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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: e249104, 2023. tab
Artículo en Inglés | LILACS, VETINDEX | ID: biblio-1339389

RESUMEN

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.


Resumo O presente estudo foi desenhado para avaliar a força da associação da concentração elevada de homocisteína no plasma como um fator de risco para doença cardíaca coronária independente do fator de risco convencional. Foi um estudo de caso-controle realizado no Punjab Institute of Cardiology Lahore. Um total de 210 indivíduos com idade entre 25 e 60 anos, compreendendo 105 pacientes recém-admitidos de CHD como casos e 105 indivíduos saudáveis ​​pareados por idade e sexo sem histórico de CHD como controle, foi recrutado para o estudo. Amostras de sangue em jejum foram obtidas de casos e controles. A homocisteína plasmática foi analisada pelo método de imunoensaio de polarização de fluorescência (FPIA) em analisador de imunoensaio automatizado (Abbott IMX). Colesterol total, triglicerídeos e colesterol HDL foram analisados ​​usando métodos de kit calorimétrico. A concentração de colesterol LDL foi calculada pela fórmula de Friedewald. Os pacientes também foram avaliados para fatores de risco tradicionais, como idade, sexo, história familiar de DCV, hipertensão, tabagismo e atividade física, e foram comparados com indivíduos de controle. Os dados coletados foram inseridos no SPSS versão 24 para análise e interpretação. A média de idade nos grupos controles e experimentais foi de 43,00 ± 8,42 anos e 44,72 ± 8,59 anos com distribuição estatisticamente igual (p-valor = 0,144). A homocisteína plasmática média para os casos foi de 22,33 ± 9,22 µmol / L, enquanto no grupo controle foi de 12,59 ± 3,73 µmol / L. Diferença altamente significativa foi observada entre o nível plasmático médio de homocisteína em casos e controles (p ˂ 0,001). A regressão logística simples indica uma forte associação de doença cardíaca coronária com hiper-homocisteinemia (OR 7,45), que permaneceu significativamente associada com doença cardíaca coronária por multivariada regressão logística (OR 7,10, 95% C1 3,12-12,83, p = 0,000). O presente estudo conclui que níveis elevados de homocisteína plasmática são fator de risco independente para doença cardíaca coronária, independentemente dos fatores de risco convencionais, e pode ser usado como um indicador para prever a possibilidade futura de aparecimento de DCV.


Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Enfermedad Coronaria/embriología , Hiperhomocisteinemia/diagnóstico , Hiperhomocisteinemia/epidemiología , Estudios de Casos y Controles , Factores de Riesgo , Ayuno
4.
Braz. j. biol ; 83: e246385, 2023. tab, graf
Artículo en Inglés | LILACS, VETINDEX | ID: biblio-1339384

RESUMEN

Abstract Coronary heart disease (CHD) has been associated with significant morbidity and mortality worldwide. Although remain controversial, several studies have demonstrated the association of M. pneumoniae infections with atherosclerosis. We evaluated the possible association of mycoplasma infections in patients diagnosed with atherosclerosis by ELISA and PCR methods. Atherosclerotic tissue samples and blood samples were collected for the detection of mycoplasma antibodies (IgA) by ELISA from the 97 patients with coronary artery disease (CAD). M. pneumoniae specific IgA, IgG and IgM were measured by using the Anti-M. pneumoniae IgA/IgG/IgM ELISA. Detection of M. pneumoniae targeting the P1 adhesion gene was performed by PCR Acute infection of M. pneumoniae was diagnosed in 43.3% (42) of patients by PCR. The M. pneumoniae specific antibodies were detected in 36.1% (35) of patients. Twenty-five (25.8%) cases had IgG antibodies, 15 (15.5%) cases had IgM antibodies, 3 (3.1%) cases had IgA antibodies, 10 (10.3%) cases had both IgM + IgG antibodies and 1 (1%) case of each had IgM + IgA and IgG + IgA antibodies. None of the cases was positive for all three antibodies. A Pearson correlation coefficient analysis revealed an excellent correlation between the PCR and the serological results (r=0.921, p<0.001). A majority (17, 40.5%) of the M. pneumoniae positive patients are within the 41-50 years of age group, followed by 10 (23.8%) patients in the age group of 61-70 years and 2 (4.8%) patients were >70 years of age. Our study reported an unusually higher prevalence of M. pneumoniae by serological tests (36.1%) and PCR (43.3%). Although the hypothesis of the association of M. pneumoniae and CAD is yet to be proven, the unusually high prevalence of M. pneumoniae in CAD patients indicates an association, if not, in the development of atherosclerosis.


