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1.
J Biochem Mol Toxicol ; 38(1): e23543, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37794744

RESUMEN

There is a growing concern that antidepressant drugs impair sexual function and adversely impact spermatogenesis and male fertility. Vitamin C is a natural antioxidant that plays a vital role in the male reproductive system. The present study investigated the ameliorating potential of vitamin C against citalopram (CTL)-evoked testicular toxicity and spermatogenesis impairment in mice. Mice were randomly divided into six groups: control, CTL, vitamin C 100, vitamin C 200, CTL plus vitamin C 100, and CTL plus vitamin C 200. Adult male mice were intraperitoneally (ip) injected with 10 mg/kg of CTL for 35 days with or without vitamin C. At the end of the study, body and testes weight, sperm parameters, histopathology of testes, testosterone level, testicular levels of malondialdehyde (MDA), nitric oxide (NO), total antioxidant capacity (TAC), and apoptosis (TUNEL assay) were evaluated. Our findings revealed that vitamin C restored spermatogenesis by improving sperm count, motility, viability, morphology, and chromatin integrity. Testosterone levels and testes histopathology were significantly improved in the vitamin C-administrated groups. Furthermore, vitamin C administration markedly alleviated CTL-induced nitro-oxidative damage, enhancing TAC levels, and reducing NO and MDA levels. Whilst CTL therapy induced a significant increase in the number of TUNEL-positive cells compared to the control, the administration of vitamin C significantly prevented the apoptotic effects of CTL. Together, vitamin C therapy protects against CTL-induced testicular damage via mitigating nitro-oxidative stress and apoptosis, which provides evidence for vitamin C as a beneficial therapy against antidepressant drug-associated reproductive toxicity and male sub/infertility.


Asunto(s)
Infertilidad Masculina , Testículo , Humanos , Masculino , Ratones , Animales , Testículo/metabolismo , Ácido Ascórbico/farmacología , Antioxidantes/metabolismo , Citalopram/farmacología , Citalopram/metabolismo , Semen/metabolismo , Estrés Oxidativo , Espermatozoides , Apoptosis , Infertilidad Masculina/metabolismo , Testosterona/farmacología
2.
Surg Endosc ; 38(7): 3940-3947, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38844728

RESUMEN

BACKGROUND: One-anastomosis gastric bypass (OAGB) is gaining more attention in patients with severe obesity and recently is used for patients with body mass index (BMI) < 35 kg/m2. In this 5-year single center experience we aim to report our outcomes of using OAGB for patients with BMI < 35 kg/m2. METHODS: This is a retrospective analysis of prospectively collected data recorded in to our national obesity registry database. Variables including age, sex, weight, BMI, any associated disease, blood levels of metabolic markers, nutrients, and vitamins before and after surgery were extracted and analyzed. RESULTS: 173 patients with mean age and BMI of 41 ± 10 years and 33 ± 1 kg/m2 underwent OAGB and at least one of the obesity-associated medical problems was found in 88 (50.5%) of them preoperatively. The mean duration of surgery and length of hospital stay were 60.7 ± 7.4 min and 1.3 ± 1.4 days. 78% and 70% of patients had available data at 24 and 60 months, respectively. The mean BMI was 23.9 ± 2.2 kg/m2 1 year after surgery and each year after that till 5 years was 24 ± 2, 24.4 ± 2.6, 25.1 ± 2.7, and 25.5 ± 2.7 kg/m2. Significant improvement in levels of fasting blood glucose, lipid profile, and liver enzymes were observed. CONCLUSION: OAGB for BMI < 35 kg/m2 has significant effects in weight loss, helps remit diabetes and hypertension in the majority of cases, improves lipid profile, and has no increased burden of postoperative problems or deficiency in nutritional factors rather than what is known and predictable.


