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1.
J Environ Manage ; 351: 119744, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38064989

RESUMO

Do geopolitical conflicts matter for the environmental, social, governance (ESG) and overall ESG performance of firms? We answer this question by studying the impact of geopolitical conflict of a country on the ESG performance, separately and collectively, of firms of that country. We use data from Refinitiv and UCDP/PRIO (Uppsala Conflict Data Program/International Peace Research Institute, Oslo) databases for the period from 2002 to 2021 for 79 countries and we use fixed effects regression as our main methodology. We find that if a country is in a geopolitical conflict, their firms are impacted in the form of lower E, S and G performance and overall ESG performance, with stronger effects for developed countries. This comes on top of the direct costs of geopolitical conflicts. Our results are robust to country, year and firm fixed effects as well as robust to endogeneity as we use Lewbel (2012) estimator to eliminate any chances of endogeneity. We provide first evidence on this topic and it has geopolitical and socioeconomical implications.


Assuntos
Condições Sociais , Bases de Dados Factuais
2.
Pediatr Blood Cancer ; 70(2): e30091, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36411263

RESUMO

INTRODUCTION: The InPOG-HL-15-01, a multicentric prospective study, used a risk-stratified and response-based approach with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) backbone to treat children and adolescents with newly diagnosed Hodgkin lymphoma (HL) and reduce the use of radiation therapy (RT). Children/adolescents with bulky disease or inadequate response at early response assessment (ERA) after two cycles of chemotherapy were assigned to receive RT. For ERA, positron emission tomography computed tomography (PET-CT) was recommended but not mandatory in view of limited access. This study aimed to compare the impact of using contrast-enhanced computed tomography (CECT) and PET-CT on treatment decisions and outcomes. METHODOLOGY: 396 patients were enrolled and 382 had an ERA at the assigned time point. Satisfactory response was defined as Deauville score 3 or less for patients undergoing PET-CT and complete response (CR)/very good partial response (VGPR) for patients undergoing CECT. Outcomes of interest incorporate 5 year event-free survival (EFS), EFS including abandonment (EFSa), and overall survival (OS). RESULTS: At ERA, satisfactory response was documented in 277 out of 382 (72.5%) participants and this was significantly higher in PET-CT (151 out of 186, 81.2%) as compared with CECT-based assessments (126 out of 196, 64.3%) respectively (p value < .001). Amongst the 203 patients with nonbulky disease (wherein the indication for RT was entirely dependent on ERA), 96 out of 114 (84.2%) and 61 out of 89 (68.5%) patients achieved a satisfactory response according to the PET-CT and CECT (p value = .008) respectively and hence a lesser proportion of patients in the PET-CT arm received RT. Despite a lower usage of RT the 5 year OS of both groups, ERA based on CECT (91.8%) versus PET-CT (94.1%) was comparable (p value = .391) and so was the 5 year EFS (86.7 vs. 85.5%, p value = .724). CONCLUSION: Use of PET-CT as the modality for ERA is more likely to indicate a satisfactory response as compared with CECT and thereby decreases the need for RT in response-based treatment algorithm for HL-afflicted children. The reduction in the application of RT did not impact the overall outcome and plausibly would lower the risk of delayed toxic effects.


Assuntos
Doença de Hodgkin , Criança , Adolescente , Humanos , Doença de Hodgkin/diagnóstico por imagem , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/radioterapia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Dacarbazina/uso terapêutico , Vimblastina/uso terapêutico , Bleomicina/efeitos adversos , Doxorrubicina/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Estudos Prospectivos , Países em Desenvolvimento , Tomografia por Emissão de Pósitrons , Estadiamento de Neoplasias
3.
Risk Anal ; 2023 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-37480163

RESUMO

Climate change poses enormous ecological, socio-economic, health, and financial challenges. A novel extreme value theory is employed in this study to model the risk to environmental, social, and governance (ESG), healthcare, and financial sectors and assess their downside risk, extreme systemic risk, and extreme spillover risk. We use a rich set of global daily data of exchange-traded funds (ETFs) from 1 July 1999 to 30 June 2022 in the case of healthcare and financial sectors and from 1 July 2007 to 30 June 2022 in the case of ESG sector. We find that the financial sector is the riskiest when we consider the tail index, tail quantile, and tail expected shortfall. However, the ESG sector exhibits the highest tail risk in the extreme environment when we consider a shock in the form of an ETF drop of 25% or 50%. The ESG sector poses the highest extreme systemic risk when a shock comes from China. Finally, we find that ESG and healthcare sectors have lower extreme spillover risk (contagion risk) compared to the financial sector. Our study seeks to provide valuable insights for developing sustainable economic, business, and financial strategies. To achieve this, we conduct a comprehensive risk assessment of the ESG, healthcare, and financial sectors, employing an innovative approach to risk modelling in response to ecological challenges.

