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1.
Space Sci Rev ; 218(1): 4, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35194256

RESUMO

The Emirates Mars Mission (EMM) was launched to Mars in the summer of 2020, and is the first interplanetary spacecraft mission undertaken by the United Arab Emirates (UAE). The mission has multiple programmatic and scientific objectives, including the return of scientifically useful information about Mars. Three science instruments on the mission's Hope Probe will make global remote sensing measurements of the Martian atmosphere from a large low-inclination orbit that will advance our understanding of atmospheric variability on daily and seasonal timescales, as well as vertical atmospheric transport and escape. The mission was conceived and developed rapidly starting in 2014, and had aggressive schedule and cost constraints that drove the design and implementation of a new spacecraft bus. A team of Emirati and American engineers worked across two continents to complete a fully functional and tested spacecraft and bring it to the launchpad in the middle of a global pandemic. EMM is being operated from the UAE and the United States (U.S.), and will make its data freely available.

2.
Eur J Neurol ; 27(8): 1638-1646, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32337811

RESUMO

BACKGROUND AND PURPOSE: Although patient-centredness is considered a key component of high-quality neurological care, it is unclear to what extent it can or should be implemented during the acute phase. Using acute stroke as an example, the aim was to identify critical junctures for patient-centredness along the acute care pathway from the perspectives of patients, relatives and staff. METHODS: A qualitative multi-method study was conducted including 27 non-participant observations and 37 semi-structured interviews with patients, relatives and staff. Junctures were defined as critical when mentioned (as problematic) in two or three information sources (i.e. observations, staff interviews, or patient and relative interviews), as potentially critical when mentioned in one, and as uncritical when not mentioned. RESULTS: Post-procedure communication after thrombectomy, patients' stay at the stroke unit and decision-making around transfer, discharge and rehabilitation were identified as critical junctures for patient-centredness. Arrival at the emergency department and the (thrombectomy) treatment itself were identified as uncritical junctures, whilst history-taking and treatment preparation, the treatment decision and patients' stay at the intensive care unit were identified as potentially critical junctures. CONCLUSIONS: In acute stroke care, patients, relatives and staff prioritize fast over patient-centred decision-making in the most time-critical phases, especially before and during treatment. This is reversed after the procedure, when difficulties arise implementing a patient-centred approach in clinical practice. To improve patient-centredness where it is most needed, clear guidelines and accessible resources are recommended. Future research should investigate whether insights from acute phases of stroke care are applicable to other neurological conditions as well.


Assuntos
Assistência Centrada no Paciente , Acidente Vascular Cerebral , Cuidados Críticos , Humanos , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Acidente Vascular Cerebral/terapia
3.
ISA Trans ; 101: 471-481, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32143850

RESUMO

In this paper, a new backstepping-based nonlinear technique for control of photovoltaic systems in DC islanded microgrids (MGs) is proposed. In contrast to most existing droop/non-droop control strategies that require an exact model of the system including line impedances, loads, other distributed generation units (DGUs) parameters, and even the MG configuration, the proposed method is taking dynamics and uncertainties into account using a designed disturbance observer. Moreover, the proposed method rapidly reaches the reference values and exhibits a more accurate robust performance using local quantities measurement, irrespective of parametric uncertainties, unmodeled dynamics, unknown loads, disturbances, and the number/structure of DGs within the MG. Finally, a low-voltage DC MG is built where the robust performance of the proposed method for different operating conditions including load variation, tracking capability, nonlinear loads, and plug-play of DGs is verified.