Resumo A doença coronariana (DCC) tem sido associada a significativa morbidade e mortalidade em todo o mundo. Embora ainda sejam controversos, vários estudos têm demonstrado a associação de infecções por M. pneumoniae com aterosclerose. Avaliamos a possível associação de infecções por micoplasma em pacientes com diagnóstico de aterosclerose pelos métodos ELISA e PCR. Amostras de tecido aterosclerótico e amostras de sangue foram coletadas para a detecção de anticorpos contra micoplasma (IgA) por ELISA de 97 pacientes com doença arterial coronariana (DAC). IgA, IgG e IgM específicos para M. pneumoniae foram medidos usando o Anti-M. pneumoniae IgA / IgG / IgM ELISA. A detecção de M. pneumoniae visando o gene de adesão P1 foi realizada por PCR. A infecção aguda por M. pneumoniae foi diagnosticada em 43,3% (42) dos pacientes pela PCR. Os anticorpos específicos para M. pneumoniae foram detectados em 36,1% (35) dos pacientes. Vinte e cinco (25,8%) casos tinham anticorpos IgG, 15 (15,5%) casos tinham anticorpos IgM, 3 (3,1%) casos tinham anticorpos IgA, 10 (10,3%) casos tinham anticorpos IgM + IgG e 1 (1%) caso de cada um tinha anticorpos IgM + IgA e IgG + IgA. Nenhum dos casos foi positivo para os três anticorpos. A análise do coeficiente de correlação de Pearson revelou uma excelente correlação entre o PCR e os resultados sorológicos (r = 0,921, p < 0,001). A maioria (17, 40,5%) dos pacientes positivos para M. pneumoniae está na faixa etária de 41-50 anos, seguida por 10 (23,8%) pacientes na faixa etária de 61-70 anos e 2 (4,8%) pacientes tinham > 70 anos de idade. Nosso estudo relatou uma prevalência incomumente maior de M. pneumoniae por testes sorológicos (36,1%) e PCR (43,3%). Embora a hipótese da associação de M. pneumoniae e DAC ainda não tenha sido comprovada, a prevalência incomumente alta de M. pneumoniae em pacientes com DAC indica uma associação, se não, no desenvolvimento de aterosclerose.


Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Anciano , Enfermedad de la Arteria Coronaria/epidemiología , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/epidemiología , Inmunoglobulina M , Prevalencia , Anticuerpos Antibacterianos , Mycoplasma pneumoniae
5.
Ann Lab Med ; 43(1): 82-85, 2023 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-36045060

RESUMEN

Cytokeratin 19 fragment antigen 21-1 (CYFRA 21-1) is useful for predicting and monitoring non-small cell lung cancer prognosis. We established reference intervals (RIs) of CYFRA 21-1 in Korean adults, including those older than 60 years. Data of 4,098 apparently healthy subjects (age range, 20-87 years) were analyzed after excluding those with a history of malignancy, high tumor marker concentrations (except CYFRA 21-1), and/or abnormal findings on a chest computed tomography scan through medical chart review. After removing two outliers, RIs of CYFRA 21-1 were determined using data of 4,096 subjects based on the non-parametric method (2.5th and 97.5th percentiles) according to CLSI guidelines EP28-A3c. The subjects were divided into two and four groups according to sex and age (20-40, 41-50, 51-60, and >60 years), respectively, and the median CYFRA 21-1 concentration was compared between the groups. The RI of CYFRA 21-1 was 0.66-3.84 ng/mL, applicable to both men and women. Regardless of sex, the CYFRA 21-1 concentration increased with age, suggesting that age-dependent RIs of CYFRA 21-1 should be applied. Rather than using a single RI provided by the manufacturer, the RI of CYFRA 21-1 should be continually verified and established in each clinical laboratory.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Adulto , Anciano , Anciano de 80 o más Años , Antígenos de Neoplasias , Biomarcadores de Tumor , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/patología , Femenino , Humanos , Queratina-19 , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , República de Corea , Adulto Joven
6.
J Biomech Eng ; 145(1)2023 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-35838340

