Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 96
Filtrar
Más filtros

Banco de datos
País/Región como asunto
Tipo del documento
Intervalo de año de publicación
1.
Circ J ; 88(6): 931-937, 2024 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-38233147

RESUMEN

BACKGROUND: The efficacy of guideline-directed medical therapy (GDMT) in the elderly remains unclear. This study evaluated the impact of GDMT (aspirin or a P2Y12inhibitor, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, ß-blocker, and statin) at discharge on long-term mortality in elderly patients with acute myocardial infarction (AMI) who had undergone percutaneous coronary intervention (PCI).Methods and Results: Of 2,547 consecutive patients with AMI undergoing PCI in 2009-2020, we retrospectively analyzed 573 patients aged ≥80 years. The median follow-up period was 1,140 days. GDMT was prescribed to 192 (33.5%) patients at discharge. Compared with patients without GDMT, those with GDMT were younger and had higher rates of ST-segment elevation myocardial infarction and left anterior descending artery culprit lesion, higher peak creatine phosphokinase concentration, and lower left ventricular ejection fraction (LVEF). After adjusting for confounders, GDMT was independently associated with a lower cardiovascular death rate (hazard ratio [HR] 0.35; 95% confidence interval [CI] 0.16-0.81), but not with all-cause mortality (HR 0.77; 95% CI 0.50-1.18). In the subgroup analysis, the favorable impact of GDMT on cardiovascular death was significant in patients aged 80-89 years, with LVEF <50%, or with an estimated glomerular filtration rate ≥30 mL/min/1.73 m2. CONCLUSIONS: GDMT in patients with AMI aged ≥80 years undergoing PCI was associated with a lower cardiovascular death rate but not all-cause mortality.


Asunto(s)
Infarto del Miocardio , Intervención Coronaria Percutánea , Guías de Práctica Clínica como Asunto , Humanos , Estudios Retrospectivos , Masculino , Femenino , Anciano de 80 o más Años , Infarto del Miocardio/mortalidad , Infarto del Miocardio/terapia , Resultado del Tratamiento , Antagonistas Adrenérgicos beta/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antagonistas de Receptores de Angiotensina/uso terapéutico , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Factores de Edad , Adhesión a Directriz
2.
Circ J ; 87(6): 799-805, 2023 05 25.
Artículo en Inglés | MEDLINE | ID: mdl-36642511

RESUMEN

BACKGROUND: Plaque characteristics associated with effective intravascular lithotripsy (IVL) treatment of calcification have not been investigated. This study identified calcified plaque characteristics that favor the use of IVL.Methods and Results: Optical coherence tomography (OCT) was performed in 16 calcified lesions in 16 patients treated with IVL and coronary stenting. Cross-sectional OCT images in 262 segments matched across pre-IVL, post-IVL, and post-stenting time points were analyzed. After IVL, 66 (25%) segments had calcium fracture. In multivariable analysis, calcium arc (odds ratio [OR] 1.22; 95% confidence interval [CI] 1.13-1.32; P<0.0001), superficial calcification (OR 6.98; 95% CI 0.07-55.57; P=0.0182), minimum calcium thickness (OR 0.66; 95% CI 0.51-0.86; P=0.0013), and nodular calcification (OR 0.24; 95% CI 0.08-0.70; P=0.0056) were associated with calcium fracture. After stenting, stent area was larger for segments with fracture (8.0 [6.9-10.6] vs. 7.1 [5.2-8.9] mm2; P=0.004). CONCLUSIONS: Post-IVL calcium fracture is more likely in calcified lesions with lower thickness, a larger calcium arc, superficial calcification, and non-nodular calcification, leading to a larger stent area.


