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1.
China Popul Dev Stud ; 4(3): 284-297, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33133735

RESUMEN

Social security is an important social and public policy measure to help address poverty in any contemporary society. The Comprehensive Social Security Assistance (CSSA) system in Hong Kong provides a safety net for those aged children and adults below 65 years old who cannot support themselves financially. It is designed to bring their income up to a prescribed level to meet their basic needs. The rapid increase in social welfare expenditure in the last decade has become a concern to the Hong Kong SAR Government. The overall social welfare expenditure has accounted for nearly 15.6% of government expenditure in 2018, with the total amount increasing from $58 billion to $90 billion (an increase of 72.4%) for the period 2014-2018. However, the amount spent on CSSA only increased from $20.7 billion to $22.3 billion with an increase of 7.7% only for the same period. The much slower magnitude of increase is related to the reduction in the number of CSSA recipients, which decreased from 237,501 to 185,528 over the period. A decomposition method was used to assess the changes in the number of people in the CSSA system. It showed that the rate of arriving into the system has been decreasing due to a robust economy with a very low unemployment rate; whereas moving out of the system has also been decreasing in the past 5 years. This phenomenon can be partly attributed to the widening of the income gap in the community in the period. Despite the increase in population size, as long as employment conditions remain strong and the momentum of leaving the system can be maintained, the number of CSSA recipients will continue to decrease. However, the results also suggested that a certain proportion of CSSA recipients will not be able to move out of the system and have been trapped. Some innovative methods to help them out of CSSA are discussed. In view of the poor economic outlook arising from the COVID-19 pandemic, it is important for the Government to have effective measures to keep people in their jobs. If the unemployment rate will does not substantially increase and then increase of in CSSA recipients can be contained.

2.
Niger J Clin Pract ; 19(1): 41-5, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26755217

RESUMEN

BACKGROUND: Many patients present to the emergency department (ED) complaining of intentional poisoning. Of those, some have major depressive disorder (MDD) in their medical history. The aim of this study was to investigate the prevalence of MDD patients who were treated for poisoning in the ED. MATERIALS AND METHODS: A retrospective review was performed on 268 patients who were treated with poisoning between July 2007 and November 2011. Of these patients, we only included those who were over 18 years of age. Information regarding age, gender, cause, time of ingestion, type of drug, history of attempting suicide, and outcome, among other characteristics, was collected and compared to patients who did not have MDD. RESULTS: A total of 244 patients were included in this study. Of those, 52 patients (21.3%) had a history of MDD. Compared to non-MDD patients, a majority (34.6% vs. 19.8%) of those in the MDD group had a history of suicide attempts (P = 0.027), and 34 (65.4% in the MDD group vs. 34.4% in the non-MDD group) took more than two types of drugs (P < 0.001). There were no differences in age, sex, time of ingestion or disease severity between MDD and non-MDD patients. CONCLUSION: In poisoning patients with MDD, physicians in the ED must consider that they have a higher tendency to show suicidal behavior and to have ingested multiple types of drugs.


Asunto(s)
Depresión/epidemiología , Trastorno Depresivo Mayor/epidemiología , Servicio de Urgencia en Hospital , Intoxicación/epidemiología , Intento de Suicidio/psicología , Intento de Suicidio/estadística & datos numéricos , Adulto , Depresión/psicología , Trastorno Depresivo Mayor/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Intoxicación/psicología , Estudios Retrospectivos , Factores Socioeconómicos , Suicidio
3.
Physiol Res ; 65(2): 271-9, 2016 06 20.
Artículo en Inglés | MEDLINE | ID: mdl-26447516

RESUMEN

The novel myokine irisin has been reported as a therapeutic target for metabolic disease. The objective of this study is to reveal the effects of aerobic training (AT) and resistance training (RT) on circulating irisin levels and their associations with change of body composition in overweight/obese adults. Twenty eight overweight/obese adults (BMI>23 kg/m(2)) were included in this study and compared before and after 8 weeks of exercise program (60 min/day, 5 times in a week). The subjects, in both aerobic and resistance training, showed significant improvement in anthropometric parameters and exercise capacities including maximal oxygen uptake and muscle strength. Interestingly, the circulating irisin was significantly increased in resistance training group (p=0.002) but not in aerobic training (p=0.426) compared to control group. In addition, we found the positive correlation between change of the circulating irisin and muscle mass (r=0.432, p=0.022) and the negative correlation between change of the circulating irisin and fat mass (r=-0.407, p=0.031). In the present pilot study, we found that circulating irisin level was increased by 8 weeks of resistance training in overweight/obese adults, suggesting that resistance training could be the efficient exercise type in overweight/obese considering positive change of body composition concomitant with increase of irisin levels.


