RESUMEN
INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) expresses the Panton-Valentine leukocidin (PVL) virulence gene, which is associated with community and hospital-acquired severe MRSA infections. The objective of this study was to determine the prevalence and antibiotic susceptibility profile with a focus on the presence of the PVL gene among MRSA isolates in healthcare settings. METHODOLOGY: A total of 1,207 clinical specimens and 304 hospital environment swabs were collected in a tertiary care hospital in Nepal, and investigated following basic microbiological techniques. S. aureus was confirmed with the coagulase test. An antibiotic susceptibility test (AST) was performed by the Kirby-Bauer method and screening for MRSA was carried out by the cefoxitin disc diffusion method guided by the Clinical and Laboratory Standards Institute (CLSI), 2020. DNA was extracted and used in a polymerase chain reaction (PCR) to detect mecA and PVL genes. RESULTS: Of the 1,511 samples, 45 (2.9%) S. aureus (23 clinical and 22 environmental) were isolated. Among them, 69.6% (16/23) and 27.3% (6/22) were MRSA in clinical and environmental isolates, respectively. Twelve (52.2%) clinical isolates and seven (31.8%) environmental isolates were multidrug resistant. The majority of isolates were susceptible to vancomycin and linezolid. The PVL gene was detected in 18.2% (n = 4/22) of the MRSA isolates, of which three were from clinical sources and one was from an environmental swab. CONCLUSIONS: The prevalence of MRSA, and PVL-producing S. aureus were higher in the hospital setting. Hence, immediate and urgent implementation of infection control and sanitation measures are needed in the hospital.
Asunto(s)
Antibacterianos , Toxinas Bacterianas , Exotoxinas , Leucocidinas , Staphylococcus aureus Resistente a Meticilina , Pruebas de Sensibilidad Microbiana , Infecciones Estafilocócicas , Centros de Atención Terciaria , Leucocidinas/genética , Exotoxinas/genética , Nepal/epidemiología , Humanos , Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Toxinas Bacterianas/genética , Centros de Atención Terciaria/estadística & datos numéricos , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/epidemiología , Antibacterianos/farmacología , Prevalencia , Femenino , Adulto , Masculino , Infección Hospitalaria/microbiología , Infección Hospitalaria/epidemiología , Persona de Mediana Edad , Adulto Joven , Adolescente , Proteínas Bacterianas/genéticaRESUMEN
Tooth loss is prevalent in older adults and associated with functional capacity decline. Studies on the susceptibility of some individuals to the effects of tooth loss are lacking. This study aimed to investigate the heterogeneity of the association between tooth loss and higher-level functional capacity in older Japanese individuals employing a machine learning approach. This is a prospective cohort study using the data of adults aged ≥65 y in Japan (N = 16,553). Higher-level functional capacity, comprising instrumental independence, intellectual activity, and social role, was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The scale ranged from 0 (lowest function) to 13 (highest function). Doubly robust targeted maximum likelihood estimation was used to estimate the population-average association between tooth loss (having <20 natural teeth) and TMIG-IC total score after 6 y. The heterogeneity of the association was evaluated by estimating conditional average treatment effects (CATEs) using the causal forest algorithm. The result showed that tooth loss was statistically significantly associated with lower TMIG-IC total scores (population-average effect: -0.14; 95% confidence interval, -0.18 to -0.09). The causal forest analysis revealed the heterogeneous associations between tooth loss and lower TMIG-IC total score after 6 y (median of estimated CATEs = -0.13; interquartile range = 0.12). The high-impact subgroup (i.e., individuals with estimated CATEs of the bottom 10%) were significantly more likely to be older and male, had a lower socioeconomic status, did not have a partner, and had poor health conditions compared with the low-impact subgroup (i.e., individuals with estimated CATEs of the top 10%). This study found that heterogeneity exists in the association between tooth loss and lower scores on functional capacity. Implementing tooth loss prevention policy and clinical measures, especially among vulnerable subpopulations significantly affected by tooth loss, may reduce its burden more effectively.