4.
Bratisl Lek Listy ; 121(2): 154-158, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32115970

RESUMO

OBJECTIVE: This study aimed to evaluate the effect of Coenzyme Q10 (CoQ10) administration to patients in the early phase of sepsis to determine its effect on the markers of inflammation and the clinical outcomes of septic patients. BACKGROUND: Previous studies showed that CoQ10 levels were decreased in septic patients and worsening of mitochondrial dysfunction was observed. METHODS: In this randomized controlled trial septic patients (n=40) received 100 mg CoQ10 twice a day for seven days added to standard treatment of sepsis. As a primary endpoint levels of Interleukin 6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Glutathione peroxidase and malondialdehyde (MDA) were assessed at baseline, third and 7th day after the intervention. Secondary endpoints included assessment of clinical scores and     in-hospital mortality. RESULTS: There was no difference in baseline inflammatory and oxidative injury markers between the groups. TNF-α and MDA levels decreased significantly in the CoQ10 group on the 7th day of the study (P:0.003 for both). There was a significant difference in the in-hospital mortality in the CoQ10 group compared to the control group (P:0.01). CONCLUSION: These findings suggest that CoQ10 has a positive effect on clinical parameters as well as mitochondrial dysfunction when administered in the early phase of sepsis (Tab. 2, Fig. 1, Ref. 38).


Assuntos
Inflamação , Sepse , Ubiquinona/análogos & derivados , Biomarcadores , Método Duplo-Cego , Humanos , Inflamação/tratamento farmacológico , Malondialdeído , Sepse/tratamento farmacológico , Sepse/imunologia , Ubiquinona/uso terapêutico
5.
Neuroimage Clin ; 24: 101962, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31416017

RESUMO

INTRODUCTION: Atrophy of the spinal cord is known to occur in multiple sclerosis (MS). The mean upper cervical cord area (MUCCA) can be used to measure this atrophy. Currently, several (semi-)automated methods for MUCCA measurement exist, but validation in clinical magnetic resonance (MR) images is lacking. METHODS: Five methods to measure MUCCA (SCT-PropSeg, SCT-DeepSeg, NeuroQLab, Xinapse JIM and ITK-SNAP) were investigated in a predefined upper cervical cord region. First, within-scanner reproducibility and between-scanner robustness were assessed using intra-class correlation coefficient (ICC) and Dice's similarity index (SI) in scan-rescan 3DT1-weighted images (brain, including cervical spine using a head coil) performed on three 3 T MR machines (GE MR750, Philips Ingenuity, Toshiba Vantage Titan) in 21 subjects with MS and 6 healthy controls (dataset A). Second, sensitivity of MUCCA measurement to lesions in the upper cervical cord was assessed with cervical 3D T1-weighted images (3 T GE HDxT using a head-neck-spine coil) in 7 subjects with MS without and 14 subjects with MS with cervical lesions (dataset B), using ICC and SI with manual reference segmentations. RESULTS: In dataset A, MUCCA differed between MR machines (p < 0.001) and methods (p < 0.001) used, but not between scan sessions. With respect to MUCCA values, Xinapse JIM showed the highest within-scanner reproducibility (ICC absolute agreement = 0.995) while Xinapse JIM and SCT-PropSeg showed the highest between-scanner robustness (ICC consistency = 0.981 and 0.976, respectively). Reproducibility of segmentations between scan sessions was highest in Xinapse JIM and SCT-PropSeg segmentations (median SI ≥ 0.921), with a significant main effect of method (p < 0.001), but not of MR machine or subject group. In dataset B, SI with manual outlines did not differ between patients with or without cervical lesions for any of the segmentation methods (p > 0.176). However, there was an effect of method for both volumetric and voxel wise agreement of the segmentations (both p < 0.001). Highest volumetric and voxel wise agreement was obtained with Xinapse JIM (ICC absolute agreement = 0.940 and median SI = 0.962). CONCLUSION: Although MUCCA is highly reproducible within a scanner for each individual measurement method, MUCCA differs between scanners and between methods. Cervical cord lesions do not affect MUCCA measurement performance.


Assuntos
Medula Cervical/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Esclerose Múltipla/diagnóstico por imagem , Neuroimagem/métodos , Adulto , Atrofia/diagnóstico por imagem , Atrofia/patologia , Medula Cervical/patologia , Imagem de Tensor de Difusão/instrumentação , Imagem de Tensor de Difusão/métodos , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/patologia , Neuroimagem/instrumentação , Reprodutibilidade dos Testes , Software
6.
Malays Fam Physician ; 14(3): 28-36, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32175038

