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Interstitial cystitis/bladder pain Syndrome (IC/BPS) remains a mysterious and intricate urological disorder, presenting significant challenges to healthcare providers. Traditional guidelines for IC/BPS follow a hierarchical model based on symptom severity, advocating for conservative interventions as the initial step, followed by oral pharmacotherapy, intravesical treatments, and, in refractory cases, invasive surgical procedures. This approach embraces a multi-tiered strategy. However, the evolving understanding that IC/BPS represents a paroxysmal chronic pain syndrome, often involving extravesical manifestations and different subtypes, calls for a departure from this uniform approach. This review provides insights into recent advancements in experimental strategies in animal models and human studies. The identified therapeutic approaches fall into four categories: (i) anti-inflammation and anti-angiogenesis using monoclonal antibodies or immune modulation, (ii) regenerative medicine, including stem cell therapy, platelet-rich plasma, and low-intensity extracorporeal shock wave therapy, (iii) drug delivery systems leveraging nanotechnology, and (iv) drug delivery systems assisted by energy devices. Future investigations will require a broader range of animal models, studies on human bladder tissues, and well-designed clinical trials to establish the efficacy and safety of these therapeutic interventions.
Assuntos
Cistite Intersticial , Modelos Animais de Doenças , Cistite Intersticial/terapia , Humanos , Animais , Sistemas de Liberação de Medicamentos , Bexiga Urinária/patologiaRESUMO
PURPOSE: To explore the relationship among resilience, stress, and demographic factors in certified nursing assistants (CNAs) who worked in long-term care institutions during the coronavirus disease 2019 pandemic. METHOD: A cross-sectional correlation-based research design was used. Data were collected using a demographic questionnaire, Connor-Davidson Resilience Scale, and Occupational Stress Scale. CNAs from 21 long-term care institutions in Taiwan were recruited. RESULTS: This study included 118 female and 26 male CNAs (response rate = 80%). Mean age was 46.8 years. A moderately negative correlation was found between workplace resilience and stress. Overall, being a woman and parent were found to be significantly correlated with CNAs' resilience. Furthermore, resilience and shift work were important predictors of stress. CONCLUSION: We suggest that leadership and management pay more attention to CNAs' basic demographic background information. Furthermore, timely, relevant strategies can be provided to enhance resilience and reduce workplace stress. [Journal of Gerontological Nursing, 50(7), 19-26.].
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COVID-19 , Assistência de Longa Duração , Assistentes de Enfermagem , Estresse Ocupacional , Resiliência Psicológica , Humanos , COVID-19/enfermagem , COVID-19/psicologia , COVID-19/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Taiwan/epidemiologia , Estudos Transversais , Assistentes de Enfermagem/psicologia , Adulto , Estresse Ocupacional/epidemiologia , Local de Trabalho/psicologia , Casas de Saúde , Pandemias , Inquéritos e Questionários , SARS-CoV-2RESUMO
BACKGROUND: This study attempted to illustrate the demographic of inpatient eye careservice from 1997 to 2011 in Taiwan, and also the ophthalmic disease landscape and utilization change over time. These insights might apply to resource allocation planning and trainees' better understandings of ophthalmic inpatient practice. METHODS: This study utilized Taiwan's National Health Insurance Research Database (NHIRD). Admission records of eye service that occurred since 1997 and until 2011 were included. Records were separated into operative and non-operative. The records were further divided according to their time: a group of early time before 2006 and a late one after 2006. RESULTS: Patients' mean age were 56 and 44 years for operative and non-operative records. The sex ratio (male to female) was 1.3, and the average of admission duration was 4 days. The average spending was around 1000 United State Dollars per admission and a gradually upgoing trend was also noted. The number of inpatient eye services decreased over time, from 3,248 to 2,174 in the studied period. Cases admitted for operation primarily underwent cataract surgery, vitrectomy, and scleral buckling during the studied period. Trabeculectomy emerged as another major indication of admission during the later time. Cases admitted for non-operative management were primarily corneal ulcer, glaucoma, and infection, including orbital cellulitis and lid abscess. Corneal ulcers made up a major proportion of admission records in the non-operative group during both periods. CONCLUSIONS: This study described the demographics of inpatient eye service in Taiwan. Ophthalmologist, especially trainees, and officials could make better policies according to the presented results in this study.