Asunto(s)
Índice de Masa Corporal , Derivación Gástrica , Obesidad Mórbida , Humanos , Derivación Gástrica/métodos , Femenino , Masculino , Adulto , Estudios Retrospectivos , Obesidad Mórbida/cirugía , Obesidad Mórbida/complicaciones , Resultado del Tratamiento , Persona de Mediana Edad , Pérdida de Peso , Tiempo de Internación/estadística & datos numéricos , Tempo Operativo , Anastomosis Quirúrgica/métodos
3.
Int J Geriatr Psychiatry ; 38(7): e5970, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37485727

RESUMEN

BACKGROUND: Delirium is an acute and transient disorder of brain function that often occurs in post-surgical patients. Rivastigmine is a cholinesterase inhibitor drug that has been proposed as an adjuvant drug in recent years, still, despite significant theoretical evidence, few clinical studies have been performed on its impact on delirium. AIM: Due to the widespread use of cholinesterase inhibitors in pediatric and adult surgery, the present study aims to investigate the impact of Rivastigmine as a cholinesterase inhibitor on delirium after radical surgery. METHODS: In this randomized double-blind clinical trial, a hundred recruited patients were randomly assigned to either Rivastigmine (n = 50) or placebo (n = 50) groups, and we measured post-operative impact on delirium, by Confusion Assessment Method (CAM) score, and cognitive impairment, by the Mini-Mental State Examination (MMSE). Our univariate and multivariate logistical regression models assessed this hypothesized impact. RESULTS: Treatment with Rivastigmine was significantly associated with reduced day one post-op delirium, as measured by CAM score (Odds Ratio (OR) = 0.35, 95% Confidence Interval (CI) 0.11 to 0.97, p = 0.05), and cognitive impairment, as measured by MMSE (OR = 0.25, 95% CI 0.1 to 0.59, p = 0.0022). These associations became stronger after controlling for age, blood loss, and post-op blood sodium levels: Delirium (OR = 0.23, 95% CI 0.05 to 0.92, p = 0.05), cognitive impairment (OR = 0.12, 95% CI 0.03 to 0.42, p = 0.000178). CONCLUSION: The significant result of our randomized clinical trial is that pre-op Rivastigmine treatment may be associated with a substantial drop in patients experiencing post-op delirium and post-op cognitive impairment.


Asunto(s)
Disfunción Cognitiva , Delirio , Humanos , Rivastigmina/uso terapéutico , Inhibidores de la Colinesterasa/efectos adversos , Fenilcarbamatos/efectos adversos , Disfunción Cognitiva/tratamiento farmacológico , Disfunción Cognitiva/etiología , Delirio/tratamiento farmacológico , Delirio/etiología
4.
Cytokine ; 153: 155849, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35339044

RESUMEN

As a member of JAK family of non-receptor tyrosine kinases, TYK2 has a crucial role in regulation of immune responses. This protein has a crucial role in constant expression of IFNAR1 on surface of cells and initiation of type I IFN signaling. In the current study, we measured expression of IFNAR1 and TYK2 levels in venous blood samples of COVID-19 patients and matched controls. TYK2 was significantly down-regulated in male patients compared with male controls (RME = 0.34, P value = 0.03). Though, levels of TYK2 were not different between female cases and female controls, or between ICU-admitted and non-ICU-admitted cases. Expression of IFNAR1 was not different either between COVID-19 cases and controls or between patients required ICU admission and non-ICU-admitted cases. However, none of these transcripts can properly diffrentiate COVID-19 cases from controls or separate patients based on disease severity. The current study proposes down-regulation of TYK2 as a molecular mechanism for incapacity of SARS-CoV-2 in induction of a competent IFN response.


Asunto(s)
COVID-19 , Femenino , Humanos , Masculino , Proteínas/metabolismo , Receptor de Interferón alfa y beta/genética , Receptor de Interferón alfa y beta/metabolismo , SARS-CoV-2 , TYK2 Quinasa/genética , TYK2 Quinasa/metabolismo
5.
Nanotechnology ; 33(29)2022 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-35313292

RESUMEN

In this study, hybrid nanofibrous 3D scaffolds containingAloe vera(AV), polyvinyl alcohol (PVA) and tetracycline hydrochloride (TCH) are fabricated by electrospinning for cell culture applications. The role of polysaccharides present in AV gel is found to enhance the biocompatibility of the nanofibrous scaffolds. Different combinations of the polymers were selected to produce homogenous nanofibers with favorable mean fiber diameter and tensile strength. The surface morphology of the products was studied by SEM and it is found that the mean fiber diameter is decreased to about 188 nm upon addition of the AV component. The electrospun scaffolds were investigated by FT-IR spectroscopy to reveal the chemical structure of the samples and their crystallinity was studied by XRD. The hydrophilicity of the scaffolds was tested by optical contact angle measurements and their mechanical strength was examined by tensile strength tests. It is found that PVA is the main component contributing the mechanical stability of the scaffold structure. The fabricated scaffolds presented a more pronounced inhibitory effect against Gram-positive bacterial strains ofS. aureusandB. cereus. Cell culture experiments using fibroblast L929 murine cells reveals that the AV/PVA/TCH scaffolds are promising for cell growth and the cells are capable of achieving a proper cell adhesion and proliferation. The cell viability experiment by MTT assay exhibits the contributing role of AV gel to L929 cell viability on the AV/PVA/TCH scaffolds.


