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1.
Poult Sci ; 99(9): 4373-4383, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32867981

RESUMO

Effects of dietary Original XPC (XPC) on 17 selected blood variables in commercial layer pullets challenged with the virulent, low-passage R strain of Mycoplasma gallisepticum (RlowMG) were investigated. Hy-Line W-36 pullets sourced from M. gallisepticum-clean layer breeders were fed a basal diet with XPC (1.25 kg/metric ton) or without from hatch until 12 wk of age (woa). At 8 and 10 woa, half of the birds in each dietary treatment were challenged with RlowMG. Blood samples were taken immediately before the initial RlowMG challenge at 8 woa and again at 12 woa (4 wk after challenge). At 8 woa, blood pH was lower and glucose concentration was higher in the preassigned challenge treatment groups. At 12 woa, the concentration of oxygen dissolved in the blood was significantly lower in the RlowMG-challenged group than the unchallenged group of birds regardless of dietary treatment. The RlowMG challenge significantly increased blood carbon dioxide partial pressure, calcium, sodium, anion gap, osmolality, glucose, and corticosterone levels but significantly decreased blood oxygen partial pressure, oxyhemoglobin concentration, concentration of oxygen dissolved in the blood, chloride, and pH levels. Because blood pH and glucose concentration at 8 woa were examined before challenge, their baseline values were biased with respect to challenge treatment before treatment was applied. However, the lack of a significant main effect due to diet at 8 woa for blood pH and glucose concentration, along with the other 15 blood variables, indicate that the baseline data with respect to dietary treatment were unbiased, allowing for real dietary effects to be accurately assessed. In conclusion, layer pullets challenged with RlowMG undergo a stress response associated with changes in various physiological blood variables, and a decrease in pH and increase in carbon dioxide partial pressure, in association with a lack of change in bicarbonate, indicates that the stress response caused by the RlowMG challenge was associated with respiratory acidosis. Nevertheless, feeding XPC did not influence the effects of challenge treatment on these postchallenge physiological blood values.


Assuntos
Galinhas , Suplementos Nutricionais , Alimentos Fermentados , Infecções por Mycoplasma , Mycoplasma gallisepticum , Doenças das Aves Domésticas , Animais , Dieta/veterinária , Feminino , Infecções por Mycoplasma/sangue , Infecções por Mycoplasma/prevenção & controle , Infecções por Mycoplasma/veterinária , Doenças das Aves Domésticas/sangue , Doenças das Aves Domésticas/prevenção & controle
2.
Sci Adv ; 5(3): eaau6078, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30891495

RESUMO

The great henge complexes of southern Britain are iconic monuments of the third millennium BCE, representing great feats of engineering and labor mobilization that hosted feasting events on a previously unparalleled scale. The scale of movement and the catchments that the complexes served, however, have thus far eluded understanding. Presenting the largest five-isotope system archeological dataset (87Sr/86Sr, δ34S, δ18O, δ13C, and δ15N) yet fully published, we analyze 131 pigs, the prime feasting animals, from four Late Neolithic (approximately 2800 to 2400 BCE) complexes to explore the networks that the feasts served. Because archeological evidence excludes continental contact, sources are considered only in the context of the British Isles. This analysis reveals wide-ranging origins across Britain, with few pigs raised locally. This finding demonstrates great investment of effort in transporting pigs raised elsewhere over vast distances to supply feasts and evidences the very first phase of pan-British connectivity.


Assuntos
Férias e Feriados/história , Migração Humana/história , Carne/história , Datação Radiométrica/métodos , Meios de Transporte/história , Animais , Arqueologia/métodos , Isótopos de Carbono/análise , Feminino , História Antiga , Humanos , Masculino , Mandíbula/química , Isótopos de Nitrogênio/análise , Isótopos de Oxigênio/análise , Isótopos de Estrôncio/análise , Isótopos de Enxofre/análise , Suínos , Reino Unido
3.
S. Afr. j. child health (Online) ; 13(1): 36-43, 2019. ilus
Artigo em Inglês | AIM | ID: biblio-1270355

RESUMO

Background. Monitoring the health status of populations of children is one of the building blocks of the health system. The provision of an indicator dashboard with disaggregated data that are collected over time can be used to gauge the performance of the health system, guide the allocation of resources and prioritise health interventions within districts.Objectives. To determine neonatal and child mortality, morbidity and health service outcomes over a 6-year period in the Metro West geographic service area (GSA) of the Cape Town metropole.Methods. A dashboard with key indicators was developed using existing data.Results. From 2010 to 2015, there was a decrease in the perinatal mortality rate from 31.7 to 24.8 per 1 000 deliveries, and the early neonatal and neonatal mortality rates from 7.8 and 8.6 to 7.0 and 8.2 per 1 000 live births, respectively. The main obstetric causes of early neonatal deaths were antepartum haemorrhage (22 - 24%) and unexplained intrauterine death (13 - 16%); the main neonatal causes were immaturity (17 - 34%), congenital abnormalities (23 - 29%) and hypoxia (23 - 26%). Under-five mortality decreased in 2013 from 25 to 22 per 1 000 live births, with the main causes being neonatal conditions (32%), pneumonia (25%), congenital abnormalities (9%), injuries (8%) and diarrhoea (8%). Fifty percent of child deaths were out of hospital, with pneumonia and diarrhoea accounting for more than half of these. There was an improvement in health service coverage rates in 2015: immunisation <1 year old (99%); measles second dose (85%), pneumococcal third dose (100%) and rotavirus second dose (100%); maternal antiretroviral coverage (90%); HIV testing in mothers (93%); HIV DNA polymerase chain reaction testing in babies (97%); and a decrease in HIV transmission (2%). Exclusive breastfeeding coverage rates at 14 weeks, and vitamin A supplementation at 12 - 59 months, were only 30% and 44%,respectively, across the GSA.Conclusion. There was a decrease in perinatal, early neonatal, infant and under-five mortality in Metro West over the 6 years. Further reductions in under-five mortality will require focusing on interventions to reduce neonatal and out-of-hospital deaths across the service delivery platform. Home visits to at-risk mothers and infants by community health workers could prevent out-of-hospital deaths and improve exclusive breastfeeding and vitamin A coverage. This will require increasing the number of community health workers and broadening their scope of practice


