p = 0.83). CONCLUSIONS: Heparin bridging is associated with a higher risk of pocket hematoma and a prolonged hospital stay. Perioperative continuation of warfarin reduces the occurrence of pocket hematoma compared with heparin bridging without any significant differences in thromboembolic complications.


Assuntos
Anticoagulantes/administração & dosagem , Desfibriladores Implantáveis/tendências , Hematoma/prevenção & controle , Cuidados Pré-Operatórios/métodos , Varfarina/administração & dosagem , Desfibriladores Implantáveis/efeitos adversos , Esquema de Medicação , Hematoma/induzido quimicamente , Hematoma/diagnóstico , Heparina/administração & dosagem , Heparina/efeitos adversos , Humanos , Tempo de Internação/tendências , Estudos Observacionais como Assunto/métodos , Marca-Passo Artificial/efeitos adversos , Marca-Passo Artificial/tendências , Cuidados Pré-Operatórios/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Fatores de Risco
13.
Pharmacotherapy ; 17(4): 832-5, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9250568

RESUMO

A 2.5-year-old child receiving phenobarbital for a history of seizures while on continuous cycling peritoneal dialysis (CCPD) had persistent subtherapeutic serum levels despite progressive dosage increases. Phenobarbital concentration was measured in the peritoneal dialysate effluent and peritoneal clearance was calculated. Thirty-five percent of the total phenobarbital daily dose was being removed through 24-hour CCPD. Our findings were consistent with previous reports of 40% and 50% phenobarbital removal during continuous ambulatory peritoneal dialysis and acute peritoneal dialysis, respectively. In addition, phenobarbital clearance was greater during the period when more exchanges were done compared with the period when patient went through one cycle with a longer dwell time. Based on these preliminary data, it seems that larger dosages of phenobarbital are necessary in patients undergoing continuous peritoneal dialysis, and that the amount removed can differ significantly depending on the number of cycles.


Assuntos
Anticonvulsivantes/administração & dosagem , Diálise Peritoneal , Fenobarbital/administração & dosagem , Fenobarbital/sangue , Pré-Escolar , Soluções para Diálise/análise , Humanos , Falência Renal Crônica/terapia , Masculino , Fenobarbital/análise , Convulsões/sangue , Convulsões/tratamento farmacológico
14.
Ann Ist Super Sanita ; 37(3): 443-8, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11889962

RESUMO

We performed a review of the current literature in order to evaluate clinical, electrocardiographic and electrophysiologic parameters predictive of atrial fibrillation development. Clinical parameters were obtained from two large observational studies (the Framingham heart study and the Cardiovascular health study). Different laboratoristic predictors were also reviewed: ECG-derived predictors, among which we separately evaluated those derived from the 12-lead surface ECG and those derived from the signal averaged P-wave, and other electrophysiologic predictors as atrial monophasic action potential analysis. We also evaluated the clinical value of these different parameters in atrial fibrillation in patients with no overt structural heart disease and in the most common clinical conditions known to be related to atrial fibrillation development such as hypertension, heart failure, cardiovascular surgery.


Assuntos
Fibrilação Atrial/fisiopatologia , Eletrocardiografia , Eletrofisiologia , Humanos
15.
J Pediatr (Rio J) ; 72(1): 14-9, 1996.
Artigo em Português | MEDLINE | ID: mdl-14688969

RESUMO

Patients during a mild to moderate acute attack of asthma (FEV1: 50 - 80% of predicted) were treated with Salmeterol MDI - 50mcg or Rotadisk - 50mcg or Salbutamol (MDI -200mcg). The children were followed by Spirometry, measuring FEV1 (basal) and after treatment: at 30 minutes, 60 minutes and thereafter every 60 minutes until 780 minutes, if the patients maintained the FEV1 above 80% of the predicted value and/or an increment of 20% in the VEF1 basal value. The Salmeterol group showed a significant bronchodilation at 60 minutes which was maintained in half of the patients up to 9 hours. This was not observed in the Salbutamol group: the peak bronchodilatation was observed at 30 minutes and the bronchodilation effect was observed in half of the patients up to 6 hours. There were no significant differences between both presentations of Salmeterol. This drug allowed a prolonged bronchodilator effect and is, according to the several consensus on management of asthma, an adequate option in the treatment of moderate to severe asthma.

16.
An Otorrinolaringol Ibero Am ; 16(3): 299-311, 1989.
Artigo em Espanhol | MEDLINE | ID: mdl-2751080

RESUMO

This article deals with the shift in audiometric tracings brought about by the discharge of firearms (acute acoustic trauma). The study included 60 subjects with normal hearing, between 18 and 20 years of age. Each individual shot 25 bullets in about 5 minutes, at an intensity level calculated at 163 dB. None of them related antecedents of sensorineural deafness. The audiometric examinations were performed as follows: the first one prior to the experiment, the second immediately after the series of shots, and others 8 and 40 hours later. These are the conclusions drawn out by the AA.: the most important and lasting deafness was verified in the left ear. The 6000 c/s frequency was the most affected. Recovery of the previous hearing level was total in 80.5% of the cases within 40 hours. Two subjects having otosclerotic relatives showed certain difficulties in recovering.