RESUMEN

This study aimed to perform quantitative biomechanical analysis for probing the effect of varying thread shapes in an implant for improved primary stability in prosthodontics surgery. Dental implants were designed with square (SQR), buttress (BUT), and triangular (TRI) thread shapes or their combinations. Cone-beam computed tomography images of mandible molar zones in human subjects belonging to three age groups were used for virtual implantation of the designed implants, to quantify patient-specific peri-implant bone microstrain, using finite element analyses. The in silico analyses were carried out considering frictional contact to simulate immediate loading with a static masticatory force of 200 N. To validate computational biomechanics results, compression tests were performed on three-dimensional printed implants having the investigated thread architectures. Bone/implant contact areas were also quantitatively assessed. It was observed that, bone/implant contact was maximum for SQR implants followed by BUT and TRI implants. For all the cases, peak microstrain was recorded in the cervical cortical bone. The combination of different thread shapes in the middle or in the apical part (or both) was demonstrated to improve peri-implant microstrain, particularly for BUT and TRI. Considering 1500-2000 microstrain generates in the peri-implant bone during regular physiological functioning, BUT-SQR, BUT-TRI-SQR, TRI-SQR-BUT, SQR, and SQR-BUT-TRI design concepts were suitable for younger; BUT-TRI-SQR, BUT-SQR-TRI, TRI-SQR-BUT, SQR-BUT, SQR-TRI for middle-aged, and BUT-TRI-SQR, BUT-SQR-TRI, TRI-BUT-SQR, SQR, and SQR-TRI for the older group of human patients.


Asunto(s)
Implantes Dentales , Fenómenos Biomecánicos , Fuerza de la Mordida , Simulación por Computador , Análisis del Estrés Dental , Análisis de Elementos Finitos , Humanos , Persona de Mediana Edad , Estrés Mecánico
7.
BMC Health Serv Res ; 22(1): 424, 2022 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-35361211

RESUMEN

BACKGROUND: The "4 + 7" volume-based procurement is a "large group purchase" led by the Chinese government, with the aim of reducing the price of medicines by trading volume for price. Although the "4 + 7" drugs had passed the national consistency evaluation, the adverse drug reactions need to be further evaluated to ensure the safety of the "4 + 7" drugs with low prices. We aimed to analyze the occurrence characteristics and related influencing factors of adverse reactions of psychiatric drugs under the chinese drug volume-based procurement policy(4 + 7 policy), and provide references for clinical medication. METHODS: 137 cases of adverse drug reactions of four psychotropic drugs reported under the "4 + 7" policy in Wuxi Mental Health Center in 2020 were collected. The gender and age of patients, related "4 + 7" drugs, involving organs / systems, clinical manifestations, distribution of new / serious adverse reactions, clinic outcomes were analyzed. RESULTS: Among the 137 cases of adverse drug reactions, the incidence of adverse drug reactions was the highest in patients aged 61-70 (25.38%). Mainly involved 4 "4 + 7" psychiatric drugs, of which olanzapine tablets caused the most adverse reactions (54, 39.24%). The adverse reactions mainly involved the digestive system, nervous system, cardiovascular system, blood and lymphatic system, among which the digestive system was the most common (61, 44.53%). A total of 8 cases (6.16%) of new and 26 cases of serious adverse reactions were reported, all of which led to the prolongation of disease course. Except for the transient side effects, most of that were improved or cured with no death, disability or teratogenicity after stopping or reducing the dose with symptomatic treatment. CONCLUSION: Since more and more drugs will be included in "4 + 7" for clinic, clinical pharmacists should strengthen the publicity and training of the knowledge of "4 + 7" drugs, strengthen the monitoring of adverse drug reactions, and provide timely feedback to the clinic, in order to achieve early prevention, early identification, timely diagnosis and reasonable intervention of the adverse drug reactions under the context of "4 + 7" policy.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Anciano , China/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Humanos , Incidencia , Persona de Mediana Edad , Psicotrópicos/efectos adversos , Política Pública
8.
Health Aff (Millwood) ; 41(2): 219-227, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35130073

RESUMEN

Theoretical research suggests that racialized felony disenfranchisement-a form of structural racism-is likely to undermine the health of Black people, yet empirical studies on the topic are scant. We used administrative data on disproportionate felony disenfranchisement of Black residents across US states, linked to geocoded individual-level health data from the 2016 Health and Retirement Study, to estimate race-specific regression models describing the relationship between racialized disenfranchisement and health among middle-aged and older adults, adjusting for other individual- and state-level factors. Results show that living in states with higher levels of racialized disenfranchisement is associated with more depressive symptoms, more functional limitations, more difficulty performing instrumental activities of daily living, and more difficulty performing activities of daily living among Black people. However, there are no statistically significant relationships between racialized disenfranchisement and health among White people. These findings suggest that policies aiming to mitigate disproportionate Black felony disenfranchisement not only are essential for political inclusion but also may be valuable tools for improving population health equity.