Assuntos
Parto Obstétrico , Nível de Saúde , Recém-Nascido , África do Sul
4.
Proc Biol Sci ; 285(1887)2018 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-30257911

RESUMO

In birds, vocal learning enables the production of sexually selected complex songs, dialects and song copy matching. But stressful conditions during development have been shown to affect song production and complexity, mediated by changes in neural development. However, to date, no studies have tested whether early-life stress affects the neural processes underlying vocal learning, in contrast to song production. Here, we hypothesized that developmental stress alters auditory memory formation and neural processing of song stimuli. We experimentally stressed male nestling zebra finches and, in two separate experiments, tested their neural responses to song playbacks as adults, using either immediate early gene (IEG) expression or electrophysiological response. Once adult, nutritionally stressed males exhibited a reduced response to tutor song playback, as demonstrated by reduced expressions of two IEGs (Arc and ZENK) and reduced neuronal response, in both the caudomedial nidopallium (NCM) and mesopallium (CMM). Furthermore, nutritionally stressed males also showed impaired neuronal memory for novel songs heard in adulthood. These findings demonstrate, for the first time, that developmental conditions affect auditory memories that subserve vocal learning. Although the fitness consequences of such memory impairments remain to be determined, this study highlights the lasting impact early-life experiences can have on cognitive abilities.


Assuntos
Encéfalo/fisiologia , Tentilhões/fisiologia , Memória/fisiologia , Vocalização Animal/fisiologia , Estimulação Acústica , Fenômenos Fisiológicos da Nutrição Animal , Animais , Encéfalo/metabolismo , Cognição , Feminino , Tentilhões/crescimento & desenvolvimento , Perfilação da Expressão Gênica , Genes Precoces , Masculino , Estresse Fisiológico
5.
J Anim Sci ; 95(6): 2758-2766, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28727068

RESUMO

Thirty cross-bred steers (initial BW 452.0 ± 12.1 kg) were used to investigate the effects of Mo water concentration on performance, carcass characteristics, and mineral status of feedlot steers. The experimental design was a randomized complete block design. Steers were blocked by weight and then divided into 2 weight blocks each consisting of 15 steers. Steers were randomly assigned within block to one of 5 treatments (3 steers/treatment per block). Water treatments consisted of: 1) 0.0 µg/L, 2) 160 µg/L, 3) 320 µg/L, 4) 480 µg/L, and 5) 960 µg/L of supplemental Mo added as Na2MoO4 to the drinking water. Steers were housed in individual pens (steer = experimental unit) that contained individual 265 L water tanks for monitoring water intake. Steers were fed a growing diet for 28 d and then transitioned to a finishing diet. Block 1 steers were fed for a total of 151 d and block 2 steers were fed for a total of 112 d. Daily water intake was recorded for each steer. Steers were individually weighed on 2 consecutive days at the beginning and end of the experiment and interim weights and jugular blood samples were obtained every 28 d. Liver biopsies were obtained on d 0 and 84 from each steer within each block. Steers were transported to a commercial abattoir, slaughtered, and individual carcass data and liver samples were collected. Initial BW was used as a covariate for statistical analysis of data and significance was determined at P ≤ 0.05. No differences were observed for final BW (P > 0.98). Overall ADG (P > 0.91), DMI (P > 0.92), feed efficiency (P > 0.94), water intake (P > 0.40), hot carcass weight (P > 0.98), dressing percentage (P > 0.98), yield grade (P > 0.91), and marbling score (P > 0.29) did not differ across treatments. Lastly, no treatment differences were observed for liver concentrations of Cu (P > 0.93), Mo (P > 0.90) and Zn (P > 0.86) or plasma concentrations of Cu (P > 0.42), Mo (P > 0.43) and Zn (P > 0.62). These data indicate that water Mo concentration, within the range studied, had no impact on performance, mineral status, water intake, and carcass characteristics in feedlot steers.