RESUMO

BACKGROUND AND OBJECTIVE: A successful family physician program needs ongoing and full cooperation between people and the organizations in charge. Ensuring the satisfaction of family physicians through improvement of the underlying factors could motivate them to provide high-quality services. This study aimed to determine the family physicians' satisfaction level with the factors affecting the dynamism of the urban family physicians program in the Fars and Mazandaran provinces of Iran. METHOD: This cross-sectional study was carried out in urban areas in the Fars and Mazandaran provinces in 2016. The sample consisted of 143 and 96 family physicians, respectively, in Fars and Mazandaran provinces and was selected using the stratified random sampling method. Data were collected using a questionnaire and included both sociodemographic variables and factors assessing the family physicians' satisfaction levels. Each factor was scored based on a Likert scale from 0 to 5 points, and any satisfaction level higher than 3 out of 5 was equated with being satisfied. RESULTS: The overall satisfaction levels among family physicians in Fars and Mazandaran provinces were 2.77±0.53 and 3.37±0.56, respectively, revealing a statistically significant difference between provinces (p<0.001). Moreover, the mean satisfaction scores for the performances of healthcare centers, insurance companies, specialists, healthcare workers, and the population covered were 2.78±0.1, 2.54±0.9, 2.52±0.8, 4.24±0.07, and 2.96±0.8, respectively. The family physicians' levels of satisfaction were significantly correlated with population size (p=0.02, r= -0.106), and willingness to stay in an urban family physician program (p<0.001, r= +0.398). CONCLUSION: This study revealed that family physicians exhibited a low level of satisfaction with the urban family physician program. Given the direct association between family physicians' satisfaction levels and retention in the program, it is expected that family physicians will no longer stay in the program, and it is likely to have subsequent executive problems.

7.
AJNR Am J Neuroradiol ; 39(1): 46-53, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29191870

RESUMO

BACKGROUND AND PURPOSE: Precise in vivo measurement of deep GM volume change is a highly demanded prerequisite for an adequate evaluation of disease progression and new treatments. However, quantitative data on the reproducibility of deep GM structure volumetry are not yet available. In this paper we aim to investigate this reproducibility using a large multicenter dataset. MATERIALS AND METHODS: We have assessed the reproducibility of 2 automated segmentation software packages (FreeSurfer and the FMRIB Integrated Registration and Segmentation Tool) by quantifying the volume changes of deep GM structures by using back-to-back MR imaging scans from the Alzheimer Disease Neuroimaging Initiative's multicenter dataset. Five hundred sixty-two subjects with scans at baseline and 1 year were included. Reproducibility was investigated in the bilateral caudate nucleus, putamen, amygdala, globus pallidus, and thalamus by carrying out descriptives as well as multilevel and variance component analysis. RESULTS: Median absolute back-to-back differences varied between GM structures, ranging from 59.6-156.4 µL for volume change, and 1.26%-8.63% for percentage volume change. FreeSurfer had a better performance for the outcome of longitudinal volume change for the bilateral amygdala, putamen, left caudate nucleus (P < .005), and right thalamus (P < .001). For longitudinal percentage volume change, Freesurfer performed better for the left amygdala, bilateral caudate nucleus, and left putamen (P < .001). Smaller limits of agreement were found for FreeSurfer for both outcomes for all GM structures except the globus pallidus. Our results showed that back-to-back differences in 1-year percentage volume change were approximately 1.5-3.5 times larger than the mean measured 1-year volume change of those structures. CONCLUSIONS: Longitudinal deep GM atrophy measures should be interpreted with caution. Furthermore, deep GM atrophy measurement techniques require substantially improved reproducibility, specifically when aiming for personalized medicine.


Assuntos
Doença de Alzheimer/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Substância Cinzenta/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Neuroimagem/métodos , Adulto , Doença de Alzheimer/patologia , Atrofia/patologia , Encéfalo/patologia , Conjuntos de Dados como Assunto , Progressão da Doença , Feminino , Substância Cinzenta/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Software
8.
Cell Mol Biol (Noisy-le-grand) ; 63(2): 76-78, 2017 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-28364796

RESUMO

High quality DNA is essential for molecular research. Secondary metabolites can affect the quantity and quality DNA. In current research two DNA isolation methods including CTAB and Delaporta (protocols 1 & 2 respectively) were applied in three leave samples from Cotinus coggygria, Citrus sinensis and Genus juglans that their leaves are rich of secondary metabolites. We successfully isolated DNA from C. coggygria, C. sinensis and Genus Juglans using the two protocols described above. Good quality DNA was isolated from C. coggygria, C. sinensis and Genus Juglans using protocol 1, while protocol 2 failed to produce usable DNA from these sources. The highest amount of DNA (1.3-1.6) was obtained from them using protocol 1. As we discovered, procedure 1 may work better for plants with secondary metabolites.