Asunto(s)
Actividades Cotidianas , Pérdida de Diente , Anciano , Humanos , Masculino , Estudios Prospectivos , Evaluación Geriátrica , JapónRESUMEN
OBJECTIVES: Research suggests that cardiometabolic disease risks are elevated among survivors of natural disasters, possibly mediated by changes in diet. Using the Brief Dietary History Questionnaire, we examined (1) dietary patterns among older survivors of the 2011 Great East Japan Earthquake and Tsunami, and (2) the contribution of posttraumatic stress symptoms (PTSS)/depressive symptoms, as well as relocation to temporary housing on dietary patterns and (3) gender differences in the associations. DESIGN, SETTING AND PARTICIPANTS: Data came from a prospective cohort study of 1,375 survivors aged 65-89 years (44.6% male). MEASUREMENTS: PTSS/depression onset was evaluated in 2013, 2.5 years after the disaster. Dietary data was collected with a self-administered brief-type diet history questionnaire in 2020. A principal component analysis identified three posterior dietary patterns. RESULTS: Diet 1 consisted of high intake of vegetables, soy products, and fruits; Diet 2 consisted of carbohydrate-rich foods and snacks/sweets; Diet 3 consisted of high intake of alcoholic beverages, meat, and seafood. Least-squares linear regression revealed that individuals with PTSS/depression were less likely to exhibit Diet 1, while individuals with PTSS were more likely to exhibit Diet 2 and 3. Especially, males who had depression showed an unhealthy dietary pattern. Those who have lived in a trailer-style temporary housing reported less consumption of Diet 3. CONCLUSION: Survivors of disaster with symptoms of mental illness tended to exhibit less healthy dietary patterns after 9 years. Diet varied by type of post-disaster mental illness, gender, and current social circumstances. We lacked pre-disaster BDHQ data, which is a limitation.
Asunto(s)
Desastres , Terremotos , Masculino , Humanos , Femenino , Tsunamis , Salud Mental , Estudios Prospectivos , Sobrevivientes/psicología , JapónRESUMEN
AIM: To evaluate the association between sarcopenic obesity and the decline in estimated GFR in people with type 2 diabetes. METHODS: We enrolled 745 people with type 2 diabetes (mean age 64.6 years, 53.6% men). Body composition was evaluated using dual-energy X-ray absorptiometry. Skeletal muscle index, calculated as appendicular non-fat mass (kg) divided by height squared (m2 ), was used to determine sarcopenia. Sarcopenic obesity was defined as the coexistence of sarcopenia and a ratio of android to gynoid fat mass greater than the median values in each gender. The association of sarcopenic obesity both with the annual rate of decline in estimated GFR and a >30% decline in estimated GFR was evaluated using multivariate linear regression models and Cox proportional hazard models, respectively. RESULTS: Participants with sarcopenic obesity were at an increased risk of a high annual rate of decline in estimated GFR, even after adjustment for the confounding variables (standardized ß = -0.228, P <0.001). Sarcopenic obesity was also significantly associated with risk of a >30% decline in estimated GFR (hazard ratio 4.52, 95% CI 2.16-9.47; P < 0.01) in multivariate model. CONCLUSIONS: Sarcopenic obesity evaluated by dual energy X-ray absorptiometry is associated with a faster decline in renal function in people with type 2 diabetes.
Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Riñón/fisiopatología , Obesidad/epidemiología , Insuficiencia Renal Crónica/epidemiología , Sarcopenia/epidemiología , Anciano , Femenino , Tasa de Filtración Glomerular , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Reino UnidoRESUMEN
BACKGROUND: The ideal concentration of lignocaine for topical anesthesia in bronchoscopy remains investigational. In this randomized, double blind study, we compared 1% versus 2% lignocaine for topical anesthesia. METHODS: Consecutive patients undergoing bronchoscopy were randomized to receive either 1% or 2% lignocaine solution by spray-as-you-go technique. All received 10% lignocaine spray to the oropharynx along with nasal 2% lignocaine gel. Nebulized lignocaine was not administered. Primary outcomes were operator-rated overall procedural satisfaction, visual analogue scale (VAS)-rated and operator-rated cough, VAS. Secondary objectives were total lignocaine dose administered, patient-rated pain on faces pain scale, cumulative dose of lignocaine and procedural complications. RESULTS: A total of 500 patients (250 in each group) were randomized. Baseline characteristics were comparable. Operator-rated overall procedural satisfaction, VAS (72.05±20.16 and 72.20±21.96 in 1% and 2% group respectively; P=0.93) and operator-rated cough, VAS [1% group: 19.1 (12.6-34.6) and 2% group: 20.6 (12.5-36.9); P>0.05] were similar between the 2 groups. Cumulative dose of lignocaine used in 2% lignocaine group was greater (220.89±12.96 mg in 1% and 319.55±19.32 mg in 2% group; P<0.001). Patients receiving sedation were comparable between the 2 groups. (10% in 1% lignocaine group and 6% in 2% lignocaine group; P=0.13). Minor complications occurred in 2 patients in each group. CONCLUSION: One percent lignocaine in flexible bronchoscopy is as efficacious as 2% lignocaine when administered using the spray as you go technique without concurrent lignocaine nebulization, at a significantly lower total dose of lignocaine administered.