Assuntos
Bovinos/fisiologia , Suplementos Nutricionais , Molibdênio/administração & dosagem , Ração Animal/análise , Animais , Composição Corporal/efeitos dos fármacos , Bovinos/crescimento & desenvolvimento , Dieta/veterinária , Masculino , Molibdênio/metabolismo , Rúmen/metabolismo , Água/química , Água/metabolismo , Aumento de Peso/efeitos dos fármacos
6.
Midwifery ; 35: 39-46, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27060399

RESUMO

OBJECTIVE: detecting and treating depression early on in pregnancy can improve health outcomes for women and their children. UK guidelines recommend that Midwives screen for antenatal depression (AND) at the woman's first Midwife appointment using recommended depression case finding questions. This is the first qualitative study to explore Midwives' and women's views of using these questions in the context of antenatal care. DESIGN: Semi-structured interviews with Midwives and pregnant women exploring their views and experiences of screening for AND, conducted alongside a validation study of the depression case finding questions. SETTING: the initial appointment with the Midwife when the woman is 10-12 weeks pregnant. Interviewees were working or living in Bristol, England. PARTICIPANTS: maximum variation samples of 15 Midwives and 20 pregnant women. MEASUREMENTS AND FINDINGS: Midwives and pregnant women viewed the depression case finding questions as a useful way of introducing mental health issues. Midwives often adapted the questions rather than using the phrasing specified in the UK guideline. Sometimes Midwives chose not to use the questions, for example if a partner was present. Both Midwives and women struggled to differentiate symptoms of early pregnancy from antenatal depression; yet thought that detecting depression early on in pregnancy was important. Women were unsure about the kind of help that was available; some women reported this as a reason for withholding their true feelings. There was a general lack of awareness among Midwives about the range of non-drug treatments potentially available to women and referral pathways to access them. KEY CONCLUSION: both Midwives and women regard screening for AND as acceptable and important but reported shortcomings with the recommended depression case finding questions. IMPLICATIONS FOR PRACTICE: providing training for Midwives on how to frame the questions and increase their knowledge and application of the referral pathways suggested by UK guidelines will help address some of the issues raised by Midwives and women in our study.


Assuntos
Depressão , Tocologia/métodos , Papel do Profissional de Enfermagem , Complicações na Gravidez , Diagnóstico Pré-Natal , Adulto , Depressão/diagnóstico , Depressão/enfermagem , Diagnóstico Precoce , Feminino , Humanos , Relações Enfermeiro-Paciente , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/enfermagem , Cuidado Pré-Natal/organização & administração , Cuidado Pré-Natal/normas , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal/psicologia , Escalas de Graduação Psiquiátrica , Melhoria de Qualidade , Encaminhamento e Consulta , Inquéritos e Questionários , Reino Unido
7.
Anaesth Intensive Care ; 41(5): 618-22, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23977913

RESUMO

Lipid emulsions have been used to treat cardiovascular collapse due to local anaesthetic toxicity. However, there are few data available on the comparative efficiency of the partitioning properties of available lipid emulsions in clinical use. This in vitro study compared the buffering properties of the lipid emulsions Clinoleic™ 20% (Baxter, Old Toongabbie, NSW) and Intralipid® 20% (Fresenius Kabi, Pymble, NSW) using both bupivacaine (Marcain® 0.5%, AstraZeneca, North Ryde, NSW) and ropivacaine (Naropin® 1%, AstraZeneca, North Ryde, NSW). The concentration of anaesthetic in buffer before and after mixing with lipid was quantified using chromatographic analysis. Bupivacaine was more effectively bound by the lipid agents, with a 40% reduction in initial concentration. Ropivacaine demonstrated a 20% reduction in concentration with the addition of lipid agents. Importantly, there was no significant difference between Intralipid and Clinoleic in terms of their buffering behaviour, suggesting equivalent binding efficacy.


Assuntos
Anestésicos Locais/química , Emulsões Gordurosas Intravenosas/química , Óleos de Plantas/química , Óleo de Soja/química , Amidas/química , Bupivacaína/química , Emulsões/química , Fosfolipídeos/química , Ropivacaina
8.
Eur J Clin Nutr ; 67(1): 2-7, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22948945

RESUMO

BACKGROUND/OBJECTIVES: Elevated oxidized low-density lipoprotein (OxLDL) may promote inflammation, and is associated with increased risk of atherosclerotic coronary heart disease and worsening complications of diabetes mellitus. The primary objective of this study was to evaluate the efficacy of chitin-glucan (CG), alone and in combination with a potentially anti-inflammatory olive oil (OO) extract, for reducing OxLDL in subjects with borderline to high LDL cholesterol (LDL-C) levels. SUBJECTS/METHODS: This 6-week, randomized, double-blind, placebo-controlled study of a novel, insoluble fiber derived from the Aspergillus niger mycelium, CG, evaluated 130 subjects free of diabetes mellitus with fasting LDL-C 3.37-4.92 mmol/l and glucose ≤ 6.94 mmol/l. Participants were randomly assigned to receive CG (4.5 g/day; n=33), CG (1.5 g/day; n=32), CG (1.5 g/day) plus OO extract (135 mg/day; n=30), or matching placebo (n=35). RESULTS: Administration of 4.5 g/day CG for 6 weeks significantly reduced OxLDL compared with placebo (P=0.035). At the end of study, CG was associated with lower LDL-C levels relative to placebo, although this difference was statistically significant only for the CG 1.5 g/day group (P=0.019). CG did not significantly affect high-density lipoprotein cholesterol, triglycerides, glucose, insulin or F2-isoprostane levels. Adverse events did not substantively differ between treatments and placebo. CONCLUSIONS: In this 6-week study, CG (4.5 g/day) reduced OxLDL, an effect that might affect the risk for atherosclerosis.