Asunto(s)
Nanofibras , Alcohol Polivinílico , Animales , Antibacterianos/química , Antibacterianos/farmacología , Técnicas de Cultivo de Célula , Proliferación Celular , Ratones , Nanofibras/química , Alcohol Polivinílico/química , Espectroscopía Infrarroja por Transformada de Fourier , Tetraciclina/farmacología , Ingeniería de Tejidos/métodos , Andamios del Tejido/química
6.
Mol Biol Rep ; 49(8): 8061-8069, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35320440

RESUMEN

INTRODUCTION: As a recurrent disease, periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is characterized by episodes of febrile attacks and is often prominent in children under five years of age. However, the etiology of this condition has not been fully understood yet. MATERIALS AND METHODS: The search in the extensive literature of peer-reviewed articles published from the inception to December 2021 was conducted to identify the relevant studies, using the electronic databases of MEDLINE/PubMed, Embase, Scopus, the Cochrane Library, and the Web of Science. RESULTS: The analysis of complex relationships indicates that inflammatory factors, such as various cytokines and acute-phase proteins (APPs), play leading roles in the pathogenesis of this disease. Accordingly, this article summarizes the current state of knowledge to explain the mechanisms involved in inflammatory responses among patients with PFAPA syndrome and investigate its role in the pathogenesis of this disease. Moreover, the possibilities for further implementation of new therapeutic strategies are pointed out. CONCLUSION: It is concluded that some pathophysiological processes are associated with immune dysregulation, which itself may be secondary to environmental factors, genetic background, and underlying diseases, including latent infections that multiply inflammatory mediators. elevated inflammatory markers similarly play a significant part in the clinical outcomes of this condition, whose pyrogenic nature is the reason for the development of episodes of febrile attacks in the population of patients suffering from PFAPA syndrome.


Asunto(s)
Amiloidosis , Linfadenitis , Faringitis , Estomatitis Aftosa , Niño , Preescolar , Fiebre/complicaciones , Fiebre/terapia , Humanos , Mediadores de Inflamación , Linfadenitis/complicaciones , Linfadenitis/terapia , Faringitis/complicaciones , Faringitis/terapia , Estomatitis Aftosa/complicaciones , Estomatitis Aftosa/terapia , Síndrome
7.
Am J Emerg Med ; 51: 144-149, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34739867

RESUMEN

OBJECTIVE: This study aims to assess the prognosis of inpatients with COVID-19 infection who have a history of sulfur mustard exposure. METHODS: We started a cohort study in October 2020 and ended in May 2021 on inpatients with COVID-19 infection who had been admitted to university healthcare centers. The analytic sample included 960 inpatients having COVID-19 infection (192 with; and 768 without sulfur mustard exposure). The exposed patients were male war veterans, and the unexposed patients were male individually age-matched people. All patients had a positive RT-PCR test and a positive chest CT for COVID-19. The outcome was death within 28 days of admission, and the predictors were clinical features recorded at patients' bedsides. RESULTS: There was a significantly higher prevalence for asthma (p = 0.026) and pulmonary disease other than asthma (p < 0.001) in patients with the exposure. Sulfur mustard exposure was associated with increased risk for mortality of COVID-19 [hazard ratio (95% CI) = 1.92 (1.14,3.24), p = 0.013]. Early intubation signified a poor prognosis [hazard = 7.34 (4.65,11.58), p < 0.001]. However, individuals with higher PaO2 [hazard = 0.97 (0.95,0.98), p < 0.001], or people undergoing O2 therapy early upon admission [hazard = 0.58 (0.38,0.89), p = 0.011] showed lower risks for mortality. Individuals with asthma were at higher risk for mortality [hazard = 3.76 (1.69,8.36), p = 0.001]. CONCLUSION: Individuals with COVID-19 infection and sulfur mustard exposure should be considered high-risk patients and that, healthcare settings should be ready to provide critical care for them, including O2 therapy. They are more likely to have asthma or other pulmonary diseases.