Assuntos
Úlcera da Córnea , Glaucoma , Oftalmologia , Humanos , Masculino , Feminino , Taiwan/epidemiologia , Pacientes Internados , HospitalizaçãoRESUMO
BACKGROUND: Increased studies have revealed that asymptomatic carriers substantially impact the epidemic and that asymptomatic transmission is very common. Therefore, the asymptomatic transmission threat to the spread of the pandemic should not be neglected. METHODS: The local outbreak in Taiwan, especially in Taipei City, is unprecedented and paramount and has claimed hundreds of lives, tens of thousands of cases, and enormous economic costs. As care providers and gatekeepers of infectious diseases, Taipei City Hospital has to perform regular polymerase chain reaction (PCR) results of admitted patients and healthcare workers (HCWs) to achieve these goals. RESULTS: In this study, the results revealed a low positive rate of less than 1%, but the asymptomatic proportions could range from 42% to 46%, which bolsters that systematic screening was effective in controlling coronavirus disease-19 (COVID-19) of Novel Coronavirus or Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) and might be an exemplar to other similar scenarios. Universal screening of admitted patients may be important and necessary, especially in asymptomatic patients. CONCLUSIONS: Regular screening for healthcare providers is also important during this pandemic, and it is recommended that admitted patients and healthcare providers undergo systemic PCR testing.
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Two new dimeric 1,4-benzoquinone derivatives, peniquinone A (1) and peniquinone B (2), a new dibenzofuran penizofuran A (3), and a new pyrazinoquinazoline derivative quinadoline D (4), together with 13 known compounds (5-17), were isolated from a marine-derived fungus Penicillium sp. L129. Their structures, including absolute configurations, were elucidated by extensive spectroscopic data and electronic circular dichroism calculations. Compound 1 exhibited cytotoxicity against the MCF-7, U87 and PC3 cell lines with IC50 values of 12.39 µM, 9.01 µM and 14.59 µM, respectively, while compound 2 displayed relatively weak cytotoxicity activities against MCF-7, U87 and PC3 cell lines with IC50 values of 25.32 µM, 13.45 µM and 19.93 µM, respectively. Furthermore, compound 2 showed weak quorum sensing inhibitory activity against Chromobacterium violaceum CV026 with an MIC value of 20 µg/well.
Assuntos
Antineoplásicos/farmacologia , Organismos Aquáticos/química , Benzoquinonas/farmacologia , Penicillium/química , Antibacterianos/química , Antibacterianos/isolamento & purificação , Antibacterianos/farmacologia , Antineoplásicos/química , Antineoplásicos/isolamento & purificação , Benzoquinonas/química , Benzoquinonas/isolamento & purificação , Linhagem Celular Tumoral , Chromobacterium/efeitos dos fármacos , Chromobacterium/fisiologia , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Concentração Inibidora 50 , Estrutura Molecular , Percepção de Quorum/efeitos dos fármacosRESUMO
An innovative approach is presented for portable and sensitive detection of pathogenic bacteria. A novel synthetic hybrid nanocomposite encapsulating platinum nanoparticles, as a highly efficient catalyst, catalyzes the hydrolysis of the ammonia-borane complex to generate hydrogen gas. The nanocomposites are used as a label for immunoassays. A portable hand-held hydrogen detector combined with nanocomposite-induced signal conversion was applied for point-of-care testing of pathogenic bacteria. A hand-held hydrogen detector was used as the transducer. Escherichia coli O157:H7 (E. coli O157: H7), as detection target, formed a sandwich structure with magnetic beads and hybrid nanocomposites. Magnetic beads were used for separation of the sandwich structure, and hybrid nanocomposites as catalysts to catalyze the generation of hydrogen from ammonia-borane. The generated hydrogen was detected by a hydrogen detector using an electrochemical method. E. coli O157:H7 has a detection limit of 10 CFU·mL-1. The immunosensor made the hand-held hydrogen detector a point-of-care meter to be used outdoors for the detection and quantification of targets beyond hydrogen. Graphical abstract Schematic presentation of one-pot synthetic peptide-Cu3(PO4)2 hybrid nanocomposites embedded PtNPs (PPNs), encapsulating many Pt particles. The PPNs acts as an ideal immunoprobe for hand-held H2 detector signal readouts, by transforming pathogenic bacteria recognition events into H2 signals.