Asunto(s)
Angioplastia Coronaria con Balón , Enfermedad de la Arteria Coronaria , Litotricia , Placa Aterosclerótica , Calcificación Vascular , Humanos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/terapia , Enfermedad de la Arteria Coronaria/etiología , Angioplastia Coronaria con Balón/métodos , Calcio , Tomografía de Coherencia Óptica , Estudios Transversales , Calcificación Vascular/diagnóstico por imagen , Calcificación Vascular/terapia , Calcificación Vascular/etiología , Placa Aterosclerótica/patología , Resultado del Tratamiento , Stents , Litotricia/efectos adversos , Litotricia/métodos
3.
Echocardiography ; 38(12): 2032-2042, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34845767

RESUMEN

BACKGROUND: The severity of MI declined markedly in the last decade, and contemporary patterns of cardiac remodeling after MI are not defined. METHODS: We prospectively enrolled community patients with first MI and performed comprehensive two- and three-dimensional echocardiography. Remodeling was defined as left ventricular (LV) end-systolic volume index (ESVI) above American Society of Echocardiography normal values. Remodeling patterns were characterized as an increase in LVESVI or LV end-diastolic volume index (LVEDVI), or both. RESULTS: Between 2014 and 2016, 213 patients (63±13 years; 34% women) were enrolled within 3 days after MI (77% non-ST-elevation MI). Acute remodeling was present in 51% of patients. Higher troponin and wall motion score index were associated with greater remodeling (p < 0.001). Atrial annular area, leaflet tenting and papillary muscle areas increased with greater remodeling (p < 0.001). The greater the cardiac remodeling, the lower the LV ejection fraction and global longitudinal strain (p < 0.001). This decrease in LV function was accompanied by stroke volume augmentation and maintenance of cardiac index at the expense of increased LVEDVI. Different remodeling patterns were identified. Cases showing increased LVEDVI and normal LVESVI had smallest infarct size and better hemodynamics compared to cases with augmented LVESVI and normal LVEDVI. CONCLUSION: Acute remodeling occurs in more than half of first MI cases and exhibits different patterns defined by cavity size and hemodynamic profile. Acute remodeling is a global phenomenon, which also involves the left atrium and the mitral apparatus.


Asunto(s)
Ecocardiografía Tridimensional , Infarto del Miocardio , Femenino , Humanos , Masculino , Infarto del Miocardio/diagnóstico por imagen , Estudios Prospectivos , Función Ventricular Izquierda , Remodelación Ventricular
4.
Biosci Biotechnol Biochem ; 84(10): 2149-2156, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32660357

RESUMEN

Mulberry leaves contain iminosugars, such as 1-deoxynojirimycin (1-DNJ), fagomine, and 2-O-α-D-galactopyranosyl deoxynojirimycin (GAL-DNJ) that inhibit α-glucosidase. In this study, we quantified iminosugars in Morus australis leaves and made the kinetic analysis in the hydrolysis of maltose by α-glucosidase. By LC-MS/MS, the concentrations of 1-DNJ, fagomine, and GAL-DNJ in the powdered leaves were 4.0, 0.46, and 2.5 mg/g, respectively, and those in the roasted ones were 1.0, 0.24, and 0.73 mg/g, respectively, suggesting that the roasting process degraded iminosugars. Steady-state kinetic analysis revealed that the powdered and roasted leaves exhibited competitive inhibition. At pH 6.0 at 37ºC, the IC50 values of the extracts from the boiled powdered or roasted leaves were 0.36 and 1.1 mg/mL, respectively. At the same condition, the IC50 values of 1-DNJ, fagomine, and GAL-DNJ were 0.70 µg/mL, 0.18 mg/mL, and 2.9 mg/mL, respectively. These results suggested that in M. australis, 1-DNJ is a major inhibitor of α-glucosidase. ABBREVIATIONS: 1-DNJ: 1-deoxynojirimycin; GAL-DNJ: 2-O-α-D-galactopyranosyl-DNJ.


Asunto(s)
Inhibidores de Glicósido Hidrolasas/farmacología , Iminoazúcares/farmacología , Morus/química , Extractos Vegetales/farmacología , Hojas de la Planta/química , alfa-Glucosidasas/metabolismo , Animales , Inhibidores de Glicósido Hidrolasas/química , Iminoazúcares/análisis , Cinética , Extractos Vegetales/química , Polvos , Ratas
5.
Echocardiography ; 37(3): 445-452, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32112459

