RESUMO
The objective of the study was to estimate the prevalence of periodontitis at state and local levels across the United States by using a novel, small area estimation (SAE) method. Extended multilevel regression and poststratification analyses were used to estimate the prevalence of periodontitis among adults aged 30 to 79 y at state, county, congressional district, and census tract levels by using periodontal data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012, population counts from the 2010 US census, and smoking status estimates from the Behavioral Risk Factor Surveillance System in 2012. The SAE method used age, race, gender, smoking, and poverty variables to estimate the prevalence of periodontitis as defined by the Centers for Disease Control and Prevention/American Academy of Periodontology case definitions at the census block levels and aggregated to larger administrative and geographic areas of interest. Model-based SAEs were validated against national estimates directly from NHANES 2009-2012. Estimated prevalence of periodontitis ranged from 37.7% in Utah to 52.8% in New Mexico among the states (mean, 45.1%; median, 44.9%) and from 33.7% to 68% among counties (mean, 46.6%; median, 45.9%). Severe periodontitis ranged from 7.27% in New Hampshire to 10.26% in Louisiana among the states (mean, 8.9%; median, 8.8%) and from 5.2% to 17.9% among counties (mean, 9.2%; median, 8.8%). Overall, the predicted prevalence of periodontitis was highest for southeastern and southwestern states and for geographic areas in the Southeast along the Mississippi Delta, as well as along the US and Mexico border. Aggregated model-based SAEs were consistent with national prevalence estimates from NHANES 2009-2012. This study is the first-ever estimation of periodontitis prevalence at state and local levels in the United States, and this modeling approach complements public health surveillance efforts to identify areas with a high burden of periodontitis.
Assuntos
Periodontite/epidemiologia , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Fatores Etários , Idoso , Algoritmos , Sistema de Vigilância de Fator de Risco Comportamental , Censos , Etnicidade/estatística & dados numéricos , Feminino , Previsões , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Vigilância da População , Pobreza/estatística & dados numéricos , Fatores Sexuais , Fumar/epidemiologia , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricosRESUMO
With the renewed interest in the use of autogenous radial arteries in coronary artery bypass grafting, concerns regarding vascular compromise and selection of patients have arisen. In this report, we describe a modification of Allen's test.
Assuntos
Ponte de Artéria Coronária/métodos , Artéria Radial/transplante , Mãos/irrigação sanguínea , Humanos , Oximetria , Oxigênio/sangue , Seleção de Pacientes , Pressão , Artéria Radial/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Reprodutibilidade dos Testes , Fatores de Tempo , Transplante Autólogo , Artéria Ulnar/fisiologiaRESUMO
A rare complication of aortoiliac bypass procedure resulting in the formation of an acute ilio-iliac arteriovenous fistula was presented. The latter was a first manifestation of anastomotic iliac pseudoaneurysm. This is only the second such case reported in the English literature. Iliac anastomotic pseudoaneurysm although rarely detected, is a potentially lethal complication that has to be repaired close to the time of its detection.
Assuntos
Falso Aneurisma/diagnóstico por imagem , Aneurisma Roto/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Arteriosclerose/complicações , Fístula Arteriovenosa/diagnóstico por imagem , Prótese Vascular , Aneurisma Ilíaco/diagnóstico por imagem , Artéria Ilíaca/anormalidades , Veia Ilíaca/anormalidades , Complicações Pós-Operatórias/diagnóstico por imagem , Idoso , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Aneurisma Roto/etiologia , Aneurisma Roto/cirurgia , Angiografia , Aneurisma da Aorta Abdominal/complicações , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/cirurgia , Diagnóstico Diferencial , Humanos , Aneurisma Ilíaco/etiologia , Aneurisma Ilíaco/cirurgia , Masculino , Palpação , Exame Físico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Pulso ArterialRESUMO
A man with allergic bronchopulmonary aspergillosis had pneumothorax and bronchopleural fistula while impacted mucus was being successfully dislodged from bronchiectatic airways. We believe this is the first report of pneumothorax with bronchopleural fistula in a patient with active ABPA, and we have proposed a mechanism to explain the development of this complication.
Assuntos
Aspergilose Broncopulmonar Alérgica/tratamento farmacológico , Fístula Brônquica/complicações , Fístula/complicações , Doenças Pleurais/complicações , Pneumotórax/complicações , Adulto , Aspergilose Broncopulmonar Alérgica/complicações , Fístula Brônquica/diagnóstico por imagem , Broncoscopia , Fístula/diagnóstico por imagem , Humanos , Masculino , Doenças Pleurais/diagnóstico por imagem , Pneumotórax/diagnóstico por imagem , Pneumotórax/etiologia , Prednisona/uso terapêutico , RadiografiaRESUMO
Real-time synchrotron diffraction has been used to monitor the phase transformations of highly exothermic, fast self-propagating solid combustion reactions on a subsecond time scale down to 100 milliseconds and in some instances to 10 milliseconds. Three systems were investigated: Ti + C --> TiC; Ti + C + xNi --> TiC + Ni-Ti alloy; and Al + Ni --> AlNi. In all three reactions, the first step was the melting of the metal reactants. Formation of TiC in the first two reactions was completed within 400 milliseconds of the melting of the Ti metal, indicating that the formation of TiC took place during the passage of the combustion wave front. In the Al + Ni reaction, however, passage of the wave front was followed by the appearance and disappearance of at least one intermediate in the afterburn region. The final AlNi was formed some 5 seconds later and exhibited a delayed appearance of the (210) reflection, which tends to support a phase transformation from a disordered AlNi phase at high temperature to an ordered CsCl structure some 20 seconds later. This new experimental approach can be used to study the chemical dynamics of high-temperature solid-state phenomena and to provide the needed database to test various models for solid combustion.
RESUMO
A patient with acute ulcerative colitis who developed acute disseminated intravascular coagulation during the course of a proctocolectomy is presented. Ulcerative colitis may represent a rare cause of acute disseminated intravascular coagulation.