Asunto(s)
Anestésicos Locales/administración & dosificación , Broncoscopía/métodos , Lidocaína/administración & dosificación , Administración por Inhalación , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Resultado del TratamientoRESUMEN
A titania-stearic acid hybrid layer was deposited onto well-defined silica-hexadecyltrimethylammonium hybrid spherical particles with 854 nm size to obtain nanoporous particles with a useful hierarchical core-shell structure. The deposition of a 35 nm-thick titania layer was confirmed by transmission electron microscopy. The core-shell particles were washed with acidic ethanol (solvent extraction) and calcined at 550 °C for 5 h to remove the template, resulting in the formation of nanoporous titania coated nanoporous silica spherical particles, which have a bimodal pore size distribution attributed to the hierarchical porous core and porous shell structure. The nanoporous titania coated particles exhibited an unusual crystal phase transition; only anatase was present even after the calcination at 1000 °C for 1 h. This would be due to the interfacial bonding between the core silica and the shell titania, preventing the crystal phase transition from anatase to rutile. On the other hand, the direct calcination of the titania-stearic acid coated particles without solvent extraction led to a shell composed of both anatase and rutile. The transformation to rutile could be caused by the strong exothermic reaction during the oxidative decomposition of the occluded stearic acid. Furthermore, the intense exothermic reaction induced the formation of a yolk-shell structure, which played a role in the sensitive/selective sensing properties for acetic acid when the yolk-shell particles were coated onto a nanomechanical Membrane-type Surface stress Sensor (MSS).
RESUMEN
STUDY DESIGN: A randomized controlled trial. OBJECTIVES: To determine the effects of orthotic therapeutic electrical stimulation (TES) on the hand in patients with paresis associated with acute cervical spinal cord injury. SETTING: Spinal Injuries Center, Fukuoka, Japan. METHODS: The study included patients treated for spinal cord injuries (Frankel classification, grades B and C) at our institution within 1 week post injury between May 2011 and December 2014. The patients were allocated randomly to TES and control groups at the time of admission and underwent TES+conventional training or conventional training alone, respectively. Both hands of each patient were treated in the same way. The primary outcome was total passive motion (TPM) of the fingers (degrees). The secondary outcomes were edema (cm) and the upper-extremity motor scores of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI). After randomization, outcomes were assessed at 1 week, 1 month and 3 months post injury in both groups. RESULTS: Twenty-nine individuals were assessed at 3 months (15, TES; 14, control). There were no significant between-group differences for TPM of the fingers, edema and upper-extremity motor scores at 1 week, 1 month and 3 months after injury, although TPM of the fingers tended to be lower in the control group. CONCLUSIONS: It is unclear from the results of this study whether TES has a therapeutic effect on TPM, edema or the upper-extremity motor score of the ISNCSCI. The results of this study provide useful data for future meta-analyses.