RESUMEN

BACKGROUND: Mitral valve prolapse (MVP) is often identified in patients with atrial septal defect (ASD), which occasionally require surgical intervention at the time of ASD closure or even long after the surgery. Ventricular and valvular geometric characteristics in preoperative ASD patients were evaluated by three-dimensional (3D) transesophageal echocardiography. METHODS AND RESULTS: Mitral valve (MV) complex geometry was quantitatively measured by 3D transesophageal echocardiography in 11 ASD patients (Qp/Qs > 1.5) and 11 controls. The ASD group had a significantly larger indexed prolapse volume and height, with a larger anterior mitral leaflet than controls (0.53 [0.33-0.75] vs 0.057 [0.027-0.11] mL/m2 , P = .0001; 2.89 [2.13-3.50] vs 0.92 [0.48-1.32] mm/m2 , P < .0001; 391.3 [346.4-445.1] vs 295.3 (281.9-330.0) mm2 /m2 , P = .011, respectively). The right ventricular (RV)-to-left ventricular (LV) end-systolic diameter ratio was larger in the ASD group than in the control group (1.34 [0.96-1.45] vs 0.85 [0.75-0.88], P = .004). The indexed inter-papillary muscle distance (IPMD) was significantly shorter in the ASD group than in the control group (7.77 [6.55-8.24] vs 9.71 [8.64-10.8] mm/m2 , P = .011). IPMD was significantly correlated with the RV-LV end-systolic diameter ratio (r = -.70, P = .017). CONCLUSIONS: Inward shift of the LV papillary muscle tips due to RV dilation may be a major mechanism of MV prolapse in ASD. At the same time, positive remodeling of the anterior leaflet was observed in the ASD group, which may compensate for the billowing leaflet geometry to maintain effective coaptation. Three-dimensional assessment of the MV apparatus geometry will help to further understand perioperative mitral regurgitation in patients with ASD.


Asunto(s)
Ecocardiografía Tridimensional , Ecocardiografía Transesofágica , Defectos del Tabique Interatrial , Insuficiencia de la Válvula Mitral , Prolapso de la Válvula Mitral , Defectos del Tabique Interatrial/complicaciones , Defectos del Tabique Interatrial/diagnóstico por imagen , Humanos , Válvula Mitral/diagnóstico por imagen , Prolapso de la Válvula Mitral/complicaciones , Prolapso de la Válvula Mitral/diagnóstico por imagen
6.
BMC Pulm Med ; 18(1): 39, 2018 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-29486747

RESUMEN

BACKGROUND: Actinomycosis is a rare bacterial infection caused by Actinomyces. The symptom of actinomycosis is nonspecific and radiological images present as a slow-progressive mass lesion similarly to malignancies. Thus, it is difficult to distinguish pulmonary actinomycosis from malignancies. CASE PRESENTATION: A 74-year-old male who had esophageal cancer and a pulmonary mass that was positive for 18F-fluorodeoxyglucose positron emission tomography/computed tomography was initially diagnosed with esophageal cancer with a lung metastasis because he was asymptomatic. However, aspiration of pleural effusion revealed that the pulmonary lesion was actinomycosis. CONCLUSION: We present a case of pulmonary actinomycosis mimicking a lung metastasis from esophageal cancer. Diagnosis of asymptomatic pulmonary actinomycosis is difficult, and needle aspiration could be useful for a definitive diagnosis of pulmonary actinomycosis.


Asunto(s)
Actinomicosis/diagnóstico , Neoplasias Esofágicas/diagnóstico , Derrame Pleural/etiología , Derrame Pleural/patología , Neumonía Bacteriana/diagnóstico por imagen , Actinomicosis/patología , Anciano , Biopsia con Aguja , Diagnóstico Diferencial , Endoscopía del Sistema Digestivo , Neoplasias Esofágicas/complicaciones , Neoplasias Esofágicas/terapia , Fluorodesoxiglucosa F18 , Humanos , Neoplasias Pulmonares , Masculino , Metástasis de la Neoplasia , Tomografía Computarizada por Tomografía de Emisión de Positrones
7.
Circ J ; 81(9): 1286-1292, 2017 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-28450676