RESUMO
Disposable syringes were used in a novel point-of-care visual test for detecting pathogenic bacteria (Escherichia coli O157:H7 and Salmonella typhimurium). Hybrid nanoflowers composed of platinum nanoparticles and concanavalin A (Pt-nanoflowers) were prepared through a one-pot reaction and were found to be viable catalase mimics. They catalyze the decomposition of hydrogen peroxide (H2O2) to generate O2. When used as labels in immunoassays, they integrate both the functions of biological recognition and signal amplification. The disposable syringe pressure readout was combined with Pt-nanoflower signal conversion and successfully applied to a visual bacteria detection scheme. Both Escherichia coli O157:H7 and Salmonella typhimurium can be quantified with detection limits of as low as 15 and 7 CFU·mL-1, respectively. Graphical abstract One-pot synthetic platinum nanoparticle (PtNP)-concanavalin A hybrid nanoflowers (Pt-nanoflowers), have been used as ideal signal labels for immunoassays and integrating both essential functions of biological recognition and signal amplification. Disposable syringes were used as a readout to detect pathogenic bacteria.
Assuntos
Escherichia coli O157/isolamento & purificação , Peróxido de Hidrogênio/química , Imunoensaio/métodos , Nanopartículas Metálicas/química , Salmonella typhimurium/isolamento & purificação , Seringas , Animais , Anticorpos/imunologia , Concanavalina A/química , Escherichia coli O157/química , Escherichia coli O157/imunologia , Microbiologia de Alimentos/instrumentação , Microbiologia de Alimentos/métodos , Imunoensaio/instrumentação , Limite de Detecção , Leite/microbiologia , Platina/química , Pressão , Salmonella typhimurium/química , Salmonella typhimurium/imunologiaRESUMO
AIMS: To examine the longitudinal effects of individual characteristics on the change pattern of insomnia and the association of occupational stress with insomnia over time in newly graduated nurses. BACKGROUND: The association between individual factors and insomnia in nurses is inconclusive. Longitudinal research on insomnia in newly graduated nurses is limited. METHODS: This prospective longitudinal study included 200 participants generating 800 observations of insomnia severity during their first year of nursing. We employed growth mixture modelling for data analyses. Both time-varying covariate (occupational stress) and time-invariant covariates (nurses' characteristics) were entered into the model simultaneously. RESULTS: Nurses had a homogeneous insomnia trajectory during the whole year of survey. The educational level significantly predicted the growth rate of insomnia severity among nurses. Occupational stress at each time point was significantly associated with worse insomnia across time points (all p < .001). CONCLUSIONS: Nurses with a baccalaureate degree were more resilient to the development of severe insomnia. Additional studies have an opportunity to investigate the reason for the effects of the educational level on the pattern of insomnia. IMPLICATIONS FOR NURSING MANAGEMENT: Considering nurses' occupational stress and educational level would lead more effective management of stress and insomnia in newly graduated nurses.