Assuntos
Anticolesterolemiantes/uso terapêutico , Aterosclerose/prevenção & controle , Quitina/química , Glucanos/química , Hipercolesterolemia/dietoterapia , Lipoproteínas LDL/sangue , Prebióticos , Adulto , Anticolesterolemiantes/administração & dosagem , Anticolesterolemiantes/efeitos adversos , Aterosclerose/epidemiologia , Aterosclerose/etiologia , Índice de Massa Corporal , Método Duplo-Cego , Feminino , Frutas/química , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/complicações , Hipercolesterolemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Olea/química , Ontário/epidemiologia , Sobrepeso/complicações , Extratos Vegetais/efeitos adversos , Extratos Vegetais/uso terapêutico , Polissacarídeos/administração & dosagem , Polissacarídeos/efeitos adversos , Polissacarídeos/uso terapêutico , Prebióticos/efeitos adversos , Risco
9.
Eur J Clin Nutr ; 66(12): 1295-302, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23073259

RESUMO

BACKGROUND/OBJECTIVES: This study explored interactions between dietary fat intake and the tumor necrosis factor-α gene (TNFA) -238G>A polymorphism (rs361525) on adiposity and serum lipid concentrations in apparently healthy premenopausal black and white South African (SA) women. SUBJECTS/METHODS: Normal-weight (N=107) and obese (N=120) black, and normal-weight (N=89) and obese (N=62) white SA women underwent measurements of body composition, fasting lipids and dietary intake, and were genotyped for the -238G>A polymorphism. RESULTS: Black women had a higher -238GA genotype frequency than white women (P<0.001), but there were no differences between body mass index groups. Black women with the -238A allele had a greater body fat % than those with the GG genotype (P<0.001). Further, in black women, with increasing polyunsaturated:saturated fat ratio and omega-6 (n-6):omega-3 (n-3) ratio, high-density lipoprotein-cholesterol (HDL-C) concentrations decreased, and total cholesterol (T-C):HDL-C ratio increased in those with the GA genotype but not the GG genotype. In addition, with increasing n-3 polyunsaturated fatty acid intake (percentage of total energy intake, %E), T-C:HDL-C ratio decreased in those with the GA genotype, but not in those with the GG genotype. In white SA women, with increasing eicosapentaenoic acid (%E) intake, low-density lipoprotein-cholesterol concentrations decreased in those with the GG genotype but not the GA genotype. CONCLUSIONS: The -238G>A polymorphism was associated with body fatness in black women. Interactions between -238G>A genotypes and dietary fat intake on serum lipids and adiposity differed depending on dietary fat intake, but those for serum lipids were not the same in black and white SA women.


Assuntos
Tecido Adiposo/efeitos dos fármacos , Colesterol/sangue , Gorduras na Dieta/farmacologia , Obesidade/genética , Polimorfismo Genético , Grupos Raciais/genética , Fator de Necrose Tumoral alfa/genética , Adiposidade/efeitos dos fármacos , Adiposidade/genética , Adolescente , Adulto , Alelos , População Negra/genética , Índice de Massa Corporal , Colesterol/genética , Dieta , Gorduras na Dieta/sangue , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-3/farmacologia , Feminino , Genótipo , Humanos , Obesidade/sangue , Valores de Referência , Fatores de Risco , África do Sul , População Branca/genética
10.
Child Care Health Dev ; 38(1): 41-7, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21083684

RESUMO

BACKGROUND: Family-centred service, functional goal setting and co-ordination of a child's move between programmes are important concepts of rehabilitation services for children with cerebral palsy identified in the literature. We examined whether these three concepts could be objectively identified in programmes providing services to children with cerebral palsy in Alberta, Canada. METHODS: Programme managers (n= 37) and occupational and physical therapists (n= 54) representing 59 programmes participated in individual 1-h semi-structured interviews. Thirty-nine parents participated in eleven focus groups or two individual interviews. Evidence of family-centred values in mission statements and advisory boards was evaluated. Therapists were asked to identify three concepts of family-centred service and to complete the Measures of Process of Care for Service Providers. Therapists also identified therapy goals for children based on clinical case scenarios. The goals were coded using the components of the International Classification of Functioning Disability and Health. Programme managers and therapists discussed the processes in their programmes for goal setting and for preparing children and their families for their transition to other programmes. Parents reflected on their experiences with their child's rehabilitation related to family-centredness, goal setting and co-ordination between programmes. RESULTS: All respondents expressed commitment to the three concepts, but objective indicators of family-centred processes were lacking in many programmes. In most programmes, the processes to implement the three concepts were informal rather than standardized. Both families and therapists reported limited access to general information regarding community supports. CONCLUSION: Lack of formal processes for delivery of family-centred service, goal-setting and co-ordination between children's programmes may result in inequitable opportunities for families to participate in their children's rehabilitation despite attending the same programme. Standardized programme processes and policies may provide a starting point to ensure that all families have equitable opportunities to participate in their child's rehabilitation programme.


