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1.
Menopause ; 31(4): 310-319, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38377450

RESUMO

OBJECTIVE: The menopausal transition is accompanied by transient symptoms that have been linked to subclinical cardiovascular disease (CVD); CVD has also been linked to air pollution. Physical activity (PA) reduces CVD, improves body composition, and can reduce menopausal symptoms. The purpose of this study was to assess the links between PA and menopausal symptoms and whether obesity, fitness, and air pollution status play a role in this relationship. METHODS: Women (40-60 y; N = 243; mean [SD] age, 47.8 [5.6] y) from areas with high versus low air pollution enrolled in the Healthy Aging in Industrial Environment Program 4 prospective cohort study completed psychological, cardiorespiratory fitness, body composition, and menopausal status screening followed by a 14-day prospective assessment of menopausal symptoms (Menopause Rating Scale) using a mobile application. Daily PA was assessed objectively across 14 days via Fitbit Charge 3 monitor. General linear mixed models were conducted and controlled for age, menopausal status, day in the study, wear time, and neuroticism. RESULTS: Peri/postmenopausal women ( ß = 0.43, P < 0.001) and those residing in a high-air-pollution environment ( ß = 0.45, P < 0.05) reported more somatovegetative symptoms. Hot flashes alone were associated with peri/postmenopausal status ( ß = 0.45, P < 0.001), and for women residing in a high-air-pollution environment, lower reporting of hot flashes was observed on days when a woman was more physically active than usual ( ß = -0.15, P < 0.001). No associations were found for cardiorespiratory fitness and visceral fat with any of the symptoms. CONCLUSIONS: PA may enhance resilience to hot flashes, especially when residing in high-air-pollution environments where we also observed higher reporting of somatovegetative menopausal symptoms.


Assuntos
Poluição do Ar , Doenças Cardiovasculares , Feminino , Humanos , Pessoa de Meia-Idade , Fogachos/psicologia , Estudos Prospectivos , Menopausa/psicologia , Exercício Físico , Obesidade , Poluição do Ar/efeitos adversos
2.
Med Sci Sports Exerc ; 56(6): 1026-1035, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38233979

RESUMO

PURPOSE: The purpose of this study was to determine whether regular running distance and biomechanics are related to medial central femur cartilage (MCFC) structure. METHODS: The cross-sectional study sample consisted of 1164 runners and nonrunners aged 18-65 yr. Participants completed questionnaires on physical activity and their running history. We performed quantitative magnetic resonance imaging of knee cartilage-T2 relaxation time (T2) mapping (high T2 indicates cartilage degeneration)-and a running biomechanical analysis using a three-dimensional motion capture system. A 14-d monitoring of the physical activity was conducted. RESULTS: Those aged 35-49 yr were at 84% higher odds of having MCFC T2 in the highest level (85th percentile, P < 0.05) compared with youngest adults indicating that MCFC structures may be altered with aging. Being male was associated with 34% lower odds of having T2 at the highest level ( P < 0.05) compared with females. Nonrunners and runners with the highest weekly running distance were more likely to have a high T2 compared with runners with running distance of 6-20 km·wk -1 ( P < 0.05). In addition, the maximal knee internal adduction moment was associated with a 19% lower odds of having T2 at the highest level ( P < 0.05). CONCLUSIONS: Females compared with males and a middle-aged cohort compared with the younger cohort seemed to be associated with the degeneration of MCFC structures. Runners who ran 6-20 km·wk -1 were associated with a higher quality of their MCFC compared with highly active individuals and nonrunners. Knee frontal plane biomechanics was related to MCFC structure indicating a possibility of modifying the medial knee collagen fibril network through regular running.