4.
Helminthologia ; 59(4): 377-384, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36875675

RESUMO

The present study reports the prevalence of Paramphistomum spp. in small and large ruminants and their association with the histopathology of the infected rumens. A total of 384 animals were screened for Paramphistomum spp. The animals found positive for Paramphistomum spp. were divided into three groups according to the worm load/5 cm2 (G1: 10 - 20 worms/5 cm2 = Low, G2: 20 - 40 worms/5 cm2 = Medium, and G3: >41 worms/5 cm2 = High). Tissue slides were prepared from samples of the rumen (1 cm2) taken from animals positive for ruminal fluke to determine the histological parameters, including epithelial length or thickness, length and width of the ruminal papilla, and thickness of tunica submucosa and mucularis externae. The overall prevalence of Paramphistomum spp. in the ruminant population of district Narowal was 56.25 % with a significant (P < 0.05) variation among different species of ruminants. The highest prevalence was in cattle, followed in order by buffalo, goat, and sheep. Epithelium thickness was significantly correlated with parasite load in large ruminants and the most significant (P < 0.05) decrease in epithelium thickness was in Group B (31.12 ± 1.82 µm) and Group C (31.07 ± 1.68 µm) and a same trend was recorded in small ruminants. Histopathological changes due to Paramphistomum spp. are reported for the first time, which explained the histomorphological and physiological changes in Paramphistomum-infected rumens which might be associated with lowered feed efficiency and productivity in ruminants.

5.
World Econ ; 45(2): 386-408, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34230757

RESUMO

This paper makes an innovative contribution to the extant literature by analysing the determinants of economic stimulus packages implemented by governments in response to the COVID-19 pandemic. In particular, we explore whether stock market declines observed in many countries can predict the size of COVID-19 stimulus packages. Moreover, we explore whether a country's level of income can augment the underlying relationship between stock market declines and stimulus packages. The findings reveal that a larger stock market decline results in a larger stimulus package; however, this effect is only observed in countries that have an income level greater than the mean and/or median per capita gross domestic product (GDP). Moreover, our results show that monetary policy is more responsive to a stock market decline than fiscal policy. Thus, our results underscore the importance of international donor agencies such as the World Bank and International Monetary Fund (IMF) in supporting less affluent countries in coping with the adverse impacts of the COVID-19 pandemic on their economies.

6.
Physiol Plant ; 172(2): 463-476, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32949405

RESUMO

Rhizobacteria containing 1-aminocyclopropane-1-carboxylic acid-deaminase (ACC-deaminase) and exopolysaccharides (EPS) activity are important to induce stress tolerance in plants. The present study was conducted to screen and characterize plant growth-promoting rhizobacteria (PGPR) with ACC-deaminase and EPS-producing activity for improving maize growth under drought stress. Eighty-five rhizobacterial strains were isolated from the rain-fed areas, among those 69 isolates were able to utilize ACC and 31 strains were found positive for EPS production. These strains containing ACC-deaminase and/or EPS-producing activity were subjected to drought tolerance assay by inducing water stress in media using polyethylene glycol 6000. Based on results of the drought tolerance bioassay, 12 most prominent strains were selected to evaluate their growth-promoting abilities in maize under water-stressed conditions by conducting jar trial. The impact of strains on maize growth parameters was variable. Strains with co-existence of ACC-deaminase and EPS-producing activity showed comparatively better results than those with either ACC-deaminase or EPS-producing activity only. These strains were also significantly better in improving the plant physiological parameters including photosynthesis rate, stomatal conductance, vapor pressure, water-use efficiency and transpiration rate. The strain D3 with co-existence of ACC-deaminase and EPS-producing activity was significantly better in colonizing maize roots, improving plant growth and physiological parameters. The strain was named as Bacillus velezensis strain D3 (accession number MT367633) as confirmed through results of 16S rRNA partial gene sequencing. It is concluded that the strains with co-existence of ACC-deaminase and EPS-producing activity could be better suited for improving crop growth and physiology under drought stress.