Assuntos
Paralisia Cerebral/reabilitação , Serviços de Saúde da Criança/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Saúde da Família , Planejamento de Assistência ao Paciente/organização & administração , Adolescente , Alberta , Atitude Frente a Saúde , Criança , Pré-Escolar , Grupos Focais , Pesquisa sobre Serviços de Saúde/métodos , Humanos , Relações Interinstitucionais , Terapia Ocupacional/organização & administração , Pais/psicologia , Especialidade de Fisioterapia/organização & administração , Relações Profissional-Família
11.
Euro Surveill ; 16(14)2011 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-21492528

RESUMO

Successful treatment of gonorrhoea is the mainstay of public health control. Cefixime and ceftriaxone, highly active third generation cephalosporins, are today the recommended first-line agents in most countries and azithromycin is a second-line agent. However, there is increasing evidence of decreasing susceptibility and emergence of therapeutic failures. In this report two cases of clinical failure to cefixime are described, one of which additionally shows failure to azithromycin and selection of a less susceptible strain during treatment.


Assuntos
Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Cefixima/uso terapêutico , Gonorreia/tratamento farmacológico , Neisseria gonorrhoeae/efeitos dos fármacos , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Azitromicina/administração & dosagem , Azitromicina/farmacologia , Cefixima/administração & dosagem , Cefixima/farmacologia , Farmacorresistência Bacteriana Múltipla , Inglaterra/epidemiologia , Feminino , Gonorreia/epidemiologia , Gonorreia/microbiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Neisseria gonorrhoeae/isolamento & purificação , Parceiros Sexuais , Falha de Tratamento , Adulto Jovem
12.
Colorectal Dis ; 11(9): 964-6, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19175654

RESUMO

INTRODUCTION: During Transanal Endoscopic Microsurgical (TEMS) full-thickness excision of a rectal lesion above the peritoneal reflection, entrance to the peritoneal cavity is inevitable. This has been regarded as a complication that requires conversion to an open procedure. We describe our experience of full thickness intraperitoneal excision of rectal lesions where the peritoneal defect was sutured endoscopically. METHOD: Data were collected prospectively on 15 patients in whom a peritoneal defect was created intraoperatively during TEMS excision of a rectal lesion. When a defect was recognized, it was closed by endoscopic suture. If there was any doubt regarding security of the closure, a defunctioning loop stoma was fashioned. RESULTS: Between November 1998 and January 2008, a total of 257 patients underwent TEMS during which a peritoneal defect was created in 15 patients. Six patients had a defunctioning stoma formed at the time of TEMS. No patient was defunctioned postoperatively and there were no deaths. The mean hospital stay was 8 days (range 3 to 19 days). A contrast enema showed sub-clinical leaks in two patients for which no treatment was required. No patient developed pelvic or peritoneal sepsis, but one patient had to return to theatre for postoperative bleeding when a single bleeding vessel was coagulated. CONCLUSION: Full thickness excision of lesions in the intraperitoneal rectum with endoscopic suture of the defect is a safe procedure. Lesions in the upper rectum should not be excluded from TEMS excision because of the chance of peritoneal breach.


Assuntos
Erros Médicos , Microcirurgia/efeitos adversos , Peritônio/lesões , Proctoscopia/efeitos adversos , Reto/cirurgia , Técnicas de Sutura , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Estomas Cirúrgicos
13.
Eye (Lond) ; 22(6): 751-60, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18425071

RESUMO

INTRODUCTION: The aim of this review was to examine the evidence as to whether antioxidant vitamin or mineral supplements prevent the development of AMD or slow down its progression. METHODS: Randomised trials comparing antioxidant vitamin and/or mineral supplement to control were identified by systematic electronic searches (updated August 2007) and contact with investigators. Data were pooled after investigating clinical and statistical heterogeneity. RESULTS: There was no evidence that antioxidant (vitamin E or beta-carotene) supplementation prevented AMD. A total of 23 099 people were randomised in three trials with treatment duration of 4-12 years; pooled risk ratio=1.03 (95% CI, 0.74-1.43). There was evidence that antioxidant (beta-carotene, vitamin C, and vitamin E) and zinc supplementation slowed down the progression to advanced AMD and visual acuity loss in people with signs of the disease (adjusted odds ratio=0.68, 95% CI, 0.53-0.87 and 0.77, 95% CI, 0.62-0.96, respectively). The majority of people were randomised in one trial (AREDS, 3640 people randomised). There were seven other small trials (total randomised 525). CONCLUSIONS: Current evidence does not support the use of antioxidant vitamin supplements to prevent AMD. People with AMD, or early signs of the disease, may experience some benefit from taking supplements as used in the AREDS trial. Potential harms of high-dose antioxidant supplementation must be considered. These may include an increased risk of lung cancer in smokers (beta-carotene), heart failure in people with vascular disease or diabetes (vitamin E) and hospitalisation for genitourinary conditions (zinc).