Assuntos
Anacardiaceae/genética , Citrus sinensis/genética , DNA de Plantas/isolamento & purificação , Juglans/genética , Folhas de Planta/genética , DNA de Plantas/análise , Eletroforese em Gel de Ágar , Biologia Molecular/métodos , Polimorfismo de Fragmento de Restrição , Reprodutibilidade dos Testes , Espectrofotometria Ultravioleta
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2016: 3910-3913, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28269140

RESUMO

Automatic parasite segmentation in fluorescent images is of high importance as it serves as an easier and faster tool for detecting and counting parasites in each focus. In this paper we present a hybrid segmentation for the Promastigote form of Leishmania parasites in Indirect Immunofluorescence (IIF) images, combining edge and region-based techniques through the morphological algorithm of watershed. The proposed approach deals first with a pre-processing step to correct illumination non-uniformities in the fluorescence Leishmania-infected images before performing the initial segmentation by means of the watershed algorithm. A merging step using joint region homogeneity and edge integrity criteria is then applied to improve the segmentation results. Segmentation tests of 1438 parasites from 40 collected IIF images illustrate the efficiency of our approach.


Assuntos
Técnica Indireta de Fluorescência para Anticorpo , Leishmania/citologia , Leishmaniose/parasitologia , Algoritmos , Animais , Análise por Conglomerados , Cães , Corantes Fluorescentes , Processamento de Imagem Assistida por Computador , Leishmaniose/diagnóstico , Leishmaniose/veterinária
10.
Eur J Vasc Endovasc Surg ; 48(6): 626-32, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25240903

RESUMO

BACKGROUND: In primary and secondary prevention, statins significantly reduce cardiovascular and cerebrovascular events. Pre-interventional statin medication shows a benefit in carotid artery stenosis patients treated with endarterectomy; however, there are few data available for patients treated with stent-angioplasty. The aim of this study was to investigate whether pre-interventional statin therapy is associated with decreased peri-interventional risk of stroke, myocardial infarction, and mortality in patients undergoing stent-angioplasty for internal carotid stenosis. METHODS: Data for 344 consecutively documented patients with internal carotid artery stenosis treated with stent-angioplasty in the years 2002-2012 at the same stroke center were collected in a prospectively defined database. Risk factors, medication, and indication for therapy were documented. Univariate and multivariate analysis was performed to investigate independent reduction of peri-interventional stroke, myocardial infarction, or death by statin medication prior to stent-angioplasty. RESULTS: The median age was 70 years (p25: 63, p75: 76), 75.5% of patients were male, and the median stenosis was 85% according to ECST criteria (p25: 80%, p75: 90%). 20.1% of patients had asymptomatic stenoses, and 60.2% had statin medication before stenting. As per multivariate analysis, pre-interventional statin medication was a predictor for significant peri-interventional risk reduction regarding primary endpoint ischemic stroke, myocardial infarction (MI), or death (odds ratio (OR) 0.31, p = .006). Statins also had a significant protective effect in secondary endpoint ischemic stroke, intracranial bleeding or death (OR 0.39, p = .014), and ischemic stroke or myocardial infarction (OR 0.20; p = .002). CONCLUSIONS: This study shows that pre-interventional statin medication has a protective effect against peri-interventional stroke, MI, or death in patients with internal carotid artery stenosis treated with stent-angioplasty. Accordingly, statins could be considered as a standard pre-interventional medical therapy in carotid stenting.


