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1.
Anal Chem ; 96(5): 1993-1999, 2024 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-38266026

RESUMO

The accurate and efficient measurement of white blood cell (WBC) counts is vital for monitoring general patient health and can aid in the diagnosis of a range of possible infections or diseases. Even with their importance universally acknowledged, access to WBC counts is largely limited to those with access to phlebotomists and centralized clinical laboratories, which house the instruments that perform the tests. As a result, large populations of people (e.g., those that are home-bound or live in remote locations) lack facile access to testing. Dried blood spot (DBS) cards are often used to bridge these gaps in access to testing by offering the ability to collect blood at home for ambient shipping to laboratories. However, it is well understood that these cards, which are prepared from cellulose cardstocks without further modification, suffer from variabilities in accuracy and precision due to uncontrolled sample spreading and hematocrit effects, which have hindered their use to determine WBC counts. In this paper, we present a method to obtain an accurate WBC count using a patterned dried blood spot (pDBS) card, which comprises collection zones that meter volumes of dried blood. Using an input volume of 75 µL of whole blood, we demonstrate that, unlike the gold standard DBS card (Whatman 903), our pDBS design allows for the collection of replicate zones containing a reproducible, average volume of dried blood (12.1 µL, 7.8% CV) over the range of hematocrits from 25 to 55%. We then used qPCR to quantify the 18S rRNA gene to determine WBC counts from the volumes of blood that are metered in pDBS zones. We observe that WBC counts generated from our method are comparable to those measured with a HemoCue point-of-care WBC analyzer. Our approach to using pDBS cards as a blood collection device has the potential to support at-home sampling and other patient populations that need WBC counts but lack access to clinical facilities.


Assuntos
Coleta de Amostras Sanguíneas , Teste em Amostras de Sangue Seco , Humanos , Hematócrito , Teste em Amostras de Sangue Seco/métodos , Contagem de Leucócitos , Celulose
2.
Pancreatology ; 24(2): 314-322, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38310036

RESUMO

BACKGROUND/OBJECTIVES: Pancreatic surgery may have a long-lasting effect on patients' health status and quality of life (QoL). We aim to evaluate patient-reported outcomes (PRO) 3 months after pancreatic surgery. METHODS: Patients scheduled for pancreatic surgery were enrolled in a prospective trial at five German centers. Patients completed PRO questionnaires (EQ-5D-5L, EORTC QLQ-PAN26, patient-reported happiness, and HADS-D), we report the first follow-up 3 months after surgery as an interim analysis. Statistical testing was performed using R software. RESULTS: From 2019 to 2022 203 patients were enrolled, a three-month follow-up questionnaire was available in 135 (65.5 %). 77 (57.9 %) underwent surgery for malignant disease. Patient-reported health status (EQ-5D-5L) was impaired in 4/5 dimensions (mobility, self-care, usual activities, pain, discomfort) for patients with malignant and 3/5 dimensions (mobility, self-care, usual activities) for patients with benign disease 3 months after surgery (p < 0.05). Patients with malignant disease reported an increase in depressive symptoms, patients with benign disease had a decrease in anxiety symptoms (HADS-D; depression: 5.00 vs 6.51, p = 0.002; anxiety: 8.04 vs. 6.34, p = 0.030). Regarding pancreatic-disease-specific symptoms (EORTC-QLQ-PAN26), patients with malignant disease reported increased problems with taste, weight loss, weakness in arms and legs, dry mouth, body image and troubling side effects at three months. Patients with benign disease indicated more weakness in arms and legs, troubling side effects but less future worries at three months. CONCLUSION: Patient-reported outcomes of patients undergoing pancreatic surgery for benign vs. malignant disease show important differences. Patients with malignant tumors report more severely decreased quality of life 3 months postoperatively than patients with benign tumors.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Neoplasias , Humanos , Estudos Prospectivos , Qualidade de Vida , Medidas de Resultados Relatados pelo Paciente
3.
Medicina (Kaunas) ; 57(8)2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-34440994