Assuntos
Antioxidantes/uso terapêutico , Degeneração Macular/tratamento farmacológico , Vitamina E/uso terapêutico , Vitaminas/uso terapêutico , beta Caroteno/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Antioxidantes/efeitos adversos , Grupos Controle , Suplementos Nutricionais , Progressão da Doença , Feminino , Humanos , Degeneração Macular/prevenção & controle , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Vitamina E/efeitos adversos , Vitaminas/efeitos adversos , beta Caroteno/efeitos adversos
14.
Cochrane Database Syst Rev ; (1): CD000253, 2008 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-18253971

RESUMO

BACKGROUND: Some observational studies have suggested that people who eat a diet rich in antioxidant vitamins (carotenoids, vitamins C and E) or minerals (selenium and zinc) may be less likely to develop age-related macular degeneration (AMD). OBJECTIVES: The aim of this review was to examine the evidence as to whether or not taking vitamin or mineral supplements prevents the development of AMD. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) in The Cochrane Library (2007, Issue 3), MEDLINE (1966 to August 2007), SIGLE (1980 to 2005/03), EMBASE (1980 to August 2007), National Research Register (2007, Issue 3), AMED (1985 to January 2006) and PubMed (on 24 January 2006 covering last 60 days), reference lists of identified reports and the Science Citation Index. We contacted investigators and experts in the field for details of unpublished studies. SELECTION CRITERIA: We included all randomised trials comparing an antioxidant vitamin and/or mineral supplement (alone or in combination) to control. We included only studies where supplementation had been given for at least one year. DATA COLLECTION AND ANALYSIS: Both review authors independently extracted data and assessed trial quality. Data were pooled using a fixed-effect model. MAIN RESULTS: Three randomised controlled trials were included in this review (23,099 people randomised). These trials investigated alpha-tocopherol and beta-carotene supplements. There was no evidence that antioxidant vitamin supplementation prevented or delayed the onset of AMD. The pooled risk ratio for any age-related maculopathy (ARM) was 1.04 (95% CI 0.92 to 1.18), for AMD (late ARM) was 1.03 (95% CI 0.74 to 1.43). Similar results were seen when the analyses were restricted to beta-carotene and alpha-tocopherol. AUTHORS' CONCLUSIONS: There is no evidence to date that the general population should take antioxidant vitamin and mineral supplements to prevent or delay the onset of AMD. There are several large ongoing trials. People with AMD should see the related Cochrane review "Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration" written by the same author.


Assuntos
Antioxidantes/administração & dosagem , Suplementos Nutricionais , Degeneração Macular/prevenção & controle , Minerais/administração & dosagem , Vitaminas/administração & dosagem , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , alfa-Tocoferol/administração & dosagem , beta Caroteno/administração & dosagem
15.
Cochrane Database Syst Rev ; (2): CD003120, 2007 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-17443523

RESUMO

BACKGROUND: Extracts of the leaves of the maidenhair tree, Ginkgo biloba, have long been used in China as a traditional medicine for various disorders of health. A standardized extract is widely prescribed for the treatment of a range of conditions including memory and concentration problems, confusion, depression, anxiety, dizziness, tinnitus and headache. The mechanisms of action are thought to reflect the action of several components of the extract and include increasing blood supply by dilating blood vessels, reducing blood viscosity, modification of neurotransmitter systems, and reducing the density of oxygen free radicals. OBJECTIVES: To assess the efficacy and safety of Ginkgo biloba for dementia or cognitive decline. SEARCH STRATEGY: Trials were identified on 10 October 2006 through a search of the Cochrane Dementia and Cognitive Improvement Group's Specialized Register which contains records from all main medical databases (MEDLINE, EMBASE, CINAHL, PsycINFO, SIGLE, LILACS), from ongoing trials databases such as Clinicaltrials.gov and Current Controlled Trials and many other sources. The search terms used were ginkgo*, tanakan, EGB-761, EGB761, "EGB 761" and gingko*. SELECTION CRITERIA: Randomized, double-blind studies, in which extracts of Ginkgo biloba at any strength and over any period were compared with placebo for their effects on people with acquired cognitive impairment, including dementia, of any degree of severity. DATA COLLECTION AND ANALYSIS: Data were extracted from the published reports of the included studies, pooled where appropriate and the treatment effects or the risks and benefits estimated. MAIN RESULTS: Clinical global improvement as assessed by the physician, was dichotomized between participants who showed improvement or were unchanged and those who were worse. There are benefits associated with Ginkgo (dose greater than 200 mg/day) at 24 weeks (207/276 compared with 178/273, OR 1.66, 95% CI 1.12 to 2.46, P=.001) (2 studies), but not for the lower dose. Cognition shows benefit for Ginkgo (any dose) at 12 weeks (SMD -0.65, 95% CI -1.22 to -0.09 P=0.02, 5 studies) but not at 24 weeks. Five studies assessed activities of daily living (ADLs), using different scales. Some scales are more comprehensive than just ADLs. The results show benefit for Ginkgo (dose less than 200 mg/day) compared with placebo at 12 weeks (MD -5.0, 95% CI -7.88, -2.12, p=0.0007, one study), and at 24 weeks (SMD -0.16, 95% CI -0.31 to -0.01, p=0.03, 3 studies) but there are no differences at the higher dose. No study assessed mood and function separately, but one study used the ADAS-Noncog, which assesses function over several domains, but not cognitive function. There was no difference between Ginkgo and placebo. There are no significant differences between Ginkgo and placebo in the proportion of participants experiencing adverse events. There are no data available on Quality of Life, measures of depression or dependency. AUTHORS' CONCLUSIONS: Ginkgo biloba appears to be safe in use with no excess side effects compared with placebo. Many of the early trials used unsatisfactory methods, were small, and we cannot exclude publication bias. The evidence that Ginkgo has predictable and clinically significant benefit for people with dementia or cognitive impairment is inconsistent and unconvincing.