Assuntos
Secas , Zea mays , Bacillus , Carbono-Carbono Liases , Raízes de Plantas , RNA Ribossômico 16S , Microbiologia do Solo
7.
Gen Comp Endocrinol ; 311: 113850, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34245767

RESUMO

MicroRNAs (miRNAs) are small non-coding RNAs that regulate gene expression primarily at the post-transcriptional levels. It is now well established that miRNAs are crucial regulators of many developmental and physiological processes, including reproduction. In teleosts, expression profiling studies have shown that miRNAs are expressed in the fish ovary and their levels are regulated during follicle development and by hormones. Using CRISPR/Cas9 mediated gene knockout strategies, several recent studies have provided strong evidence that miR-202 and miR-200s on chromosome 23 play critical roles in regulating ovarian development, oogenesis, and ovulation. In this mini review, we provide a brief overview of canonical miRNA biogenesis and functions; summarize miRNAs that are expressed in fish ovary; and discuss the emerging role of miRNAs in regulating fish ovarian functions.


Assuntos
Peixes , MicroRNAs , Ovário , Animais , Feminino , Peixes/genética , Perfilação da Expressão Gênica , MicroRNAs/genética , MicroRNAs/metabolismo , Oogênese/genética , Ovário/metabolismo , Ovulação
8.
Ophthalmic Plast Reconstr Surg ; 37(3S): S19-S22, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33009327

RESUMO

PURPOSE: To report the etiology, management, and possible risk factors for diplopia after canalicular bypass surgery. METHODS: A multicenter retrospective, noncomparative case series of patients who developed diplopia following canalicular bypass surgery were assessed. RESULTS: Twenty-four cases of diplopia were identified across 12 institutions. Tubes were inserted as a primary procedure with external dacryocystorhinostomy (DCR) (1; 4%) or without DCR (10; 42%) or as a secondary procedure after external (8; 33%) or endonasal (5; 21%) DCR. Factors predisposing to local damage were noted in 17 (71%): these factors included preexisting autoimmune/inflammatory condition (7 cases), medial canthal tumor resection (5 cases), preoperative radiotherapy (2 cases), 2 drug treatments (topical and systemic), and 1 local surgery. Horizontal diplopia was due to restriction of abduction and first noted at a median of 3.5 months (mean: 17.8 months, range: 1 day to 112 months) and persisted in 23 (96%) cases with a mean restriction of -2, affecting primary gaze in 4 patients and activities of daily living in 13 (42%). Seventeen patients received various treatments: 10 were operated on resulting in cure in 1 and improvement in 9. A stable degree of diplopia persisted in all but one patient. CONCLUSIONS: Restriction of abduction causing horizontal diplopia is a rare complication with canalicular bypass surgery and a notably high proportion occurred after tube placement without DCR; carunculectomy was not ubiquitous. Although in some the diplopia may be improved with intervention, the chance of cure is low. This complication should probably be included during informed consent for canalicular bypass tubes.


Assuntos
Dacriocistorinostomia , Obstrução dos Ductos Lacrimais , Ducto Nasolacrimal , Atividades Cotidianas , Diplopia/etiologia , Humanos , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
9.
J Environ Manage ; 299: 113545, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34455352

RESUMO

This study explores the ecological ambitions of banks by studying the coincidence of economic realities with environmental management strategies. We address this question by studying the environmental performance of US banks and its impact on their tail risk as US is not committed to carbon neutrality in COP 21. We proxy economic reality with tail risk of banks and employ a novel extreme value theory to measure this. We use Asset4 ESG data for environmental performance score and test our hypothesis with a sample of 256 US banks. The results indicate that the US banks are ecologically ambitious and their environmental strategies are likely to reduce their tail risk. This provides evidence that better environmental strategies do coincide with the economic realities. We test the consistency of our results by using alternate proxies for tail risk and find our results robust. Our results are also not driven by endogeneity concerns. Finally, our additional results show that the nature of relationship differs with corporate governance levels, CSR committee existence, institutional ownership presence and crisis period.