Asunto(s)
Médula Cervical/lesiones , Terapia por Estimulación Eléctrica , Paresia/terapia , Traumatismos de la Médula Espinal/terapia , Edema/etiología , Edema/fisiopatología , Edema/terapia , Femenino , Mano , Humanos , Masculino , Persona de Mediana Edad , Actividad Motora , Paresia/etiología , Paresia/fisiopatología , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/fisiopatología , Factores de Tiempo , Resultado del TratamientoRESUMEN
STUDY DESIGN: A retrospective, consecutive case series. OBJECTIVES: The relationship between dysphagia and acute cervical spinal cord injury (CSCI) has been recently reported; however, the cause and mechanism of dysphagia are still not well understood. No definitive factors have yet been established according to multivariate analysis. The objective is to elucidate the incidence and risk factors of dysphagia in patients with acute CSCI. SETTING: Spinal Injuries Center, Fukuoka, Japan. METHODS: A total of 298 patients with acute CSCI, who were evaluated for neurological impairment within 3 days after injury, were reviewed. CSCI patients with tube dependence due to obvious aspiration after injury were defined as having dysphagia. The factors postulated to increase the risk for dysphagia, including the patient's age, sex, American Spinal Injury Association (ASIA) impairment scale at 3 days after injury, level of injury, tracheostomy and operative treatment, were analyzed using a multiple logistic regression model. RESULTS: Of 298 patients, 21 were suffering from severe dysphagia after acute CSCI (7.0%). Of these 21 patients, 12 (57%) had CSCI at the C3-C4 level. Multivariable logistic regression analysis revealed that old age (>72 years), severe ASIA impairment scale (A or B) and presence of tracheostomy were significant risk factors of dysphagia. Level of injury ⩾C3-C4 was not a significant risk factor after adjustment for several potential confounders. CONCLUSION: The incidence of severe dysphagia associated with aspiration was 7%. Old age, severe paralysis and presence of tracheostomy may be the risk factors for dysphagia. The risk for dysphagia should be evaluated to prevent aspiration pneumonia.
Asunto(s)
Médula Cervical/lesiones , Trastornos de Deglución/epidemiología , Trastornos de Deglución/etiología , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/epidemiología , Enfermedad Aguda , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Vértebras Cervicales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Traqueostomía , Adulto JovenRESUMEN
STUDY DESIGN: A retrospective radiographic study with a minimum 2-year follow-up. OBJECTIVE: To evaluate the relationships between the cervical articular facets' morphology and the incidence of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation. SETTING: Spinal Injuries Center, Japan. METHODS: This study included 113 patients with traumatic CSCI without major fracture or dislocation. Eighty-four healthy volunteers without neurological deficits or cervical cord pathology on magnetic resonance imaging (MRI) were defined as control subjects. We used a plain sagittal radiograph to measure the facet sagittal angles (FSA) at four cervical segments in all the CSCI patients and controls. We defined the FSA as the angle between the inferior margin of the superior cervical spinal body and the inferior articular process of the superior vertebra. RESULTS: Most frequent incidence of CSCI was seen at C3-4 segment (54%). With respect to CSCI at C3-4 segment, 55.7% of the subjects showed smallest FSA at C3-4 segment. CONCLUSION: Most of the traumatic CSCI at C3-4 segment showed raised cervical articular facets at C3-4 segment. On the basis of our results, we hypothesized that the raised cervical articular facets might have an important role in the etiology of traumatic CSCI. The cervical spinal cord at the C3-4 segment might receive the highest load during acute hyperextension of the cervical spine because of the C3-4 articular facets' morphology.
Asunto(s)
Vértebras Cervicales/fisiopatología , Traumatismos de la Médula Espinal/etiología , Adulto , Médula Cervical/lesiones , Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/lesiones , Femenino , Fracturas Óseas/epidemiología , Humanos , Luxaciones Articulares/diagnóstico por imagen , Luxaciones Articulares/epidemiología , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Traumatismos de la Médula Espinal/diagnóstico por imagen , Adulto JovenRESUMEN
STUDY DESIGN: A retrospective imaging and clinical study. OBJECTIVES: To evaluate the relationship between magnetic resonance imaging (MRI) features and neurological prognosis in patients with traumatic cervical spinal cord injury (CSCI) without major bone injury. METHODS: A total of 72 patients with CSCI without major bone injury were treated conservatively in our hospital. MRI was performed for all patients at admission and 1 month following injury. We measured the antero-posterior and cranio-caudal diameter of intramedullary intensity changed area with T1-weighted images at the injured segment. Neurological evaluations were performed using the American Spinal Injury Association (ASIA) motor score and the modified Frankel grade at the time of admission and discharge. RESULTS: There was a significant relationship between the antero-posterior diameter ratio of the T1-weighted low-intensity area on MRI at the subacute stage and the ASIA motor score. The optimal threshold of the T1-weighted low-intensity diameter ratio for predicting the patient's ability to walk with or without assistance at discharge was determined to be 46%. Moreover, 96.8% of the patients with <50% T1-weighted low-intensity area recovered to walk with or without a cane at discharge. CONCLUSION: The T1-low intensity area may be an important predictive factor for the neurological recovery of CSCI without major bone injury.