RESUMO

Background and Objectives: Wnt signaling leads to stimulation of osteoblasts and it reduces osteoclastogenesis and bone resorption via the regulation of the osteprotegrin and receptor activator of nuclear factor kappa-Β ligan (RANKL). Wnt signaling pathways are regulated by their physiological antagonists such as sclerostin (SOST) as well as WNT-5a. The aim of this study was to determine the total amount of Sclerostin and WNT-5a in the gingival crevicular fluid (GCF) in sites with a continuum from a healthy to diseased periodontium. Materials and Methods: In this cross-sectional study, a total of 20 patients with generalized periodontitis, 10 subjects with gingivitis as well as 14 individuals with a healthy periodontium were recruited upon clinical and radiographic periodontal examination. In patients diagnosed with periodontitis, GCF samples were collected from periodontitis, gingivitis and healthy sites, while gingivitis patients provided samples from gingivitis and healthy sites. In healthy patients, only healthy sites were sampled. Protein total amount of SOST and WNT-5a were quantified by sandwich enzyme-linked immunosorbent assay (ELISA). Results: A total of 108 GCF samples were collected from a total of 44 individuals. When all periodontitis (n = 51), gingivitis (n = 12) and healthy (n = 45) sites were analyzed regardless of the patient diagnosis, periodontitis sites demonstrated significantly elevated WNT-5a total amounts (p = 0.03) when compared to gingivitis sites. Gingivitis sites demonstrated a trend of more total SOST (p = 0.09) when compared to periodontitis and healthy sites. Within each patient diagnostic category, sites showed similar SOST and WNT-5a total amounts (p > 0.05). Conclusions: WNT-5a levels in GCF depend on the stage of periodontitis sites. SOST trended higher in the GCF of gingivitis sites but similar in chronic periodontitis and healthy sites. WNT-5a and SOST play a crucial role in periodontal tissue remodeling and depend on the inflammatory and osteoclastogenic activities.


Assuntos
Líquido do Sulco Gengival , Gengivite , Proteínas Adaptadoras de Transdução de Sinal , Estudos Transversais , Humanos , Osteogênese , Periodonto , Proteína Wnt-5a
4.
Odontology ; 108(3): 511-520, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31955297

RESUMO

Patients with hematologic cancers often develop acute and chronic oral complications from their disease and its treatment. These problems could change patients' oral health-related quality of life (OHRQoL) negatively. Quality of life (QoL) has become an increasingly important outcome measure in oncology. This systematic literature review evaluates the impact of hematological malignancies and their treatment on OHRQoL as assessed by the Oral Health Impact Profile (OHIP-14) questionnaire. Medline through Pubmed and Web of Science were searched through April 2017. Two randomized controlled trials, one cohort study, one cross-sectional study, and one case-control study were included. Heterogeneity across the included studies did not allow for meta-analysis. OHIP-14 domains that were frequently given the highest scores were functional limitation (67%), physical pain (50%), physical disability (50%), and psychological discomfort (33%). The domains that were frequently given the lowest scores were social handicap (100%), social disability (100%), and psychological disability (67%). Insufficient evidence is available to draw any robust conclusions regarding OHRQoL assessed by the OHIP-14 in individuals with hematological malignancies. However, functional limitations because of problems with oral mucosal tissues, the dentition, or dentures, seem to have a larger negative impact on the OHRQoL than social aspects associated with oral health problems. Well-designed larger studies are required to determine effects of hematological malignancies as well as acute and long-term effects of their treatment on patients' OHRQoL.


Assuntos
Neoplasias Hematológicas , Qualidade de Vida , Estudos de Casos e Controles , Estudos de Coortes , Estudos Transversais , Humanos , Saúde Bucal , Inquéritos e Questionários
5.
J Periodontal Res ; 54(5): 555-565, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30982988

RESUMO

BACKGROUND AND OBJECTIVE: Wnt signaling pathways regulate osteoblast differentiation and bone formation and are associated with inflammatory responses driven by innate and adaptive immunity via the NF-κB pathway. The aim of this study was to compare the levels of sclerostin (SOST), WNT-5a, and TNF-α between chronic periodontitis and periodontally healthy sites and determine their value as diagnostic markers of chronic periodontitis. MATERIAL AND METHODS: In a cross-sectional assessment 25 chronic periodontitis cases and 25 periodontally healthy controls were selected upon clinical and radiographic periodontal evaluation. Gingival crevicular fluid (GCF) was collected cross-sectionally from diseased and healthy sites in periodontitis patients and from healthy sites in each control subject. In a subgroup analysis, ten patients with generalized moderate and severe chronic periodontitis and ten generalized periodontally healthy individuals were included. The protein levels of SOST, WNT-5a, and TNF-α in GCF were measured by sandwich ELISA. The Shapiro-Wilk test was utilized to assess the normality of the distribution and non-parametric comparisons were performed. RESULTS: The protein levels of SOST were significantly higher in the generalized moderate and severe chronic periodontitis subgroup when compared to the generalized healthy (P = 0.002), while the WNT-5a and TNF-α GCF total amounts were similar (P > 0.05). Diseased sites in the periodontitis patients exhibited significantly higher total protein levels of WNT-5a than in healthy sites (P = 0.017), whereas no differences were detected for SOST and TNF-α (P > 0.05). The total protein levels of SOST, WNT-5a, and TNF-α in GCF were similar in periodontitis and non-periodontitis patients (P > 0.05). CONCLUSIONS: Sclerostin and WNT-5a gingival protein levels demonstrated a high diagnostic value for generalized moderate and severe chronic periodontitis, while a low accuracy was detected for localized chronic periodontitis.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal , Produtos Biológicos , Periodontite Crônica , Proteína Wnt-5a , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Produtos Biológicos/metabolismo , Periodontite Crônica/diagnóstico , Periodontite Crônica/metabolismo , Estudos Transversais , Gengiva , Líquido do Sulco Gengival , Humanos , Fator de Necrose Tumoral alfa , Proteína Wnt-5a/metabolismo
6.
Clin Genet ; 93(4): 800-811, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29112243