Assuntos
Cartilagem Articular , Articulação do Joelho , Imageamento por Ressonância Magnética , Corrida , Humanos , Corrida/fisiologia , Masculino , Feminino , Estudos Transversais , Adulto , Articulação do Joelho/fisiologia , Articulação do Joelho/diagnóstico por imagem , Pessoa de Meia-Idade , Cartilagem Articular/fisiologia , Cartilagem Articular/anatomia & histologia , Cartilagem Articular/diagnóstico por imagem , Fenômenos Biomecânicos , Adulto Jovem , Adolescente , Idoso , Fatores Etários , Fatores Sexuais , Fêmur/fisiologia , Fêmur/anatomia & histologia , Fêmur/diagnóstico por imagem
3.
Sleep Med ; 106: 69-77, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37054557

RESUMO

Heart rate variability (HRV) is an important marker of cardiac autonomic regulation and health. We examined the influence of sleep duration and sex on HRV in younger and middle-aged adults. Cross-sectional data (888 participants, 44% women) were analyzed from Program 4 of the Healthy Aging in Industrial Environment study (HAIE). Sleep duration was measured across 14 days using Fitbit Charge monitors. Short-term EKG recordings were used to evaluate HRV in the time (RMSSD) and frequency domains (low frequency (LF) and high frequency (HF) power). Regression analysis showed age was associated with lower HRV across all HRV variables (all P < 0.001). Sex was a significant predictor for LF (ß = 0.52) and HF (ß = 0.54; both P < 0.001) in normalized units. Similarly, sleep duration was only associated with HF in normalized units (ß = 0.06, P = 0.04). To explore this finding further, participants within each sex were separated into groups based on age (<40 and ≥ 40y) and adequate sleep duration (<7 and ≥7 h). Middle-aged women with sleep durations <7 h, but not ≥7 h, had lower HRV than younger women after adjusting for medications, respiratory frequency, and cardiorespiratory fitness (peak VO2). Middle-aged women with sleep durations <7 h also had lower RMSSD (33 ± 2 vs. 41±4 ms, P = 0.04), HF power (5.6 ± 0.1 vs. 6.0 ± 0.1 log ms2, P = 0.04), and HF in normalized units (39 ± 1 vs. 48 ± 2, P = 0.01) than middle-aged women with sleep durations ≥7 h. In contrast, middle-aged men irrespective of sleep duration had lower HRV than younger men. These results suggest that adequate sleep duration may positively influence HRV in middle-aged women but not men.


Assuntos
Envelhecimento Saudável , Duração do Sono , Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Masculino , Frequência Cardíaca/fisiologia , Estudos Transversais , Meio Ambiente
4.
Metabolites ; 12(6)2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35736500

RESUMO

Long-chain polyunsaturated fatty acids (LC-PUFAs) play important roles in human health, from controlling inflammation to lipid and glucose homeostasis. In our previous study, which employed a cluster analysis of a plasma fatty acid (FA) pattern, we identified two clusters of metabolic syndrome (MetS) independent of clinical and biochemical parameters within the whole study group (controls together with metabolic syndrome (MetS) patients). FA desaturase (FADS) genes are the key regulators of LC-PUFA metabolism. The aim of this study was to analyze associations between FADS polymorphisms and clusters of MetS. The study group consisted of 188 controls and 166 patients with MetS. The first cluster contained 71 controls (CON1) and 109 MetS patients (MetS1). The second cluster consisted of 117 controls (CON2) and 57 MetS patients (MetS2). In comparison with MetS2, cluster MetS1 displayed a more adverse risk profile. Cluster CON1 had, in comparison with CON2, higher body weight and increased triacylglycerol levels (p < 0.05). We found that the FADS rs174537 (p < 0.001), rs174570 (p < 0.01), and rs174602 (p < 0.05) polymorphisms along with two inferred haplotypes had statistically significant genotype associations with the splitting of MetS into MetS1 and MetS2. Conversely, we observed no significant differences in the distribution of FADS polymorphisms between MetS and CON subjects, or between CON1 and CON2. These associations between FADS polymorphisms and two clusters of MetS (differing in waist circumference, HOMA-IR, lipolysis, and oxidative stress) implicate the important influence of genetic factors on the phenotypic manifestation of MetS.