Asunto(s)
Composición Corporal/fisiología , Ejercicio Físico/fisiología , Fibronectinas/sangre , Sobrepeso/sangre , Sobrepeso/terapia , Entrenamiento de Fuerza , Adulto , Biomarcadores/sangre , Femenino , Humanos , Masculino , Obesidad/sangre , Obesidad/diagnóstico , Obesidad/terapia , Sobrepeso/diagnóstico , Proyectos Piloto , Entrenamiento de Fuerza/métodos , Resultado del Tratamiento
4.
Niger J Clin Pract ; 18(5): 659-63, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26096246

RESUMEN

BACKGROUND AND OBJECTIVES: The ability to predict future clinical deterioration early in patients who present to an emergency care center with a hepatobiliary tract infection is difficult. We studied the clinical usefulness of the initial serum levels of procalcitonin in a hepatobiliary tract infection as an indicator for predicting aggravation in the early stages. METHODS: Of the patients who presented with the clinical symptoms of a hepatobiliary tract infection, 99 were diagnosed with a hepatobiliary tract infection by imaging studies and subsequently enrolled in the study. Laboratory tests were obtained in the early stage of disease after presentation to an emergency care center. We assessed and compared the serum levels of many early inflammatory markers (white blood cell [WBC] counts, C-reactive protein and procalcitonin) between patients whose symptoms were initially stable upon arrival to an emergency care center but then deteriorated to, those whose symptoms remained consistently stable. Thus, we examined if the above serum markers are useful in predicting the possibility of future symptom aggravation. RESULTS: Of a total of 99 patients, 27 were assigned to the symptom aggravation group. The serum levels of WBC counts and C-reactive protein in the aggravation group were elevated. However, the median value (interquartile range) of procalcitonin was relatively increased at 2.28 (0.41-7.84 ng/ml), demonstrating a significant difference. CONCLUSIONS: In conclusion, initial serum levels of procalcitonin might be used as an indicator for aggravation in patients with hepatobiliary tract infection at the emergency department, even though there is hemodynamic stability.


Asunto(s)
Enfermedades de las Vías Biliares/diagnóstico , Calcitonina/sangre , Precursores de Proteínas/metabolismo , Adulto , Enfermedades de las Vías Biliares/complicaciones , Biomarcadores/sangre , Proteína C-Reactiva , Péptido Relacionado con Gen de Calcitonina , Servicio de Urgencia en Hospital , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas
5.
Clin Endocrinol (Oxf) ; 83(1): 20-7, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25400021

RESUMEN

OBJECTIVE: Unilateral primary aldosteronism (PA) should have a contralaterally normal and therefore suppressed adrenal zona glomerulosa. However, there is no validated definition of adrenal suppression. We created two biochemical hypotheses of adrenal suppression based upon measurements taken during adrenal vein sampling (AVS) to determine whether either proved useful for interpretation of AVS or prediction of hypertension outcome in operated cases. DESIGN: Retrospective database analysis. PATIENTS: Ninety-nine cases of PA from a tertiary hypertension unit. MEASUREMENTS: Hypothesis 1 was the proportional suppression of the uninvolved/lowest adrenal(aldo/cortisol) to IVC(aldo/cortisol) ratio pre- and post cosyntropin. Hypothesis 2 was the absolute decrease in the uninvolved adrenal(aldo/cortisol) ratio after cortrosyn injection. ROC analysis performed using lateralization and hypertension resolution as the outcomes of interest. RESULTS: Hypothesis 1 proved highly predictive of lateralization with a ROC AUC of 0.958, P < 0.0001, giving adrenal(aldo/cortisol):IVC(aldo/cortisol) <1.4 as the optimized criterion (sensitivity 90%, specificity 94%). For blood pressure outcomes in the surgical subgroup (n = 52), hypertension resolution was most commonly seen among subjects with adrenal suppression by both definitions although there was significant overlap with subjects requiring ongoing medication. CONCLUSIONS: Post cosyntropin suppression of the uninvolved adrenal-to-IVC ratio is a highly useful definition of adrenal suppression that accurately predicts unilateral PA. This may be particularly useful in a case where AVS fails to catheterize one of the adrenal veins but suppression is seen on the other side. Adrenal suppression may also predict blood pressure outcome, however, a much larger PA database is likely necessary to determine the relative contribution of this predictor.