RESUMO

Richieri-Costa-Pereira syndrome is a rare autosomal recessive acrofacial dysostosis that has been mainly described in Brazilian individuals. The cardinal features include Robin sequence, cleft mandible, laryngeal anomalies and limb defects. A biallelic expansion of a complex repeated motif in the 5' untranslated region of EIF4A3 has been shown to cause this syndrome, commonly with 15 or 16 repeats. The only patient with mild clinical findings harbored a 14-repeat expansion in 1 allele and a point mutation in the other allele. This proband is described here in more details, as well as is his affected sister, and 5 new individuals with Richieri-Costa-Pereira syndrome, including a patient from England, of African ancestry. This study has expanded the phenotype in this syndrome by the observation of microcephaly, better characterization of skeletal abnormalities, less severe phenotype with only mild facial dysmorphisms and limb anomalies, as well as the absence of cleft mandible, which is a hallmark of the syndrome. Although the most frequent mutation in this study was the recurrent 16-repeat expansion in EIF4A3, there was an overrepresentation of the 14-repeat expansion, with mild phenotypic expression, thus suggesting that the number of these motifs could play a role in phenotypic delineation.


Assuntos
Pé Torto Equinovaro/genética , RNA Helicases DEAD-box/genética , Fator de Iniciação 4A em Eucariotos/genética , Deformidades Congênitas da Mão/genética , Laringe/fisiopatologia , Deformidades Congênitas dos Membros/genética , Síndrome de Pierre Robin/genética , Adolescente , Adulto , Alelos , Brasil/epidemiologia , Criança , Pé Torto Equinovaro/epidemiologia , Pé Torto Equinovaro/fisiopatologia , Expansão das Repetições de DNA/genética , Inglaterra/epidemiologia , Extremidades/fisiopatologia , Feminino , Genótipo , Deformidades Congênitas da Mão/epidemiologia , Deformidades Congênitas da Mão/fisiopatologia , Humanos , Laringe/anormalidades , Deformidades Congênitas dos Membros/fisiopatologia , Masculino , Fenótipo , Síndrome de Pierre Robin/epidemiologia , Síndrome de Pierre Robin/fisiopatologia , Mutação Puntual/genética , Adulto Jovem
7.
Eur J Vasc Endovasc Surg ; 56(1): 87-93, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29622512

RESUMO

OBJECTIVE/BACKGROUND: Heparin coating has recently been shown to reduce the risk of graft failure in arterial revascularisation, at least transiently. The aim of this study was to assess the cost-effectiveness of heparin coated versus standard polytetrafluoroethylene grafts for bypass surgery in peripheral artery disease from a long-term healthcare system perspective. METHODS: Cost-effectiveness evaluation was conducted alongside the Danish part of the Scandinavian Propaten trial in which 431 patients planned for femoro-femoral or femoro-popliteal bypass surgery were randomised to either type of graft and followed for 5 years. Based on the intention to treat principle, the differences in healthcare costs (general practice, prescription medication, hospital admission, rehabilitation, and long-term care in 2015 Euros), life years (LYs), and quality adjusted life years (QALYs) were analysed as arithmetic means with bootstrapped 95% confidence intervals. Cost-effectiveness acceptability curves were used to illustrate the probability of cost-effectiveness for a range of threshold values of willingness to pay (WTP). RESULTS: No statistically significant differences between the randomisation groups were observed for costs or gains of LYs or QALYs. The average cost per QALY was estimated at €10,792. For a WTP threshold of €40,000 per QALY, the overall probability of cost-effectiveness was estimated at 62%, but owing to cost savings in patients with critical ischaemia (cost per QALY <€0), it increased to 89% for this subgroup. CONCLUSION: Until further evidence, heparin coated grafts appear overall, to be cost-effective over standard grafts, but important heterogeneity between claudication and critical ischaemia should be noted. While the optimal choice for claudication remains uncertain, heparin coated grafts should be used for critical ischaemia.