5.
Resuscitation ; 169: 214-219, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34678332

RESUMO

BACKGROUND: We performed a retrospective analysis of our earlier study on cerebral oxygenation monitoring by jugular venous oximetry (SjvO2) in patients of out-of-hospital cardiac arrest (OHCA). The study was focused on high SjvO2 values (≥75%) and their association with neurological outcomes and serum neuron-specific enolase (NSE) concentration. METHOD: Forty OHCA patients were divided into (i) high (Group I), (ii) normal (Group II), and (iii) low (Group III) SjvO2, with the mean SjvO2 ≥ 75%, 55-74% and <55% respectively. The neurological outcome was evaluated using the Cerebral Performance Category scale (CPC) on the 90th day after cardiac arrest (post-CA). NSE concentration was determined after ICU admission and then at 24, 48, and 72 hours (h) post-CA. RESULTS: High mean SjvO2 occurred in 67% of patients, while no patients had low mean SjvO2. The unfavourable outcome was significantly more common in Group I than Group II (74% versus 23%, p < 0.01). Group I patients had significantly higher median NSE than Group II at 48 and 72 h post-CA. A positive correlation was found between SjvO2 and PaCO2. Each 1 kPa increase in CO2 led to an increase of SjvO2 by 2.2 %+/-0.66 (p < 0.01) in group I and by 5.7%+/-1.36 (p < 0.0001) in group II. There was no correlation between SjvO2 and MAP or SjvO2 and PaO2. CONCLUSION: High mean SjvO2 are often associated with unfavourable outcomes and high NSE at 48 and 72 hours post-CA. Not only low but also high SjvO2 values may require therapeutic intervention.


Assuntos
Parada Cardíaca Extra-Hospitalar , Oxigênio , Humanos , Veias Jugulares , Parada Cardíaca Extra-Hospitalar/terapia , Oximetria , Saturação de Oxigênio , Estudos Retrospectivos
6.
Insects ; 12(6)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34063796

RESUMO

Understanding the impact of the changing proportion of land-use patterns on species diversity is a critical issue in conservation biology, and odonates are good bioindicators of these environmental changes. Some freshwater ecosystems that have been modified due to human activities can serve as important secondary habitats for odonate assemblages; however, the majority of studies addressing the value of secondary habitats in industrial and urban areas for adult dragonfly diversity have been limited to the local scale, and the value of such habitats for gamma diversity is still unclear. The aim of this study was to determine the relationship between human transformations of land use/land cover and dragonfly diversity. We interpolated the information based on dragonfly occurrence per grid cell and land cover data, indicating naturalness and degradation in 677 grid cells in the Czech Republic. Species richness did not correspond to habitat naturalness, but the occurrence of endangered species was significantly positively correlated with increasing naturalness; thus, habitat degradation and/or the level of naturalness significantly affected species composition, while species richness remained unchanged. Threatened species that occur predominantly in natural areas and threatened species with a dominant occurrence in degraded squares were also separated, which indicated that the conservation of the latter should be prioritised.

7.
Artif Organs ; 45(8): 881-892, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33534922

RESUMO

Despite increasing clinical experience with extracorporeal membrane oxygenation (ECMO), its optimal indications remain unclear. Here, we externally evaluated all currently available ECMO survival-predicting scoring systems and the APACHE II score in subjects undergoing veno-venous ECMO (VV ECMO) support due to acute respiratory distress syndrome (ARDS) with influenza (IVA) and non-influenza (n-IVA) etiologies. Our aim was to find the best scoring system for influenza A ARDS ECMO success prediction. Retrospective data were analyzed to assess the abilities of the PRESERVE, RESP, PRESET, ECMOnet, Roch, and APACHE II scores to predict patient outcome. Patients treated with veno-venous ECMO support for ARDS were divided into two groups: IVA and n-IVA etiologies. Parameters collected within 24 hours before ECMO initiation were used to calculate PRESERVE, RESP, PRESET, ECMOnet, Roch, and APACHE II scores. Compared to the IVA group, the n-IVA group exhibited significantly higher ICU, 28-day, and 6-month mortality (P = .043, .034, and .047, respectively). Regarding ECMO support success predictions, the area under the receiver operating characteristic curve (AUC) was 0.62 for PRESERVE, 0.44 for RESP, 0.57 for PRESET, and 0.67 for ECMOnet, and 0.62 for Roch calculated for all subjects according to the original papers. In the IVA group, APACHE II had the best predictive value for ICU, hospital, 28-day, and 6-month mortality (AUC values of 0.73, 0.73, 0.70, and 0.73, respectively). In the n-IVA group, APACHE II was the best predictor of survival in the ICU and hospital (AUC 0.54 and 0.57, respectively). From all possible ECMO survival scoring systems, the APACHE II score had the best predictive value for VV ECMO subjects with ARDS caused by influenza A-related pneumonia with a cut-off value of about 32 points.