Asunto(s)
Vértebras Cervicales/patología , Trastornos Neurológicos de la Marcha/etiología , Traumatismos de la Médula Espinal/patología , Traumatismos de la Médula Espinal/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Médula Cervical , Femenino , Trastornos Neurológicos de la Marcha/diagnóstico , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Examen Neurológico , Pronóstico , Curva ROC , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
Silica/titania-based functional nanoparticles were prepared through controlled nucleation of titania and subsequent encapsulation by silica through a multistep microfluidic approach, which was successfully applied to obtaining aminopropyl-functionalized silica/titania nanoparticles for a highly sensitive humidity sensor.
Asunto(s)
Nanopartículas del Metal/química , Compuestos Organometálicos/química , Dióxido de Silicio/química , 2-Propanol , Aminas/química , Electrodos , Tamaño de la Partícula , Propilaminas/síntesis química , Propilaminas/química , Cuarzo , Silanos/química , Titanio/química , Agua/químicaRESUMEN
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To elucidate the pathophysiology of rapid progressive clinical deterioration following the onset of cervical myelopathy. SETTING: Spinal Injuries Center, Fukuoka, Japan. METHODS: A total of 43 cervical spondylotic myelopathy (CSM) patients were treated surgically by a senior surgeon. All patients showed intramedullary intensity changes on magnetic resonance (MR) imaging. Overall, eight patients suffered rapid progressive clinical deterioration; four of them had obvious anamnesis of minor trauma. We assessed the responsible injured segment by MR T2-weighted images. Clinical instabilities at the focal segment were evaluated using functional sagittal plain radiographs. Neurological evaluations were performed preoperatively and at 12 months postoperatively using American Spinal Injury Association (ASIA) motor scores and Japanese Orthopaedic Association (JOA) scores for cervical myelopathy. Intraoperatively, we evaluated the presence of adhesive scar tissue on the dura mater at the focal segment. RESULTS: The responsible injured segment was C3-4 in 75% of the rapid progressive (rp)-CSM and in 28.57% of the conventional CSM subjects. One with rp-CSM showed sagittal translational segmental instability. Preoperative ASIA motor scores and JOA scores in the rp-CSM were significantly lower than those in the conventional CSM subjects. Postoperative ASIA motor scores between the subjects showed no significant differences; however, postoperative JOA scores in the rp-CSM subjects were significantly lower. Moreover, an epidural membrane was observed in 62.5% of rp-CSM and 11.4% of conventional CSM subjects. CONCLUSIONS: We hypothesized that the pathophysiology of rp-CSM might be additional cervical cord disorder following the onset of cervical myelopathy. Early decompression surgery is recommended in such patients.
Asunto(s)
Vértebras Cervicales/patología , Enfermedades de la Médula Espinal/etiología , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/cirugía , Espondilosis/etiología , Adulto , Anciano , Anciano de 80 o más Años , Progresión de la Enfermedad , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Examen Neurológico , Estudios Retrospectivos , Estadísticas no ParamétricasRESUMEN
STUDY DESIGN: This was a retrospective observational study. OBJECTIVES: The objectives were to describe the prognosis of upper extremity function following cervical spinal cord injury (CSCI), and to identify prognostic factors for functional recovery. SETTING: Spinal Injuries Center, Japan. METHODS: Sixty patients with C3-4 CSCI without major bone injury participated in the study. Patients were treated nonsurgically and evaluated using the American Spinal Injury Association (ASIA) scales for the upper and lower extremities, their residual cervical motor functions, the modified Frankel grade and an upper extremity function scale. We compared the findings for the upper extremity function scale at 6 months with those for the residual cervical motor functions and modified Frankel grade obtained 3 days after injury. RESULTS: Most patients with CSCI who could flex their hip and knee from a supine position (95%) or who showed some active elbow extension (86%) 3 days after their injury could use a spoon at 6 months. We compared patients who used their fingers at 6 months to those who could not, and observed significant differences in age and ASIA scores for the upper and lower extremities obtained 3 days after injury. A strong correlation was observed between the initial motor scores and the extent of functional recovery at 6 months. CONCLUSION: Hip and knee flexion from the supine position and elbow extension 3 days after injury significantly predicted a positive prognosis for upper extremity function. Younger age and higher ASIA motor scores obtained 3 days after injury were factors associated with neurological recovery.