Assuntos
Anticoagulantes/administração & dosagem , Anticoagulantes/economia , Implante de Prótese Vascular/economia , Implante de Prótese Vascular/instrumentação , Prótese Vascular/economia , Materiais Revestidos Biocompatíveis/economia , Artéria Femoral/cirurgia , Custos de Cuidados de Saúde , Heparina/administração & dosagem , Heparina/economia , Doença Arterial Periférica/economia , Doença Arterial Periférica/cirurgia , Artéria Poplítea/cirurgia , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Redução de Custos , Análise Custo-Benefício , Dinamarca , Feminino , Heparina/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Politetrafluoretileno/economia , Desenho de Prótese , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Tempo , Resultado do Tratamento
8.
Clin Otolaryngol ; 43(1): 249-255, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28800204

RESUMO

OBJECTIVES: To compare the efficacy and safety of transoral robotic surgery (TORS) with endoscope-guided coblation tongue base resection. DESIGN: Retrospective case-control study. SETTING: University-based tertiary care medical center. PARTICIPANTS: Patients with obstructive sleep apnoea (OSA) who underwent endoscope-guided tongue base coblation resection or transoral robotic surgery (TORS) in combination with lateral pharyngoplasty at a single institution in South Korea between April 2013 and December 2016 were investigated. Forty-five patients who had moderate-to-severe OSA with tongue base collapse and a minimum follow-up period of 6 months with postoperative polysomnography (PSG) were enrolled in this study. MAIN OUTCOME MEASURES: All patients underwent pre- and postoperative (at least 4 months after surgery) overnight PSG. Available information on results of the PSG, Epworth sleepiness scale and complications of the TORS and coblation groups were compared. RESULTS: Postoperative PSG studies showed improved sleep quality for most patients. The mean postoperative apnoea-hypopnea index (AHI) was reduced significantly from 45.0 to 17.0 events/h (P < .0001) in the TORS group and from 45.6 to 16.2 events/h (P < .0001) in the coblation group. The mean rates of improvement (AHI reduction > 50%) were 75.0% in TORS patients and 62.1% in coblation patients and the difference was not significant. Less frequent postoperative morbidity, including bleeding, taste dysfunction and foreign body sensation, was recorded in TORS patients. CONCLUSIONS: Both the coblation and TORS groups showed similar surgical outcomes, TORS achieved PSG results non-inferior to and complication rates comparable to coblation.


Assuntos
Ablação por Cateter/métodos , Glossectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Apneia Obstrutiva do Sono/cirurgia , Língua/cirurgia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Complicações Pós-Operatórias/epidemiologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia , Resultado do Tratamento
9.
Mol Plant Microbe Interact ; 29(11): 854-861, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27831211

RESUMO

Herbivore selection of plant hosts and plant responses to insect colonization have been subjects of intense investigations. A growing body of evidence suggests that, for successful colonization to occur, (effector/virulence) proteins in insect saliva must modulate plant defense responses to the benefit of the insect. A range of insect saliva proteins that modulate plant defense responses have been identified, but there is no direct evidence that these proteins are delivered into specific plant tissues and enter plant cells. Aphids and other sap-sucking insects of the order Hemiptera use their specialized mouthparts (stylets) to probe plant mesophyll cells until they reach the phloem cells for long-term feeding. Here, we show, by immunogold-labeling of ultrathin sections of aphid feeding sites, that an immuno-suppressive aphid effector localizes in the cytoplasm of mesophyll cells near aphid stylets but not in cells further away from aphid feeding sites. In contrast, another aphid effector protein localizes in the sheaths composed of gelling saliva that surround the aphid stylets. Thus, insects deliver effectors directly into plant tissue. Moreover, different aphid effectors locate extracellularly in the sheath saliva or are introduced into the cytoplasm of plant cells. [Formula: see text] Copyright © 2016 The Author(s). This is an open-access article distributed under the CC BY-NC-ND 4.0 International license .


Assuntos
Afídeos/fisiologia , Proteínas de Insetos/metabolismo , Plantas/ultraestrutura , Animais , Citosol/metabolismo , Citosol/ultraestrutura , Herbivoria , Células do Mesofilo/metabolismo , Células do Mesofilo/parasitologia , Células do Mesofilo/ultraestrutura , Floema/metabolismo , Floema/parasitologia , Floema/ultraestrutura , Folhas de Planta/metabolismo , Folhas de Planta/parasitologia , Folhas de Planta/ultraestrutura , Plantas/metabolismo , Plantas/parasitologia , Saliva/metabolismo
10.
Gene Ther ; 22(4): 325-32, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25588739