Assuntos
Oxigenação por Membrana Extracorpórea , Influenza Humana/terapia , Influenza Humana/virologia , Gravidade do Paciente , Síndrome do Desconforto Respiratório/terapia , Síndrome do Desconforto Respiratório/virologia , APACHE , Adulto , República Tcheca , Feminino , Mortalidade Hospitalar , Humanos , Influenza Humana/mortalidade , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Síndrome do Desconforto Respiratório/mortalidade , Estudos Retrospectivos , Análise de Sobrevida
8.
PLoS One ; 14(1): e0210370, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30625219

RESUMO

Citizen science and data collected from various volunteers have an interesting potential in aiding the understanding of many biological and ecological processes. We describe a mobile application that allows the public to map and report occurrences of the odonata species (dragonflies and damselflies) found in the Czech Republic. The application also helps in species classification based on observation details such as date, GPS coordinates, and the altitude, biotope, suborder, and colour. Dragonfly Hunter CZ is a free Android application built on the open-source framework NativeScript using the JavaScript programming language which is now fully available on Google Play. The server side is powered by Apache Server with PHP and MariaDB SQL database. A mobile application is a fast and accurate way to obtain data pertaining to the odonata species, which can be used after expert verification for ecological studies and conservation basis like Red Lists and policy instruments. We expect it to be effective in encouraging Citizen Science and in promoting the proactive reporting of odonates. It can also be extended to the reporting and monitoring of other plant and animal species.


Assuntos
Aplicativos Móveis , Odonatos , Altitude , Animais , Biodiversidade , República Tcheca , Ecossistema , Sistemas Inteligentes , Feminino , Lógica Fuzzy , Masculino , Odonatos/anatomia & histologia , Odonatos/classificação , Estações do Ano , Voluntários
9.
Ther Clin Risk Manag ; 14: 999-1006, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29881282

RESUMO

BACKGROUND: Major abdominal surgery (MAS) is high-risk intervention usually accompanied by tissue injury leading to a release of signaling danger molecules called alarmins. This study evaluates the surgical injury caused by two fundamental types of gastrointestinal surgical procedures (open surgery and laparoscopy) in relation to the inflammation elicited by alarmins. PATIENTS AND METHODS: Patients undergoing MAS were divided into a mixed laparoscopy group (LPS) and an open surgery group (LPT). Serum levels of alarmins (S100A8, S100A12, HMGB1, and HSP70) and biomarkers (leukocytes, C-reactive protein [CRP], and interleukin-6 [IL-6]) were analyzed between the groups. The secondary objectives were to compare LPT and LPS cancer subgroups and to find the relationship between procedure and outcome (intensive care unit length of stay [ICU-LOS] and hospital length of stay [H-LOS]). RESULTS: A total of 82 patients were analyzed. No significant difference was found in alarmin levels between the mixed LPS and LPT groups. IL-6 was higher in the LPS group on day 2 (p=0.03) and day 3 (p=0.04). Significantly higher S100A8 protein levels on day 1 (p=0.02) and day 2 (p=0.01) and higher S100A12 protein levels on day 2 (p=0.03) were obtained in the LPS cancer subgroup. ICU-LOS and H-LOS were longer in the LPS cancer subgroup. CONCLUSION: The degree of surgical injury elicited by open MAS as reflected by alarmins is similar to that of laparoscopic procedures. Nevertheless, an early biomarker of inflammation (IL-6) was higher in the laparoscopy group, suggesting a greater inflammatory response. Moreover, the levels of S100A8 and S100A12 were higher with a longer ICU-LOS and H-LOS in the LPS cancer subgroup.