Assuntos
Transtornos Cognitivos/tratamento farmacológico , Demência/tratamento farmacológico , Ginkgo biloba , Fitoterapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
Lett Appl Microbiol ; 44(1): 19-23, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17209809

RESUMO

AIMS: Escherichia coli O157 is considered to be one of most important human pathogens of animal origin which causes serious clinical complications. One of the most common methods to isolate E. coli O157 is the immunomagnetic separation (IMS) technique which employs specific antibodies coupled to magnetic beads to bind and extract cells from enrichment broths followed by plating onto sorbitol MacConkey agar supplemented with cefixime and potassium tellurite (CT-SMAC) plates. The aim of this study was to determine strain variation by pulsed-field gel electrophoresis (PFGE) among E. coli O157 on IMS/CT-SMAC plates. METHODS AND RESULTS: Every suspect colony of E. coli O157 was tested following isolation by the IMS/CT-SMAC technique. From 124 colonies detected; six XbaI-PFGE profiles were identified. CONCLUSIONS: Our results demonstrate that mixed populations of E. coli O157 with distinguishable PFGE profiles that are simultaneously present in bovine faeces can be isolated with IMS/CT-SMAC technique. SIGNIFICANCE AND IMPACT OF THE STUDY: If the aim of the study was to analyse diversity of PFGE profiles of E. coli O157 in a faecal sample following isolation by the IMS/CT-SMAC technique, at least five colonies per sample should be analysed to detect different PFGE subtypes if present.


Assuntos
Infecções por Escherichia coli/microbiologia , Escherichia coli O157/classificação , Fezes/microbiologia , Variação Genética , Animais , Bovinos , Doenças dos Bovinos/microbiologia , Eletroforese em Gel de Campo Pulsado , Escherichia coli O157/genética , Escherichia coli O157/isolamento & purificação , Separação Imunomagnética , Filogenia
17.
Cochrane Database Syst Rev ; (4): CD006221, 2006 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-17054283

RESUMO

BACKGROUND: In view of the theoretical possibility of beneficial effects of DHEA or DHEAS in retarding age-associated deterioration in cognitive function, we have reviewed studies in this area. OBJECTIVES: To establish whether administration of DHEA, or its sulphate, DHEAS, improves cognitive function or reduces the rate of decline of cognitive function in normal older adults. SEARCH STRATEGY: Trials were identified from a last updated search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 10 October 2005 using the terms dhea*, prasterone, dehydroepiandrosterone*. In addition MEDLINE, EMBASE, PsycINFO and CINAHL were searched to find trials with volunteers who had no or minor memory complaints. Relevant journals, personal communications and conference abstracts were searched for randomized controlled trials investigating the effects of DHEA/S on cognition in older adults. SELECTION CRITERIA: All randomized placebo-controlled trials enrolling people aged over 50 without dementia and to whom DHEA/S in any dosage was administered for more than one day were considered for inclusion in the review. DATA COLLECTION AND ANALYSIS: Data for the specified outcomes were independently extracted by two reviewers (JGE and RM) and cross-checked. Any discrepancies were discussed and resolved. No data pooling was undertaken owing to the lack of availability of the relevant statistics. MAIN RESULTS: Only three studies provided results from adequate parallel-group data. Barnhart 1999 enrolled perimenopausal women with complaints of decreased well-being and, using three cognitive measures, found no significant effect of DHEA compared with placebo at 3 months. Wolf 1998b enrolled 75 healthy volunteers (37 women and 38 men aged 59-81) in a study of the effect of DHEA supplements on cognitive impairment induced by stress; after two weeks of treatment, placebo group performance deteriorated significantly on a test of selective attention following a psychosocial stressor (p<0.05), while deterioration was not evident in the DHEA group (p=0.85). However, when compared with placebo, DHEA was associated with a significant impairment on a visual memory recall test (p<0.01) following the stressor. No significant effects were found on a third cognitive task. Effects were not found on tasks when administered in the absence of a stressor. van Niekerk 2001 found no effect on cognitive function in 46 men aged 62-76 from three months of DHEA supplementation. DHEA supplements were well tolerated and without significant adverse effects apart from the reduced performance in the visual memory recall test observed in one trial. AUTHORS' CONCLUSIONS: What little evidence there is from controlled trials does not support a beneficial effect of DHEA supplementation on cognitive function of non demented middle-aged or elderly people. There is no consistent evidence from the controlled trials that DHEA produces any adverse effects. In view of growing public enthusiasm for DHEA supplementation, particularly in the USA, and the theoretical possibility of long-term neuroprotective effects of DHEA/S, there is a need for further high quality trials in which the duration of DHEA treatment is longer than one year, and the number of participants is large enough to provide adequate statistical power.