RESUMO

Gene therapy using RNA interference can be directed against tumors through various strategies, but has been hindered owing to the inefficiency of non-viral delivery. To evaluate the antitumor effects of adenine nucleotide translocase-2 (ANT2) short hairpin RNA (shRNA) by intraperitoneal injection using the polyethylenimine (PEI) and an ultrasound gene delivery method, human breast carcinoma MDA-MB-231 cells were injected subcutaneously into NOG (NOD/Shi-scid/IL-2Rγ(null)) mice. The results showed greater tumor regression (*P<0.05) as well as an increased survival rate in the group receiving ANT2 shRNA+two types of enhancer relative to the groups receiving ANT2 shRNA without enhancer. These findings demonstrate that the introduction of PEI and ultrasound with SonoVue exerted enhanced antitumor effects in vivo. Although the combination of jet-PEI and ultrasound provided the best results with respect to tumor regression, the antitumor effects from the individual enhancers were approximately equivalent. In addition, we confirmed that there was no toxicity on aspartate aminotransferase and alanine aminotransferase levels in the liver and albumin, blood urea nitrogen or creatine kinase levels in the kidney following the various gene delivery methods.


Assuntos
Translocador 2 do Nucleotídeo Adenina/metabolismo , Antineoplásicos/metabolismo , Polietilenoimina/farmacologia , RNA Interferente Pequeno/metabolismo , Animais , Linhagem Celular Tumoral/efeitos dos fármacos , Técnicas de Transferência de Genes , Xenoenxertos , Rim/efeitos dos fármacos , Fígado/efeitos dos fármacos , Camundongos , Microbolhas , Transplante de Neoplasias , RNA Interferente Pequeno/toxicidade , Terapia por Ultrassom
11.
Anaesthesia ; 70(8): 933-8, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25789568

RESUMO

Securing a clear airway is important for successful fibreoptic intubation. We investigated whether the jaw-thrust manoeuvre in the 25° semi-sitting position improves airway clearance compared with the supine position in 88 anaesthetised patients randomly assigned to the two positions. After induction of anaesthesia, the fibreoptic bronchoscope was advanced into the mouth along the dorsum of the tongue during the jaw-thrust manoeuvre. Airway clearance was assessed at the level of the soft palate and epiglottis. Patients in the 25° semi-sitting position had clearer airways (judged subjectively by a three-level scale) than those in the supine position at the soft palate level (p = 0.012). At the level of the epiglottis, airway clearance was equally good in both positions. The mean (SD) times to view the vocal cord and carina were shorter in the 25° semi-sitting position (4 (1) s and 8 (1) s, respectively) compared with the supine position (6 (3) s and 11 (3) s; p < 0.001, respectively). The time to achieve intubation was also shorter in the 25° semi-sitting position (21 (5) s) than in the supine position (25 (7) s; p = 0.018).


Assuntos
Obstrução das Vias Respiratórias/prevenção & controle , Tecnologia de Fibra Óptica , Movimentos da Cabeça , Intubação Intratraqueal/instrumentação , Arcada Osseodentária , Feminino , Humanos , Intubação Intratraqueal/métodos , Masculino , Pessoa de Meia-Idade , Postura
12.
Int J Dent Hyg ; 13(4): 273-82, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26094654

RESUMO

AIMS: The purpose of this study was to identify gender differences in chewing discomfort among elderly Koreans. METHODS: This study used data from 56 616 (weighted sample: 5 638 394) subjects aged over 65 years who participated in the 2011 Community Health Survey in Korea. Of them, 23 059 (weighted sample: 2 368 200, 42.0%) were men and 33 357 (weighted sample: 3 270 194, 58.0%) were women. Data were analysed using chi-square tests and hierarchical logistic regression analyses, with SPSS 20.0. Chewing discomfort was set as the dependent variable, and independent variables were divided into socio-economic factors (place of residence, age, education, monthly household income, basic living security stipend, private insurance, economic activity, living arrangements), general health factors (hypertension, diabetes) and oral health factors (tooth defects, denture use, subjective periodontal health status). RESULTS: A greater proportion of women (50.2%) than men (42.6%) exhibited chewing discomfort (P < 0.001). In men, place of residence, monthly household income, private health insurance, tooth defects and periodontal health were associated with chewing discomfort (P < 0.05). In women, age, education level, basic living security stipend and denture use were associated with chewing discomfort (P < 0.05). CONCLUSIONS: Elderly Korean women experience more severe chewing discomfort than their male counterparts. The factors associated with chewing also differ by gender.