Asunto(s)
Recuperación de la Función/fisiología , Traumatismos de la Médula Espinal/fisiopatología , Extremidad Superior/fisiopatología , Anciano , Anciano de 80 o más Años , Huesos/fisiología , Femenino , Cadera/fisiopatología , Humanos , Japón , Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Traumatismos de la Médula Espinal/complicacionesRESUMEN
STUDY DESIGN: Retrospective radiographic study. OBJECTIVE: To investigate the pincers effect on cervical spinal cord in the development of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation. SETTING: The Japan LHWO Spinal Injuries Center. METHODS: Two hundred and twenty cases of traumatic CSCI without major fracture or dislocation were examined. The pinched diameters of the cervical spinal cord for 70 patients who complained of neck pain without neurological deficits were measured using sagittal-plane neutral and extension radiographs at 5 segments. These 70 patients were divided into 2 groups: group A patients were less than 40 years old and group B patients were 41 or more. We defined the pinched ratio of the cervical spinal cord during extension as ((sagittal diameter in the neutral image)-(sagittal diameter in the extension image))/(sagittal diameter in the neutral image)*100. RESULTS: The incidence of traumatic CSCI without major fracture or dislocation at the C3-4, C4-5, C5-6 and C6-7 was 59.5, 25, 11.4 and 4.1%, respectively. Further, the pinched ratio of the cervical spinal cord at the C3-4 segment was significantly higher than that at the other segments. CONCLUSION: We concluded that the cervical spinal cord at the C3-4 segment might receive the highest bony impingement load during acute hyperextension of the cervical spine. The extreme pincers load on the cervical spinal cord at the C3-4 segment may have one of the important roles in the development of traumatic CSCI at the C3-4 segment.
Asunto(s)
Vértebras Cervicales/lesiones , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Vértebras Cervicales/diagnóstico por imagen , Femenino , Humanos , Japón , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Dolor de Cuello/etiología , Estudios Retrospectivos , Traumatismos de la Médula Espinal/diagnóstico por imagen , Estadísticas no Paramétricas , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
The hypothalamus has a critical role in the regulation of feeding behavior, energy metabolism and reproduction. Galanin-like peptide (GALP), a novel 60 amino-acid peptide with a nonamidated C-terminus, was first discovered in porcine hypothalamus. GALP is mainly produced in the hypothalamic arcuate nucleus and is involved in the regulation of feeding behavior and energy metabolism, with GALP-containing neurons forming networks with several feeding-regulating peptide-containing neurons. The effects of GALP on food intake and body weight are complex. In rats, the central effect of GALP is to first stimulate and then reduce food intake, whereas in mice, GALP has an anorectic function. Furthermore, GALP regulates plasma luteinizing hormone levels through activation of gonadotropin-releasing hormone-producing neurons, suggesting that it is also involved in the reproductive system. This review summarizes the research on these topics and discusses current evidence regarding the function of GALP, particularly in relation to feeding and energy metabolism. We also discuss the effects of GALP activity on food intake, body weight and locomotor activity after intranasal infusion, a clinically viable mode of delivery.
Asunto(s)
Ingestión de Alimentos/fisiología , Metabolismo Energético/fisiología , Péptido Similar a Galanina/fisiología , Hormona Liberadora de Gonadotropina/metabolismo , Homeostasis/fisiología , Hipotálamo/metabolismo , Animales , Peso Corporal/fisiología , Conducta Alimentaria , Humanos , Hormona Luteinizante/metabolismo , Ratones , Actividad Motora , RatasRESUMEN
STUDY DESIGN: A multicenter prospective study comparing the neurological outcome of patients treated by surgical intervention versus conservative treatment for cervical spinal cord injury (CSCI) without bone and disc injury. OBJECTIVE: To evaluate the neurological outcome of decompression surgery for CSCI without bone and disc injury in patients with spinal cord compression with incomplete paralysis (AIS B, C). SETTING: The Japan LHWO Spinal Injuries Center and the other 10 labor accident hospitals in Japan. METHODS: Thirty-four patients with AIS B, C and cervical spinal cord compression were classified into either a surgical treatment group or a conservative treatment group. The 34 patients enrolled were equally divided between the groups. Patients with AIS B, C and mild spinal compression were enrolled into another group. RESULTS: The neurological outcome of surgical treatment and conservative treatment for AIS B, C with spinal cord compression was found to be closely similar. In addition, the neurological outcome was also similar to that observed after conservative treatment for AIS B, C in patients presenting with mild spinal cord compression. CONCLUSIONS: Surgical treatment was not found to be superior to conservative treatment for CSCI patients without bone and disc injury suffering from spinal cord compression in the acute phase.