RESUMEN

BACKGROUND: Although paclitaxel-coated balloon (PCB) angioplasty is an effective procedure for in-stent restenosis (ISR) after coronary stenting, recurrent ISR after PCB angioplasty still occurs. The aim of this study was to evaluate the predictors of recurrent ISR after PCB angioplasty for ISR.Methods and Results:A total of 157 ISR lesions treated with PCB angioplasty from January 2014 to May 2015 were retrospectively examined. Recurrent ISR was judged on 6-month follow-up angiography. Clinical, angiographic and procedural parameters were evaluated as possible predictors of recurrent ISR. Recurrent ISR occurred in 13.9% of lesions after PCB angioplasty. On multivariate analysis the following independent predictors of recurrent ISR were identified: (1) smaller acute gain after initial ballooning (OR, 3.06; 95% CI: 1.08-8.71; P=0.04); (2) geographic mismatch between PCB position and initial ballooning (OR, 5.59; 95% CI: 1.64-19.1; P=0.006); and (3) use of percutaneous transluminal coronary rotational atherectomy (PTCRA) at primary percutaneous coronary intervention (PCI; OR, 5.53; 95% CI: 1.89-16.2; P=0.002). CONCLUSIONS: Optimal expansion at initial ballooning before PCB angioplasty and careful positioning of PCB are important technical tips to prevent recurrent ISR after PCB angioplasty. Recurrent ISR occurred more frequently in severely calcified lesions that required PTCRA at primary PCI.


Asunto(s)
Angioplastia Coronaria con Balón , Aterectomía , Angiografía Coronaria , Oclusión de Injerto Vascular , Paclitaxel/administración & dosificación , Anciano , Bases de Datos Factuales , Femenino , Estudios de Seguimiento , Oclusión de Injerto Vascular/diagnóstico por imagen , Oclusión de Injerto Vascular/fisiopatología , Oclusión de Injerto Vascular/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Stents
8.
J Clin Biochem Nutr ; 61(1): 47-52, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28751809

RESUMEN

The effect of 1-deoxynojirimycin, a caloric restriction mimetic, was examined in ICR mice with azoxymethane dextran sodium sulfate-induced colorectal cancer. Azoxymethane is a carcinogen (10 mg/kg body weight), and 2% dextran sodium sulfate (w/v) used as a colitis-inducing agent. Mice were separated into 5 groups: a group without colorectal cancer fed a normal diet (CO- group), and groups with colorectal cancer fed a normal diet (CO+ group), a calorie-restricted diet (caloric restriction group), and diets including 0.02% and 0.1% 1-deoxynojirimycin (l-1-deoxynojirimycin and H-1-deoxynojirimycin groups). The tumor incidence and number were reduced significantly in the caloric restriction group compared to the CO+ group, and were also suppressed in a dose-dependent manner by 1-deoxynojirimycin. mRNA for anti-apoptotic Bcl-2 was decreased and that for pro-apoptotic Bax was increased in the carcinoma tissue of CR, l-1-deoxynojirimycin and H-1-deoxynojirimycin groups. These results suggest that caloric restriction and 1-deoxynojirimycin inhibit growth of colorectal cancer by inducing apoptosis in an induced cancer model in mice.

9.
J Endovasc Ther ; 23(1): 83-91, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26442951

RESUMEN

PURPOSE: To evaluate the clinical implications of additional pedal artery angioplasty (PAA) for patients with critical limb ischemia (CLI). METHODS: Twenty-nine patients (mean age 77.8±8.6 years; 21 men) with CLI (32 limbs) presenting with de novo infrapopliteal and pedal artery (Kawarada type 2/3) disease were reviewed. The need for PAA was based on the existence of sufficient wound blush (WB) around the target wounds after conventional above-the-ankle revascularization. Fourteen patients with insufficient WB in 14 limbs received additional PAA, while 15 patients with sufficient WB in 18 limbs did not. The groups were compared for overall survival, limb salvage, and amputation-free survival within 1 year after the procedure. The wound healing rate, time to wound healing, and freedom from reintervention rate were also evaluated. RESULT: The success rate of additional PAA was 93% (13/14). All limbs with successful PAA achieved sufficient WB (13/13). Despite insufficient WB before the additional PAA, overall survival (86% vs 73%, p=0.350), limb salvage (93% vs 83%, p=0.400), amputation-free survival (79% vs 53%, p=0.102), and freedom from reintervention (64% vs 73%, p=0.668) rates were similar in both groups. Furthermore, the wound healing rate (93% vs 60%, p=0.05) was higher and time to wound healing (86.0±18.7 vs 152.0±60.2 days, p=0.05) was shorter in the patients who received PAA. CONCLUSION: Additional PAA might improve the WB and clinical outcomes (especially speed and extent of wound healing) in patients with CLI attributed to infrapopliteal and pedal artery disease.