Assuntos
Nível de Saúde , Mastigação/fisiologia , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Feminino , Avaliação Geriátrica , Humanos , Masculino , Fatores Sexuais , Fatores Socioeconômicos
13.
Int J Dent Hyg ; 13(4): 254-60, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25142953

RESUMO

OBJECTIVES: This study aimed to assess the relationship between socio-economic factors and community periodontal treatment needs in Korea. METHODS: Data were obtained from the year 2009 Korean National Health and Nutrition Examination Survey. Our analysis included 7510 survey participants over the age of 19 years. To assess the relationship between socio-economic factors and the need for periodontal scaling, we performed multivariate logistic regression analyses for data with a complex sampling structure. PASW statistics 19.0 (SPSS Inc., Chicago, IL, USA) was used to perform the statistical analyses, and the results were expressed as odds ratios (OR) with corresponding 95% confidence intervals (CIs). RESULTS: A very high percentage of Korean adults required periodontal scaling (71.5%). After adjusting for sex, age, and socio-economic factors, the need for periodontal scaling was associated with low levels of education (OR: 1.41, 95% CI: 1.03-1.93), low incomes (OR: 1.27, 95% CI: 1.01-1.60), employment as a service and sales worker (OR: 1.39, 95% CI: 1.10-1.77), and employment as a manual worker (OR: 1.31, 95% CI: 1.02-1.69). CONCLUSIONS: In South Korea, the need for periodontal scaling was associated with socio-economic factors, such as low levels of education, low incomes, employment as a service and sales worker and employment as a manual worker. Consequently, clinical and community dental hygienists should consider adults with these risk factors as belonging to high-priority subgroups to whom they should respond first.


Assuntos
Odontologia Comunitária , Assistência Odontológica/estatística & dados numéricos , Raspagem Dentária/estatística & dados numéricos , Avaliação das Necessidades , Doenças Periodontais/terapia , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Doenças Periodontais/epidemiologia , Índice Periodontal , República da Coreia/epidemiologia , Fatores de Risco , Fatores Sexuais , Adulto Jovem
14.
Antimicrob Agents Chemother ; 58(11): 6742-6, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25182638

RESUMO

Fluconazole is a first-line antifungal agent for the treatment and prophylaxis of invasive candidiasis in pediatric patients. Pediatric patients are at risk of suboptimal drug exposure, due to developmental changes in gastrointestinal and renal function, metabolic capacity, and volume of distribution. Therapeutic drug monitoring (TDM) can therefore be useful to prevent underexposure of fluconazole in children and infants. Children, however, often fear needles and can have difficult vascular access. The purpose of this study was to develop and clinically validate a method of analysis to determine fluconazole in oral fluid in pediatric patients. Twenty-one paired serum and oral fluid samples were obtained from 19 patients and were analyzed using a validated liquid chromatography-tandem mass spectrometry (LC-MS-MS) method after cross-validation between serum and oral fluid. The results were within accepted ranges for accuracy and precision, and samples were stable at room temperature for at least 17 days. A Pearson correlation test for the fluconazole concentrations in serum and oral fluid showed a correlation coefficient of 0.960 (P < 0.01). The mean oral fluid-to-serum concentration ratio was 0.99 (95% confidence interval [CI], 0.88 to 1.10) with Bland-Altman analysis. In conclusion, an oral fluid method of analysis was successfully developed and clinically validated for fluconazole in pediatric patients and can be a noninvasive, painless alternative to perform TDM of fluconazole when blood sampling is not possible or desirable. When patients receive prolonged courses of antifungal treatment and use fluconazole at home, this method of analysis can extend the possibilities of TDM for patients at home.


Assuntos
Antifúngicos/sangue , Antifúngicos/uso terapêutico , Candidíase Invasiva/tratamento farmacológico , Fluconazol/sangue , Fluconazol/uso terapêutico , Administração Oral , Adolescente , Antifúngicos/administração & dosagem , Área Sob a Curva , Candidíase Invasiva/microbiologia , Criança , Pré-Escolar , Feminino , Fluconazol/administração & dosagem , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva , Masculino , Testes de Sensibilidade Microbiana , Estudos Prospectivos , Saliva/química
15.
Strahlenther Onkol ; 190(1): 94-9, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24343757

RESUMO

PURPOSE: To determine the variability of patient positioning errors associated with intensity-modulated radiotherapy (IMRT) for prostate cancer and to assess the impact of thermoplastic pelvic immobilization on these errors using kilovoltage (kV) cone-beam computed tomography (CBCT). MATERIALS AND METHODS: From February 2012 to June 2012, the records of 314 IMRT sessions in 19 patients with prostate cancer, performed with or without immobilization at two different facilities in the Korea University Hospital were analyzed. The kV CBCT images were matched to simulation computed tomography (CT) images to determine the simulation-to-treatment variability. The shifts along the x (lateral)-, y (longitudinal)- and z (vertical)-axes were measured, as was the shift in the three dimensional (3D) vector. RESULTS: The measured systematic errors in the immobilized group during treatment were 0.46 ± 1.75 mm along the x-axis, - 0.35 ± 3.83 mm along the y-axis, 0.20 ± 2.75 mm along the z-axis and 4.05 ± 3.02 mm in the 3D vector. Those of nonimmobilized group were - 1.45 ± 7.50 mm along the x-axis, 1.89 ± 5.07 mm along the y-axis, 0.28 ± 3.81 mm along the z-axis and 8.90 ± 4.79 mm in the 3D vector. The group immobilized with pelvic thermoplastics showed reduced interfractional variability along the x- and y-axes and in the 3D vector compared to the nonimmobilized group (p < 0.05). CONCLUSION: IMRT with thermoplastic pelvic immobilization in patients with prostate cancer appears to be useful in stabilizing interfractional variability during the planned treatment course.