Asunto(s)
Equidad en Salud , Salud Poblacional , Racismo , Actividades Cotidianas , Anciano , Humanos , Persona de Mediana Edad , Estados Unidos
9.
Ann R Coll Surg Engl ; 104(4): e122-e124, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34939843

RESUMEN

A 49-year-old patient with a history of aspirin-exacerbated respiratory disease presented with carotid artery injury following revision functional endoscopic sinus surgery. Carotid artery injury is a rare but catastrophic complication of this surgery. The patient was transferred to our tertiary facility with interventional radiology for immediate management of the carotid artery injury. This case reaffirms that any surgery can have disastrous complications and highlights the importance of multidisciplinary management of complications such as carotid artery injury.


Asunto(s)
Traumatismos de las Arterias Carótidas , Sinusitis , Traumatismos de las Arterias Carótidas/diagnóstico por imagen , Traumatismos de las Arterias Carótidas/etiología , Traumatismos de las Arterias Carótidas/cirugía , Arteria Carótida Interna/diagnóstico por imagen , Arteria Carótida Interna/cirugía , Endoscopía/efectos adversos , Humanos , Persona de Mediana Edad
10.
Rural Remote Health ; 22(1): 7050, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35119906

RESUMEN

INTRODUCTION: Past studies examined factors associated with rural practice, but none employed newer machine learning (ML) methods to explore potential predictors. The primary aim of this study was to identify factors related to practice in a rural area. Secondary aims were to capture a more precise understanding of the demographic characteristics of the healthcare professions workforce in Utah (USA) and to assess the viability of ML as a predictive tool. METHODS: This study incorporated four datasets - the 2017 dental workforce, the 2016 physician workforce, the 2014 nursing workforce and the 2017 pharmacy workforce - collected by the Utah Medical Education Council. Supervised ML techniques were used to identify factors associated with practice location, the outcome variable of interest. RESULTS: The study sample consisted of 11 259 healthcare professionals with an average age of 46.6 years, of which 36.6% were males and 94.5% Caucasian. Four ML methods were applied to assess model performance by comparing accuracy, sensitivity, specificity and area under the receiver operating characteristic (ROC) curve. Of the methods used, support vector machine performed the best (accuracy 99.7%, precision 100%, sensitivity 100%, specificity 99.4% and ROC 0.997). The models identified income and rural upbringing as the top factors associated with rural practice. CONCLUSION: By far, income emerged as the most important factor associated with rural practice, suggesting that attractive income offers might help rural communities address health professional shortages. Rural upbringing was the next most important predictive factor, validating and updating earlier research. The performance of the ML algorithms suggests their usefulness as a tool to model other databases for individualized prediction.


Asunto(s)
Servicios de Salud Rural , Atención a la Salud , Personal de Salud , Humanos , Aprendizaje Automático , Masculino , Persona de Mediana Edad , Ubicación de la Práctica Profesional , Recursos Humanos
11.
JBJS Case Connect ; 12(1)2022 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-35108225

RESUMEN

CASE: A 61-year-old woman presented with a failed proximal ulna allograft-prosthetic composite after revision total elbow arthroplasty (TEA). The ulnar deficiency was addressed using an osteomuscular flap from the distal radius pedicled on the radial artery. At final follow-up, she had minimal pain and a flexion-extension arc of 0° to 130°. Radiographs demonstrated graft incorporation and a stable TEA construct. CONCLUSION: This demonstrates utilization of a vascularized osteomuscular flap from the radius for treatment of proximal ulnar deficiency in the setting of revision TEA. This technique offers an alternative option for the challenge of a failed TEA with ulnar bone loss.