Assuntos
Angioplastia/instrumentação , Estenose das Carótidas/terapia , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Infarto do Miocárdio/prevenção & controle , Stents , Acidente Vascular Cerebral/prevenção & controle , Adulto , Idoso , Angioplastia/efeitos adversos , Angioplastia/mortalidade , Estenose das Carótidas/diagnóstico , Estenose das Carótidas/mortalidade , Distribuição de Qui-Quadrado , Bases de Dados Factuais , Feminino , Alemanha , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/etiologia , Razão de Chances , Fatores de Proteção , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologia , Fatores de Tempo , Resultado do Tratamento
11.
Clin Radiol ; 69(10): 1062-5, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25037147

RESUMO

AIM: To evaluate the clinical features of zinc phosphide poisoning and to investigate whether outcome could be prognosticated based on abdominal radiography on presentation. MATERIALS AND METHODS: All zinc phosphide-poisoned patients who were referred to Loghman-Hakim Hospital between March 2011 and September 2013 were retrospectively reviewed. Data regarding patients' demographic characteristics, characteristics of the poisoning, abdominal radiography results, and patients' outcome were recorded. RESULTS: In 102 patients, the most common presenting signs/symptoms were nausea and vomiting (60%). Four patients died and another seven had developed complications during their hospitalization (metabolic acidosis, liver abnormalities, or acute renal failure). Nineteen patients had radio-opaque abdominal radiographs, nine of whom had died or developed complications (p = 0.001). Plain abdominal radiography had a sensitivity and specificity of 81% and 89% in predicting the patients' death or further development of complications. The positive and negative predictive values were 47% and 97%, respectively. CONCLUSION: Plain abdominal radiography is a very good tool for prognostication in patients with zinc phosphide poisoning. Immediate abdominal radiography can help stratify patients into high- or low-risk groups and determine treatment strategies.


Assuntos
Fosfinas/intoxicação , Intoxicação/diagnóstico por imagem , Radiografia Abdominal/métodos , Rodenticidas/intoxicação , Compostos de Zinco/intoxicação , Acidose/induzido quimicamente , Acidose/mortalidade , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/mortalidade , Adolescente , Adulto , Idoso , Doença Hepática Induzida por Substâncias e Drogas/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Intoxicação/complicações , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Resultado do Tratamento , Adulto Jovem
12.
Neuroradiology ; 56(5): 389-95, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24599219

RESUMO

INTRODUCTION: This study was aimed to assess clinical safety and efficacy of the LVIS Jr. microstent in stent-assisted coil embolization of wide-neck intracranial aneurysms. METHODS: IRB approved single-center interventional clinical study in 22 patients (10 females, 12 males, mean age 55, age range 33-74 years) for the endovascular treatment of wide-neck aneurysms. After obtaining informed consent, patients were included according to the following criteria: aneurysm fundus-to-neck ratio < 2 or neck diameter > 4 mm, and a parent vessel diameter of ≤3.5 mm. Primary end point for clinical safety was absence of death, absence of major or minor stroke, and absence of transient ischemic attack. Primary end point for treatment efficacy was complete angiographic occlusion according to the Raymond-Roy Occlusion Classification (RROC) immediately after the procedure and at follow-up after 3 and 6 months on magnetic resonance imaging (MRI). RESULTS: In 20/22 (91 %) of patients, the primary end point of safety was reached; in the two remaining patients, transient ischemic attack, but no permanent deficit was observed; in 16/22 (73 %), efficient occlusion (RROC1) was reached, and in 6/22 (27 %), a residual neck remained (RROC2). Single [seven with antegrade, two in crossover configuration, and four with "first-balloon-then-stent" (FBTS) technique] or double-stent (eight patients with Y configuration and one patient with X configuration) deployment was technically successful in all cases. CONCLUSION: Deployment of the LVIS Jr. microstent in various single- or double-stent configurations is safe and effective to assist the treatment of intracranial wide-neck aneurysms.