10.
APMIS ; 126(2): 152-159, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29700911

RESUMO

The dysregulation of inflammatory response to surgical injury affects outcomes. Alarmins, the earliest bioactive substances from damaged cells, play a crucial role in initiating the inflammation. We analyzed serum levels of alarmins (S100A8, S100A12, high mobility group box, and heat shock protein 70) after major abdominal surgery (MAS) in surgical (S) (n = 82) and nonsurgical (NS) groups (n = 35). The main objective was determining a role of selected alarmins in host response to MAS. The secondary objectives were (i) evaluation of the relationship among alarmins and selected biomarkers (C-reactive protein, interleukin-6), (ii) influence of the place of gastrointestinal resection, and (iii) role of alarmins in MAS for cancer. Except for HMGB1, the levels of all alarmins were higher in the S group compared with the NS group. In the S group, positive correlations were found between S100A8 and both IL-6 and CRP. Additionally, the S100A8 level was higher (p < 0.01) in patients who underwent upper gastrointestinal tract (GIT) surgery compared to middle and lower GIT resections. Alarmins levels did not differ between cancer and noncancer patients. MAS is able to elicit increase in alarmin levels. S100A8 can be considered a potential biomarker of surgical injury, especially in the upper part of the GIT.


Assuntos
Alarminas/sangue , Procedimentos Cirúrgicos do Sistema Digestório , Adulto , Idoso , Biomarcadores/sangue , Proteína C-Reativa/análise , Calgranulina A/sangue , Feminino , Proteína HMGB1/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos
11.
Low Urin Tract Symptoms ; 10(1): 12-16, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27291645

RESUMO

OBJECTIVES: Sonouroflowmetry represents a novel method for estimating urinary flow parameters. The aim of this study was to compare the urinary flow parameters acquired using sonouroflowmetry with those of standard uroflowmetry in healthy female volunteers. METHODS: Thirty-six healthy female volunteers (aged 25-54 years) were subjected to standard uroflowmetry. Simultaneously, subjects dialed a dedicated number on a mobile phone and kept recording until urination was finished. Sound data were analyzed and compared to the uroflowmetry data. Of 218 recordings, 183 were included in the final analysis. Thirty-four measurements were excluded for voided volume <150 mL or technical problems during the recording. A linear model was fitted to calculate the urinary flow parameters and the voided volume from data obtained by sonouroflowmetry. Subsequently the matching datasets of UF and SUF were compared with respect to flow time, voided volume, maximum (Qmax ) and average (Qave ) flow rate. Pearson's correlation coefficient (PCC) was used to compare parameters recorded by uroflowmetry with those calculated based on sonouroflowmetry recordings. RESULTS: A strong correlation (PCC = 0.95) was noted between uroflowmetry recorded flow time and duration of the sonouroflowmetry sound signal. The voided volume measured by uroflowmetry showed a moderate correlation (PCC = 0.68) with the calculated area under the sonouroflowmetry curve. Qmax recorded using uroflowmetry and sonouroflowmetry recorded peak sound intensity showed a weak correlation (PCC = 0.38). CONCLUSIONS: This study validates the basic concept of using sound analysis to estimate urinary flow parameters and voided volume.


Assuntos
Reologia/métodos , Espectrografia do Som , Micção , Urodinâmica , Adulto , Feminino , Voluntários Saudáveis , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Urina
12.
Ther Clin Risk Manag ; 13: 1223-1231, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29033572