Asunto(s)
Artroplastia de Reemplazo de Codo , Radio (Anatomía) , Artroplastia de Reemplazo de Codo/métodos , Codo/cirugía , Femenino , Antebrazo/cirugía , Humanos , Persona de Mediana Edad , Arteria Radial/cirugía , Radio (Anatomía)/cirugía , Reoperación/métodos , Cúbito/cirugía
12.
JBJS Case Connect ; 12(1)2022 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-35108231

RESUMEN

CASE: A 51-year-old lady with multiple comorbidities presented with T11 spondylolysis in association with thoracic stenosis and myelopathy. Our patient underwent T11-T12 laminectomy, T10-L1 posterior instrumented stabilization, and T11-T12 transforaminal interbody fusion. She had a good neurological recovery, and the radiographs at 1-year follow-up showed good fusion and implant position. CONCLUSION: Spondylolysis is an anatomical defect or stress fracture of the pars interarticularis and usually reported in the lumbar region. This case of T11 spondylolysis in association with thoracic stenosis, spinal instability, and myelopathy is highlighted for its rarity and to reiterate the need for high index of suspicion among surgeons for the timely diagnosis.


Asunto(s)
Enfermedades de la Médula Espinal , Enfermedades de la Columna Vertebral , Fusión Vertebral , Espondilólisis , Femenino , Humanos , Persona de Mediana Edad , Enfermedades de la Columna Vertebral/complicaciones , Fusión Vertebral/efectos adversos , Espondilólisis/complicaciones , Espondilólisis/diagnóstico por imagen , Espondilólisis/cirugía , Vértebras Torácicas/diagnóstico por imagen , Vértebras Torácicas/cirugía
13.
Anticancer Res ; 42(5): 2657-2663, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35489760

RESUMEN

BACKGROUND/AIM: Many head-and-neck cancer patients receive radiotherapy, which may be associated with significant toxicities. Xerostomia is considered one of the most debilitating late adverse events. This study was performed to identify risk factors for xerostomia. PATIENTS AND METHODS: Several characteristics were investigated for associations with late xerostomia in 159 patients irradiated for head-and-neck cancer including age, sex, tumor site and size, underlying pathology, histologic grading, upfront resection, systemic treatment, and type and dose of radiotherapy. RESULTS: Ninety (57%) and 35 (22%) patients experienced grade ≥2 and ≥3 xerostomia, respectively. Grade ≥2 xerostomia was significantly associated with tumor site (nasopharynx/oropharynx/oral cavity/floor of mouth, p=0.049). Grade ≥3 xerostomia was significantly associated with age ≥61 years (p=0.035); trends were found for tumor site (p=0.088), bilateral nodal involvement (p=0.093), definitive treatment (p=0.082), and systemic treatment (p=0.055). CONCLUSION: Risk factors for xerostomia following radiotherapy of head-and-neck cancers were identified including older age, unfavorable tumor site, bilateral involvement of lymph nodes, definitive treatment, and addition of systemic therapies. For patients with risk factors, sparing of the salivary glands is particularly important.


Asunto(s)
Neoplasias de Cabeza y Cuello , Xerostomía , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Persona de Mediana Edad , Factores de Riesgo , Glándulas Salivales , Xerostomía/epidemiología , Xerostomía/etiología
14.
Rev. urug. enferm ; 17(2): 1-20, dic. 2022.
Artículo en Español | LILACS, BDENF, BNUY, BNUY-Enf | ID: biblio-1392412

RESUMEN

El contexto epidemiológico que se vive a nivel mundial desde el comienzo de la pandemia por COVID-19, puso de manifiesto factores de sobrecarga laboral en el personal de la salud, relacionados con la exposición diaria a situaciones que ponen en riesgo su integridad física y mental. Tomando en cuenta el valor social, la validez científica y el beneficio que se genera con la investigación en el campo de la salud, nos propusimos explorar y analizar en qué medida y en qué aspectos la situación de pandemia ha afectado las cargas en enfermería partiendo de la hipótesis de un aumento en la percepción de cargas desde el inicio de la pandemia por COVID-19. En función de los resultados obtenidos, elaboramos recomendaciones y una propuesta que contribuya al desarrollo de un entorno de trabajo saludable para el personal de enfermería, estableciendo medidas de prevención e intervención destinadas a minimizar los riesgos e incrementar la satisfacción laboral. Para el relevamiento de los datos se aplicó una encuesta online, anónima, auto administrada dirigida al personal de enfermería de Uruguay que trabaja en los tres niveles de atención, la cual nos permitió un acercamiento a los principales indicadores de carga física y mental. En términos absolutos se encuestaron 304 licenciados en enfermería y 677 auxiliares. Si se comparan los encuestados con el Registro de Habilitación del MSP (2017), la participación alcanzó el 3,29 % de la población total en enfermería. Se logró la cobertura de los 19 departamentos de Uruguay. Los resultados obtenidos, evidenciaron un incremento en la carga física y mental, a partir del contexto generado por COVID-19, relacionado principalmente con aspectos institucionales, alteraciones fisiológicas, psicoafectivas y sociofamiliares.