Assuntos
Fracionamento da Dose de Radiação , Imobilização/instrumentação , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/radioterapia , Radioterapia Conformacional/métodos , Tomografia Computadorizada por Raios X/métodos , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Pelve , Plásticos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
16.
Oral Dis ; 20(6): 551-9, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24033864

RESUMO

OBJECTIVES: The aim of this study was to identify the socioeconomic factors associated with the prevalence of periodontitis in Koreans. METHODS: Cross-sectional data from 12 763 subjects, 15 years old and above, who underwent periodontal examinations were obtained from the Korean National Health and Nutrition Examination Survey IV (2007-209). Multivariate linear and logistic regression analyses were applied to estimate the association between socioeconomic indicators and prevalence of periodontitis. RESULTS: A significant association was found between increasing age and periodontitis. Participants with higher income were less likely to have periodontitis (aOR = 0.9 and 95% CI = 0.78-0.98, and aOR = 0.7 and 95% CI = 0.60-0.80 in the middle and highest quintiles of monthly household income, respectively). In addition, participants living in rural areas were less likely to have periodontitis (aOR = 0.9 and 95% CI = 0.81-0.99), and current smokers were more likely to have periodontitis (aOR = 1.7 and 95% CI = 1.49-1.89). The analysis of comorbidities revealed that individuals with diabetes mellitus (DM) were significantly more likely to have periodontitis (aOR = 1.4 and 95% CI = 1.18-1.68). CONCLUSIONS: In a rapidly increasing Korean population, the lower socioeconomic groups as well as individuals with DM were significantly more likely to present with periodontitis.


Assuntos
Diabetes Mellitus/epidemiologia , Disparidades nos Níveis de Saúde , Renda/estatística & dados numéricos , Periodontite/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , República da Coreia/epidemiologia , População Rural/estatística & dados numéricos , Fumar/epidemiologia , Adulto Jovem
17.
Oral Dis ; 20(2): 191-204, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23496287

RESUMO

OBJECTIVE: The purposes of this study were to isolate and characterize stem cells from inflamed pulp tissue of human functional deciduous teeth (iSHFD) and to evaluate the influence of fibroblastic growth factor-2 (FGF-2) on the regenerative potential. MATERIALS AND METHODS: We successfully isolated mesenchymal stem cells (MSCs) from the inflamed dental pulp tissue of human deciduous teeth and demonstrated that their regenerative potential could be enhanced by the application of FGF-2 (20 ng ml(-1)) during ex vivo expansion. Isolated stem cells expanded in FGF-2 were characterized using a colony-forming assay, proliferation, migration, in vitro differentiation, in vivo ectopic transplantation assay, and gene expression profiling. RESULTS: MSCs isolated from the inflamed pulp tissue of functional deciduous teeth potentially possess the qualities of those from human exfoliated deciduous teeth. FGF-2 applied to iSHFD during expansion enhanced the colony-forming efficiency of these cells, increased their proliferation and migration potential, and reduced their differentiation potential in vitro. However, the ectopic transplantation of iSHFD/FGF-2 in vivo increased the formation of dentin-like material. CONCLUSION: FGF-2 expansion of stem cells from inflamed pulp tissues of human deciduous teeth can be a good source of stem cells for future clinical applications and a novel way of using discarded inflamed tissues.