Assuntos
Embolização Terapêutica/instrumentação , Aneurisma Intracraniano/terapia , Stents , Adulto , Idoso , Embolização Terapêutica/efeitos adversos , Feminino , Humanos , Aneurisma Intracraniano/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
14.
Artigo em Inglês | MEDLINE | ID: mdl-25571049

RESUMO

This paper describes the first steps for the automation of the serum titration process. In fact, this process requires an Indirect Immunofluorescence (IIF) diagnosis automation. We deal with the initial phase that represents the fluorescence images segmentation. Our approach consists of three principle stages: (1) a color based segmentation which aims at extracting the fluorescent foreground based on k-means clustering, (2) the segmentation of the fluorescent clustered image, and (3) a region-based feature segmentation, intended to remove the fluorescent noisy regions and to locate fluorescent parasites. We evaluated the proposed method on 40 IIF images. Experimental results show that such a method provides reliable and robust automatic segmentation of fluorescent Promastigote parasite.


Assuntos
Técnica Indireta de Fluorescência para Anticorpo/métodos , Processamento de Imagem Assistida por Computador , Leishmaniose/parasitologia , Parasitos/citologia , Algoritmos , Animais , Automação , Análise por Conglomerados , Cães , Lógica Fuzzy
15.
Nervenarzt ; 84(12): 1504-7, 2013 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-24337619

RESUMO

Asymptomatic carotid artery stenosis may be treated with carotid endarterectomy (CEA), carotid artery stenting (CAS) or with best medical treatment (BMT) only. Definitive and evidence-based treatment recommendations for one of these options are currently not possible. Studies showing an advantage of CEA over BMT alone do not meet current standards from a pharmacological point of view. On the other hand, more recent data point to a further stroke risk reduction using BMT according to current standards. Studies on carotid artery stenting as a third alternative treatment are partially insufficient, especially when comparing CAS with BMT. Initiated in 2009, the randomized, controlled, multicenter SPACE-2 trial is intended to answer the question about the best treatment option of asymptomatic carotid artery stenosis; however, to increase recruitment rates as a condition for the successful completion of this important study, the trial design had to be modified.


Assuntos
Fármacos Cardiovasculares/uso terapêutico , Estenose das Carótidas/terapia , Endarterectomia das Carótidas , Comportamento de Redução do Risco , Stents , Idoso , Idoso de 80 Anos ou mais , Estenose das Carótidas/diagnóstico , Estenose das Carótidas/mortalidade , Causas de Morte , Europa (Continente) , Medicina Baseada em Evidências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Recidiva , Fatores de Risco , Taxa de Sobrevida
16.
Am J Transplant ; 13(12): 3210-4, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24266971

RESUMO

The aim of this cross-sectional study was to assess the health status and quality of life (QOL) of paid unrelated versus related living kidney donors postdonation at Shiraz Transplant Center in Iran. We invited all donors (n = 580, 347 paid unrelated, 233 related) who underwent donor nephrectomy at our center from 2004 to 2010 to participate in a health survey and physical examination. Of 580 donors, 144 consented to participate; participation of paid unrelated donors was significantly lower than related (52/347 vs. 92/233; p < 0.001). Participants underwent a complete physical examination, QOL assessment (using a 36-item short form health survey [SF-36] questionnaire) and laboratory work-up. The paid unrelated donors compared with related donors were younger (34.2 ± 7.2 vs. 40.7 ± 9.7 years, p < 0.001), had shorter time since donation (2.9 ± 1.6 vs. 3.8 ± 2 years, p = 0.004), had higher estimated GFR (72.6 ± 22 vs. 63.8 ± 15.3 mL/min/1.73 m(2), p = 0.006) and had a higher percentage of patients with microalbuminuria (35% vs. 0%, p < 0.001). Additionally, general health and social functioning scores among paid unrelated donors were significantly lower (p < 0.001 and p = 0.02, respectively) than related donors. Other SF-36 scores, although lower in paid unrelated donors, did not reach statistical significance. Iranian paid unrelated donors have lower QOL and higher incidence of microalbuminuria compared with related donors.