Assuntos
Carbono , Organizações , Conservação dos Recursos Naturais , Propriedade , Condições Sociais
10.
Ecotoxicol Environ Saf ; 187: 109712, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31654867

RESUMO

Mycotoxicosis is the second most important problem faced by the Pakistan poultry industry, after high feed prices. The present experimental study was designed to investigate the toxicopathological effects of aflatoxin B1 (AFB1) in commercial broiler chicks and its amelioration with locally produced mycotoxin binder. Total of 125 broiler chicks was divided into five equal groups (A-E). Group A served as negative control, group B (300 µg AFB1/kg feed) as positive control, group C (300 µg AFB1/kg + Local Mycotoxin Binder (LMB), 1 g/kg feed), group D (300 µg AFB1/kg + 2 g LMB/kg feed), and group E (300 µg AFB1/kg + Commercial Mycotoxin Binder (CMB), 2 g/kg of feed). Parameters studied included mortality, feed intake, bodyweights, absolute and relative organ weights, and gross and microscopic lesions in visceral organs. Clinical signs including alertness, fecal consistency, and feather shine were significantly lower in group B compared with control group A. The feed intake of 2 g/kg LMB treated group was significantly higher than that of the positive control group B. Also mean bodyweights of group D birds was higher than that of group B birds indicating an ameliorative effect of LMB. Histopathological results showed that moldy feed produced necrotic changes in the liver and kidneys in group B birds. However, in group D and E birds, the hepatic and renal parenchyma was normal, showing a protective effect of LMB. In the present study, a higher dose of LMB (2 g/kg) in group D showed higher bodyweights and feed intake. In group D, birds hepatic and renal parenchyma was also normal. The results suggested that local mycotoxin binder ameliorated the toxicopathological effects of AFB1 in mortality, feed intake, bodyweights, organ weights and, gross and microscopic lesions in visceral organs. These ameliorative effects of LMB were dose-dependent. The results of the present study concluded that AFB1 intoxication leads to decrease in bodyweights, feed intake in dose-related manner. The mortality was also dose-dependent. Gross and microscopic changes in the aflatoxin groups were more pronounced, however, all these deleterious effects were ameliorated in higher dose of LMB (group D) and CMB (group E). In group C, these deleterious effects were partially ameliorated. Local mycotoxin binder is an economical solution for aflatoxicosis problem, making poultry production more cost-effective.


Assuntos
Aflatoxina B1/toxicidade , Ração Animal/análise , Contaminação de Alimentos/prevenção & controle , Micotoxicose/prevenção & controle , Doenças das Aves Domésticas/prevenção & controle , Aflatoxina B1/química , Animais , Bentonita/administração & dosagem , Bentonita/química , Galinhas , Contaminação de Alimentos/análise , Rim/efeitos dos fármacos , Rim/patologia , Fígado/efeitos dos fármacos , Fígado/patologia , Micotoxicose/veterinária , Tamanho do Órgão , Paquistão , Saccharomyces cerevisiae/química
11.
J Environ Manage ; 265: 110533, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32421559

RESUMO

This paper empirically investigates the effect of carbon emissions on sovereign risk? To answer this question, we use fixed effects model by using annual data from G7 advanced economies, which includes Canada, France, Germany, Italy, Japan, UK and USA, for the period from 1996 to 2014. We employ a novel extreme value theory to measure sovereign risk. The results indicate that climate change (carbon emissions) are likely to increase sovereign risk significantly. We also expand our analysis to some specific sectors, as some of the sectors emit more carbon than others. Specifically, we take top three polluting sectors namely: transportation, electricity and industry and show that they are more likely to increase the sovereign risk. Our results are robust to change in risk measures, estimation in differences and dynamic version of econometric models. Therefore, we have robust consideration that the carbon emissions significantly explain the sovereign risk.