Assuntos
Polpa Dentária/citologia , Fator 2 de Crescimento de Fibroblastos/fisiologia , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/fisiologia , Pulpite/patologia , Diferenciação Celular , Células Cultivadas , Fator 2 de Crescimento de Fibroblastos/farmacologia , Humanos , Células-Tronco Mesenquimais/efeitos dos fármacos , Dente Decíduo
18.
J Oral Rehabil ; 41(7): 523-31, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24717149

RESUMO

Dentin hypersensitivity (DH) is defined as pain derived from exposed dentin in response to chemical, thermal, tactile, or osmotic stimuli that cannot be explained as having arisen from any other dental defect or disease. The aim of this trial was to test the efficacy and the safety of a low-level laser-emitting toothbrush on management of DH. A prospective, double blind, randomised clinical trial was designed; 96 individuals with hypersensitive teeth without caries or fracture were selected as subjects. The subjects were randomly allocated to either the test group with the 635 nm per 6 mW laser-emitting toothbrush, or the control group with the 635 nm per 12.9 µW light-emitting diode (LED) toothbrush. An air blast was applied with a dental air syringe held 3 mm away from the selected tooth and a visual analogue scale (VAS: 0-10) was used to quantify subjective pain. Assessments were completed at a screening visit and after 2-week and 4-week of using a test/control toothbrush. Results demonstrated that the use of both control and test toothbrushes resulted in decreased discomfort after 4 weeks. In the test group, pain intensity scores decreased from 5.8 ± 1.2 to 2.3 ± 1.6, and in the control group, the scores decreased from 6.4 ± 1.3 to 5.5 ± 2.0 (P < 0.05). This decrease was significantly greater in the test group. There were no significant adverse events or side effects. It was concluded that the use of the low-level laser emitting toothbrush is a safe and effective treatment option for the management of DH.


Assuntos
Sensibilidade da Dentina/radioterapia , Dor Facial , Terapia com Luz de Baixa Intensidade/métodos , Escovação Dentária/instrumentação , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
19.
Int J Dent Hyg ; 12(2): 133-40, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24034864

RESUMO

OBJECTIVE: To develop a dental hygiene care programme based on the specific needs of patients with mental disorders and to suggest practical guidelines to improve the oral health care of these patients. METHODS: A total of 73 patients with mental illness participated in the study. The patients were randomly classified into three groups and followed over 12 weeks at 4-week intervals. A newly designed dental hygiene care programme using flash-based video, brochures and a toothpick method was implemented by five dental hygienists. Plaque index, stimulated saliva, subjective oral dryness and dental caries activity were analysed as outcome variables. RESULTS: Results showed that the dental plaque index significantly decreased after each session (P < 0.0001) in all three groups, and significant differences were found between groups (P = 0.036). Patients' oral dryness decreased significantly, but stimulated saliva and dental caries activity did not improve. CONCLUSION: The results of this study suggest that the dental hygiene care programme, which made use of a short, 10-min flash-based video and brochures every 4 weeks, was effective in reducing the dental plaque index of patients with mental disorders.


Assuntos
Placa Dentária/prevenção & controle , Profilaxia Dentária/métodos , Transtornos Mentais , Adulto , Idoso , Recursos Audiovisuais , Assistência Odontológica para a Pessoa com Deficiência , Testes de Atividade de Cárie Dentária , Dispositivos para o Cuidado Bucal Domiciliar , Índice de Placa Dentária , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/tratamento farmacológico , Pessoa de Meia-Idade , Avaliação das Necessidades , Higiene Bucal/educação , Folhetos , Educação de Pacientes como Assunto/métodos , Saliva/metabolismo , Escovação Dentária/instrumentação , Escovação Dentária/métodos , Resultado do Tratamento , Gravação em Vídeo , Xerostomia/classificação , Adulto Jovem
20.
Biosens Bioelectron ; 258: 116327, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-38703496

RESUMO

Proper customization in size and shape is essential in implantable bioelectronics for stable bio-signal recording. Over the past decades, many researchers have heavily relied on conventional photolithography processes to fabricate implantable bioelectronics. Therefore, they could not avoid the critical limitation of high cost and complex processing steps to optimize bioelectronic devices for target organs with various sizes and shapes. Here, we propose rapid prototyping using all laser processes to fabricate customized bioelectronics. PEDOT:PSS is selectively irradiated by an ultraviolet (UV) pulse laser to form wet-stable conductive hydrogels that can softly interact with biological tissues (50 µm line width). The encapsulation layer is selectively patterned using the same laser source by UV-curing polymer networks (110 µm line width). For high stretchability (over 100%), mesh structures are made by the selective laser cutting process. Our rapid prototyping strategy minimizes the use of high-cost equipment, using only a single UV laser source to process the electrodes, encapsulation, and substrates that constitute bioelectronics without a photomask, enabling the prototyping stretchable microelectrode array with an area of 1 cm2 less than 10 min. We fabricated an optimized stretchable microelectrode array with low impedances (∼1.1 kΩ at 1 kHz) that can effectively record rat's cardiac signals with various health states.


Assuntos
Técnicas Biossensoriais , Condutividade Elétrica , Hidrogéis , Lasers , Hidrogéis/química , Animais , Técnicas Biossensoriais/instrumentação , Ratos , Polímeros/química , Desenho de Equipamento , Poliestirenos/química , Tiofenos
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