Asunto(s)
Isquemia/terapia , Enfermedad Arterial Periférica/terapia , Arteria Poplítea , Anciano , Anciano de 80 o más Años , Amputación Quirúrgica , Angioplastia de Balón/efectos adversos , Enfermedad Crítica , Bases de Datos Factuales , Supervivencia sin Enfermedad , Femenino , Humanos , Isquemia/diagnóstico , Isquemia/fisiopatología , Recuperación del Miembro , Masculino , Enfermedad Arterial Periférica/diagnóstico , Enfermedad Arterial Periférica/fisiopatología , Arteria Poplítea/diagnóstico por imagen , Arteria Poplítea/fisiopatología , Flujo Sanguíneo Regional , Retratamiento , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Grado de Desobstrucción Vascular , Cicatrización de Heridas
10.
Bull Tokyo Dent Coll ; 55(2): 111-22, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24965956

RESUMEN

The aim of this study was to investigate risk factors affecting 5- and 10-year survival in autotransplantation of third molars with complete root formation at dental clinics. Participating dentists were requested to provide information on transplantations performed between 1 January 1990 and 31 December 2009. After data screening and elimination, 183 teeth in 171 men aged 20-72 years (mean, 44.8 years) and 205 teeth in 189 women aged 20-74 years (mean, 42.0 years) were included in the study. A single-factor analysis using the log-rank test revealed that the following factors had a significant influence (p<0.05) on 5-year survival in transplanted teeth in men: recipient site in the maxilla and fewer than 25 present teeth; those for 10-year survival, on the other hand, were recipient site tooth extraction due to periodontal disease, recipient site in the maxilla, fewer than 25 present teeth, and Eichner index Group B1 to C. Cox regression analysis revealed that the odds ratio for 5-year survival for recipient site in the maxilla was 2.873 (95% CI, 1.073-7.695), while that for 10-year survival was 3.713 (95% CI, 1.601-8.609) for recipient site extraction due to periodontal disease, 2.190 (95% CI, 1.021-4.700) for recipient site in the maxilla, and 3.110 (95% CI, 1.470-6.581) for fewer than 25 present teeth. In women, the log-rank test indicated experience of less than 10-year in performing treatment as a significant factor (p <0.05) in 5-year survival. These results suggest that medium-term survival in transplanted teeth is influenced by operational risk factors in women, while long-term survival in transplanted teeth is influenced by individual oral status in men.


Asunto(s)
Autoinjertos/trasplante , Tercer Molar/trasplante , Adulto , Factores de Edad , Anciano , Competencia Clínica , Prótesis Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Odontogénesis/fisiología , Periodontitis/complicaciones , Factores de Riesgo , Factores Sexuales , Fumar , Tasa de Supervivencia , Extracción Dental/métodos , Raíz del Diente/fisiología , Alveolo Dental/cirugía , Diente no Vital/complicaciones , Resultado del Tratamiento , Adulto Joven
11.
J Pharmacol Toxicol Methods ; 127: 107508, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38670388

RESUMEN

To measure α-glucosidase activity, rat intestinal acetone powder is commonly used as a source of α-glucosidase, and the mutarotase-glucose oxidase (GOD) methods commonly used to quantitate glucose produced by enzymatic hydrolysis of the substrates. In this study, we compared human Caco-2 cell extracts with rat intestinal acetone powder extracts. We also compared high-performance anion-exchange chromatography with pulsed amperometric detection (HPAE-PAD) with the mutarotase-GOD method. The sensitivity of HPAE-PAD was higher than that of mutarotase-GOD. The glucose concentration quantified by HPAE-PAD was similar to that quantified using the mutarotase-GOD method. In the maltase reaction, 1-deoxynojirimycin (1-DNJ) exerted a more potent inhibitory effect on human enzymes than on rat enzymes. This order was reversed during the sucrase reaction. These results suggested that the combined use of Caco-2 cell extracts and HPAE-PAD is advantageous for use in α-glucosidase-related basic research.