Assuntos
Dióxido de Carbono , Carbono , Canadá , França , Alemanha , Itália , Japão
12.
J Environ Manage ; 247: 525-537, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31255967

RESUMO

To guide households on implementing low-carbon consumption patterns, it is necessary to comprehensively measure carbon emissions of household consumption. This study expands the input-output relationship into the production-consumption relationship. It uses optimized data of the relationship between household consumption and production industry to calculate the entire production-side carbon emissions, including from capital formation, of Chinese household consumption, and uses LMDI model to analyze the factors affecting the growth of carbon emissions from Chinese household consumption. The results show that the carbon emissions of Chinese household consumption grew steadily from 2005 to 2015 almost 50% of carbon emissions were accounted for by high growth rates in residence consumption. Carbon emissions and growth rate of urban households' consumption are significantly higher than the same figures for rural households. The carbon emissions intensity of all types of household consumption except residence and education has shown a downward trend. Household consumption structure and income level are the two main factors that promote the growth of household carbon emissions. Urbanization level and population size are secondary factors while household consumption carbon intensity is an important factor for curbing the growth of household consumption emissions. The study also proposes policy recommendations on how to improve the consumption structure of households, reduce the carbon intensity of household consumption, and curb the growth of carbon emissions from urban households.


Assuntos
Carbono , Urbanização , Indústrias
13.
Colorectal Dis ; 19(12): 1050-1057, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29028289

RESUMO

AIMS: The objective of this study was to evaluate the surgical outcomes and feasibility of early loop defunctioning ileostomy closure, within 2 weeks of index surgery, in patients undergoing distal colorectal resection. METHODS: A systematic review of the literature on published randomized controlled trials reporting the feasibility and outcomes on early vs delayed closure of loop defunctioning ileostomy in patients undergoing distal colorectal resection using the principles of meta-analysis on RevMan 5.4 statistical software was undertaken. RESULTS: Four randomized, controlled trials on 446 patients evaluating the feasibility and outcomes on early vs delayed closure of loop defunctioning ileostomy in patients undergoing low colorectal resection were analysed. There were 176 patients in the early closure group and 270 patients in the delayed closure group. The risk of anastomotic leak [risk ratio 0.37 (CI: 0.10-1.42), P = 0.15], anastomotic stenosis [risk ratio 4.79 (CI: 0.23-98.47), P = 0.31] and postoperative complications [risk ratio 0.75 (CI: 0.48-1.16), P = 0.19] was similar in both groups. In addition, there was no significant difference between the groups with regard to the duration of operation [standardized mean difference -0.49 (CI: -01.09, -0.12), P = 0.12] and length of hospitalization [standardized mean difference -0.04 (CI: -0.25, -0.18), P = 0.75]. CONCLUSIONS: Early closure of loop defunctioning ileostomy in patients undergoing distal colorectal resection is feasible with comparable outcomes to delayed closure.


Assuntos
Colo/cirurgia , Neoplasias Colorretais/cirurgia , Ileostomia/métodos , Complicações Pós-Operatórias/etiologia , Reto/cirurgia , Idoso , Anastomose Cirúrgica/efeitos adversos , Anastomose Cirúrgica/métodos , Fístula Anastomótica/etiologia , Constrição Patológica/etiologia , Feminino , Humanos , Ileostomia/efeitos adversos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Razão de Chances , Duração da Cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento
14.
J Sci Food Agric ; 97(15): 5139-5145, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28436040

RESUMO

BACKGROUND: Limited information is available about the effectiveness of biochar with plant growth-promoting rhizobacteria (PGPR) and compost. A greenhouse study was conducted to evaluate the effect of biochar in combination with compost and PGPR (Pseudomonas fluorescens) for alleviating water deficit stress. Both inoculated and un-inoculated cucumber seeds were sown in soil treated with biochar, compost and biochar + compost. Three water levels - field capacity (D0), 75% field capacity (D1) and 50% field capacity (D2) - were maintained. RESULTS: The results showed that water deficit stress significantly suppressed the growth of cucumber; however, synergistic use of biochar, compost and PGPR mitigated the negative impact of stress. At D2, the synergistic use of biochar, compost and PGPR caused significant increases in shoot length, shoot biomass, root length and root biomass, which were respectively 88, 77, 89 and 74% more than in the un-inoculated control. Significant improvements in chlorophyll and relative water contents as well as reduction in leaf electrolyte leakage demonstrated the effectiveness of this approach. Moreover, the highest population of P. fluorescens was observed where biochar and compost were applied together. CONCLUSION: These results suggest that application of biochar with PGPR and/or compost could be an effective strategy for enhancing plant growth under stress. © 2017 Society of Chemical Industry.