Assuntos
Transtornos Cognitivos/prevenção & controle , Cognição/efeitos dos fármacos , Desidroepiandrosterona/uso terapêutico , Suplementos Nutricionais , Nootrópicos/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Desidroepiandrosterona/efeitos adversos , Sulfato de Desidroepiandrosterona/efeitos adversos , Sulfato de Desidroepiandrosterona/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nootrópicos/efeitos adversos
18.
Ultrasound Med Biol ; 32(6): 985-9, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16785020

RESUMO

We present values for the speed of sound (SOS) in bovine bone marrow as a function of temperature between 17 degrees C and 44 degrees C. The measurements were made using a time-of-flight approach on a volume of roughly 10 mL, at 750 kHz. The equipment was validated using both distilled water and castor oil. The results show a linear response with SOS changing from 1456.23 ms(-1) at 17 degrees C to 1342.40 ms(-1) at 44 degrees C. The mean value at 37 degrees C was (1371.91 ms(-1)). The temperature coefficient of the SOS was found to be -4.21 +/- 0.19 ms(-1) degrees C(-1). This was well fitted to a least squares model with R2 = 0.88.


Assuntos
Medula Óssea/diagnóstico por imagem , Acústica , Animais , Medula Óssea/fisiologia , Óleo de Rícino , Bovinos , Fêmur/diagnóstico por imagem , Fêmur/fisiologia , Temperatura , Ultrassonografia
19.
Cochrane Database Syst Rev ; (2): CD000254, 2006 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-16625532

RESUMO

BACKGROUND: It has been proposed that antioxidants may prevent cellular damage in the retina by reacting with free radicals that are produced in the process of light absorption. OBJECTIVES: The objective of this review was to assess the effects of antioxidant vitamin or mineral supplementation, or both, on the progression of age-related macular degeneration (AMD). SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2005, Issue 4); MEDLINE (1966 to January 2006); SIGLE (1980 to March 2005); EMBASE (1980 to January 2005); NRR (2005, Issue 4); AMED (1985 to January 2006); and PubMed (24 January 2006 covering last 60 days), reference lists of identified reports and the Science Citation Index. We contacted investigators and experts in the field for details of unpublished studies. SELECTION CRITERIA: We included randomised trials comparing antioxidant vitamin or mineral supplemention (alone or in combination) to a control intervention in people with AMD. DATA COLLECTION AND ANALYSIS: The author extracted data and assessed trial quality. Where appropriate, data were pooled using a random-effects model unless three or fewer trials were available in which case a fixed-effects model was used. MAIN RESULTS: Eight trials were included in this review. The majority of people were randomised in one trial (AREDS in the USA) that found a beneficial effect of antioxidant (beta-carotene, vitamin C and vitamin E) and zinc supplementation on progression to advanced AMD (adjusted odds ratio 0.68, 99% confidence interval 0.49 to 0.93). People taking supplements were less likely to lose 15 or more letters of visual acuity (adjusted odds ratio 0.77, 99% confidence interval 0.58 to 1.03). Hospitalisation for genito-urinary problems was more common in people taking zinc and yellowing of skin was more common in people taking antioxidants. The other trials were, in general, small and the results were inconsistent. AUTHORS' CONCLUSIONS: The evidence as to the effectiveness of antioxidant vitamin and mineral supplementation in halting the progression of AMD comes mainly from one large trial in the USA. The generalisability of these findings to other populations with different nutritional status is not known. Further large, well-conducted randomised controlled trials in other populations are required. Long-term harm from supplementation cannot be ruled out. Beta-carotene has been found to increase the risk of lung cancer in smokers; vitamin E has been associated with an increased risk of heart failure in people with vascular disease or diabetes.


Assuntos
Antioxidantes/uso terapêutico , Suplementos Nutricionais , Degeneração Macular/prevenção & controle , Minerais/uso terapêutico , Vitaminas/uso terapêutico , Idoso , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
J Pharm Sci ; 95(4): 883-95, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16489607

RESUMO

In this paper, we present a preclinical approach for evaluating the feasibility of applying controlled-release (CR) oral drug delivery to increase the duration of exposure and lower the C(max) of compounds in a lead series of short half-life atypical antipsychotics. Three lead compounds in the series had demonstrated potential pharmacological benefits for the treatment of psychosis, in preclinical studies. However, the compounds showed evidence of insufficient half-lives to enable a once-a-day (QD) product using immediate-release (IR) oral delivery. To evaluate and compare the potential for oral CR delivery to extend the duration of action and thereby enable QD administration, the in vitro solubility and permeability, and the duodenal and colonic absorption of three compounds in the series were measured. Based on the results, one candidate was selected for advancement that showed moderate in vitro solubility, but had the highest in vitro permeability and ratio of colonic to duodenal bioavailability (0.9) in the rat. The results from this study provided evidence that a CR drug delivery system could be used to extend the duration of exposure of the compounds in the series and a scientific basis for selecting one of the three compounds as a candidate.


Assuntos
Antipsicóticos/administração & dosagem , Antipsicóticos/farmacocinética , Carbolinas/administração & dosagem , Carbolinas/farmacocinética , Avaliação Pré-Clínica de Medicamentos/métodos , Risperidona/administração & dosagem , Risperidona/farmacocinética , Administração Oral , Animais , Antipsicóticos/química , Disponibilidade Biológica , Carbolinas/química , Colo/metabolismo , Preparações de Ação Retardada , Duodeno/metabolismo , Estudos de Viabilidade , Meia-Vida , Concentração de Íons de Hidrogênio , Absorção Intestinal , Masculino , Ratos , Ratos Sprague-Dawley , Risperidona/química , Solubilidade
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