Asunto(s)
Inhibidores de Glicósido Hidrolasas , alfa-Glucosidasas , Células CACO-2 , Humanos , alfa-Glucosidasas/metabolismo , Animales , Ratas , Inhibidores de Glicósido Hidrolasas/farmacología , 1-Desoxinojirimicina/farmacología , Cromatografía por Intercambio Iónico/métodos , Glucosa/metabolismo , Glucosa/análisis , Acetona/química , Masculino , Intestinos/enzimología , Cromatografía Líquida de Alta Presión/métodos , Pruebas de Enzimas/métodos
12.
Am J Cardiol ; 222: 1-7, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38677665

RESUMEN

The prognostic implications of cardiac troponin elevation after percutaneous coronary intervention (PCI) with atherectomy have not been established. The aim of this study was to investigate the incidence of periprocedural myocardial injury (PMI) and its association with cardiovascular events in patients with severely calcified lesions who underwent PCI with atherectomy. The study analyzed 346 patients (377 lesions) who underwent PCI with atherectomy between January 2018 and December 2021. Peak post-PCI high-sensitivity cardiac troponin (hs-cTn) was measured. The primary outcome was target lesion failure (TLF), a composite of cardiovascular death, target vessel myocardial infarction, and clinically driven target lesion revascularization. A lesion-based analysis was conducted to assess the association of PMI with TLF up to 5 years after PCI. Increase of hs-cTn was seen with 362 lesions (96%), and significant PMI, defined as hs-cTn increase ≥70 × upper reference limit, was seen with 83 lesions (22%). Significant PMI was associated with a significantly greater risk of TLF (adjusted hazard ratio 1.93, 95% confidence interval 1.12 to 3.30, p = 0.017), primarily driven by an increased risk of cardiovascular death (adjusted hazard ratio 5.29, 95% confidence interval 1.46 to 19.16, p = 0.011). In conclusion, hs-cTn increase was frequently observed in patients who underwent PCI with atherectomy, and significant PMI was associated with an increased risk of TLF and cardiovascular death.


Asunto(s)
Aterectomía Coronaria , Enfermedad de la Arteria Coronaria , Intervención Coronaria Percutánea , Humanos , Masculino , Femenino , Anciano , Aterectomía Coronaria/métodos , Enfermedad de la Arteria Coronaria/cirugía , Incidencia , Estudios Retrospectivos , Calcificación Vascular/epidemiología , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Lesiones Cardíacas/epidemiología , Lesiones Cardíacas/etiología , Infarto del Miocardio/epidemiología , Factores de Riesgo , Pronóstico , Anciano de 80 o más Años , Factores de Tiempo
13.
Infect Drug Resist ; 17: 207-219, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38283110

RESUMEN

Objective: This study aimed to identify factors that should be focused on by the antimicrobial stewardship team for treating patients with sepsis, by investigating the mortality of patients with sepsis within 30 days and the mortality-related factors in our hospital over a 10-year period from the perspective of appropriate antimicrobial use. Methods: Factors associated with 30-day mortality were investigated using hierarchical multiple logistic regression in 1406 patients with pathogen-identified sepsis in Hirosaki University Hospital. These factors were clinical data, microbiological data, antimicrobials used in empiric and definitive therapies, presence/absence of ineffective use, underdosing as evaluated using Monte Carlo simulation, and practice of de-escalation. Results: The ineffective use of antimicrobials in empiric therapy and the underdosing and ineffective use in definitive therapy were significantly associated with 30-day mortality (odds ratio [OR] = 2.70, 3.72, and 3.65, respectively). Multiple blood culture sampling was inversely associated with these inappropriate antimicrobial uses. Every year, the 30-day mortality rate has been decreasing, in line with the increase in multiple blood culture sampling and de-escalation; the inappropriate use of antimicrobials has also decreased. Conclusion: Multiple blood culture sampling, proper choice of antimicrobial, and using an adequate dose in definitive therapy could decrease the 30-day mortality rate in patients with sepsis and these factors could be supported by the antimicrobial stewardship team.