Asunto(s)
COVID-19/mortalidad , Sustancias para la Guerra Química/efectos adversos , Gas Mostaza/efectos adversos , Asma , Estudios de Cohortes , Hospitalización , Hospitales Universitarios , Humanos , Pacientes Internos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Análisis de Supervivencia , Tomografía Computarizada por Rayos X , Veteranos
8.
Surg Today ; 52(5): 795-803, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34698938

RESUMEN

PURPOSES: Recognizing which patients admitted postsurgically to the intensive care unit (ICU) are at greater risk of mortality assists medical staff to identify who will benefit most from the care. We developed a prediction model for the 1-month mortality of postsurgical ICU patients. METHODS: From May, 2019 to May, 2020, we conducted a prospective cohort study in the postsurgical ICU of a teaching hospital affiliated with our University of Medical Sciences. The outcome was death within 1 month of admission and the predictors were a variety of anthropometric and clinical features. The subjects of this analysis were 805 consecutive adult postsurgical patients with a mean (SD) age of 54.8 (18.9) years. RESULTS: Overall, the resulted logistic model was well-fitted [χ2 (26) = 772.097, p < 0.001, Nagelkerke R2 = 0.814] accurate (88%), and specific (92%). The adjusted odds ratio for body temperature was 0.51, p < 0.001. Patients with comorbidities and those undergoing multiple operations were at a greater risk of mortality, odds = 10.00 and 10.65 (both p < 0.001). CONCLUSIONS: Higher body temperature at the time of postoperative ICU admission is a protective factor against 1-month mortality. Our study found that patients with several comorbidities and those who have undergone multiple operations are at a greater risk of a poor outcome.


Asunto(s)
Hospitalización , Unidades de Cuidados Intensivos , Adulto , Mortalidad Hospitalaria , Humanos , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos
9.
Am J Drug Alcohol Abuse ; 48(4): 422-432, 2022 07 04.
Artículo en Inglés | MEDLINE | ID: mdl-35658689

RESUMEN

Background: Quetiapine is an atypical antipsychotic that antagonizes dopamine and serotonin receptors. It has been suggested that quetiapine can be used to treat substance use disorders, including opioid use disorder. Opioids modulate dopaminergic functions associated with conditioned reinforcement and these effects can be measured via the conditioned place preference (CPP) paradigm. Opioids' unconditioned effects are regulated by several proteins, including extracellular signal-regulated kinase (ERK) and cAMP-responsive element-binding (CREB).Objective: To assess the effect of quetiapine on morphine-induced CPP and motor activity levels, and on the levels of ERK and CREB proteins in the hippocampus and cerebral cortex.Methods: 42 male rats were exposed to a CPP protocol, in which they underwent a conditioning paradigm with saline, quetiapine (40 mg/kg), morphine (10 mg/kg), morphine plus quetiapine (10, 20, or 40 mg/kg), or morphine plus memantine (7.5 mg/kg, a positive control drug) (n = 6 per group). The rats were tested for CPP and exploratory activity. Levels of ERK and CREB proteins in the hippocampus and cerebral cortex were also measured.Results: Quetiapine co-administered with morphine inhibited morphine-induced CPP [F (6, 70) = 11.67, p < .001] and morphine's effects on motor activity (p < .001). Morphine enhanced ERK phosphorylation in the hippocampus (p < .001) and cerebral cortex (p < .001), an effect inhibited by quetiapine.Conclusion: Quetiapine attenuates morphine-induced CPP and locomotion and these effects are associated with a reduction of ERK phosphorylation in the hippocampus and cerebral cortex. These results suggest that quetiapine should be further explored as a potential treatment for opioid use disorder.