Assuntos
Produção Agrícola/métodos , Cucumis sativus/crescimento & desenvolvimento , Pseudomonas fluorescens/fisiologia , Solo/química , Biomassa , Carvão Vegetal/análise , Carvão Vegetal/metabolismo , Produção Agrícola/instrumentação , Cucumis sativus/metabolismo , Cucumis sativus/microbiologia , Folhas de Planta/crescimento & desenvolvimento , Folhas de Planta/metabolismo , Pseudomonas fluorescens/crescimento & desenvolvimento , Microbiologia do Solo , Água/análise , Água/metabolismo
15.
J Theor Biol ; 397: 22-32, 2016 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-26903204

RESUMO

Gliding bacteria are an assorted group of rod-shaped prokaryotes that adhere to and glide on certain layers of ooze slime attached to a substratum. Due to the absence of organelles of motility, such as flagella, the gliding motion is caused by the waves moving down the outer surface of these rod-shaped cells. In the present study we employ an undulating surface model to investigate the motility of bacteria on a layer of non-Newtonian slime. The rheological behavior of the slime is characterized by an appropriate constitutive equation, namely the Carreau model. Employing the balances of mass and momentum conservation, the hydrodynamic undulating surface model is transformed into a fourth-order nonlinear differential equation in terms of a stream function under the long wavelength assumption. A perturbation approach is adopted to obtain closed form expressions for stream function, pressure rise per wavelength, forces generated by the organism and power required for propulsion. A numerical technique based on an implicit finite difference scheme is also employed to investigate various features of the model for large values of the rheological parameters of the slime. Verification of the numerical solutions is achieved with a variational finite element method (FEM). The computations demonstrate that the speed of the glider decreases as the rheology of the slime changes from shear-thinning (pseudo-plastic) to shear-thickening (dilatant). Moreover, the viscoelastic nature of the slime tends to increase the swimming speed for the shear-thinning case. The fluid flow in the pumping (generated where the organism is not free to move but instead generates a net fluid flow beneath it) is also investigated in detail. The study is relevant to marine anti-bacterial fouling and medical hygiene biophysics.


Assuntos
Algoritmos , Fenômenos Fisiológicos Bacterianos , Hidrodinâmica , Modelos Biológicos , Bactérias/classificação , Bactérias/citologia , Aderência Bacteriana/fisiologia , Biofísica , Movimento/fisiologia , Reologia , Propriedades de Superfície , Viscosidade
16.
Colorectal Dis ; 18(5): 477-82, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26784279

RESUMO

AIM: Lipomodelling has been successfully used in reconstructive breast surgery but not yet in patients with permanent stomas. METHOD: A feasibility study of six patients with permanent stomas was undertaken. Patients underwent lipomodelling of the peristomal area. The number of leakages and quality of life were measured before and for 6 months after the procedure. RESULTS: All patients reported an improvement in their stoma-related quality of life and a reduction in the number of leakages experienced (mean: 2.25 leakages/24 h before lipomodelling and 0.5 leakages/24 h after lipomodelling). CONCLUSION: Lipomodelling appears to be an effective method to reduce stoma leakages caused by peristomal skin contour abnormalities.


Assuntos
Tecido Adiposo/transplante , Fístula Anastomótica/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Estomas Cirúrgicos/efeitos adversos , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida , Resultado do Tratamento
17.
Epidemiol Infect ; 143(9): 1931-5, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25358382

RESUMO

This study describes the first large-scale serosurvey on West Nile virus (WNV) conducted in the equine population in Pakistan. Sera were collected from 449 equids from two provinces of Pakistan during 2012-2013. Equine serum samples were screened using a commercial ELISA kit detecting antibodies against WNV and related flaviviruses. ELISA-positive samples were further investigated using virus-specific microneutralization tests (MNTs) to identify infections with Japanese encephalitis virus (JEV), WNV and tick-borne encephalitis virus (TBEV). Anti-WNV antibodies were detected in 292 samples by ELISA (seroprevalence 65.0%) and WNV infections were confirmed in 249 animals by MNT. However, there was no animal found infected by JEV or TBEV. The detection of WNV-seropositive equines in Pakistan strongly suggests a widespread circulation of WNV in Pakistan.