Asunto(s)
Neoplasias de la Corteza Suprarrenal/sangre , Glándulas Suprarrenales/irrigación sanguínea , Adenoma Corticosuprarrenal/sangre , Aldosterona/sangre , Hidrocortisona/sangre , Hiperaldosteronismo/sangre , Vena Cava Inferior , Neoplasias de la Corteza Suprarrenal/patología , Neoplasias de la Corteza Suprarrenal/cirugía , Glándulas Suprarrenales/patología , Adenoma Corticosuprarrenal/patología , Adenoma Corticosuprarrenal/cirugía , Adulto , Estudios de Cohortes , Bases de Datos Factuales , Femenino , Humanos , Hiperaldosteronismo/patología , Hiperaldosteronismo/cirugía , Hiperplasia , Masculino , Estudios Retrospectivos , Resultado del Tratamiento , Venas
6.
World J Surg ; 38(11): 2855-62, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25002246

RESUMEN

BACKGROUND: Computed tomography (CT) of the adrenals is a common first step for investigation of primary aldosteronism (PA). However, prior studies report poor specificity, necessitating adrenal vein sampling (AVS) prior to surgical consideration. METHODS: We examined our AVS database to determine whether CT adrenal findings could help select patients with a high likelihood of lateralization by AVS or high-value blood pressure (BP) outcomes. Subjects (N = 113) with validated outcomes were divided into groups of CT 'positive' or CT 'negative' according to the presence or absence of an adrenal mass and compared for the outcomes of lateralization by AVS or proportions achieving normotension off medications following surgery. RESULTS: For patients with CT adrenal masses, there was a significantly higher odds ratio (OR) for both outcomes (6.3 and 9.7, p < 0.01). In subgroup analysis, age <40 years carried particularly high odds for lateralization and cure when a CT mass was present (ORs 45 and 26, p < 0.01). Young individuals with normal CT adrenals rarely lateralized (10 %) and, in such patients, even factors like hypokalemia, body mass index (BMI), and plasma aldosterone level did not change the result on regression analysis. CONCLUSIONS: CT-imaged adrenal masses strongly predicted lateralization by AVS and normotension with surgical treatment of lateralized PA. In PA, CT-positive patients should indeed be offered AVS and/or surgery given the high chance of good outcomes; younger CT-negative patients should be advised of a low chance of finding surgical disease by AVS.


Asunto(s)
Adenoma/diagnóstico por imagen , Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Glándulas Suprarrenales/diagnóstico por imagen , Hiperaldosteronismo/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adenoma/sangre , Adenoma/complicaciones , Neoplasias de las Glándulas Suprarrenales/sangre , Neoplasias de las Glándulas Suprarrenales/complicaciones , Adulto , Factores de Edad , Aldosterona/sangre , Presión Sanguínea , Femenino , Humanos , Hiperaldosteronismo/sangre , Hiperaldosteronismo/etiología , Hipopotasemia/sangre , Masculino , Persona de Mediana Edad , Flebotomía , Renina/sangre , Sensibilidad y Especificidad
7.
Vox Sang ; 106(4): 316-21, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24877234

RESUMEN

BACKGROUND: Source reduction is important in minimizing bacterial-contaminated risk of blood products, but previous evaluation of chlorhexidine (CHX) was confounded by inability of Tween and lecithin to neutralize CHX. The study aims to address this limitation and also evaluates the effectiveness of two CHX­alcohol-based skin disinfectants in blood donation setting. METHODS: A two-stage observational study was conducted. A single step 2% chlorhexidine gluconate/70% isopropyl alcohol brush (CHX/IPA-1) was first compared with current skin disinfection procedure consisting of sequential application of 10% povidone-iodine and 70% isopropyl alcohol (PI/IPA). Standard plates with conventional neutralizers (0·3% Tween-80, 0·1% lecithin) were used to enumerate residual bacterial counts. Then, CHX/IPA-1 was compared with another applicator CHX/IPA-2 with identical disinfectant contents using in-house plates with neutralizers (3% Tween-80, 0·3% lecithin, 0·1% histidine, 0·5% sodium thiosulphate, 3% saponin, 1% ether sulphate) having enhanced ability to neutralize CHX. RESULTS: All three products were found to reduce plate counts by > 2 log10 after disinfection. The CHX/IPA-1 group gave fewer residual bacterial growth on standard plates than PI/IPA group (5·9% vs. 61·7%, P < 0·001). With the use of in-house plates, residual bacterial growth was of no difference in both CHX/IPA-1 and CHX/IPA-2 groups (42·5% vs. 49·4%, P = 0·26). CONCLUSION: Good efficacy was observed with one-stage application of CHX/IPA in predonation skin disinfection and it could replace PI/IPA. However, the efficacy of CHX/IPA could be grossly overestimated in testing with standard plates because of insufficient neutralization