Assuntos
Audiometria , Armas de Fogo , Perda Auditiva Provocada por Ruído/fisiopatologia , Militares , Adolescente , Adulto , Humanos
17.
Acta Otorrinolaringol Esp ; 40 Suppl 2: 295-7, 1989 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-2627522

RESUMO

The technique used for DNA determination in tumoral cells from carcinomas of head and neck is described. Results obtained are commented on as is too the future of this technique for the better understanding of the behavior of the tumor and consequently of its treatment.


Assuntos
Carcinoma de Células Escamosas/análise , Carcinoma de Células de Transição/análise , DNA de Neoplasias/análise , Fibrossarcoma/análise , Citometria de Fluxo/métodos , Neoplasias de Cabeça e Pescoço/análise , Núcleo Celular/análise , Feminino , Citometria de Fluxo/tendências , Humanos , Masculino
18.
Rev Bras Enferm ; 49(3): 435-44, 1996.
Artigo em Português | MEDLINE | ID: mdl-9295748

RESUMO

This paper aims at analyzing the findings from nurses speeches who experience, in their assistance praxis, the problematic concerning professionals who work for the nursing service at a public hospital in Rio de Janeiro and the quality of services provided to clients. I hope to have contributed for a reflection on nursing matters from the view of those who experience them in a critical dialect perspective.


Assuntos
Recursos Humanos de Enfermagem Hospitalar , Qualidade da Assistência à Saúde , Brasil , Hospitais Públicos , Hospitais Urbanos , Humanos , Enfermeiras e Enfermeiros/psicologia
19.
Oral Health Dent Manag ; 13(2): 502-6, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24984672

RESUMO

UNLABELLED: The longevity and durability of composite resins are influenced by the actions of water, saliva, drinks, food and features of the oral environment. OBJECTIVE: The aim of this study was to evaluate the effect of mouthwashes containing alcohol on the surface hardness, sorption and solubility of composite resins. METHODS: Disc-shaped specimens were prepared with two composite resins Z250 (Z2) and Z350XT (Z3). Measurements of Vickers hardness were performed before and after immersion in Plax, PerioGard, Listerine, ethanol and distilled water for 12 h at 37°C, followed by a further 12 h at 37°C in artificial saliva. Sorption and solubility were performed according to ISO 4049. Data were analysed using one-way ANOVA and Tukey tests (α=0.05). RESULTS: None of the mouthwashes significantly reduced the hardness of the resin Z2 (p>0.05). The greatest change in resin Z3 hardness was produced by PerioGard (p<0.01). Plax produced the lowest changes in the sorption and solubility of resins Z2 and Z3 (p<0.01), followed by Listerine and PerioGard. CONCLUSIONS: The sorption and solubility properties of the composite resins were more altered by mouthwashes than the surface hardness.

20.
Int J Cardiol ; 168(3): 1917-22, 2013 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-23369675

RESUMO

BACKGROUND: Peripheral arterial disease is a risk factor for cardiac mortality but pathophysiologic mechanisms linking atherosclerosis of peripheral arteries with coronary events in the single patient have not been established. METHOD AND RESULTS: We evaluated by frequency-domain optical coherence tomography (FD-OCT) the possible association between culprit coronary plaque characteristics and proximal radial artery features in a cohort of 51 patients symptomatic coronary artery disease undergoing coronary procedures by transradial route. FD-OCT coronary artery analysis included assessment of TCFA and thrombus. FD-OCT radial artery analysis included intimal thickness index (ITI: intimal area/medial area), intima-media ratio (IMR: the maximum intimal thickness/medial thickness), and percentage of luminal narrowing [%LN: (intimal area+medial area)/external elastic membrane area × 100]. Coronary TCFA and thrombus were detected in 19 (37%) and 7 (14%) patients, respectively. TCFA was significantly associated with higher values of radial artery ITI (0.35 vs. 0.26, p=0.02) and IMR (0.45 vs. 0.32, p=0.03), but not with %LN. In contrast, coronary thrombus was only associated with higher %LN (26.7 vs. 22.8, p=0.02). Multivariate logistic regression analysis identified proximal radial artery IMR (OR 16.3, 95% CI 1.1 to 245.1) as an independent predictor of TCFA. CONCLUSIONS: In patients with symptomatic coronary atherosclerosis, vessel wall modifications at the level of the proximal radial artery are associated with adverse coronary features like TCFA and thrombus.


Assuntos
Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/patologia , Placa Aterosclerótica/patologia , Artéria Radial/patologia , Tomografia de Coerência Óptica/métodos , Túnica Média/patologia , Idoso , Feminino , Seguimentos , Humanos , Hiperplasia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco
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