Assuntos
Vírus da Encefalite Japonesa (Espécie)/isolamento & purificação , Encefalite Japonesa/veterinária , Equidae , Doenças dos Cavalos/epidemiologia , Febre do Nilo Ocidental/veterinária , Vírus do Nilo Ocidental/isolamento & purificação , Animais , Anticorpos Antivirais/sangue , Encefalite Japonesa/epidemiologia , Encefalite Japonesa/virologia , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Doenças dos Cavalos/virologia , Cavalos , Masculino , Paquistão/epidemiologia , Prevalência , Estudos Soroepidemiológicos , Especificidade da Espécie , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/virologia
18.
Colorectal Dis ; 17(2): 111-23, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25393051

RESUMO

AIM: Conventional air insufflation (AI) may cause prolonged abdominal bloating, excessive abdominal pain and discomfort during colonoscopy. Carbon dioxide may be an acceptable alternative to avoid these complications. The object of this study was to evaluate systematically the effectiveness of carbon dioxide insufflation (CI) for colonoscopy compared with AI. METHOD: Randomized controlled trials (RCTs) comparing the effectiveness of CI with that of AI during colonoscopy were retrieved from medical electronic databases and combined analysis was performed using the RevMan statistical package. The combined outcome of dichotomous and continuous variables was expressed as an odds ratio (OR) and standardized mean difference (SMD). RESULTS: Twenty-one RCTs comprising 3607 patients were included in the study. There was statistically significant heterogeneity among included studies. CI showed a significant trend towards reduced procedural pain [SMD -1.34; 95% confidence interval (95% CI) -2.23 to -0.45; z = 2.96; P < 0.003] and also postprocedural pain at 1 h (SMD -1.11; 95% CI -1.83 to -0.38; z = 2.97; P < 0.003), 6 and 24 h (OR 0.44; 95% CI 0.23-0.85; z = 2.44; P < 0.01). CI was associated with faster caecal intubation (SMD -0.20; 95% CI -0.37 to -0.02; z = 2.23; P < 0.03) but the caecal intubation rate was similar (P = 0.59) in both colonic insufflation techniques . CONCLUSION: CI seems to have clinical advantages over AI for colonoscopy with regard to pain during and after the procedure.


Assuntos
Dióxido de Carbono/administração & dosagem , Colonoscopia/métodos , Insuflação/métodos , Complicações Intraoperatórias/epidemiologia , Dor Pós-Operatória/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ar , Ceco/cirurgia , Feminino , Humanos , Insuflação/efeitos adversos , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
20.
BJOG ; 121(7): 793-9; discussion 799, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24628729

RESUMO

BACKGROUND: The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15% Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of hospitalisation periods. There is currently no guideline that supports the use of chewing gum after caesarean sections. OBJECTIVES: To systematically analyse the published randomised controlled trials regarding the effectiveness of chewing gum in preventing POI in women undergoing caesarean sections. SEARCH STRATEGY: Systematic search of medical databases up to March 2013. SELECTION CRITERIA: Randomised controlled trials that reported the role of chewing gum in preventing POI in women undergoing caesarean sections. DATA COLLECTION AND ANALYSIS: Two authors independently identified the relevant studies for inclusion, extracted outcome-related data, and analysed it systematically using REVMAN(®). The combined outcome was expressed as an odds ratio and standardised mean difference. MAIN RESULTS: Seven randomised controlled trials involving 1462 women (728 in the chewing gum group, 734 controls) were systematically analysed. There was significant heterogeneity (χ(2) = 29.02, df = 7; P < 0.0001; I(2) = 76%) among the included trials. Among women undergoing caesarean sections, chewing gum reduced the risk of POI (odds ratio 0.36; 95% confidence interval 0.19-0.69; z = 3.08; P < 0.002) but did not affect duration of hospitalisation (P = 0.32). CONCLUSIONS: Chewing gum for 30-60 minutes at least three times a day appears to be effective in reducing the incidence and consequences of POI following caesarean sections.


Assuntos
Cesárea , Goma de Mascar , Íleus/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Feminino , Humanos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
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