Asunto(s)
Descompresión Quirúrgica/métodos , Evaluación de Resultado en la Atención de Salud/métodos , Compresión de la Médula Espinal/cirugía , Adulto , Anciano , Vértebras Cervicales/cirugía , Femenino , Humanos , Japón , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Examen Neurológico/métodos , Estudios Prospectivos , Estudios Retrospectivos , Compresión de la Médula Espinal/fisiopatologíaRESUMEN
Small implantable medical devices, such as wireless capsule endoscopes, that can be swallowed have previously been developed. However, these devices cannot continuously operate for more than 8 h because of battery limitations; moreover, additional functionalities cannot be introduced. This paper proposes a design method for a high-efficiency energy transmission transformer (ETT) that can transmit energy transcutaneously to small implantable medical devices using electromagnetic induction. First, the authors propose an unconventional design method to develop such a high-efficiency ETT. This method can be readily used to calculate the exact transmission efficiency for changes in the material and design parameters (i.e., the magnetic material, transmission frequency, load resistance, etc.). Next, the ac-to-ac energy transmission efficiency is calculated and compared with experimental measurements. Then, suitable conditions for practical transmission are identified. A maximum efficiency of 33.1% can be obtained at a transmission frequency of 500 kHz and a receiving power of 100 mW for a receiving coil size of ¿5 mm × 20 mm. Future design optimization is possible by using this method.
RESUMEN
A patterned two-dimensional hexagonally ordered array of ferritin molecules, the outer surfaces of which had been genetically modified by titanium (Ti) specific binding peptides (minT1-LF), was realized in a self-assembling manner on a hexagonal Ti thin film island made on a silicon substrate. The optimum degree of order was realized at the pH with the maximum selectivity of minT1-LF adsorption on the Ti surface with respect to the silicon dioxide (SiO2) surface. Quartz crystal microbalance (QCM) measurement revealed that minT1-LF adsorbed onto the Ti surface strongly and irreversibly, but adsorbed onto the silicon dioxide surface weakly and reversibly. It was suggested that the concentration of minT1-LF on the Ti pattern promotes hexagonal close-packed ordering and axis aligning.
Asunto(s)
Ferritinas/química , Titanio/química , Adsorción , Materiales Biocompatibles/química , Carbono/química , Cristalización , Concentración de Iones de Hidrógeno , Ensayo de Materiales , Microscopía de Fuerza Atómica/métodos , Microscopía Electrónica de Rastreo , Péptidos/química , Cuarzo , Dióxido de Silicio/química , Propiedades de SuperficieRESUMEN
STUDY DESIGN: A retrospective study. OBJECTIVE: We have encountered several cases of complete sensorimotor paralysis in which patellar tendon reflex (PTR) was demonstrated approximately 3 days after injury and improvement of motor paralysis was subsequently achieved. We considered that PTR apparent in the early stage after injury may offer an index to predict improvements in motor paralysis. MATERIALS AND METHODS: A total of 142 patients assessed as ASIA Impairment Scale A on admission from 1979 to 1998 were included in the study. The patients who demonstrated PTR within 72 h after injury were classified as the PTR(+) group and those who did not constituted the PTR(-) group. With regard to the method of motor paralysis assessment at about 6 months after injury, patients assessed as ASIA Impairment Scale A or B (that is, complete motor paralysis) were classified as 'Non-recovered', whereas those assessed as ASIA Impairment Scale C, D or E (that is, showing obvious improvement of motor paralysis) were considered as 'Recovered'. RESULTS: A significant difference was noted between groups, with the Recovered group including 16 of the 17 PTR(+) patients (94.1%) and 11 of the 115 PTR(-) patients (9.6%) (P<0.0001). CONCLUSION: The results obtained indicate that motor paralysis recovery could be expected at a very high rate among patients demonstrating PTR within 72 h of injury. As all physicians should be familiar with the PTR, this seems to represent a simple and highly useful sign to predict improvements in motor paralysis during the acute stage of cervical cord injury.