RESUMO

BACKGROUND: Major abdominal surgery (MAS) is associated with increased morbidity and mortality. The main objective of our study was to evaluate the predictive value of heart-rate variability (HRV) concerning development of postoperative complications in patients undergoing MAS. The secondary objectives were to identify the relationship of HRV and use of vasoactive drugs during anesthesia, intensive care unit length of stay (ICU-LOS), and hospital length of stay (H-LOS). PATIENTS AND METHODS: Sixty-five patients scheduled for elective MAS were enrolled in a prospective, single-center, observational study. HRV was measured by spectral analysis (SA) preoperatively during orthostatic load. Patients were divided according to cardiac autonomic reactivity (CAR; n=23) and non-cardiac autonomic reactivity (NCAR; n=30). RESULTS: The final analysis included 53 patients. No significant difference was observed between the two groups regarding type of surgery, use of minimally invasive techniques or epidural catheter, duration of surgery and anesthesia, or the amount of fluid administered intraoperatively. The NCAR group had significantly greater intraoperative blood loss than the CAR group (541.7±541.9 mL vs 269.6±174.3 mL, p<0.05). In the NCAR group, vasoactive drugs were used during anesthesia more frequently (n=21 vs n=4; p<0.001), and more patients had at least one postoperative complication compared to the CAR group (n=19 vs n=4; p<0.01). Furthermore, the NCAR group had more serious complications (Clavien-Dindo ≥ Grade III n=6 vs n=0; p<0.05) and a greater number of complications than the CAR group (n=57 vs n=5; p<0.001). Significant differences were found for two specific subgroups of complications: hypotension requiring vasoactive drugs (NCAR: n=10 vs CAR: n=0; p<0.01) and ileus (NCAR: n=11 vs CAR: n=2; p<0.05). Moreover, significant differences were found in the ICU-LOS (NCAR: 5.7±3.5 days vs CAR: 2.6±0.7 days; p<0.0001) and H-LOS (NCAR: 12.2±5.6 days vs CAR: 7.2±1.7 days; p<0.0001). CONCLUSION: Preoperative HRV assessment during orthostatic load is objective and useful for identifying patients with low autonomic physiological reserves and high risk of poor post-operative course.

13.
Metab Syndr Relat Disord ; 15(7): 371-378, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28727953

RESUMO

BACKGROUND: This study examines the associations of fatty acids (FAs) in plasma phosphatidylcholine (PC) with the anthropometrical and biochemical characteristic of patients with metabolic syndrome (MetS)-related traits. METHODS: We analyzed the FA profiles of PC in 300 persons with MetS-related traits (152 M/148F, mean age 46.9 ± 9.0 years) and in 70 healthy controls of the same age using a balanced men/women ratio and gas-liquid chromatography. Multivariate linear regression analysis was performed to determine the coefficients of determination (R2) using FA proportions of the mentioned proband characteristics. RESULTS: The FA composition of PC in patients with MetS traits was only associated with waist circumference (R2 = 0.27), waist-to-hip ratio (WHR; R2 = 0.41), body fat percentage (R2 = 0.62), and fat mass (R2 = 0.29). Positive associations were found for dihomo-γ-linolenic (DGLA), palmitic, stearic (SA), α-linolenic (ALA), and eicosapentaenoic acids, whereas negative associations were found for linoleic (LA), oleic, and docosapentaenoic acids. Palmitoleic acid (POA) was positively associated with waist circumference but negatively with fat percentage. In controls, significant associations were found for waist circumference (R2 = 0.51), WHR (R2 = 0.53), body fat percentage (R2 = 0.60), and fat mass (R2 = 0.34). DGLA and saturated FA (SFA) were positively associated, whereas docosahexaenoic, adrenic, and cis-vaccenic acids were negatively associated. The study group differed from controls as follows: lower concentrations of LA and total n-6 FA, higher indices of delta-9-desaturase and delta-6 desaturase activity and higher proportions of POA, SA, ALA, DGLA, and SFA. CONCLUSIONS: We found significant associations (R2 >0.25) of FA in plasma PC with adiposity in middle-aged persons with MetS-related traits, but not with metabolic indices.


Assuntos
Adiposidade , Ácidos Graxos/sangue , Síndrome Metabólica/sangue , Fosfatidilcolinas/sangue , Adulto , Antropometria , Estudos de Casos e Controles , Cromatografia Líquida , Estudos Transversais , Feminino , Humanos , Resistência à Insulina , Modelos Lineares , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Projetos Piloto , Análise de Regressão , Estearoil-CoA Dessaturase/metabolismo , Circunferência da Cintura , Relação Cintura-Quadril
14.
Artigo em Inglês | MEDLINE | ID: mdl-28323290