Asunto(s)
Alcoholes/farmacología , Donantes de Sangre , Clorhexidina/análogos & derivados , Desinfectantes/farmacología , Povidona Yodada/farmacología , Piel/microbiología , Clorhexidina/farmacología , Desinfección/métodos , Humanos
8.
Scanning ; 36(2): 252-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-23733414

RESUMEN

The aim of this ex vivo study was to evaluate, by scanning electron microscopy (SEM), the presence of gaps at the interface between filling material and three root-end filling materials. Thirty human upper molars disto-buccal roots were instrumented and filled with gutta-percha and eugenol-based sealer. The apicoectomy was performed 2 mm from the apex and retrograde cavities were prepared with ultrasonic points (3 mm in deep). The samples were divided into three experimental groups (n = 10): Group I-white mineral trioxide aggregate (MTA); Group II-Super EBA; and Group III-Portland cement. The root-end filling materials were inserted into the retocavities using a MTA carrier. After 48 h, the roots were transversally sectioned in order to obtain the apical 5 mm. Next, each specimen was prepared longitudinally with crescent granulation of abrasives water-wet sandpapers in order to expose the filling and root-end filling materials. Then, the specimens were subjected to slow dehydration with silica gel, mounted onto specific stubs and coated with paladium coverage for SEM analysis of the interface between filling and root-end filling materials. The percentage of gaps at the interfacial area was calculated by using Image Tool 3.0 software. Super EBA presented the higher percentage of gaps (1.5 ± 0.67%), whereas MTA presented the lowest values (0.33 ± 0.20%; p = 0.0004). Despite the statistical differences observed between Super EBA and MTA, all the root-end filling materials presented great adaptation to the filling material, presenting small amount of gaps.


Asunto(s)
Restauración Dental Permanente/métodos , Materiales de Obturación del Conducto Radicular , Humanos , Procesamiento de Imagen Asistido por Computador , Microscopía Electrónica de Rastreo , Diente Molar/ultraestructura , Obturación del Conducto Radicular
9.
J Hum Hypertens ; 28(5): 298-302, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24284382

RESUMEN

We hypothesized aldosteronoma responsiveness to cosyntropin may be a characterizing feature that could be determined in addition to standard adrenal vein sampling (AVS) data. We reviewed an AVS database from June 2005 to October 2011 including 65 patients with confirmed primary aldosteronism (PA) who underwent AVS and, if applicable, unilateral adrenalectomy. Patients were divided into confirmed lateralized and non-lateralized groups and subgrouped by histology. Plasma aldosterone in inferior vena cava (IVC) pre- and post-cosyntropin infusion during AVS was measured. Peak aldosterone and proportional change was compared between groups. Baseline and peak IVC aldosterone was higher in lateralized patients but incremental aldosterone rise was much greater in subjects with bilateral hyperplasia. From receiver operator characteristics (ROC) analysis, the optimized diagnostic cut point of peak IVC aldosterone of >649 pmol l(-1) would have a sensitivity of 94% for surgical disease although specificity of just 59%. A 250% increase in IVC aldosterone following cosyntropin would be specific enough to exclude 87% of surgical/lateralized disease. These diagnostic capabilities are similar to other results with non-AVS tests performed for diagnosis of lateralization. Although not specific enough to replace standard AVS interpretation, a marked IVC aldosterone increase after cosyntropin during AVS is a useful additional test to diagnose non-lateralizing forms of PA. Such a calculation requires no additional expense or tests.


Asunto(s)
Neoplasias de la Corteza Suprarrenal/diagnóstico , Adenoma Corticosuprarrenal/diagnóstico , Aldosterona/sangre , Cosintropina , Hiperaldosteronismo/diagnóstico , Vena Cava Inferior , Neoplasias de la Corteza Suprarrenal/sangre , Neoplasias de la Corteza Suprarrenal/cirugía , Glándulas Suprarrenales/irrigación sanguínea , Glándulas Suprarrenales/cirugía , Adrenalectomía , Adenoma Corticosuprarrenal/sangre , Adenoma Corticosuprarrenal/cirugía , Adulto , Proteínas de Arabidopsis , Cosintropina/administración & dosificación , Ciclofilinas , Diagnóstico Diferencial , Femenino , Hormonas/administración & dosificación , Humanos , Hiperaldosteronismo/sangre , Hiperaldosteronismo/cirugía , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Retrospectivos , Sensibilidad y Especificidad
10.
Transplant Proc ; 45(4): 1481-6, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23726602