14.
Circ Cardiovasc Imaging ; 17(3): e016239, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38415386

RESUMEN

BACKGROUND: Patients with only moderate atrial secondary mitral regurgitation (asMR) frequently develop heart failure (HF). Mechanisms of HF with moderate asMR and the impact of mild asMR remain unclarified. Although mild/moderate primary mitral regurgitation is compensated by left ventricular (LV) dilatation, the LV is not dilated in asMR. We hypothesized that patients with mild asMR without LV dilatation may have impaired hemodynamics and higher risks of subsequent symptomatic HF deterioration. METHODS: Stroke volume, cardiac output, and systolic pulmonary artery pressure were measured by echocardiography in 142 patients with isolated atrial fibrillation and 30 healthy controls. The prognosis of patients with isolated atrial fibrillation was followed up. RESULTS: In the 142 patients with isolated atrial fibrillation, asMR was no/trivial in 55, mild in 83, moderate in 4, while none had severe asMR. Compared with controls and patients with no/trivial asMR, LV end-diastolic volume index was not increased and hemodynamic parameters were abnormal in patients with mild asMR (LV end-diastolic volume index, 65±6 versus 58±8 versus 60±8 mL/m²; stroke volume index, 42±4 versus 35±4 versus 29±6 mL/m²; P<0.001 versus other 2 groups; cardiac output index, 2.8±0.4 versus 2.8±0.5 versus 2.3±0.6 L/min per m²; P<0.001; systolic pulmonary artery pressure, 21±3 versus 26±5 versus 37±9 mm Hg; P<0.001). Although the event-free rate of HF symptomatic deterioration or hospitalization in patients with no/trivial asMR during a median 13.9 months follow-up was 86.9% and 100%, the rate in mild asMR was 59.4% and 85.0% (P<0.001 or P=0.032), respectively. CONCLUSIONS: In the presence of isolated AF and no compensatory LV dilatation, impaired hemodynamics and higher risks of symptomatic HF deterioration were associated with mild asMR, requiring further studies of causalities.


Asunto(s)
Fibrilación Atrial , Insuficiencia Cardíaca , Insuficiencia de la Válvula Mitral , Humanos , Insuficiencia de la Válvula Mitral/etiología , Insuficiencia de la Válvula Mitral/complicaciones , Fibrilación Atrial/complicaciones , Fibrilación Atrial/diagnóstico , Atrios Cardíacos , Ecocardiografía , Pronóstico
15.
Biosci Biotechnol Biochem ; 77(4): 771-5, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23563547

RESUMEN

Cyathus stercoreus has a superior ability to increase the cellulase saccharification yields of rice straw under biological pretreatment. As a first step to improve the biological pretreatment efficiency of C. stercoreus further, a new gene transformation system was constructed. Uracil auxotrophic mutant uv-180 was generated as host strain by ultraviolet radiation. It was transformed using plasmid pGE containing the orotate phosphoribosyltransferase (CsURA5) and enhanced green fluorescent protein (egfp). Many transformants exhibited strong fluorescence, indicating successful genetic transformation. An intron was needed for the expression of egfp. The EGFP fluorescence intensities of the three transformants did not decay even after subculturing on uracil-containing semisolid medium 5 times, suggesting that the transformed plasmids were stably retained in the absence of selective pressure.


Asunto(s)
Cyathus/genética , Cyathus/metabolismo , Oryza/metabolismo , Oryza/microbiología , Cyathus/fisiología , Marcadores Genéticos/genética , Proteínas Fluorescentes Verdes/genética , Plásmidos/genética , Transformación Genética
17.
Bull Tokyo Dent Coll ; 54(1): 27-35, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23614950

RESUMEN

The purpose of this study was to analyze the survival rate in autotransplanted premolars with complete root formation in dental clinics. Participating dentists were requested to provide information on transplantations they had undertaken between 1 January 1990 and 31 December 2010. Data on a total of 708 teeth from 637 patients were collected. Data for other tooth types and for teeth with incomplete root formation were eliminated. In this study, data on 40 teeth in 35 patients were analyzed. Participants consisted of 17 men and 18 women ranging from 24 to 79 years in age (mean age, 43.7 years). The cumulative survival rate was 100% at the 5-year mark and 72.7% at 10 years, as calculated by the Kaplan-Meier method. Single-factor analysis revealed that "transplanted to the molar regions" was a significant risk factor (p<0.05) influencing the survival of transplanted teeth. However, a Cox regression analysis showed no significance. The results of this study suggest that, in cases where there is a suitable donor tooth and the oral condition is good, premolar autotransplantation is a viable treatment option, even when there is complete root formation in the donor teeth.