Asunto(s)
Morfina , Trastornos Relacionados con Opioides , Analgésicos Opioides/farmacología , Animales , Corteza Cerebral/metabolismo , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/metabolismo , Quinasas MAP Reguladas por Señal Extracelular/metabolismo , Quinasas MAP Reguladas por Señal Extracelular/farmacología , Hipocampo/metabolismo , Masculino , Morfina/metabolismo , Morfina/farmacología , Fosforilación , Fumarato de Quetiapina/metabolismo , Fumarato de Quetiapina/farmacología , Ratas
10.
BMC Musculoskelet Disord ; 22(1): 134, 2021 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-33536010

RESUMEN

BACKGROUND: Our study compare the short and long-term efficacy of the intra articular injections (IAIs) of hyaluronic acid (HA), platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), and ozone in patients with knee osteoarthritis (OA). METHODS: In this randomized clinical trial, 238 patients with mild to moderate knee OA were randomized into 4 groups of IAIs: HA (3 doses weekly), PRP (2 doses with 3 weeks interval), PRGF (2 doses with 3 weeks interval), and Ozone (3 doses weekly). Our outcome measures were the mean changes from baseline (immediately from the first injections) until 2,6, and 12 months post intervention in scores of visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne index. RESULTS: A total of 200 patients enrolled in the final analysis. The mean age of patients was 56.9 ± 6.3 years, and 69.5% were women. In 2 months follow up, significant improvement of pain, stiffness, and function were seen in all groups compared to the baseline, but the ozone group had the best results (P < 0.05). In 6 month follow up HA, PRP, and PRGF groups demonstrated better therapeutic effects in all scores in comparison with ozone (P < 0.05). At the end of the 12th month, only PRGF and PRP groups had better results versus HA and ozone groups in all scores (P < 0.05). Despite the fact that ozone showed better early results, its effects begin to wear off earlier than other products and ultimately disappear in 12 months. CONCLUSIONS: Ozone injection had rapid effects and better short-term results after 2 months, but its therapeutic effects did not persist after 6 months and at the 6-month follow up, PRP,PRGF and HA were superior to ozone. Only patients in PRP and PRGF groups improved symptoms persisted for 12 months. Therefore, these products could be the preferable choices for long-term management. TRIAL REGISTRATION: Registered in the Iranian Center of Clinical Trials ( www.irct.ir ) in 11/11/2017 with the following code: IRCT2017082013442N17.


Asunto(s)
Osteoartritis de la Rodilla , Ozono , Plasma Rico en Plaquetas , Femenino , Humanos , Ácido Hialurónico/uso terapéutico , Inyecciones Intraarticulares , Péptidos y Proteínas de Señalización Intercelular/uso terapéutico , Irán , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/tratamiento farmacológico , Osteoartritis de la Rodilla/terapia , Ozono/uso terapéutico , Resultado del Tratamiento
11.
J Mater Sci Mater Med ; 31(7): 57, 2020 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-32596771

RESUMEN

Our previous studies have been focused on the design, optimization and manufacture of a partially resorbable composite bone plate consisting of a poly l-lactic acid matrix reinforced with braided fabrics bioactive glass fibers (PLLA/BG). In the present study, the response of the composite samples, the degradation rate, the inflammatory response, fibrous capsule formation and tissue-implant bonding to the in-vivo environment were assessed via implantation in the rabbit subcutaneous tissue. Despite the presence of both enzymatic degradation and hydrolysis processes within the body, the rate of the molecular weight loss as an indicator of degradation did not show a significant difference with the in-vitro conditions. It was predicted that strength loss would show the same trend since it was a consequence of molecular chain disruption and the loss of molecular weight. Inexistence of chronic inflammation, as confirmed by our previous results on the controlled degradation rate, also showed the maintenance of the physiological pH in the peripheral environment of the implant. Moreover, lack of the fibrous capsule tissue around the implant indicated that the implant was bioactive. In addition, given the composition of the bioactive glass fibers, that could be bonded to soft and hard tissues, tissue bonding with the PLLA/BG composite samples was also observed, thereby confirming the bioactivity and biocompatibility of the proposed bone plate.


Asunto(s)
Materiales Biocompatibles , Sustitutos de Huesos , Cerámica/química , Fijación de Fractura/instrumentación , Poliésteres/química , Implantes Absorbibles , Animales , Materiales Biocompatibles/síntesis química , Materiales Biocompatibles/química , Materiales Biocompatibles/uso terapéutico , Sustitutos de Huesos/síntesis química , Sustitutos de Huesos/química , Sustitutos de Huesos/uso terapéutico , Fracturas Óseas/terapia , Vidrio/química , Masculino , Ensayo de Materiales , Nanocompuestos/química , Nanocompuestos/uso terapéutico , Prótesis e Implantes , Conejos , Propiedades de Superficie , Soporte de Peso/fisiología
12.
Tohoku J Exp Med ; 252(1): 73-84, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32908083