The epidemiological context that has been experienced worldwide since the beginning of the COVID-19 pandemic has revealed factors of work overload in health personnel, related to daily exposure to situations that put their physical and mental integrity at risk. Considering the social value, the scientific validity and the benefit generated by research in the field of health, we set out to explore and analyze to what extent and in what aspects the pandemic situation has affected nursing work load based on the hypothesis of an increase in the perception of burdens since the start of the COVID-19 pandemic. Based on the results obtained, we developed recommendations and a proposal that contributes to the development of a healthy work environment for nursing staff, establishing prevention and intervention measures aimed at minimizing risks and increasing job satisfaction. To collect the data, an online, anonymous, self-administered survey was applied to nursing staff in Uruguay who work at the three levels of care, which allowed us to approach the main indicators of physical and mental load. In absolute terms, 304 nursing graduates and 677 auxiliaries were surveyed. When we compare the respondents with the MSP Qualification Registry (2017), participation reached 3.29% of the total nursing population. Coverage of the 19 departments of Uruguay was achieved. The results showed an increase in the physical and mental load, based on the context generated by COVID-19, mainly related to institutional aspects, physiological, psycho-affective and socio-family alterations.


O contexto epidemiológico que se vive mundialmente desde o início da pandemia do COVID-19 tem revelado fatores de sobrecarga de trabalho nos profi ssionais de saúde, relacionados à exposição diária a situações que colocam em risco sua integridade física e mental. Levando em conta o valor social, a validade científica e o benefício gerado pela pesquisa na área da saúde, propusemo-nos a explorar e analisar em que medida e em que aspectos a situação pandêmica afetou as cargas de trabalho de enfermagem com base na hipótese de aumento na percepção de ônus desde o início da pandemia de COVID-19. Com base nos resultados obtidos, desenvolvemos recomendações e uma proposta que contribui para o desenvolvimento de um ambiente de trabalho saudável para a equipe de enfermagem, estabelecendo medidas de prevenção e intervenção paravive minimizar riscos e aumentar a satisfação no trabalho. Para coletar os dados, foi aplicada uma pesquisa online, anônima e autoadministrada aos profissionais de enfermagem do Uruguai que atuam nos três níveis de atenção, o que permitiu abordar os principais indicadores de carga física e mental. Em termos absolutos, foram pesquisados 304 egressos de enfermagem e 677 auxiliares. Se compararmos os respondentes com o Registro de Qualificação MSP (2017), a participação atingiu 3,29% do total da população de enfermagem. A cobertura dos 19 departamentos do Uruguai foi alcançada. Os resultados obtidos mostraram um aumento da carga física e mental, com base no contexto gerado pela COVID-19, principalmente relacionado a aspectos institucionais, alterações fisiológicas, psicoafetivas e sociofamiliares.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Riesgos Laborales , Carga de Trabajo , Estrés Laboral , COVID-19 , Personal de Enfermería , Uruguay , Condiciones de Trabajo , Agotamiento Profesional , Estudios Transversales , Encuestas y Cuestionarios , COVID-19/psicología
15.
Braz. j. oral sci ; 21: e227017, jan.-dez. 2022. ilus
Artículo en Inglés | LILACS, BBO | ID: biblio-1393192

RESUMEN

During COVID-19 pandemic, fulminant deep fungal infection started emerging in India, known as Mucormycosis. This type of mucormycosis was termed as COVID-19 associated mucormycosis (CAM). These patients had previous history of COVID-19 infection. Such cases were mainly reported in immunocompromised patients such as patients with poorly controlled diabetes and chronic renal diseases etc. Rhinomaxillary mucormycosis is an aggressive, fulminant, fatal deep fungal infection of head and neck region. Early diagnosis and prompt treatment can reduce the mortality and morbidity associated with the disease; hence we present case series of rhinomaxillary mucormycosis to create awareness amongst dental surgeons


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Anciano , Signos y Síntomas , Comorbilidad , Infecciones Fúngicas Invasoras/diagnóstico , COVID-19 , Mucorales , Mucormicosis/epidemiología , Micosis/diagnóstico
16.
Braz. j. oral sci ; 21: e227259, jan.-dez. 2022. ilus
Artículo en Inglés | LILACS, BBO | ID: biblio-1393334