Assuntos
Nível de Saúde , Transplante de Rim/métodos , Doadores Vivos/estatística & dados numéricos , Qualidade de Vida , Adulto , Albuminúria/diagnóstico , Estudos Transversais , Feminino , Taxa de Filtração Glomerular , Humanos , Irã (Geográfico) , Transplante de Rim/economia , Transplante de Rim/psicologia , Doadores Vivos/psicologia , Masculino , Pessoa de Meia-Idade , Nefrectomia/economia , Proteinúria , Insuficiência Renal/terapia
17.
Occup Med (Lond) ; 62(7): 578-80, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22949585

RESUMO

BACKGROUND: Chronic carbon black exposure in the work environment can cause both respiratory symptoms and changes in lung function. There is limited information on the respiratory effects of acute exposure to carbon black. METHODS: Case report and literature review. RESULTS: A 44-year-old man had intense exposure to carbon black when his crane ran into a truck with a trailer filled with carbon black. One week after this exposure he developed shortness of breath and cough with sputum production. These symptoms persisted and increased in intensity. Physical examination revealed expiratory wheezes when in the supine position. Pulmonary function tests revealed a mild obstructive ventilatory defect with a reduced FEV(1)/FVC ratio. The patient responded to treatment with fluticasone and salmeterol with a reduction in symptoms and improvement in his spirometry to a normal range. CONCLUSIONS: Acute exposure to carbon black can cause respiratory symptoms and an obstructive ventilatory defect. This presentation suggests a small airway disease which improved over time with inhaled steroids and long-acting beta-agonists. Patients with intense carbon black exposure following industrial accidents will need frequent evaluation to manage any related respiratory tract injury.


Assuntos
Albuterol/análogos & derivados , Androstadienos/uso terapêutico , Broncodilatadores/uso terapêutico , Doenças Profissionais/tratamento farmacológico , Exposição Ocupacional/efeitos adversos , Transtornos Respiratórios/tratamento farmacológico , Fuligem/efeitos adversos , Acidentes de Trabalho , Adulto , Albuterol/uso terapêutico , Fluticasona , Volume Expiratório Forçado , Humanos , Masculino , Veículos Automotores , Doenças Profissionais/induzido quimicamente , Doenças Profissionais/fisiopatologia , Transtornos Respiratórios/induzido quimicamente , Transtornos Respiratórios/fisiopatologia , Testes de Função Respiratória , Xinafoato de Salmeterol , Resultado do Tratamento , Estados Unidos
18.
J Mycol Med ; 22(4): 301-7, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23518163

RESUMO

OBJECTIVES: Candida colonization is an important precursor for candidiasis. However, there is little information about its risk factors in critically ill patients. We aimed to identify risk factors for oropharyngeal Candida colonization in critically ill patients. PATIENTS, MATERIALS AND METHODS: This is a prospective observational study of 110 patients admitted to a medical intensive care unit (MICU). Oropharyngeal swabs were obtained on day one and day four. Characteristics of patients colonized with Candida species at admission or not colonized were compared. In addition, patients becoming colonized during their ICU stay were compared to patients who did not. RESULTS: Independent risk factors for a positive Candida sample at the time of admission were: a history of proton pump inhibitor (PPI) use before admission (OR: 5.24, 95% CI: 1.36-20.19), the presence of diabetes mellitus (OR: 2.84, 95%CI: 1.02-7.92) and a lower BMI (OR: 0.9, 95% CI: 0.84-0.97). Chronic kidney disease was associated with a decreased frequency of Candida colonization (OR: 0.26, 95% CI: 0.01-0.46). No independent risk factors could be identified for patients who gained Candida during their ICU hospitalization. Patients with Candida colonization frequently had abnormal oral bacterial flora. CONCLUSIONS: Diabetes mellitus, PPI use and a lower BMI are risk factors for Candida colonization in critically ill patients being admitted to the MICU.