RESUMEN

The Coronavirus Disease 2019 (COVID-19) pandemic has killed many people worldwide since December 2019, and Iran has been among the most affected countries. In this retrospective study, we aimed to determine the prognostic factors associated with mortality in COVID-19 patients by analyzing 396 survived and 63 non-survived patients in Shahid Modarres Hospital, Tehran, Iran, from January 30th until April 5th, 2020. As the results, the BMI > 35 (p = 0.0003), lung cancer (p = 0.007), chronic kidney disease (p = 0.002), Immunocompromised condition (p = 0.003), and diabetes (p = 0.018) were more frequently observed in the expired group. The history of statins use was more common in the discharged group (p = 0.002), while there was no significant difference in the drug history of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, nonsteroidal anti-inflammatory drugs, aspirin, and/or steroids, and in the past-year influenza vaccination. Multivariable regression demonstrated rising odds of in-hospital death related with age (odds ratio (OR) = 1.055, p = 0.002), levels of C-reactive protein (CRP) (OR = 2.915, p < 0.001), creatinine (OR = 1.740, p = 0.023), lymphocyte count (OR = 0.999, p = 0.008), and magnesium level (OR = 0.032, p < 0.001) on admission. In conclusion, the patients with older age and higher BMI with lymphopenia, hypomagnesemia, elevated CRP and/or raised creatinine on admission are at higher risk of mortality due to the COVID-19 infection, which requires the physicians to use timely and strong therapeutic measures for such patients.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Pandemias , Neumonía Viral/mortalidad , Factores de Edad , Anciano , COVID-19 , Enfermedades Cardiovasculares/epidemiología , Comorbilidad , Infecciones por Coronavirus/sangre , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Humanos , Huésped Inmunocomprometido , Inflamación/epidemiología , Pacientes Internos/estadística & datos numéricos , Irán/epidemiología , Enfermedades Renales/epidemiología , Linfopenia/epidemiología , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Oportunidad Relativa , Sobrepeso/epidemiología , Neumonía Viral/sangre , Pronóstico , Derivación y Consulta/estadística & datos numéricos , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2 , Evaluación de Síntomas
13.
Eur J Anaesthesiol ; 37(6): 457-465, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31842026

RESUMEN

BACKGROUND: Bariatric surgery is a well established treatment of the obese. Postoperative respiratory failure and airway obstruction after bariatric surgery can often be attributed to the residual depressant effects of anaesthetics, sedatives and opioids. Peri-operative management of morbidly obese patients is still a concern for operating room professionals. OBJECTIVE: The evaluation of the effects of doxapram on the outcomes of general anaesthesia following bariatric surgical procedures in the morbidly obese. DESIGN: A single-blind randomised controlled trial with two parallel arms. SETTING: A tertiary care teaching hospital, Tehran, Iran, from 2017 to 2018. PARTICIPANTS: In total, 100 patients (69 women) with at least class two obesity were included in two groups of equal sizes and underwent bariatric surgery. MAIN OUTCOME MEASURES: The primary outcome was the time from the administration of doxapram to tracheal extubation. Secondary outcomes included vital signs and variables including peak expiratory flow rate, time to return to spontaneous breathing, time to eye-opening and hand-squeezing on the commands, and time to recovery. INTERVENTIONS: Both groups underwent general anaesthesia. The intervention group received a single dose of doxapram 1 mg kg ideal body weight, immediately after reversal of neuromuscular blockade and after discontinuation of all anaesthetics. RESULTS: Doxapram decreased time to extubation, time to eye-opening and hand-squeezing, shortened recovery time and lowered end-tidal CO2 significantly (all P < 0.001). Moreover, it increased peak expiratory flow rate, oxygen saturation, temperature, heart rate and blood pressure (all P < 0.001). The two groups were similar in the bispectral index and mean arterial pressure (both P > 0.05). None of our participants had complications attributable to doxapram. CONCLUSION: The postoperative use of doxapram improves peak expiratory flow rate, and decreases respiratory complications of anaesthesia during recovery in the morbidly obese undergoing bariatric surgery. Doxapram is well tolerated in young ASA physical status classes 1 to 2 morbidly obese patients; however, the anaesthesiologist should cautiously evaluate the vital signs for at least half an hour following the administration of doxapram. REGISTRATION: Iranian Registry of Clinical Trials (IRCT) http://www.irct.ir/ number IRCT2017060712203N9.