RESUMEN

The present study compared the efficacy and safety of mizoribine (MZR) with mycophenolate mofetil (MMF) in kidney transplantation. This multicenter, randomized clinical trial. Employed doses of study drug tailored to the immunosuppressive need. The primary efficacy outcome was the incidence of biopsy-proven acute rejection episodes (BPAR). The safety of the study drug was assessed using the incidences of adverse events, drug discontinuations, and abnormal laboratory results. The 7 (6.4%) BPARs above grade II were observed in the MZR group noninferior to the 2 (1.8%) in the MMF group (95% confidence interval, -0.007-0.097 > noninferiority limit [-0.2]). BPAR was significantly decreased in the MZR group after the dose change (17/41 [41.4%] vs 8/69 [11.6%]; P < .0001) and the incidence of BPAR was similar between the MZR and MMF groups after the dose change (P = .592). The uric acid level was significantly elevated in the MZR group (P = .002). In conclusion, the efficacy and safety of MZR were similar and statistically noninferior to MMF in combination therapy with tacrolimus.


Asunto(s)
Inmunosupresores/administración & dosificación , Trasplante de Riñón , Ácido Micofenólico/análogos & derivados , Ribonucleósidos/administración & dosificación , Tacrolimus/administración & dosificación , Adulto , Anciano , Quimioterapia Combinada , Femenino , Humanos , Inmunosupresores/efectos adversos , Masculino , Persona de Mediana Edad , Ácido Micofenólico/administración & dosificación , Ácido Micofenólico/efectos adversos , Ribonucleósidos/efectos adversos , Tacrolimus/efectos adversos , Adulto Joven
11.
Ann Surg Oncol ; 20(7): 2274-8, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23504117

RESUMEN

BACKGROUND: In primary aldosteronism (PA), lateralized aldosterone excess can be treated with aldosterone antagonists or surgery, which raises the question as to whether surgery or medications should be the preferred management. A difference in required patient follow-up/clinic resource utilization might provide a surrogate estimate of the comparative outcome efficacy of medical versus surgical therapy. METHODS: From a retrospective review of our adrenal vein sampling (AVS) database June 2005 to August 2011, we chose all patients with PA who were surgical candidates and investigated with AVS. There were 77 subjects; 38 (with aldosteronoma) had unilateral adrenalectomy, and 39 (7 aldosteronoma and 32 hyperplasia) were treated with primary medical therapy. After AVS, patients with nonsurgical disease immediately started mineralocorticoid antagonists and follow-up measured from the AVS date. Surgical patients were seen in the clinic immediately after hospital discharge and follow-up measured from the operative date. Target BP was <140/90 before discharge to the community. RESULTS: Total follow-up ranged from 1 to 55 months, and 4 subjects were lost to follow-up. Mean follow-up in the medical and surgical groups was 13.4 versus 6.5 months (p < 0.004). There was a trend toward more clinic visits for the medical group (7.0 vs 5.2, p = 0.17). CONCLUSIONS: Most PA patients can be managed by medical or surgical approaches. Medically treated patients require much longer-term follow-up to manage their condition, whereas most surgical patients can be successfully discharged shortly after surgery. When possible, surgical management may represent a more expeditious means of treating PA.


Asunto(s)
Adenoma/terapia , Neoplasias de las Glándulas Suprarrenales/terapia , Glándulas Suprarrenales/patología , Recursos en Salud/estadística & datos numéricos , Hiperaldosteronismo/terapia , Adenoma/complicaciones , Neoplasias de las Glándulas Suprarrenales/complicaciones , Glándulas Suprarrenales/cirugía , Adrenalectomía , Adulto , Aldosterona/sangre , Antihipertensivos/uso terapéutico , Presión Sanguínea , Diuréticos Conservadores de Potasio/uso terapéutico , Femenino , Humanos , Hiperaldosteronismo/etiología , Hiperplasia/complicaciones , Hiperplasia/terapia , Hipertensión/tratamiento farmacológico , Hipertensión/etiología , Hipopotasemia/tratamiento farmacológico , Hipopotasemia/etiología , Masculino , Persona de Mediana Edad , Antagonistas de Receptores de Mineralocorticoides/uso terapéutico , Visita a Consultorio Médico/estadística & datos numéricos , Renina/sangre , Estudios Retrospectivos
12.
Res Vet Sci ; 94(1): 144-51, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22975229

RESUMEN

Multipotent mesenchymal stem cells have been considered as a novel clinical approach for cell therapy and regenerative medicine. In this study, mesenchymal stem cells (MSCs) were successfully isolated from canine umbilical cord matrix (cUCM; also referred to as Wharton's Jelly) by collagenase digestion and further characterized for multipotent properties associated with MSCs. Our cUCM-derived MSCs (cUCM-MSCs) were plastic adherent, spindle-shaped and fibroblast-like cells, maintaining expression of pluripotency markers such as Oct3/4, Nanog, Sox-2 and SSEA-4 as well as normal chromosomal number during a long-term proliferative culture. The cells expressed MSCs-specific surface markers, including CD44, CD90, CD105, and CD184, but did not CD29, CD33, CD34, and CD45. More importantly, cUCM-MSCs could differentiate into mesodermal (adipocyte, osteocyte and chondrocyte) and ectodermal (neuronal cell) cell lineages. These results imply that collagenase digestion would be a highly effective way to isolate multipotent MSCs in abundant amounts.


Asunto(s)
Células Madre Mesenquimatosas/citología , Cordón Umbilical/citología , Animales , Diferenciación Celular/fisiología , Colagenasas , Colorantes , Perros , Citometría de Flujo/veterinaria , Técnica del Anticuerpo Fluorescente/veterinaria , Perfilación de la Expresión Génica/veterinaria , Técnicas In Vitro , Cariotipificación/veterinaria , Células Madre Mesenquimatosas/metabolismo , Células Madre Mesenquimatosas/fisiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/veterinaria
13.
Appl Ergon ; 44(3): 414-22, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23153515

RESUMEN

INTRODUCTION: Community nurses are exposed to high physical demands at work resulting in musculoskeletal disorders. The present study examined the short- and long-term benefits of a multifaceted intervention program designed especially for community nurses in Hong Kong. METHODS: Fifty community nurses working in 4 local hospitals participated in the study. All of them underwent an 8-week intervention program consisting of ergonomic training, daily exercise program, equipment modification, computer workstation assessment and typing training. RESULTS: All participants showed significant improvement in musculoskeletal symptoms and functional outcomes comparing pre- and post-intervention results. Significant reduction in symptom score was observed at 1-year follow-up compared to post-intervention. Symptomatic group (n=40) showed more significant changes overall compared to asymptomatic group (n=10). CONCLUSION: Results support the positive benefits, both short- and long-term, of the multifaceted ergonomic intervention programme for community nurses.


Asunto(s)
Ergonomía/métodos , Enfermedades Musculoesqueléticas/prevención & control , Personal de Enfermería en Hospital/educación , Enfermedades Profesionales/prevención & control , Adulto , Computadores/normas , Educación Continua en Enfermería/métodos , Ejercicio Físico , Femenino , Hong Kong , Humanos , Masculino , Persona de Mediana Edad , Personal de Enfermería en Hospital/estadística & datos numéricos , Salud Laboral
14.
Transplant Proc ; 44(4): 1169-70, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22564655

RESUMEN

PURPOSE: We designed this experimental study to assess the mucosal protective effects of continuous prostaglandin I2 (PGI2) infusion after canine small bowel autotransplantation. MATERIALS AND METHODS: Six Mongrel dogs were randomly divided two groups: PGI2 (n = 3) and control (n = 3). The small bowel from jejunum to ileum was obtained, including the mesenteric vascular pedicle. After cold flushing ex vivo, the harvested segment was preserved in an icebox for 3 hours. Thereafter we reimplanted the harvested intestinal segment. While completing the anastomosis, PGI2 (50 µg) was slowly infused through the mesenteric artery in the PGI2 group versus the same volume of saline in the control group. At 1, 3 and 6 days after autotransplantation, we obtained blood samples, and at 6 days, small bowel segments. Endotoxin and interleukin 6 (IL-6) levels were measured and all histologic specimens stained with hematoxylin-eosin H-E were reviewed by a pathologist to grade mucosal damage as: mild (1 point), moderate (2 points), or severe (3 points) change. RESULTS: Mean basal serum endotoxin levels were similar in both groups the PGI2 groups versus control group were 0.216 ± 0.018 versus 0.223 ± 0.040 EU/mL, respectively. However, on day 3 after the operation, the PGI2 group showed much decreased levels of serum endotoxin compared to control levels: 0.349 ± 0.196 versus 0.842 ± 0.446 EU/mL. The mean concentration of serum IL-6 on day 1 after operation among the PGI2 versus control group were 32.13 ± 7.13 pg/mL versus 36.96 ± 3.65 pg/mL. The histologic scores at 6 days after the operation were PGI2 group versus control group: 1.33 versus 1.66 (P = NS). CONCLUSION: Continuous infusions of PGI2 through the mesenteric artery after the canine small bowel autotransplantation may protect the small bowel mucosal barrier.


Asunto(s)
Epoprostenol/administración & dosificación , Íleon/efectos de los fármacos , Íleon/trasplante , Mucosa Intestinal/efectos de los fármacos , Mucosa Intestinal/trasplante , Yeyuno/efectos de los fármacos , Yeyuno/trasplante , Animales , Citoprotección , Perros , Endotoxinas/sangre , Íleon/metabolismo , Íleon/patología , Infusiones Intraarteriales , Interleucina-6/sangre , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patología , Yeyuno/metabolismo , Yeyuno/patología , Arterias Mesentéricas , Factores de Tiempo , Trasplante Autólogo
15.
Vet Rec ; 157(2): 53-6, 2005 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-16006642

RESUMEN

In the nine years from 1993 to 2001, 210 cases of rabies were recorded in domestic animals in South Korea; 115 cattle, 94 dogs and one farmed deer were affected. The annual incidence of rabies cases increased to a peak of 64 in 1998, and then decreased to about 30 cases per year. The cases were confined to the northern part of Kyounggi and Kangwon provinces. One hundred and forty-six cases (69.5 per cent) occurred in Kyounggi and 64 cases (30.5 per cent) in Kangwon province, and about 82 per cent of them were confined to two counties in Kyounggi province (29 per cent in Paju and 28.1 per cent in Younchun) and to Chulwon county in Kangwon province (25.2 per cent). However, over several years the outbreaks gradually moved south and east in both Kyounggi and Kangwon provinces. There were more rabies cases in cattle than in dogs, suggesting that the disease is transmitted by the sylvatic cycle. To investigate the relationship between rabies in domestic animals and wild animals, 107 wild animals, including Korean raccoon dogs, badgers, weasels and feral cats, were tested for rabies; 21 of the 67 Korean raccoon dogs tested (31 per cent) were infected. The cases in domestic animals were most common in winter, from December to February, and least common in summer, from June to September.


Asunto(s)
Rabia/veterinaria , Animales , Gatos , Bovinos , Ciervos , Perros , Incidencia , Corea (Geográfico)/epidemiología , Mustelidae , Rabia/epidemiología , Perros Mapache , Estaciones del Año
16.
Transplant Proc ; 37(1): 155-8, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-15808579

RESUMEN

Mizoribine (MZR), an inhibitor of inosine monophosphate dehydrogenase, which depletes cellular guanadine triphosphate, is an immunosuppressive drug. The aim of this study was to evaluate the mechanism by which MZR exerts cytotoxic effects on human Jurkat T cells. Our study showed that MZR-induced apoptotic death of human Jurkat T cells is dose-dependent and time-dependent, as revealed by chromatin condensation and H2AX phosphorylation. Furthermore, MZR increased the catalytic activity of caspase family cysteine proteases, including caspase-3, caspase-8, and caspase-9, in human Jurkat T cells. In conclusion, MZR induces the apoptotic death of human Jurkat T cells via activation of caspase family proteases as well as by mitochondrial dysfunction.


Asunto(s)
Apoptosis/efectos de los fármacos , Inmunosupresores/farmacología , Ribonucleósidos/farmacología , Transducción de Señal/efectos de los fármacos , Caspasas/metabolismo , Línea Celular , Núcleo Celular/efectos de los fármacos , Núcleo Celular/ultraestructura , Supervivencia Celular/efectos de los fármacos , Humanos , Células Jurkat , Proteínas Proto-Oncogénicas c-bcl-2/efectos de los fármacos , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Linfocitos T/efectos de los fármacos , Linfocitos T/inmunología , Proteína bcl-X
17.
Singapore Med J ; 43(6): 305-7, 2002 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12380728

RESUMEN

AIM: Anal fistula is usually treated by either fistulotomy or fistulectomy. We described the routine use of setons to treat anal fistula without any surgery. METHOD: Forty-seven consecutive patients with diagnosed anal fistulae were treated using setons alone. RESULTS: The median age of the patients was 41 (range: 18-70). Of the 47 patients, 15 had surgery previously for fistula and perianal abscess. At least two setons were inserted through each fistula. One was tied tightly to function as a cutting seton and this was sequentially tightened by the patient and another was tied loosely for drainage. Of the 47 patients, 33 (70%) had the placement of setons in the clinic without any anaesthesia. The remaining 14 patients had the setons inserted in the operating room, with one patient having a complex anal fistula and 13 patients having perianal abscess requiring drainage at the same time. There were no post procedure complications in the series. Forty-one patients had completed follow up at clinic within a median duration of 15 weeks (range: two to 67 weeks). The fistula was completely healed by this method in 37 patients (78%). The median healing time was nine weeks (range: four to 62 weeks). One patient developed recurrent fistula and was healed after another seton placement. No patient developed any faecal incontinence and all patients were satisfied with this treatment. CONCLUSION: The routine seton method is safe, cheap and effective in the treatment of anal fistula regardless of type. It does not leave an open wound and most patients are satisfied with the treatment.


Asunto(s)
Fístula Rectal/cirugía , Técnicas de Sutura , Adolescente , Adulto , Anciano , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Suturas , Resultado del Tratamiento
18.
Lipids ; 36(4): 427-9, 2001 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11383697

RESUMEN

A new diacylgalactolipid was isolated from the marine cyanobacterium Oscillatoria sp., and the structure was elucidated as (2S)-3-O-beta-D-galactopyranosyl-1-O-(9Z,12Z-oc-tadecadienoyl)-2-O-(4Z-hexadecenoyl)glycerol by enzymatic partial hydrolysis using lipase and physicochemical evidence, which included determining the double bond position in the hexadecenoic acid moiety.


Asunto(s)
Cianobacterias/química , Galactolípidos , Glucolípidos/química , Fenómenos Químicos , Química Física , Ácidos Grasos/análisis , Cromatografía de Gases y Espectrometría de Masas , Glucolípidos/aislamiento & purificación , Hidrólisis , Lipasa/metabolismo , Espectroscopía de Resonancia Magnética , Espectrometría de Masa Bombardeada por Átomos Veloces
19.
Cancer Res ; 61(3): 984-90, 2001 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-11221894

RESUMEN

To investigate the role of membrane-type matrix metalloproteinase-1 (MT1-MMP) in mammary gland development and tumorigenesis, transgenic mice overexpressing MT1-MMP in mammary gland under the control of the mouse mammary tumor virus long terminal repeat-promoter were generated. The mouse mammary tumor virus/MT1-MMP transgenic mice displayed abnormalities in 82% of female mammary glands. The abnormalities were verified as lymphocytic infiltration, fibrosis, hyperplasia, alveolar structure disruption, dysplasia, and adenocarcinoma. Northern and reverse transcription-PCR analyses demonstrated that MT1-MMP mRNA was overexpressed in mammary glands exhibiting abnormalities. Western blot analysis and immunohistochemical studies have revealed that the protein expression level was also increased in these glands. In addition, the beta-casein gene as a functional epithelial cell marker was poorly expressed in the mammary glands of transgenic mice exhibiting abnormalities. Gelatin zymography showed significantly increased MMP-2 activation in these mammary glands. These results showed that overexpression of MT1-MMP induced remodeling of the extracellular matrix and tumor formation in the mammary glands of transgenic mice. Therefore, we suggest that overexpression of MT1-MMP may play a key role in development and tumorigenesis in mammary glands.


Asunto(s)
Adenocarcinoma/genética , Glándulas Mamarias Animales/enzimología , Neoplasias Mamarias Experimentales/genética , Metaloendopeptidasas/genética , Adenocarcinoma/enzimología , Animales , Caseínas/biosíntesis , Caseínas/genética , Activación Enzimática , Precursores Enzimáticos/metabolismo , Femenino , Gelatinasas/metabolismo , Expresión Génica , Masculino , Glándulas Mamarias Animales/patología , Neoplasias Mamarias Experimentales/enzimología , Metaloproteinasa 14 de la Matriz , Metaloproteinasas de la Matriz Asociadas a la Membrana , Metaloendopeptidasas/biosíntesis , Metaloendopeptidasas/metabolismo , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos DBA , Ratones Endogámicos ICR , Ratones Transgénicos , Lesiones Precancerosas/enzimología , Lesiones Precancerosas/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
20.
Can Assoc Radiol J ; 52(6): 379-84, 2001 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11780547

RESUMEN

OBJECTIVE: To determine the success and immediate complication rates associated with 3412 central venous catheter placements performed in an interventional radiology suite. METHODS: Success and immediate complication rates were prospectively recorded for 3412 consecutive patients who had central venous catheters radiologically placed at a tertiary care centre between July 1993 and October 2000. The indication for placement and the insertion site were also recorded. RESULTS: The most common indication for both short- and long-term venous access was hemodialysis, and the right internal jugular vein was the most common site for catheter insertion. Placement was successful for 98.8% of tunnelled lines and 99.3% of temporary catheters. The rate for immediate complications (including pneumothorax, air emboli, bleeding and arterial puncture) for tunnelled catheter placements was 3.8% and for temporary catheter placements was 1.6%; no major complications were documented. CONCLUSION: Our results lend further evidence to the claim that the success and immediate complication rates of radiologically placed central venous catheters compare favourably with blind placement and surgical placement of central venous catheters.


Asunto(s)
Arterias/lesiones , Cateterismo Venoso Central/instrumentación , Embolia Aérea/epidemiología , Hemorragia/epidemiología , Neumotórax/epidemiología , Radiología Intervencionista/instrumentación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Alberta , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Punciones/instrumentación , Garantía de la Calidad de Atención de Salud , Riesgo , Ultrasonografía/instrumentación
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