RESUMEN

Aim: This study analyzes factors associated with dimensions of health literacy (HL) functional, communicative and critical among public health service users with chronic non-communicable diseases. Methods: A cross-sectional analytical research was carried out in Piracicaba, São Paulo, Brazil, with adults and older adults attending Family Health Units (FHU). Data were collected by oral exam (CPOD and CPI) and a questionnaire on systemic conditions, sociodemographic factors, health behaviors and HLS (HLS-14). The outcomes consisted of functional, communicative, and critical HL dimensions dichotomized by median (high and low), which were analyzed by chi-square test (p<0.05) to find associations with the variables studied. Results: The study sample comprised 238 FHU users with 62.7 (± 10.55) mean age, of which 47.5% (n=113) showed high functional HL, 50.0% (n=119) high communicative HL, and 46.2% (n=110) high critical HL. High functional HL was associated with men (p<0.05). Functional and communicative HL were associated with having higher education (p<0.001 and p=0.018, respectively). High communicative and critical HL were associated with regular use of dental and medical services (p<0.05). Individuals with low functional HL were more likely to present poor tooth brushing (p=0.020). High HL (in all three dimensions) was associated with regular flossing and having more teeth (p<0.05). Conclusion: Functional, communicative and critical HL were associated with health behaviors and clinical outcomes, whereas the functional dimension was also associated with sociodemographic factors. HL dimensions allowed to differentiate health-related factors


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Sistema Único de Salud , Salud Bucal , Enfermedad Crónica , Alfabetización en Salud , Factores Sociodemográficos , Programas Nacionales de Salud
17.
Braz. j. oral sci ; 21: e226611, jan.-dez. 2022. ilus
Artículo en Inglés | LILACS, BBO | ID: biblio-1393384

RESUMEN

Aim: This study aimed to evaluate the relationship between clinical findings and some factors such as age, gender, and remaining teeth on the anatomy of the temporomandibular joint in order to diagnose normal variations from abnormal cases. Methods: In this cross-sectional study, cone-beam computed tomography (CBCT) images of 144 patients referring to Tabriz Dental School for various reasons were selected and evaluated. The different aspects of the clinical parameters and the morphology of the condyle were evaluated on coronal, axial, and sagittal views. The CBCT prepared using the axial cross-sections had been 0.5 mm in thickness. The sagittal cross-sections had been evaluated perpendicular to the lengthy axis of the condyle at a thickness of 1 mm and the coronal cross-sections had been evaluated parallel to the lengthy axis of the condyle at a thickness of 1 mm. Data were analyzed with descriptive statistical methods and t-test, chi-squared test, using SPSS 20. The significance level of the study was p < 0.05. Results: There was a significant relationship between the condyle morphology, number of the teeth, and mastication side (p = 0.040). There were significant relationships between the condyle morphology, age between 20-40, and occlusion class I on the all the three views (coronal, axial, sagittal) (p = 0.04), (p = 0.006), (p = 0.006). Also, significant relationships were found in the condyle morphology and location of pain according to age, the number of remaining teeth, and gender. (p = 0.046) (p = 0.027) (p = 0.035). Conclusion:There are significant relationships between the clinical symptoms and condyle morphology based on age, gender, and the number of remaining teeth. The clinical finding that has the most significant relationship between the condyle morphology, remaining teeth (9-16 teeth), all of the age range (20-80 year), and gender was mastication side


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Articulación Temporomandibular/anatomía & histología , Tomografía Computarizada de Haz Cónico , Cóndilo Mandibular/anatomía & histología
18.
Braz. j. oral sci ; 21: e225946, jan.-dez. 2022. ilus
Artículo en Inglés | LILACS, BBO | ID: biblio-1384159