Asunto(s)
Cirugía Bariátrica , Obesidad Mórbida , Extubación Traqueal , Cirugía Bariátrica/efectos adversos , Doxapram , Femenino , Humanos , Irán , Obesidad Mórbida/cirugía , Método Simple Ciego
14.
Aust Crit Care ; 33(4): 367-374, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-31402266

RESUMEN

OBJECTIVE: We conducted a systematic review of primary models to predict intensive care unit (ICU) readmission. REVIEW METHODS: We searched MEDLINE, PubMed, Scopus, and Embase for studies on the development of ICU readmission prediction models that are published until January 2017. Data were extracted on the source of data, participants, outcomes, candidate predictors, sample size, missing data, methods for model development, and measures of model performance and model evaluation. The quality and applicability of the included studies were assessed using the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies. RESULTS: We identified five studies describing the development of the primary prediction models of ICU readmission. Studies ranged in size from 343 to 704,963 patients with the mean age of 58.0-68.9 years. The proportion of readmission ranged from 2.5% to 9.6%. The discriminative ability of prediction models measured by area under the receiver operating characteristic curve was 0.66-0.81. None of the studies performed external validations. The quality scores ranged from 42 to 54 out of 62, and the applicability scores from 24 to 32 out of 38. CONCLUSION: We identified five prediction models for ICU readmission. However, owing to the numerous methodological and reporting deficiencies in the included studies, physicians using these models should interpret the predictions with precautions until an external validation study shows the acceptable level of calibration and accuracy of these models.


Asunto(s)
Unidades de Cuidados Intensivos , Readmisión del Paciente , Medición de Riesgo/métodos , Humanos
15.
Nurs Educ Perspect ; 40(4): 231-233, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30407982

RESUMEN

Given the importance of patient safety, this study aimed to explore clinical instructors' experience of managing students' errors. A qualitative approach was adopted to conduct semistructured interviews with 12 clinical nursing and midwifery instructors. Three main categories emerged: prevention (orienting, review of the knowledge, repeating procedure by instructor, checking steps prior to performing procedure, and reminding), action (correcting, monitoring and follow-up, and informing), and feedback (cause analysis, notifying, and affecting assessment). Patient safety and error management programs should be included in the nursing curriculum and nursing education.


Asunto(s)
Competencia Clínica , Docentes de Enfermería , Estudiantes de Enfermería , Curriculum , Femenino , Humanos , Embarazo , Investigación Cualitativa , Estudiantes , Encuestas y Cuestionarios
16.
Aust Crit Care ; 32(2): 155-164, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-29574007

RESUMEN

OBJECTIVE: We sought to systematically review data on the risk factors influencing the incidence of sepsis in patients admitted to intensive care units (ICUs). REVIEW METHODS: An electronic search was undertaken in PubMed, MEDLINE, Scopus, and the Cochrane Library for studies reporting the risk factors of sepsis from the earliest available date up to December 30, 2016. RESULTS: Among the 2978 articles, 14 studies met the inclusion criteria with a total of 56 164 participants from nine countries. The extracted risk factors were from the following categories: demographic, critical care interventions, surgery-related factors, pre-existing comorbidities, severity of organ injury, and biomarkers and biochemical and molecular indicators. From demographic factors, older age and male gender were associated with an increased risk of sepsis among ICU-admitted patients. CONCLUSION: Our analysis comprehensively summarised the risk factors of sepsis in patients admitted to medical, surgical, neurologic, trauma, and general ICUs. Age, sex, and comorbidities were non-modifiable risk factors; however, critical care interventions and surgery-related factors were modifiable factors and suggest that improving the care of surgical patients and effective management of critical care interventions may play a key role in decreasing the development of sepsis in patients admitted to the ICUs.


Asunto(s)
Mortalidad Hospitalaria , Unidades de Cuidados Intensivos , Sepsis/etiología , Sepsis/mortalidad , Humanos , Factores de Riesgo
17.
Int J Nurs Educ Scholarsh ; 15(1)2018 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-29306920

RESUMEN

The present study is aimed at examining the status of violence among the students of nursing, midwifery, and operating room. A self-reporting questionnaire with two sections of demographic characteristics and experience of violence was used. The data obtained were analyzed, using SPSS software. 58.7 percent of the students had a history of violence in the previous year. The maximum percentage of violence exposure belonged to the students of operating room (76.9%). The highest incidence of violence was verbal (76.4%), happened in patients' rooms (32.9%) and was in the form of insult (75.1%). Accordingly, preventive actions are required to prevent and control violence and support students. Informing students about violence, communicative skills, reaction, and coping with violence during studying is necessary. Therefore, educational authorities and theoretical and clinical instructors should take appropriate measures in order to prevent violence and create supportive mechanisms for the students.