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Enfermeiras e Enfermeiros/classificação , Enfermeiras e Enfermeiros/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Enfermeiras e Enfermeiros/estatística & dados numéricos , Estresse Ocupacional/etiologia , Estresse Ocupacional/psicologia , Estudos Prospectivos , Psicometria/instrumentação , Psicometria/métodos , Distúrbios do Início e da Manutenção do Sono/classificação , Inquéritos e Questionários , Taiwan , Local de Trabalho/psicologia , Local de Trabalho/normas , Adulto JovemRESUMO
Schistosomiasis is considered the most important disease caused by helminth parasites, in terms of morbidity and mortality. Tools to facilitate gain- and loss-of-function approaches can be expected to precipitate the discovery of novel interventions, and drug selection of transgenic schistosomes would facilitate the establishment of stable lines of engineered parasites. Sensitivity of developmental stages of schistosomes to the aminonucleoside antibiotic puromycin was investigated. For the schistosomulum and sporocyst stages, viability was quantified by fluorescence microscopy following dual staining with fluorescein diacetate and propidium iodine. By 6 days in culture, the 50% lethal concentration (LC50) for schistosomula was 19 µg/ml whereas the sporocysts were 45-fold more resilient. Puromycin potently inhibited the development of in vitro-laid eggs (LC50, 68 ng/ml) but was less effective against liver eggs (LC50, 387 µg/ml). Toxicity for adult stages was evaluated using the xCELLigence-based, real-time motility assay (xWORM), which revealed LC50s after 48 h of 4.9 and 17.3 µg/ml for male and female schistosomes, respectively. Also, schistosomula transduced with pseudotyped retrovirus encoding the puromycin resistance marker were partially rescued when cultured in the presence of the antibiotic. Together, these findings will facilitate selection on puromycin of transgenic schistosomes and the enrichment of cultures of transgenic eggs and sporocysts to facilitate the establishment of schistosome transgenic lines. Streamlining schistosome transgenesis with drug selection will open new avenues to understand parasite biology and hopefully lead to new interventions for this neglected tropical disease.
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Puromicina/farmacologia , Schistosoma mansoni/efeitos dos fármacos , Animais , Animais Geneticamente Modificados , Feminino , Fluoresceínas/farmacologia , Genômica/métodos , Masculino , Schistosoma mansoni/genética , Esquistossomose/tratamento farmacológicoRESUMO
Rapid, sensitive and point-of-care detection of foodborne pathogenic bacteria is essential for food safety. In this study, we found that hemin-concanavalin A hybrid nanoflowers (HCH nanoflowers), as solid mimic peroxidase, could catalyze oxidation of 2,2'-azino-bis (3-ethylbenzthiazoline-6-sulfonic acid) diammonium salt (ABTS) in the presence of H2O2 to a green-colored product. HCH nanoflowers, integrating the essential functions of both biological recognition and signal amplification, meet the requirements of signal labels for colorimetric immunoassay of bacteria. In view of the excellent peroxidase mimetic catalytic activity of HCH nanoflowers, a colorimetric biosensing platform was newly constructed and applied for sensitive detection of foodborne Escherichia coli O157:H7 (E. coli O157:H7). The corresponding detection limits was as low as 4.1â¯CFU/mL with wide linear ranges (101-106â¯CFU/mL).
Assuntos
Materiais Biomiméticos/química , Técnicas Biossensoriais/métodos , Colorimetria/métodos , Infecções por Escherichia coli/microbiologia , Escherichia coli O157/isolamento & purificação , Hemina/química , Nanoestruturas/química , Animais , Benzotiazóis/química , Doenças Transmitidas por Alimentos/microbiologia , Humanos , Peróxido de Hidrogênio/química , Imunoensaio/métodos , Limite de Detecção , Leite/microbiologia , Peroxidase/química , Ácidos Sulfônicos/químicaRESUMO
OBJECTIVE: To describe the methodology of transurethral seminal vesiculoscopy and the anatomy of the seminal tract, and to report a single-surgeon experience with this procedure. METHODS: A total of 38 consecutive patients with intractable macroscopic hemospermia were enrolled from January 2010 to July 2016. A 6/7.5-Fr semirigid ureteroscope was used to enter the seminal tract by one of these two approaches: through either a trans-ejaculatory duct opening or a trans-utricle fenestration. Patient characteristics and their preoperative and postoperative measurements were analyzed retrospectively. RESULTS: The success rate of transurethral seminal vesiculoscopy was 92.1%, whereas the approaching method in most patients was the trans-utricle fenestration (88.89%). A total of 34 (94.4%) transurethral seminal vesiculoscopy inspections ended with complete remission, even though nearly half of them (47.2%) only disclosed negative perioperative findings. The median period to complete remission was 4 weeks (interquartile range 4-6 weeks) after the procedure. Four patients had recurrent hemospermia, and the median time to recurrence was 21.5 (range 13-48.5) months. CONCLUSIONS: Transurethral seminal vesiculoscopy is a valuable diagnostic tool for intractable hemospermia, and also plays a therapeutic role by blocking the vicious cycle of stasis, calculi and seminal vesiculitis. More familiarity of the anatomy and enough practice would make the learning curve less steep.
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Endoscopia/métodos , Hemospermia/terapia , Glândulas Seminais/diagnóstico por imagem , Ureteroscópios , Adulto , Ductos Ejaculatórios/cirurgia , Endoscopia/instrumentação , Hemospermia/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Resultado do TratamentoAssuntos
COVID-19/psicologia , Corpo Clínico/psicologia , Saúde Mental , Pandemias , Humanos , Taiwan/epidemiologiaRESUMO
Schistosomiasis is a parasitic zoonosis posing great threat to human health. The infection is acquired by larval cercariae penetrating host skin and transforming into juveniles, schistosomula. Proteolytic enzymes secreted from the cercarial acetabular glands are known to aid to the skin penetration, but molecular mechanisms remain largely unclear. To profile the protein composition and identify potential invasive proteases, we developed a new method for simulating cercarial transformation and collecting schistosomula, and for the first time, we compared the proteomes of Schistosoma japonicum cercariae and schistosomula by using in-gel shotgun proteomic analysis. Totally, 1972 proteins were identified in association with ten main biological processes based on Gene Ontology analysis; 46 proteases were detected in cercariae, and among them, 25 proteases disappeared after penetrated. Notably, leishmanolysins and serine and cysteine proteases were found abundant but differentially expressed. Recombinant serine protease SjCE2b and cysteine protease SjCB2 were produced and used for validation of native proteins. Immunofluorescence and Western blotting assays detected SjCE2b and SjCB2 in cercariae but not in schistosomula, suggesting the two enzymes might be consumed upon skin migration. Our data comprehensively chart the proteomic changes during cercarial invasion, revealing the potential proteases involved, providing a platform for the development of molecular anti-infection strategy.
Assuntos
Cercárias/metabolismo , Cisteína Proteases/química , Proteínas de Helminto/química , Fragmentos de Peptídeos/isolamento & purificação , Proteoma/química , Schistosoma japonicum/metabolismo , Serina Endopeptidases/química , Sequência de Aminoácidos , Animais , Cercárias/genética , Cercárias/crescimento & desenvolvimento , Cromatografia Líquida , Cisteína Proteases/genética , Cisteína Proteases/metabolismo , Escherichia coli/genética , Escherichia coli/metabolismo , Feminino , Expressão Gênica , Proteínas de Helminto/genética , Proteínas de Helminto/metabolismo , Estágios do Ciclo de Vida/genética , Camundongos , Camundongos Endogâmicos C57BL , Anotação de Sequência Molecular , Dados de Sequência Molecular , Proteólise , Proteoma/genética , Proteoma/metabolismo , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Schistosoma japonicum/genética , Schistosoma japonicum/crescimento & desenvolvimento , Serina Endopeptidases/genética , Serina Endopeptidases/metabolismo , Pele/parasitologia , Caramujos/parasitologia , Espectrometria de Massas em TandemRESUMO
OBJECTIVE: To clone and express recombinant calpain of Schistosoma japonicum (Sjcalpain), observe the distribution of Sjcalpain in S. japonicum cercariae and analyze its role in skin invasion. METHODS: The primers were designed according to the full-length sequence of calpain (GenBank accession No. AB016726). The genes encoding catalytic domain and Ca2+ binding domain of Sjcalpain were amplified by PCR, and the target fragments were subcloned into pET-28a. The recombinant proteins were expressed in E. coli BL21 (DE3) and purified by Ni-NTA resin. The rabbit polyclonal antibodies were prepared with the two purified recombinant proteins by immunizing New Zealand white rabbits. ELISA was used to detect the titer of rabbit antiserum. Immunolocalization was used to investigate the distribution of Sjcalpain in S. japonicum cercariae. Cercariae were incubated with specific inhibitor before infection of mice and the worm reduction rate was calculated. RESULTS: The recombinant expression vector Sjcalpain catalytic domain/pET28a and Sjcalpain Ca2+ binding domain/pET28a were constructed and the recombinant proteins were successfully expressed in E. coli BL21 (DE3) (about M(r) 43 000 and M(r) 39 000, respectively). The two target proteins were expressed as inclusion bodies. The purified target proteins were obtained through Ni-NTA affinity purification. ELISA result showed that the titer of prepared rabbit polyclonal antibodies was higher than 1 : 80 000. Immunolocalization study demonstrated that Sjcalpain protein was mainly expressed in the head of cercariae. Inhibition assays suggested that the average number of adult worms in calpain inhibitor-incubation group and control group was 19 and 23, respectively, with a worm reduction rate of 17.4%. CONCLUSION: Sjcalpain is mainly expressed in the head of S. japonicum cercariae. Inhibition of Sjcalpain could reduce the number of invading cercariae in infected mice, which suggest that Sjcalpain may play a role in skin invasion by cercariae.
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Calpaína/metabolismo , Schistosoma japonicum/metabolismo , Esquistossomose Japônica/metabolismo , Animais , Cercárias , Ensaio de Imunoadsorção Enzimática , Escherichia coli , Camundongos , Coelhos , Proteínas Recombinantes , Schistosoma japonicum/genéticaRESUMO
BACKGROUND: The demand for certified nurse aides (CNAs) in long-term care institutions is gradually increasing. Factors such as well-being that positively influence the work of CNAs have been inadequately explored in the literature. PURPOSE: This study was designed to examine the relationships among social support, self-efficacy, demographics, and psychological well-being in CNAs during the recent COVID-19 pandemic and to assess the moderating role of social support on self-efficacy and well-being in this population. METHODS: In this quantitative correlational study, CNAs from 24 legally registered long-term care institutions were recruited as participants. Data were collected using a demographic questionnaire, the General Self-Efficacy Scale, the Social Support Scale, and the Chinese Happiness Inventory. Partial least squares structural equation modeling was used to test the research hypotheses model. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was followed in this cross-sectional study. RESULTS: A total of 148 CNAs were enrolled as participants. The mean age of the participants was 46.48 years. Social support and having children were identified as being significantly and positively correlated with well-being, and self-efficacy was identified as having no significant impact on well-being. Importantly, social support was found to moderate the relationship between self-efficacy and well-being. Overall, social support and having children were important predictors of well-being, with a combined explanatory power of 41.6% ( Q2 = .28, f2 = 0.40). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Self-efficacy was found to be less predictive of well-being in the presence of higher levels of social support. Being a parent was also identified as an important factor affecting the well-being of CNAs under stress. Managers of long-term care institutions should intervene to improve the CNA's social support. Also, CNAs who do not have children should pay more attention to their well-being.
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Assistência de Longa Duração , Assistentes de Enfermagem , Autoeficácia , Apoio Social , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China , Estudos Transversais , Assistência de Longa Duração/psicologia , Assistentes de Enfermagem/psicologia , Assistentes de Enfermagem/estatística & dados numéricos , Bem-Estar Psicológico , Inquéritos e QuestionáriosRESUMO
To perform a meta-analysis to compare the efficacy and safety of diode laser transscleral cyclophotocoagulation (TSCPC) and cyclocryotherapy (CCT) in the treatment of intractable glaucoma. Systemic searches of the Ovid MEDLINE, EMBASE, and Cochrane Library databases yielded experimental and observational comparative studies. TSCPC and CCT efficacy and safety outcomes were compared. Subgroup analyses of participant ethnicity, preoperative intraocular pressure (IOP) level, and underlying causes of glaucoma were conducted. The pooled effects were computed using the random-effects model. The meta-analysis included nine studies totalling 668 eyes. There was no statistically significant difference between the TSCPC and CCT groups in the IOP reduction (IOPR%), decrease in antiglaucoma medications, the operative success rate with or without medications, or retreatment rate in the efficacy analysis. In the subgroup analysis, CCT had a better IOP-lowering effect among non-Asian participants and a non-inferior IOPR% to TSCPC among Asian participants. TSCPC and CCT were associated with similar rates of deterioration in visual acuity, postoperative visual analog scale, and other analysed postoperative complications in the safety analysis. In both groups, severe complications were uncommon. Diode laser TSCPC and CCT had nearly equivalent clinical efficacy in treating intractable glaucoma, while CCT demonstrated a better IOP-lowering effect in non-Asian. Both cyclodestructive procedures have a comparable safety profile.
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Glaucoma , Fotocoagulação a Laser , Humanos , Fotocoagulação a Laser/métodos , Glaucoma/cirurgia , Pressão Intraocular , Tonometria Ocular , Corpo Ciliar/cirurgia , Resultado do Tratamento , Esclera/cirurgia , Estudos RetrospectivosRESUMO
Recent studies propose fallopian tubes as the tissue origin for many ovarian epithelial cancers. To further support this paradigm, we assessed whether salpingectomy for treating ectopic pregnancy had a protective effect using the Taiwan Longitudinal National Health Research Database. We identified 316â882 women with surgical treatment for ectopic pregnancy and 3â168â820 age- and index-date-matched controls from 2000 to 2016. In a nested cohort, 91.5% of cases underwent unilateral salpingectomy, suggesting that most surgically managed patients have salpingectomy. Over a follow-up period of 17 years, the ovarian carcinoma incidence was 0.0069 (95% confidence interval [CI] = 0.0060 to 0.0079) and 0.0089 (95% CI = 0.0086 to 0.0092) in the ectopic pregnancy and the control groups, respectively (P < .001). After adjusting the events to per 100 person-years, the hazard ratio (HR) in the ectopic pregnancy group was 0.70 (95% CI = 0.61 to 0.80). The risk reduction occurred only in epithelial ovarian cancer (HR = 0.73, 95% CI = 0.63 to 0.86) and not in non-epithelial subtypes. These findings show a decrease in ovarian carcinoma incidence after salpingectomy for treating ectopic pregnancy.
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Carcinoma Epitelial do Ovário , Neoplasias Ovarianas , Gravidez Ectópica , Salpingectomia , Humanos , Feminino , Gravidez , Neoplasias Ovarianas/prevenção & controle , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/epidemiologia , Adulto , Taiwan/epidemiologia , Gravidez Ectópica/epidemiologia , Carcinoma Epitelial do Ovário/cirurgia , Carcinoma Epitelial do Ovário/epidemiologia , Incidência , Estudos de Casos e Controles , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Adulto JovemRESUMO
BACKGROUND: An ideal technique for peritoneal dialysis (PD) catheter insertion should provide a long-term functioning catheter until permanent renal replacement therapy becomes available. We developed a technique using the nephroscope-assisted single-trocar approach in 2011. In this study, we report the outcomes, learning curve analysis and cost-effectiveness analysisof the nephroscopic approach compared with the traditional laparoscopic approach. METHOD: Between January 2005 and December 2020, we retrospectively reviewed 511 patients who received PD catheter insertions using the laparoscopic or nephroscopic approach. We compared the baseline characteristics of the patients, surgical outcomes, and complications of the two groups. We further analyzed the nephroscopic group to determine the cost-effectiveness analysis, learning curve and the complication frequency between the learning and mastery periods of the nephroscopic approach. RESULTS: A total of 208 patients underwent laparoscopic PD catheter insertion, whereas 303 patients received nephroscopic surgery. The median catheter survival in the nephroscopic group is significantly longer (43.1 vs. 60.5 months, p = 0.019). The incidence of peritonitis (29.3% vs.20.8%, p = 0.035) and exit site infection (12.5% vs. 6.6%, p = 0.019) were significantly lower in the nephroscopic group. The cost-effectiveness analysis showed a medical expense reduction of 16000 USD annually by using the nephroscopic technique. There was no difference in the frequency of surgical complications between the learning and mastery phases when examining the learning curve analysis for the nephroscopic technique. CONCLUSIONS: Compared with the traditional laparoscopic approach, the nephroscopic technique effectively prolonged catheter survival and reduces health care cost by reducing infectious complications. The low complication rate during the learning phase of surgery makes the procedure safe for patients and surgeons.
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Falência Renal Crônica , Laparoscopia , Diálise Peritoneal , Humanos , Cateteres de Demora , Estudos Retrospectivos , Diálise Peritoneal/métodos , Laparoscopia/métodos , Instrumentos Cirúrgicos , Falência Renal Crônica/etiologia , Falência Renal Crônica/terapiaRESUMO
Radio frequency identification (RFID) applications have the potential to increase the reliability of healthcare environments. However, there are obvious security and privacy concerns with regard to storing personal and medical data in RFID tags, and the lack of secure authentication systems in healthcare environments remains as a challenge the further use of this technology, one that touches on issues of confidentiality, unforgeability, location privacy, and scalability. This study proposes a novel mutual authentication protocol that considers all of these issues and solves the tradeoff between location privacy and scalability in healthcare environments. A formal proof and analysis is demonstrated to prove the effectiveness of the proposed scheme, and that high reliability has and can be easily deployed and managed. This study also provides a scenario example that applied proposed protocol in the newborn care and management. The result shows that the proposed scheme solves the related tradeoff problem, and is capable of providing both location privacy and scalability. To apply the authentication scheme proposed in this work would be able to increase confidence in future implementations of RFID systems in healthcare environments.
Assuntos
Confidencialidade , Instalações de Saúde , Sistemas de Informação , Dispositivo de Identificação por Radiofrequência/normas , AlgoritmosRESUMO
OBJECTIVE: To screen a ribosomal protein (SjRibosomal_L18a) of Schistosoma japonicum and predict its B cell epitopes, and evaluate the potential diagnostic value of the recombinant protein and the synthetic B cell epitopes. METHOD: S. japonicum protein sequences were screened and analyzed by using B-cell epitope prediction softwares. The immunogenic protein was selected based on the predicted score and the quantity of epitopes. The epitopes with higher score (P1 and P2) were synthesized. The relative molecular mass (M(r)), isoelectric point, grand average of hydropathicity, signal peptide, and transmembrane domain were predicted by bioinformatics tools. RT-PCR was used to analyze the transcription level of the different development stages. The encoding sequence was amplified by PCR, and cloned into pET28a vector. The recombinant plasmid was transformed into in E. coli BL21 (DE3) cells and induced with IPTG. The recombinant SjRibosomal_L18a protein was purified with Ni-NTA resin. ELISA was used to evaluate the potential diagnostic value of the recombined protein and the synthetic B cell epitopes. RESULTS: SjRibosomal_L18a protein was obtained, its B cell epitopes and physicochemical properties were predicted. The open reading frame of SjRibosomal_L18a was composed of 531 bp, and encoded a 176-amino-acid protein with M(r) 20 741, pI 11.12. RT-PCR result showed that this gene was transcribed at high level in each developmental stage. The recombinant plasmid SjRibosomal_L18a/pET-28a was constructed and the protein was expressed as inclusion bodies (M(r) 26069). The sensitivity and specificity of recombined protein, P1 and P2 were 53.3% (8/15) and 100% (15/15), 60% (9/15) and 100% (15/15), 73.3% (11/15) and 100% (15/15), respectively. CONCLUSION: The recombinant protein (SjRibosomal_L18a) and its epitopes with higher immunogenicity are obtained. The sensitivity of the two epitopes (P1 and P2) was higher than that of SjRibosomal_L18a protein.