RESUMEN

Aim This study aims to evaluate and validate the sensibility and the level of agreement between different gingival color measures obtained by a spectrophotometer (SPECTRO) and a photography (PHOTO) method. Methods Among 40 patients, the color was measured 2 mm apical to the gingival margin by CIE L*, a*, b* system using a reflectance spectrophotometer and the photography's plus software. The level of agreement between three different measures (m1, m2, m3) in parameters L*, a*, b*, and ∆E (color variation) was evaluated by random and systematic errors, as well as the limits and coefficient of concordance. A comparison between the methods was performed by the Bland-Altman test and the sensibility level was evaluated accordingly to the ∆E: 3.7 thresholds with p<0.05 as the level of significance for these comparisons. Results The SPECTRO method has not presented the systematic error (p>0.05) and had reproducibly and agreement level in three variable measures L* (r: 0.6), a* (r: 0.3), and b* (r: 0.5) as to the PHOTO method L* (r: 0.6), a* (r: 0.5), and b* (r: 0.5), which presented systematic error in L* values (p<0.05). The means of ∆E between measurements were: 6.5 SPECTRO and 5.9 PHOTO. There was no good level of sensitivity ∆E> 3.7 and agreement between the methods, mainly for the a* values. On the other hand, for the L* and in for the most comparisons of b* values, the level of agreement was higher. Conclusion Both methods could quantify the gingival color from the coordinates L *, a *, and b *, which has shown greater reliability between the measurements acquired by the SPECTRO method.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Espectrofotómetros , Color , Fotografía Dental , Encía , Incisivo
19.
Braz. j. oral sci ; 21: e226999, jan.-dez. 2022. ilus
Artículo en Inglés | LILACS, BBO | ID: biblio-1392965

RESUMEN

Background: Tooth extraction socket in the aesthetic area is a major indication for immediate implant placement greatly improving patient satisfaction and preserving the alveolar ridge. However, the effect of non-axial force on the peri-implant bone with subsequent early implant failure remains unclear. Objective:Evaluate the prognosis of tilted implants immediately placed and restored with angled abutments in comparison to straight implants restored with straight abutments in the esthetic area (anterior or premolars) using computer-aided surgical guides. Material and methods: Badly decayed non-restorable teeth in the aesthetic zone (anterior or premolars) were extracted atraumatically. Immediately after guided implant insertion, the abutments were adjusted and placed according to the allocation group (0, 15, or 25-degree angle) then a temporary crown was performed out of occlusion in centric and eccentric relation. Early implant failure was assessed at three and six months. Results:There was no statistically significant difference between the two groups (P=0.305). Straight and angled abutment groups showed 6 (14.3%) and 8 (20%) failed cases, respectively. The post-hoc subgroup analysis showed no statistically significant difference between angle 15 and angle 25 degree groups where (P=0.686) or between Anterior and Premolar groups (P=0.853). Conclusion: There was no statistically significant difference in the failure rate when comparing angled to straight immediately placed & restored implants. This applies to both anterior and premolar implants


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Pronóstico , Extracción Dental , Soporte de Peso , Fracaso de la Restauración Dental , Implantación Dental , Carga Inmediata del Implante Dental
20.
Braz. j. oral sci ; 21: e228274, jan.-dez. 2022. tab
Artículo en Inglés | LILACS, BBO | ID: biblio-1392982

RESUMEN

Parents are responsible for their children's health care, and their oral health-related knowledge, attitude, and habits can affect their children's oral health. Aim: The objective of this study was to evaluate parents' knowledge, attitudes, and practices regarding their children's oral health. Methods: In this study, a sample of 398 parents of 4- to 6-year-old children completed a self-designed questionnaire. The parents' oral health-related knowledge, attitudes, and practices were assessed. Children's oral health was evaluated using decayed, missing, and filled tooth index (dmft). Data were analyzed using the SPSS version 23.0 with a p < 0.05 as statistically significant. Categorical data were reported as frequency (%), and continuous data were reported as mean ± SD. Moreover, Spearman's correlation, multiple regression, Mann-Whitney test, Kruskal Wallis test, and Kolmogorov-Smirnov test were used. Results: Most of the parents had a satisfactory level of knowledge and positive attitudes regarding their children's oral health. The knowledge and attitude scores were higher among parents with higher education (p<0.001), and the knowledge score was higher among mothers (p=0.004). Also, the attitude score was correlated with the number of decayed, missed, and filled teeth of children (p=0.01, p=0.04, and p=0.007, respectively). However, there was no significant relationship between dmft and the parents' knowledge, attitudes, and practices using multiple regression. The mean dmft of children was 6.86 ± 3.56, and most of the parents had poor oral health-related practices. Conclusion: The parents' level of knowledge and attitudes were satisfactory, but they had poor oral health practices. Moreover, there was no significant relationship between children's oral health and their parents' level of knowledge, attitudes, and practices. Educating programs and strategies are needed to enhance parents' oral health-related attitudes and knowledge and, more importantly, change their oral health practices


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Padres , Niño , Salud Bucal , Educación en Salud Dental , Encuestas y Cuestionarios , Conocimiento
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