Asunto(s)
Docentes de Enfermería/psicología , Enfermería de Quirófano/educación , Estudiantes de Enfermería/psicología , Violencia Laboral/psicología , Adaptación Psicológica , Adulto , Prácticas Clínicas , Docentes de Enfermería/estadística & datos numéricos , Femenino , Humanos , Relaciones Interprofesionales , Masculino , Persona de Mediana Edad , Violencia Laboral/estadística & datos numéricos , Adulto Joven
18.
J Dairy Res ; 84(1): 49-53, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28007040

RESUMEN

The purpose of the study reported in this Research Communication was to evaluate alterations in concentration of total antioxidant capacity (TAC) of plasma, plasma total thiols as markers of oxidative protein damage and malondialdehyde (as a final product of lipid peroxidation) in samples obtained at different stages of the lactation cycle and dry period of dairy cows. We found that TAC was significantly lower in the primiparous cows compared to multiparous cows. This study clearly demonstrates a need for monitoring primiparous cows during the production cycle, especially when they are faced with severe metabolic conditions. Furthermore, TAC may be a sensitive, reliable and useful indicator for measurement of cumulative effects of antioxidants as an addition to metabolic profile tests, which are currently used to analyse dairy cattle health.


Asunto(s)
Antioxidantes/análisis , Bovinos/fisiología , Lactancia/fisiología , Animales , Biomarcadores/sangre , Femenino , Peroxidación de Lípido , Malondialdehído/sangre , Oxidación-Reducción , Paridad , Periodo Posparto , Compuestos de Sulfhidrilo/sangre
19.
Lasers Med Sci ; 31(9): 1837-1843, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27677478

RESUMEN

Ceramic dental materials, especially alumina (20 %vol)-yttrium stabilized tetragonal zirconia poly crystal (A-Y-TZP20), have been considered as alternatives to metals for endosseous dental implant application. For increasing the bone-to-implant contact as well as the speed of bone formation, a new surface modification can be effective. The aim of this study was to design microgroove patterns by femtosecond laser on A-Y-TZP20 nano-composite disks for endosseous dental implant application. The phase composition and the morphology of the A-Y-TZP20 nano-composite samples were characterized using X-ray diffraction and Scanning electron microscopy equipped with energy dispersive X-ray spectroscopy techniques. Statistical analysis was submitted to Kolmogorov-Smirnov test and Student's t test for independent variables, with a 5 % significance level. EDAX analysis revealed a significant decrease in the relative content of contaminants like carbon (p < 0.05) in laser surface-treated group as compared to non surface-treated group. X-ray diffraction did not show any change in the crystalline structure induced by laser processing. It was concluded that the femtosecond laser is a clean and safe method for surface modification of A-Y-TZP20.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Materiales Dentales/química , Nanocompuestos/química , Óxido de Aluminio/química , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Espectrometría por Rayos X , Propiedades de Superficie , Difracción de Rayos X , Itrio/química , Circonio/química
20.
J Opt Soc Am A Opt Image Sci Vis ; 32(10): 1764-71, 2015 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-26479929

RESUMEN

Transverse chromatic aberration (TCA) is one of the largest optical errors affecting the peripheral image quality in the human eye. However, the effect of chromatic aberrations on our peripheral vision is largely unknown. This study investigates the effect of prism-induced horizontal TCA on vision, in the central as well as in the 20° nasal visual field, for four subjects. Additionally, the magnitude of induced TCA (in minutes of arc) was measured subjectively in the fovea with a Vernier alignment method. During all measurements, the monochromatic optical errors of the eye were compensated for by adaptive optics. The average reduction in foveal grating resolution was about 0.032 ± 0.005 logMAR/arcmin of TCA (mean ± std). For peripheral grating detection, the reduction was 0.057 ± 0.012 logMAR/arcmin. This means that the prismatic effect of highly dispersive spectacles may reduce the ability to detect objects in the peripheral visual field.

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