Asunto(s)
Diente Premolar/trasplante , Raíz del Diente/crecimiento & desarrollo , Adulto , Anciano , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Encuestas y Cuestionarios , Trasplante Autólogo , Resultado del Tratamiento
18.
Bull Tokyo Dent Coll ; 54(1): 37-44, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23614951

RESUMEN

The main reasons for loss of autotransplanted teeth are different from those involved in natural teeth loss. The aim of this study was to investigate which procedures were employed to treat spaces vacated when autotransplanted teeth were lost. Participating dentists were requested to provide information on transplantations they had undertaken. A total of 614 teeth in 552 patients (37 dentists) ranging in age from 17 to 79 years (mean age: 44.1 years) were examined. A total of 102 transplanted teeth were lost during the observation period. Procedures for treatment of spaces vacated were not influenced by main reason for transplanted tooth loss. The procedure used to treat depended on the original prosthodontic treatment of the transplanted teeth. For single crowns, the spaces were left empty (33.9%) or replaced by bridge work (30.5%), implants (20.3%), or dentures (10.2%). For single crowns in the upper and lower second molar regions, the spaces were usually left empty (upper 100%, lower 71.4%), while for those in the upper and lower first molar regions, the spaces were often replaced by bridge work (upper 41.7%, lower 50.0%). For bridge abutments, spaces were replaced by dentures (42.9%), implants (33.3%), or left empty (14.3%), and in the lower second molar region, they were mostly replaced by implants (5 cases, 41.7%). For most denture abutment cases, the spaces were replaced by dentures (88.9%). During the survival period of the transplanted teeth, the masticatory burden on the other teeth is reduced and the adjacent teeth are supported by the transplanted tooth. Even if transplanted teeth are eventually lost, traditional procedures can be performed to fill the vacated space.


Asunto(s)
Prótesis Dental/estadística & datos numéricos , Fracaso de la Restauración Dental , Pérdida de Diente/etiología , Diente/trasplante , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pérdida de Diente/rehabilitación , Trasplante Autólogo
19.
J Biomed Biotechnol ; 2012: 637125, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22791962

RESUMEN

In order to produce petroleum alternatives from biomass, a significant amount of research has been focused on oils from microalgae due to their origin, which would not affect food availability. Nanoporous hybrid catalysts composed of ns Al2O3 and zeolites have been proven to be very useful compared to traditional catalysts in hydrotreating (HT), hydrocracking (HC), and catalytic cracking (CC) of large molecules. To evaluate the reaction scheme and products from model isoprenoid compounds of microalgae oil, nanoporous hybrid catalyst technologies (CC: ns Al2O3/H-USY and ns Al2O3/H-GaAlMFI; HC: [Ni-Mo/γ-Al2O3]/ns Al2O3/H-beta) were studied. The major product from CC on ns Al2O3/H-USY was highly aromatic gasoline, while the product from HC was half-isoparaffinic/olefinic kerosene. Although more than 50 wt% of the products from HT/CC on the USY catalyst was liquefied petroleum gas due to overcracking, the product from HT/CC on the MFI catalyst was high-octane-number gasoline. Delightfully, the product from HT/HC was kerosene and its average number was 11, with more than 80 wt% being isoparaffinic. As a result, it was demonstrated that hydrotreating may convert isoprenoid oil from microalgae over nanoporous hybrid catalysts into a variety of products.


Asunto(s)
Biocombustibles , Nanoporos , Aceites/química , Terpenos/química , Óxido de Aluminio , Catálisis , Microalgas , Modelos Biológicos , Temperatura , Zeolitas
20.
Biosci Biotechnol Biochem ; 76(9): 1805-8, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22972347

RESUMEN

Supplementation to an AIN93G-based diet of tocotrienol (T3) for 13 weeks administered to Fischer 344/slc rats showed a safety profile with no side effects. Dose-dependent T3 levels were detected in many tissues. Under the present experimental conditions, a continuous intake of the T3 concentrate would be safe in the rats as long as the T3 content was less than 0.20% of the dietary intake.


Asunto(s)
Suplementos Dietéticos , Tocotrienoles/farmacocinética , Vitamina E/farmacocinética , Animales , Peso Corporal/efectos de los fármacos , Dieta , Esquema de Medicación , Masculino , Ratas , Ratas Endogámicas F344 , Distribución Tisular , Tocotrienoles/administración & dosificación , Vitamina E/administración & dosificación
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA