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1.
Med Gas Res ; 13(1): 10-14, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-35946217

RESUMEN

The intubating laryngeal mask airway (ILMA) can be used for ventilation and oxygenation between intubation attempts, but there is a varied success rate ranging from 33% to 96%. Air Q is a relatively new entrant. Parker flex tube aids in atraumatic intubation. The primary aim of this study was to compare Air Q intubating laryngeal airway with ILMA as intubation conduits in patients with simulated fixed cervical spine using a Parker flex tube. It was a single-blinded, randomized, prospective, and comparative study conducted on 91 patients aged between 18 to 60 years of either sex, scheduled to undergo elective surgery under general anesthesia belonging to the American Society of Anesthesiologists physical status I and II. Out of 45 patients in each group, Air Q was successfully placed in 43 patients and ILMA was successfully placed in 44 patients. 35.56% of the patients required maneuvers for placing the Air Q, whereas, for placing the ILMA, only 15.56% of the patients required maneuvers. Intubation through the AIR Q was successful in 39 patients and through the ILMA in 44 patients, but there was no significant difference between the two groups. The number of attempts and the time of device insertion were comparable. There were a similar number of attempts, maneuvers required, and time is taken for endotracheal intubation. The incidence of cough and sore throat was comparable in both groups. We conclude that ILMA has a higher success rate than Air Q for tracheal intubation with Parker Flex tube in patients with simulated fixed cervical spine. More optimized maneuvers were required for the placement of Air Q.


Asunto(s)
Máscaras Laríngeas , Adolescente , Adulto , Anestesia General , Vértebras Cervicales , Humanos , Intubación Intratraqueal , Persona de Mediana Edad , Estudios Prospectivos , Adulto Joven
2.
Braz. j. biol ; 83: e246803, 2023. tab, graf
Artículo en Inglés | LILACS, VETINDEX | ID: biblio-1339417

RESUMEN

Abstract Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitant's age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.


Resumo A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados ​​por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das plantas da área para suas necessidades de saúde e outros usos como vegetal, lenha, forragem etc. O resultado atual de RFC, UV, ICF, FL e JI mostra que a flora medicinal precisa ser investigada farmacológica e fitoquimicamente para comprovar sua eficácia. A documentação do conhecimento medicinal é importante para preservar esse precioso conhecimento antigo antes que se perca para sempre, devido às mudanças tecnológicas e ambientais do mundo.


Asunto(s)
Humanos , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Plantas Medicinales , Pakistán , Encuestas y Cuestionarios , Hojas de la Planta , Etnobotánica , Fitoterapia , Medicina Tradicional
3.
Braz. j. biol ; 83: e249911, 2023. tab, graf
Artículo en Inglés | LILACS, VETINDEX | ID: biblio-1339366

RESUMEN

Abstract Hematological and hematopoietic cells malignancies of the genes and hematopoietic cells are associated with the genetic mutation, often at the chromosomal level. The standard cytogenetic study is widely accepted as one of the main diagnostics and prognostic determinants in patients. Therefore, the current descriptive and cross-sectional study sought to determine the cytogenetic analysis of frequent hematological malignancies in Pakistan. A total of 202 peripheral bone marrow or blood samples from patients with benign and malignant hematological malignancy were taken using a conventional G-banding technique. Among enrolled patients, the mean age was 21.5 years ± 23.4, and gender-wise distribution showed a marked predominance of the male 147 (73%) population compared to the female 55 (27%). Patients in the age group (2-10 years) had the highest frequency, 48 (24%), of hematological neoplasms, followed by age (11-20 years) with 40 (20%). Normal karyotypes (46, XX/46, XY) was found in 51% (n=103) patients. Furthermore, the frequency of complex karyotype was 30 (15%), while normal was seen in 171 (85%) patients. Pre-B Acute Lymphoblastic Leukemia (Pre-B ALL) was the most prevalent malignancy of 66 (33%), followed by Chronic Myelogenous Leukemia (CML) of 41 (20%) and Acute Lymphocytic Leukemia of 29 (14%). Translocation was the most prevalent 50 (25%), followed by hypotriploidy 14 (7%) and monosomy 8 (4%) on chromosome aberration analysis. In addition, t(9:22) translocation was found to be 20 (10%) in CML, with the majority in the age group (31-40 years). This study recommends that karyotyping should be tested frequently in hematological conditions because it may provide insight into the relative chromosomal changes associated with particular malignancies.


Resumo As neoplasias hematológicas e de células hematopoiéticas dos genes e as células hematopoiéticas estão associadas à mutação genética, geralmente em nível cromossômico. O estudo citogenético padrão é amplamente aceito como um dos principais determinantes diagnósticos e prognósticos em pacientes. Portanto, o presente estudo descritivo e transversal buscou determinar a análise citogenética de neoplasias hematológicas frequentes no Paquistão. Um total de 202 amostras de medula óssea periférica ou sangue de pacientes com malignidade hematológica benigna e maligna foi coletado usando uma técnica convencional de banda G. Entre os pacientes inscritos, a média de idade foi de 21,5 anos ± 23,4, e a distribuição por gênero mostrou uma marcada predominância da população masculina de 147 (73%) em comparação com a feminina de 55 (27%). Pacientes na faixa etária (2-10 anos) tiveram a maior frequência, 48 (24%), de neoplasias hematológicas, seguida da idade (11-20 anos) com 40 (20%). Cariótipos normais (46, XX / 46, XY) foram encontrados em 51% (n = 103) dos pacientes. Além disso, a frequência de cariótipo complexo foi de 30 (15%), enquanto normal foi observada em 171 (85%) pacientes. Leucemia linfoblástica aguda pré-B (LLA Pré-B) foi a doença maligna mais prevalente de 66 (33%), seguida por leucemia mieloide crônica (LMC) de 41 (20%) e leucemia linfocítica aguda de 29 (14%). A translocação foi o 50 mais prevalente (25%), seguido por hipotriploidia 14 (7%) e monossomia 8 (4%) na análise de aberração cromossômica. Além disso, a translocação t (9:22) encontrada foi de 20 (10%) na LMC, com a maioria na faixa etária (31-40 anos). Este estudo recomenda que o cariótipo deve ser testado com frequência em condições hematológicas porque pode fornecer informações sobre as alterações cromossômicas relativas associadas a doenças malignas específicas.


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Adulto Joven , Aberraciones Cromosómicas , Neoplasias Hematológicas/genética , Neoplasias Hematológicas/epidemiología , Pakistán/epidemiología , Estudios Transversales , Cariotipificación
4.
Clin Pharmacol Drug Dev ; 11(2): 165-172, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34453416

RESUMEN

Tadalafil is an effective, reversible, and competitive phosphodiesterase 5 inhibitor mainly used to treat erectile dysfunction. This study investigated the bioequivalence of generic and marketed formulations of 10-mg tadalafil tablets under fasted and fed conditions. This open-label, randomized, single-dose, 2-period crossover study included 53 healthy Chinese men (aged 20-43 years). Plasma samples were collected from 0.5 hours before treatment to 72 hours after each dose and analyzed using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry. Pharmacokinetic parameters were calculated using noncompartmental analysis. Safety assessments were performed throughout the study. For the fasted state, the 90% confidence intervals of the geometric mean ratios between the generic and marketed formulations were 86.1% to 99.1% for the maximum plasma concentration and 88.4% to 100.3% for the area under the plasma concentration-time curve from time 0 to infinity, and the corresponding values under the fed state were and 99.9% to 108.4% and 95.7% to 104.3%, respectively. All data were within the accepted bioequivalence range of 80% to 125%. After consuming high-fat, high-calorie meals in the fed condition, the time to the maximum plasma concentration was similar between the formulations, and area under the plasma concentration-time curve from time 0 to infinity and maximum plasma concentration were 10.2% and 6.55% higher, respectively, for the marketed formulation. Thus, food had no clinically relevant effect on tadalafil exposure following a single oral dose in healthy Chinese men. No serious adverse reactions were reported. These results indicated that the analyzed generic and marketed tadalafil tablets were bioequivalent with similar safety profiles.


Asunto(s)
Ayuno , Adulto , China , Estudios Cruzados , Humanos , Masculino , Comprimidos , Tadalafilo/efectos adversos , Equivalencia Terapéutica , Adulto Joven
5.
Gigascience ; 112022 03 07.
Artículo en Inglés | MEDLINE | ID: mdl-35254424

RESUMEN

BACKGROUND: One of the goals of neuropsychology is to understand the brain mechanisms underlying aspects of attention and cognitive control. Several tasks have been developed as a part of this body of research, however their results are not always consistent. A reliable comparison of the data and a synthesis of study conclusions has been precluded by multiple methodological differences. Here, we describe a publicly available, high-density electroencephalography (EEG) dataset obtained from 42 healthy young adults while they performed 3 cognitive tasks: (i) an extended multi-source interference task; (ii) a 3-stimuli oddball task; (iii) a control, simple reaction task; and (iv) a resting-state protocol. Demographic and psychometric information are included within the dataset. DATASET VALIDATION: First, data validation confirmed acceptable quality of the obtained EEG signals. Typical event-related potential (ERP) waveforms were obtained, as expected for attention and cognitive control tasks (i.e., N200, P300, N450). Behavioral results showed the expected progression of reaction times and error rates, which confirmed the effectiveness of the applied paradigms. CONCLUSIONS: This dataset is well suited for neuropsychological research regarding common and distinct mechanisms involved in different cognitive tasks. Using this dataset, researchers can compare a wide range of classical EEG/ERP features across tasks for any selected subset of electrodes. At the same time, 128-channel EEG recording allows for source localization and detailed connectivity studies. Neurophysiological measures can be correlated with additional psychometric data obtained from the same participants. This dataset can also be used to develop and verify novel analytical and classification approaches that can advance the field of deep/machine learning algorithms, recognition of single-trial ERP responses to different task conditions, and detection of EEG/ERP features for use in brain-computer interface applications.


Asunto(s)
Interfaces Cerebro-Computador , Electroencefalografía , Encéfalo/fisiología , Cognición/fisiología , Electroencefalografía/métodos , Potenciales Evocados/fisiología , Humanos , Adulto Joven
6.
J Clin Pharmacol ; 62(2): 206-219, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34435684

RESUMEN

Population pharmacokinetic (PK) and exposure-safety analyses of alisertib were performed in children enrolled in 2 clinical trials: NCT02444884 and NCT01154816. NCT02444884 was a dose-finding study in children with relapsed/refractory solid malignancies (phase 1) or neuroblastomas (phase 2). Patients received oral alisertib 45 to 100 mg/m2 as powder-in-capsule once daily or twice daily for 7 days in 21-day cycles. Serial blood samples were collected up to 24 hours after dosing on cycle 1, day 1. NCT01154816 was a phase 2 single-arm study evaluating efficacy in children with relapsed/refractory solid malignancies or acute leukemias. Patients received alisertib 80 mg/m2 as enteric-coated tablets once daily for 7 days in 21-day cycles. Sparse PK samples were collected up to 8 hours after dosing on cycle 1, day 1. Sources of alisertib PK variability were characterized and quantified using nonlinear mixed-effects modeling to support dosing recommendations in children and adolescents. A 2-compartment model with oral absorption described by 3 transit compartments was developed using data from 146 patients. Apparent oral clearance and central distribution volume were correlated with body surface area across the age range of 2 to 21 years, supporting the use of body surface area-based alisertib dosing in the pediatric population. The recommended dose of 80 mg/m2 once daily enteric-coated tablets provided similar alisertib exposures across pediatric age groups and comparable exposure to that in adults receiving 50 mg twice daily (recommended adult dose). Statistically significant relationships (P < .01) were observed between alisertib exposures and incidence of grade ≥2 stomatitis and febrile neutropenia, consistent with antiproliferative mechanism-related toxicities.


Asunto(s)
Antineoplásicos/farmacocinética , Azepinas/farmacocinética , Neoplasias/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/farmacocinética , Pirimidinas/farmacocinética , Adolescente , Antineoplásicos/efectos adversos , Azepinas/efectos adversos , Superficie Corporal , Niño , Preescolar , Esquema de Medicación , Femenino , Humanos , Masculino , Dosis Máxima Tolerada , Modelos Biológicos , Estadificación de Neoplasias , Neoplasias/patología , Inhibidores de Proteínas Quinasas/efectos adversos , Pirimidinas/efectos adversos , Adulto Joven
7.
Dermatol Ther ; 35(2): e15229, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34820974

RESUMEN

Carboxytherapy has been used in the treatment of autoimmune skin diseases such as psoriasis and morphea. Carboxytherapy has antioxidant effects, and leads to better tissue oxygenation, and release of growth factors. In this article, we decided to evaluate efficacy of combined carboxytherapy and narrowband-ultraviolet B (NB-UVB) compared to NB-UVB alone in the treatment of vitiligo. This is a prospective, split-body double-blind comparative study performed in patients with generalized stable vitiligo in acral areas and extremities referred to dermatology clinic of Afzalipour hospital in Kerman University of Medical Sciences. NB-UVB was performed three times a week in non-consecutive days for 4 months. In each patient, one lesion was randomly treated with carboxytherapy (weekly sessions for total of 16 sessions). Efficacy of treatment was evaluated by percentage of repigmentation of the lesions. Chi-square test and analysis of variance test (ANOVA) were used to compare efficacy of treatment based on demographic features of the patients and clinical features of the lesions, respectively. Twenty-eight patients with mean age of 32.35 ± 7.37 years old completed the study. At the end of the treatment, 37% of the patients in combination therapy group demonstrated more than 75% improvement compared to 0% in the monotherapy group (p = 0.001). There was no significant difference between either demographic features of the patients (age, sex, and skin phototypes) or duration of disease with efficacy of the treatment in both groups. Combination of carboxytherapy with NB-UVB leads to higher percentage of repigmentation and patients' satisfaction compared to monotherapy with NB-UVB.


Asunto(s)
Terapia Ultravioleta , Vitíligo , Adulto , Terapia Combinada , Humanos , Estudios Prospectivos , Piel/patología , Resultado del Tratamiento , Terapia Ultravioleta/efectos adversos , Vitíligo/diagnóstico , Vitíligo/tratamiento farmacológico , Vitíligo/radioterapia , Adulto Joven
8.
Horm Metab Res ; 54(2): 67-75, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35130567

RESUMEN

Resistance to thyroid hormone syndrome (RTHS) is defined as increased thyroxine and triiodothyronine associated with normal or increased thyrotropin. This is usually due to a pathogenic variant of the gene coding for thyroid hormone receptor B (THRB). THRB is a rare genetic disorder characterized by an altered response of target tissue to the thyroid hormone action. Retrospective cross-sectional observational study with diagnosis of RTHS evaluated in secondary and tertiary hospitals for 6 years, from 2014 to 2020, in order to describe variables including age, sex, anthropometric data, clinical and biochemical characteristics of patients, who were divided according to age, in a pediatric group from 0 to 14 years (index cases), and an adult group composed of adult relatives of index cases. A molecular analysis of the THRB gene was performed. The total retrospective cohort included 7 pediatric patients and 15 adults. We found 22 cases with a clear male predominance (14/22). Mean age is 24.8 years old (22 days-70 years). Patients were referred because of symptoms 18.2% (4/22), analysis results 22.7% (5/22), or familial study 59.1% (13/22). About 31.8% (7/22) cases show goiter, 31.8% (7/22) sympathetic symptoms and 13.6% (3/22) abnormalities in behavior. In most cases, 77.3%, (17/22) show familial background of thyroid abnormalities. It is important to remark that 18.2% (4/22) relatives received previous incorrect treatments such as thyroidectomy, because of wrong diagnosis. In conclusion, a better understanding of RTHS, its prompt molecular diagnosis and genetic counseling, could avoid unnecessary tests and inappropriate treatments.


Asunto(s)
Síndrome de Resistencia a Hormonas Tiroideas , Adolescente , Adulto , Niño , Preescolar , Estudios Transversales , Humanos , Lactante , Recién Nacido , Masculino , Mutación , Estudios Retrospectivos , Receptores beta de Hormona Tiroidea/genética , Síndrome de Resistencia a Hormonas Tiroideas/diagnóstico , Síndrome de Resistencia a Hormonas Tiroideas/genética , Tirotropina , Tiroxina , Triyodotironina , Adulto Joven
9.
Ann R Coll Surg Engl ; 104(4): 308-313, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34931547

RESUMEN

INTRODUCTION: This study reviews our experience with the management a retained knife in the setting of thoracic stab wounds. METHODS: A retrospective study was conducted at a major trauma in South Africa over a 15-year period from January 2004 to December 2018. RESULTS: There were 40 patients, of whom 37 were males (93%). Median age was 24 years; 78% of cases (31 of 40) were a retained knife and 23% (9 of 40) were a retained blade. The locations of the stab wounds were 19 (48%) anterior and 21 (53%) posterior. Plain x-ray was performed in 85% (34) of patients and computed tomography angiography was performed in 85% (34). Six patients had haemodynamic instability and were expedited to the operating room without further imaging. Three of these had cardiac tamponade and three a massive haemothorax. Simple extraction and wound exploration were performed in 58% (23 of 40) of cases and the remaining 43% (17 of 40) required operative exploration and extraction. The operative approach was anterolateral thoracotomy in nine cases, posterolateral thoracotomy in four and median sternotomy in three cases. One patient required extraction and concurrent vertebral laminectomy due to cord compression. Twelve patients (30%) experienced complications (nine wound sepsis and three hospital-acquired pneumonia). There was one mortality (3%). The median length of hospital stay was 6 days. CONCLUSION: Uncontrolled extraction of a retained thoracic knife outside the operating room must be avoided. An unstable patient should proceed directly for operative exploration. For stable patients, cross-sectional imaging will allow for planned extraction in operating room.


Asunto(s)
Heridas Penetrantes , Heridas Punzantes , Adulto , Humanos , Masculino , Estudios Retrospectivos , Sudáfrica/epidemiología , Centros Traumatológicos , Heridas Penetrantes/cirugía , Heridas Punzantes/epidemiología , Heridas Punzantes/cirugía , Adulto Joven
10.
Braz. j. oral sci ; 21: e226288, jan.-dez. 2022. ilus
Artículo en Inglés | LILACS, BBO | ID: biblio-1366204

RESUMEN

Aim: To describe the pattern of toothache experience in a cohort of children aged 2-5 over 21 years and to find the relationship between previous toothache experience and later reports of toothache to get finding on the most critical period of toothache as a problem in life. Methods: This is a secondary data analysis from Indonesia Family Life Survey (IFLS). A total of 1,927 children from IFLS-1 with complete data were included as baseline participants. They were followed up four times within 21 years (age 6-9y, age 9-12y, age 16-19y, age 23- 26y). Toothache was based on the question of self-reported toothache experience during the last four weeks. After 21 years, a total of 1,098 individuals could be traced and completed every cohort of the survey. Toothache experiences were reported for frequencies in every cohort and accumulative experiences over 21 years. Logistic regression tests were performed to analyze the association of previous toothache experience and later toothache experience. Results: Almost 40% of the respondents reported toothache at least once in their life. The age of 6-9 years is the period when a high percentage of children had teeth-related pain. The experience of toothache at this period was significantly related to every period of age in life. Conclusions: The period of early mixed dentition is important. Oral health status in this period is associated with future oral health. A comprehensive dental health prevention program targeting this population is essential to increase the quality of life


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Adulto Joven , Odontalgia/epidemiología , Salud Bucal , Factores Socioeconómicos , Encuestas de Salud Bucal , Prevalencia , Estudios Longitudinales , Indonesia/epidemiología
11.
Int Arch Occup Environ Health ; 95(3): 701-708, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34626220

RESUMEN

PURPOSE: Secondary metalworking carries exposure to relatively heavy levels of respirable particulate. We investigated the extent to which metalworking is associated with increased exhaled nitric oxide (FeNO), an established inflammatory biomarker. METHODS: We studied 80 metalworking factory employees in Kazakhstan. Informed by industrial hygiene data, we categorized them into three groups: (1) machine operators (41%); (2) welders or assemblers (33%); and (3) all others, including administrative and ancillary staff (26%). Participants completed questionnaires covering occupational history, smoking, home particulate sources, respiratory symptoms, and comorbidities. We measured exhaled carbon monoxide (CO), exhaled fractional nitric oxide (FeNO), and spirometric function. We used mixed-effects modeling to test the associations of occupational group with FeNO, adjusted for covariates. RESULTS: The median age was 51.5 (interquartile range 20.5) years; 7% were women. Occupational group (p < 0.01), daily current cigarette smoking intensity (p < 0.05), and age (p < 0.05), each was statistically associated with FeNO. Welders, or assemblers (Group 2), who had intermediate particulate exposure, manifested significantly higher exhaled FeNO compared to machinists (Group 1, with the highest particulate exposure) and all others (Groups 3, the lowest particulate): adjusted Group 2 mean 44.8 ppb (95% confidence interval (CI) 33.8-55.9) vs. Group 1 24.6 ppb (95% 20.5-28.7) and Group 3, 24.3 ppb (95% CI 17.7-30.9). Secondhand smoking and height were not associated with FeNO. CONCLUSION: In a metalworking industrial cohort, welders/assemblers manifested significantly higher levels of FeNO. This may reflect respiratory tract inflammation associated with airborne exposures specific to this group.


Asunto(s)
Espiración , Óxido Nítrico , Adulto , Pruebas Respiratorias , Monóxido de Carbono/análisis , Polvo , Femenino , Humanos , Espirometría , Adulto Joven
12.
BMJ Glob Health ; 7(8)2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35914832

RESUMEN

BACKGROUND: A few studies have assessed the epidemiological impact and the cost-effectiveness of COVID-19 vaccines in settings where most of the population had been exposed to SARS-CoV-2 infection. METHODS: We conducted a cost-effectiveness analysis of COVID-19 vaccine in Kenya from a societal perspective over a 1.5-year time frame. An age-structured transmission model assumed at least 80% of the population to have prior natural immunity when an immune escape variant was introduced. We examine the effect of slow (18 months) or rapid (6 months) vaccine roll-out with vaccine coverage of 30%, 50% or 70% of the adult (>18 years) population prioritising roll-out in those over 50-years (80% uptake in all scenarios). Cost data were obtained from primary analyses. We assumed vaccine procurement at US$7 per dose and vaccine delivery costs of US$3.90-US$6.11 per dose. The cost-effectiveness threshold was US$919.11. FINDINGS: Slow roll-out at 30% coverage largely targets those over 50 years and resulted in 54% fewer deaths (8132 (7914-8373)) than no vaccination and was cost saving (incremental cost-effectiveness ratio, ICER=US$-1343 (US$-1345 to US$-1341) per disability-adjusted life-year, DALY averted). Increasing coverage to 50% and 70%, further reduced deaths by 12% (810 (757-872) and 5% (282 (251-317) but was not cost-effective, using Kenya's cost-effectiveness threshold (US$919.11). Rapid roll-out with 30% coverage averted 63% more deaths and was more cost-saving (ICER=US$-1607 (US$-1609 to US$-1604) per DALY averted) compared with slow roll-out at the same coverage level, but 50% and 70% coverage scenarios were not cost-effective. INTERPRETATION: With prior exposure partially protecting much of the Kenyan population, vaccination of young adults may no longer be cost-effective.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , COVID-19/prevención & control , Análisis Costo-Beneficio , Humanos , Kenia/epidemiología , SARS-CoV-2 , Adulto Joven
13.
Sci Rep ; 12(1): 13225, 2022 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-35918463

RESUMEN

Acute kidney injury (AKI) increases the risk of morbidity, mortality, and progression to chronic kidney disease (CKD). There are few data on the risk of CKD following community-acquired AKI (CA-AKI) and its predictors from developing countries. We evaluated the association of a panel of serum and urine biomarkers at the time of hospital discharge with 4-month renal outcome in CA-AKI. Patients of either sex, aged between 18 and 70 years, with no underlying CKD, and with CA-AKI were recruited at the time of discharge from hospital in this prospective observational study. Levels of serum and urine biomarkers were analyzed and association between these markers and development of CKD, defined as eGFR < 60 ml/min/1.73 m2 or dialysis dependence at 4 month after discharge, were analyzed using multivariate logistic regression analysis and penalized least absolute shrinkage and selection operator logistic regression. Out of a total 126 patients followed up for 4 months, 25 developed CKD. Those who developed CKD were older (p = 0.008), had higher serum creatinine (p < 0.001) and lower serum albumin (p = 0.001) at discharge. Adjusted logistic regression showed that each 10% increase in standardized serum myo-inositol oxygenase (MIOX) level increased the odds of progression to CKD by 13.5%. With 10% increase in standardized urine Neutrophil gelatinase-associated lipocalin (NGAL), serum creatinine and urine protein creatinine ratio (uPCR), increase in the odds of progression to CKD was 10.5%, 9.6% and 8%, respectively. Multivariable logistic model including serum MIOX, discharge serum creatinine and discharge uPCR, was able to predict the progression of CKD [AUC ROC 0.88; (95% CI 0.81, 0.95)]. High level serum MIOX levels at the time of discharge from hospital are associated with progression to CKD in patients with CA-AKI.


Asunto(s)
Lesión Renal Aguda , Insuficiencia Renal Crónica , Lesión Renal Aguda/metabolismo , Adolescente , Adulto , Anciano , Biomarcadores , Creatinina , Hospitales , Humanos , Inositol-Oxigenasa/metabolismo , Lipocalina 2/orina , Persona de Mediana Edad , Alta del Paciente , Diálisis Renal , Insuficiencia Renal Crónica/complicaciones , Adulto Joven
14.
Sci Rep ; 12(1): 13286, 2022 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-35918502

RESUMEN

The study of associations between inter-individual differences in brain structure and behaviour has a long history in psychology and neuroscience. Many associations between psychometric data, particularly intelligence and personality measures and local variations of brain structure have been reported. While the impact of such reported associations often goes beyond scientific communities, resonating in the public mind, their replicability is rarely evidenced. Previously, we have shown that associations between psychometric measures and estimates of grey matter volume (GMV) result in rarely replicated findings across large samples of healthy adults. However, the question remains if these observations are at least partly linked to the multidetermined nature of the variations in GMV, particularly within samples with wide age-range. Therefore, here we extended those evaluations and empirically investigated the replicability of associations of a broad range of psychometric variables and cortical thickness in a large cohort of healthy young adults. In line with our observations with GMV, our current analyses revealed low likelihood of significant associations and their rare replication across independent samples. We here discuss the implications of these findings within the context of accumulating evidence of the general poor replicability of structural-brain-behaviour associations, and more broadly of the replication crisis.


Asunto(s)
Sustancia Gris , Imagen por Resonancia Magnética , Encéfalo , Mapeo Encefálico , Sustancia Gris/diagnóstico por imagen , Humanos , Psicometría , Adulto Joven
15.
Health Qual Life Outcomes ; 20(1): 121, 2022 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-35918765

RESUMEN

BACKGROUND: Socioeconomic status is a key predictor of lifetime health: poorer people can expect to live shorter lives with lower average health-related quality-of-life (HRQoL) than richer people. In this study, we aimed to improve understanding of the socioeconomic gradient in HRQoL by exploring how inequalities in different dimensions of HRQoL differ by age. METHODS: Data were derived from the Health Survey for England for 2017 and 2018 (14,412 participants). HRQoL was measured using the EQ-5D-5L instrument. We estimated mean EQ-5D utility scores and reported problems on five HRQoL dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) for ages 16 to 90+ and stratified by neighbourhood deprivation quintiles. Relative and absolute measures of inequality were assessed. RESULTS: Mean EQ-5D utility scores declined with age and followed a socioeconomic gradient, with the lowest scores in the most deprived areas. Gaps between the most and least deprived quintiles emerged around the age of 35, reached their greatest extent at age 60 to 64 (relative HRQoL of most deprived compared to least deprived quintile: females = 0.77 (95% CI: 0.68-0.85); males = 0.78 (95% CI: 0.69-0.87)) before closing again in older age groups. Gaps were apparent for all five EQ-5D dimensions but were greatest for mobility and self-care. CONCLUSION: There are stark socioeconomic inequalities in all dimensions of HRQoL in England. These inequalities start to develop from early adulthood and increase with age but reduce again around retirement age.


Asunto(s)
Depresión , Calidad de Vida , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estado de Salud , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Dolor , Clase Social , Encuestas y Cuestionarios , Adulto Joven
16.
PLoS One ; 17(8): e0270870, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35921325

RESUMEN

BACKGROUND: Research on the influences on bike share use and potential favorable relationships between use and obesity is limited, particularly in the U.S. context. Therefore, the aims of this exploratory study were to examine correlates of awareness and use of Boston's Bluebikes bike share system and assess the association between use and weight status. METHODS: Students, faculty, and staff (n = 256) at a public urban university completed an online survey that assessed sociodemographic, behavioral, and physical activity characteristics, Bluebikes awareness, and use of Bluebikes and personal bikes. Multivariable logistic regression models were estimated to examine associations between sociodemographic and behavioral factors and bike share awareness and use; and between use and overweight/obesity status. RESULTS: Respondents were mostly students (72.2%), female (69.1%), White (62.1%), and the mean age was 32.4±13.8 years. The percentage of respondents classified as aware of Bluebikes was 33.6% with only 12.9% reporting any use of the system. Living in a community where bike share stations were located (odds ratio (OR) = 2.01, 95% confidence interval (CI): 1.10, 3.67), personal bike ownership (OR = 2.27, 95% CI:1.27, 4.45), and not exclusively commuting to campus via car (OR = 3.19, 95% CI:1.63, 6.22) had significant positive associations with awareness. Living in a bike share community (OR = 2.34; 95% CI:1.04, 5.27) and personal bike ownership (OR = 3.09; 95% CI:1.27, 7.52) were positively associated with bike share use. Any reported use of Bluebikes was associated with 60% lower odds of being overweight/obese (OR = 0.40; 95% CI:0.17, 0.93). CONCLUSIONS: Several environmental and behavioral variables, including access to stations and personal bicycle ownership, were significantly associated with Bluebikes awareness and use. Findings also suggest a potential benefit to bike share users in terms of maintaining a healthy weight, though further longitudinal studies are needed to rule out the possibility that more active and leaner individuals tend to use bike share more frequently.


Asunto(s)
Ciclismo , Sobrepeso , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Obesidad/epidemiología , Transportes , Universidades , Adulto Joven
17.
Ulus Travma Acil Cerrahi Derg ; 28(8): 1148-1155, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35920416

RESUMEN

BACKGROUND: Return to sports rate of chronic meniscus repair concurrent with Anterior Cruciate Ligament (ACL) reconstruction remains unclear, especially there is no well-defined return to sports criteria for evaluation. The purpose of this retrospective study was to determine the success rate of chronic locked bucket-handle meniscal tear (BHMT) repair with concomitant ACL reconstruction. METHODS: This study includes 51 chronic ACL injury patients with a locked meniscal tear of at least 6 weeks who underwent surgery. All cases were treated with arthroscopic BHMT repair and ACL reconstruction between 2017 and 2020. Patient demograph-ics, chronicity, pre-operative, and intraoperative surgical variables which associated with return to sports were defined. BHMT was repaired with an all-in-side meniscus repair and/or combined repair procedure first, then an anatomic outside-in ACL reconstruction using a suspension device for femoral fixation was performed. Patients underwent same rehabilitation program with the goal of return-ing to sport at approximately 4-8 months. A modified return-to-sport criterion was performed in this study. RESULTS: Fifty-one patients with an average age of 27.4 (range 18-48) years were included in the study. The average time elapsed from the occurrence of locked knee symptoms to surgery was 10.5±4.4 weeks. The mean follow-up time was 25.3±4.5 months. Sig-nificant improvement was observed in all patient-reported outcomes from baseline to the final follow-up. The mean modified Lysholm knee score increased from 45.5 points to 91.5 at the final follow-up (p<0.001). The 43 out of 51 patients (84.3%) were return to their recreational activities (amateur sports). The mean time to return to sport was 5.9±0.8 (5-8) months. CONCLUSION: Majority of the patients who underwent ACL reconstruction with BHMT repair return to their pre-operative activity levels in 8 months. All neglected BHMTs with concomitant chronic ACL rupture should be repaired in a single-stage surgery if the half plane-concave shape of the menisci has been preserved regardless of the delay in time to surgery.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Traumatismos de la Rodilla , Menisco , Lesiones de Menisco Tibial , Adolescente , Adulto , Lesiones del Ligamento Cruzado Anterior/cirugía , Reconstrucción del Ligamento Cruzado Anterior/métodos , Humanos , Traumatismos de la Rodilla/cirugía , Menisco/cirugía , Persona de Mediana Edad , Estudios Retrospectivos , Volver al Deporte , Rotura/cirugía , Lesiones de Menisco Tibial/complicaciones , Lesiones de Menisco Tibial/diagnóstico , Lesiones de Menisco Tibial/cirugía , Adulto Joven
18.
Ulus Travma Acil Cerrahi Derg ; 28(8): 1134-1141, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35920423

RESUMEN

BACKGROUND: Management of unstable tibial fractures (UTF) can be challenging due to widening of the proximal and distal metaphyseal zone, soft tissue problems, and poor vascularity. We aimed to compare the effect of novel tibial orthopedic reduction support (TORS) frame constructed by re-used tubular external fixator systems and manual traction with regard to the quality of re-duction, and fracture healing. METHODS: A total of 65 patients who were admitted with UTF and underwent intramedullary nailing were assessed; 43 patients un-derwent manual traction technique, and 22 patients underwent TORS technique. The sagittal and coronal plane angulations were eval-uated in initial postoperative radiographs, and radiologic union scores for tibial fractures (RUST) were compared at follow-up X-rays. RESULTS: The mean age of patients was 43.49±19.09 years in the manual-traction group and 43.41±16.8 years in the TORS group. The mean coronal plane angulation was 1.84±3.16 in the manual traction group and 1.86±4.21 in the TORS group. The mean sagittal plane angulation was 1.19±1.93 in manual traction group and 0.32±0.65 in the TORS group. The number of coronal and sagittal plane angulations >5° was higher in manual traction group than TORS group. The mean RUST was significantly higher in the TORS group than in the manual traction group at 6th, 9th, and 12th-month controls. The union rates were also higher in the TORS group at 9th and 12th-month controls. CONCLUSION: TORS frame is a simple and cheap technique and should be considered as reduction support in the management of UTF by intramedullary nailing.


Asunto(s)
Fijación Intramedular de Fracturas , Fracturas de la Tibia , Adulto , Clavos Ortopédicos , Fijación Intramedular de Fracturas/métodos , Curación de Fractura , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/cirugía , Resultado del Tratamiento , Adulto Joven
19.
Ulus Travma Acil Cerrahi Derg ; 28(8): 1193-1196, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35920431

RESUMEN

Automatic nail gun injuries to the hand commonly occur with the use of these machines in construction. However, such injuries to the cardiothoracic area are atypical. Herein, we report a case of emergency surgery to remove a nail, which was accidentally shot through the sternum and reached the heart. A 24-year-old man was working in a narrow space at a construction site, where he tripped over the air hose of an automatic pneumatic nail gun. The trigger was accidentally pulled, while the machine was facing his direction, and a nail entered his sternum. The patient felt chest pain, walked to a nearby orthopedic clinic, and then was transferred to our hospital for treatment. On examination, the nail was completely embedded in the midline of the precordial chest. Chest X-ray and computed tomography (CT) images showed a rod-shaped nail penetrating the sternum from the precordial region and reaching the anterior medi-astinum. The nail tip was located between the pulmonary artery and the aorta; it was touching the main trunk of the pulmonary artery. Emergency surgery was performed to remove the 45-mm-long nail (2 mm in diameter) on the same day, considering the possibility of massive bleeding and infection. An auxiliary circulatory system was not used, and intraoperative blood transfusion was not required. The patient was extubated on the same day. On post-operative day 7, CT confirmed that there were no issues of concern and no signs of infection. The patient was discharged on post-operative day 8 and returned home on foot. The patient was followed up for 6 months in the outpatient clinic, and there were no signs of infection or abnormal hemodynamics. This case demonstrates the need for careful assessment of nail gun injuries, which may initially appear insignificant.


Asunto(s)
Cuerpos Extraños , Heridas Penetrantes , Adulto , Dolor en el Pecho , Cuerpos Extraños/cirugía , Humanos , Masculino , Esternón/diagnóstico por imagen , Esternón/cirugía , Tomografía Computarizada por Rayos X , Heridas Penetrantes/diagnóstico por imagen , Heridas Penetrantes/etiología , Heridas Penetrantes/cirugía , Adulto Joven
20.
Rev Gaucha Enferm ; 43: e20210170, 2022.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-35920525

RESUMEN

OBJECTIVE: Identify the prevalence and factors associated with dating violence among school adolescents. METHOD: Quantitative, descriptive, cross-sectional study, conducted in a state public school in Recife, Pernambuco, in August 2018, with 270 adolescents, aged between 12 and 19 years, from middle and high school. A form was applied with questions about the characterization of the adolescents, the experience of dating relationships, and the Conflict in Adolescent Dating Relationships Inventory. Pearson's chi-square test or Fisher's exact test was used for statistical analysis. RESULTS: The prevalence of physical, sexual, and psychological victimization was 31.9%, 36.4% and 81.8%, respectively. An association was identified between religious affiliation (p = 0.002), sexual orientation of the participants (p = 0.027), and parents' education (p = 0.015) and physical victimization during dating. CONCLUSION: Individual and contextual aspects related to dating violence among adolescents imply the need for the involvement of the school nurse in intersectoral and interdisciplinary health interventions.


Asunto(s)
Conducta del Adolescente , Víctimas de Crimen , Violencia de Pareja , Adolescente , Conducta del Adolescente/psicología , Adulto , Niño , Víctimas de Crimen/psicología , Estudios Transversales , Femenino , Humanos , Violencia de Pareja/psicología , Masculino , Prevalencia , Adulto Joven
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