RESUMO

BACKGROUND AND AIMS: Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. METHODS: A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period. We evaluated the incidence of delirium and its predisposing and precipitating risk factors. All patients were assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU). RESULTS AND CONCLUSIONS: Of the total of 332 patients with a median APACHE II (the Acute Physiology and Chronic Health Evaluation) score of 12, who were evaluated for delirium, 48 could not be assessed using CAM-ICU (47 due to prolonged coma, 1 due to language barriers). The incidence of delirium was 26.1%, with trauma and medical patients being more likely to develop delirium than surgical patients. Risk of delirium was significantly associated with age ≥ 65 years, and alcohol abuse in their anamnesis, with APACHE II score on admission, and with the use of sedatives and/or vasopressors. Delirious patients who remained in the ICU for a prolonged period showed a greater need for ventilator support and had a greater ICU-mortality.


Assuntos
Estado Terminal/terapia , Delírio/etiologia , Delírio/enfermagem , Unidades de Terapia Intensiva/estatística & dados numéricos , Respiração Artificial/efeitos adversos , Respiração Artificial/estatística & dados numéricos , APACHE , Idoso , República Tcheca , Delírio/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
15.
Respir Care ; 62(1): 113-122, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27803355

RESUMO

ARDS is severe form of respiratory failure with significant impact on the morbidity and mortality of critical care patients. Epidemiological data are crucial for evaluating the efficacy of therapeutic interventions, designing studies, and optimizing resource distribution. The goal of this review is to present general aspects of mortality data published over the past decades. A systematic search of the MEDLINE/PubMed was performed. The articles were divided according to their methodology, type of reported mortality, and time. The main outcome was mortality. Extracted data included study duration, number of patients, and number of centers. The mortality trends and current mortality were calculated for subgroups consisting of in-hospital, ICU, 28/30-d, and 60-d mortality over 3 time periods (A, before 1995; B, 1995-2000; C, after 2000). The retrospectivity and prospectivity were also taken into account. Moreover, we present the most recent mortality rates since 2010. One hundred seventy-seven articles were included in the final analysis. General mortality rates ranged from 11 to 87% in studies including subjects with ARDS of all etiologies (mixed group). Linear regression revealed that the study design (28/30-d or 60-d) significantly influenced the mortality rate. Reported mortality rates were higher in prospective studies, such as randomized controlled trials and prospective observational studies compared with retrospective observational studies. Mortality rates exhibited a linear decrease in relation to time period (P < .001). The number of centers showed a significant negative correlation with mortality rates. The prospective observational studies did not have consistently higher mortality rates compared with randomized controlled trials. The mortality trends over 3 time periods (before 1995, 1995-2000, and after 2000) yielded variable results in general ARDS populations. However, a mortality decrease was present mostly in prospective studies. Since 2010, the overall rates of in-hospital, ICU, and 28/30-d and 60-d mortality were 45, 38, 30, and 32%, respectively.


Assuntos
Mortalidade Hospitalar/tendências , Unidades de Terapia Intensiva/estatística & dados numéricos , Síndrome do Desconforto Respiratório/mortalidade , Humanos , Unidades de Terapia Intensiva/tendências , Estudos Observacionais como Assunto , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Fatores de Tempo
16.
J Invest Surg ; 30(3): 152-161, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27689623

RESUMO

PURPOSE: Tissue injury causing immune response is an integral part of surgical procedure. Evaluation of the degree of surgical trauma could help to improve postoperative management and determine the clinical outcomes. MATERIALS AND METHODS: We analyzed serum levels of alarmins, including S100A5, S100A6, S100A8, S100A9, S100A11, and S100A12; high-mobility group box 1; and heat-shock protein 70, after elective major abdominal surgery (n = 82). Blood samples were collected for three consecutive days after surgery. The goals were to evaluate the relationships among the serum levels of alarmins and selected surgical characteristics and to test potential of alarmins to predict the clinical outcomes. RESULTS: Significant, positive correlations were found for high-mobility group box 1 with the length of surgery, blood loss, and intraoperative fluid intake for all three days of blood sampling. The protein S100A8 serum levels showed positive correlations with intensive care unit length of stay, 28-day and in-hospital mortality. The protein S100A12 serum levels had significant, positive correlations with intensive care unit length of stay, 28-day mortality, and in-hospital mortality. We did not find significant differences in alarmin levels between cancer and noncancer subjects. CONCLUSION: The high-mobility group box 1 serum levels reflect the degree of surgical injury, whereas proteins S100A8 and S100A12 might be considered good predictors of major abdominal surgery morbidity and mortality.