Assuntos
Candida/isolamento & purificação , Unidades de Terapia Intensiva , Orofaringe/microbiologia , APACHE , Adulto , Índice de Massa Corporal , Comorbidade , Estado Terminal , Infecção Hospitalar/epidemiologia , Diabetes Mellitus/epidemiologia , Suscetibilidade a Doenças , Feminino , Humanos , Hospedeiro Imunocomprometido , Nefropatias/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Boca/microbiologia , Estudos Prospectivos , Inibidores da Bomba de Prótons/efeitos adversos , Inibidores da Bomba de Prótons/uso terapêutico , Fatores de Risco
19.
Internist (Berl) ; 52(11): 1310, 1312-6, 2011 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-21922224

RESUMO

Ischemic stroke is a medical emergency and must be treated as quickly as possible according to the "time-is-brain" concept. At present, intravenous administration of recombinant tissue plasminogen activator (rt-PA) within the first 4.5 h from stroke onset is the only effective treatment but is currently still only approved within the first 3 h from onset of symptoms (0.9 mg/kg body weight, maximum dose 90 mg, 10% of the cumulative dose as bolus, remaining 90% subsequently infused within 60 min). The therapeutic effect of magnetic resonance imaging (MRI) based thrombolytic therapy beyond the 4.5 h time window remains to be proven. Proximal occlusions of the middle cerebral artery can be treated successfully within the first 6 h from stroke onset by catheter-based intra-arterial administration of plasminogen activator leading to a significant improvement of outcome. Acute basilar artery occlusion should be treated in specialized centres using intra-arterial application of urokinase, rt-PA or mechanical recanalization but intravenous thrombolysis beyond the 3 h window is an acceptable alternative.


Assuntos
Anticoagulantes/uso terapêutico , Cateterismo Periférico/métodos , Fibrinolíticos/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/prevenção & controle , Terapia Trombolítica/métodos , Antígeno Polipeptídico Tecidual/uso terapêutico , Cateterismo Periférico/instrumentação , Humanos
20.
Pharm Biol ; 49(9): 920-6, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21592001

RESUMO

CONTEXT: Tanacetum parthenium Schultz Bip. (Asteraceae) is an aromatic perennial plant, widely distributed in the northern hemisphere. This species traditionally has been used in insecticides, cosmetics, balsams, dyes, medicines and preservatives. MATERIAL AND METHODS: The essential oil of T. parthenium was obtained by hydrodistillation in three developmental stages and analyzed by gas chromatography-mass spectrometry. The antibacterial activity of the oils was investigated against four Gram-positive and four Gram-negative bacteria. The oil was tested for cytotoxicity against THP-1 cells using the Trypan blue assay. RESULTS: Twenty-nine components were identified in the essential oil; the highest amount was extracted at the flowering stage. The main component, in the flowering stage, was camphor (18.94%) and other major components were bornyl acetate (18.35%), camphene (13.74%), bornyl isovalerate (3.15%), borneol (10.93%), juniper camphor (6.23%) and ß-eudesmol (2.65%). Minimum inhibitory concentration of essential oil was evaluated from 4 µL mL(-1) against Staphylococcus subtilis to 38 µL mL(-1) against Entrobacter aerogenes. Toxicity assay showed that the oil has no significant toxicity at 5-15% v/v concentrations on THP-1 cells. DISCUSSION AND CONCLUSION: This study demonstrates the occurrence of camphor/bornyl acetate chemotype of T. parthenium in western regions of Iran. The finding showed also the studied oils have relatively good antibacterial activity without significant toxicity, thus have great potentiality to be used as natural health product.


Assuntos
Antibacterianos/farmacologia , Óleos Voláteis/farmacologia , Preparações de Plantas/farmacologia , Tanacetum parthenium/química , Antibacterianos/química , Antibacterianos/uso terapêutico , Antibacterianos/toxicidade , Cânfora/análise , Cânfora/química , Cânfora/farmacologia , Cânfora/toxicidade , Linhagem Celular Tumoral , Bactérias Gram-Negativas/efeitos dos fármacos , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Bactérias Gram-Positivas/efeitos dos fármacos , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Humanos , Irã (Geográfico) , Leucemia Monocítica Aguda/tratamento farmacológico , Testes de Sensibilidade Microbiana , Óleos Voláteis/química , Óleos Voláteis/uso terapêutico , Óleos Voláteis/toxicidade , Fitoterapia , Componentes Aéreos da Planta/química , Componentes Aéreos da Planta/metabolismo , Preparações de Plantas/análise , Preparações de Plantas/química , Preparações de Plantas/toxicidade , Tanacetum parthenium/crescimento & desenvolvimento , Azul Tripano/metabolismo
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