Assuntos
Alarminas/sangue , Procedimentos Cirúrgicos do Sistema Digestório/mortalidade , Proteína HMGB1/sangue , Proteínas de Choque Térmico HSP70/sangue , Proteínas S100/sangue , Abdome/cirurgia , Idoso , República Tcheca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Neoplasias/cirurgia , Estudos Prospectivos
17.
Artigo em Inglês | MEDLINE | ID: mdl-27154363

RESUMO

Chronic pancreatitis (CP) is an irreversible inflammatory disorder characterized by the destruction of both exocrine and endocrine tissue. There is growing evidence that dysregulation of fatty acid (FA) metabolism is connected with many diseases; however, there are few data concerning FA composition in CP. Therefore, we analyzed FA profiles in plasma phosphatidylcholines in 96 patients with CP and in 108 control subjects (CON). The patients with CP had, in comparison with CON, increased sum of monounsaturated FA (ΣMUFA) and decreased content of polyunsaturated FA (PUFA) in both n-6 and n-3 families. Moreover, CP patients had increased indexes for delta-9, delta-6 desaturases, and fall in activity of delta-5 desaturase. Increased ratio of 16:1n-7/18:2n-6 (marker of essential n-6 FA deficiency), was more prevalent among CP patients. These changes implicated decreased fat intake, including n-3 as well as n-6 PUFA, and intrinsic changes in FA metabolism due to the alteration of delta desaturase activities.


Assuntos
Pancreatite Crônica/metabolismo , Fosfatidilcolinas/análise , Adulto , Ácidos Graxos Monoinsaturados/sangue , Ácidos Graxos Insaturados/sangue , Feminino , Humanos , Metabolismo dos Lipídeos , Masculino , Pessoa de Meia-Idade , Fosfatidilcolinas/sangue
18.
Int J Urol ; 22(8): 761-5, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25988672

RESUMO

OBJECTIVES: To evaluate the accuracy of sonouroflowmetry in recording urinary flow parameters and voided volume. METHODS: A total of 25 healthy male volunteers (age 18-63 years) were included in the study. All participants were asked to carry out uroflowmetry synchronous with recording of the sound generated by the urine stream hitting the water level in the urine collection receptacle, using a dedicated cell phone. From 188 recordings, 34 were excluded, because of voided volume <150 mL or technical problems during recording. Sonouroflowmetry recording was visualized in a form of a trace, representing sound intensity over time. Subsequently, the matching datasets of uroflowmetry and sonouroflowmetry were compared with respect to flow time, voided volume, maximum flow rate and average flow rate. Pearson's correlation coefficient was used to compare parameters recorded by uroflowmetry with those calculated based on sonouroflowmetry recordings. RESULTS: The flow pattern recorded by sonouroflowmetry showed a good correlation with the uroflowmetry trace. A strong correlation (Pearson's correlation coefficient 0.87) was documented between uroflowmetry-recorded flow time and duration of the sound signal recorded with sonouroflowmetry. A moderate correlation was observed in voided volume (Pearson's correlation coefficient 0.68) and average flow rate (Pearson's correlation coefficient 0.57). A weak correlation (Pearson's correlation coefficient 0.38) between maximum flow rate recorded using uroflowmetry and sonouroflowmetry-recorded peak sound intensity was documented. CONCLUSIONS: The present study shows that the basic concept utilizing sound analysis for estimation of urinary flow parameters and voided volume is valid. However, further development of this technology and standardization of recording algorithm are required.


Assuntos
Acústica , Micção/fisiologia , Urina/fisiologia , Urodinâmica/fisiologia , Adolescente , Adulto , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Som , Bexiga Urinária , Adulto Jovem
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