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1.
Eur Radiol ; 2024 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-38308678

RESUMEN

Optoacoustic imaging (OAI) is an emerging field with increasing applications in patients and exploratory clinical trials for breast cancer. Optoacoustic imaging (or photoacoustic imaging) employs non-ionizing, laser light to create thermoelastic expansion in tissues and detect the resulting ultrasonic emission. By combining high optical contrast capabilities with the high spatial resolution and anatomic detail of grayscale ultrasound, OAI offers unique opportunities for visualizing biological function of tissues in vivo. Over the past decade, human breast applications of OAI, including benign/malignant mass differentiation, distinguishing cancer molecular subtype, and predicting metastatic potential, have significantly increased. We discuss the current state of optoacoustic breast imaging, as well as future opportunities and clinical application trends. CLINICAL RELEVANCE STATEMENT: Optoacoustic imaging is a novel breast imaging technique that enables the assessment of breast cancer lesions and tumor biology without the risk of ionizing radiation exposure, intravenous contrast, or radionuclide injection. KEY POINTS: • Optoacoustic imaging (OAI) is a safe, non-invasive imaging technique with thriving research and high potential clinical impact. • OAI has been considered a complementary tool to current standard breast imaging techniques. • OAI combines parametric maps of molecules that absorb light and scatter acoustic waves (like hemoglobin, melanin, lipids, and water) with anatomical images, facilitating scalable and real-time molecular evaluation of tissues.

2.
Radiographics ; 44(1): e230090, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38127658

RESUMEN

Women in the United States who continue to face obstacles accessing health care are frequently termed an underserved population. Safety-net health care systems play a crucial role in mitigating health disparities and reducing burdens of disease, such as breast cancer, for underserved women. Disparities in health care are driven by various factors, including race and ethnicity, as well as socioeconomic factors that affect education, employment, housing, insurance status, and access to health care. Underserved women are more likely to be uninsured or underinsured throughout their lifetimes. Hence they have greater difficulty gaining access to breast cancer screening and are less likely to undergo supplemental imaging when needed. Therefore, underserved women often experience significant delays in the diagnosis and treatment of breast cancer, leading to higher mortality rates. Addressing disparities requires a multifaceted approach, with formal care coordination to help at-risk women navigate through screening, diagnosis, and treatment. Mobile mammography units and community outreach programs can be leveraged to increase community access and engagement, as well as improve health literacy with educational initiatives. Radiology-community partnerships, comprised of imaging practices partnered with local businesses, faith-based organizations, homeless shelters, and public service departments, are essential to establish culturally competent breast imaging care, with the goal of equitable access to early diagnosis and contemporary treatment. Published under a CC BY 4.0 license. Test Your Knowledge questions are available in the Online Learning Center. See the invited commentary by Leung in this issue.


Asunto(s)
Neoplasias de la Mama , Estados Unidos , Femenino , Humanos , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/terapia , Accesibilidad a los Servicios de Salud , Mamografía , Área sin Atención Médica , Tamizaje Masivo , Detección Precoz del Cáncer
3.
Breast Cancer Res Treat ; 201(1): 127-138, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37330947

RESUMEN

PURPOSE: The purpose of this study was to determine the impact of COVID-19 on county safety-net breast imaging services and describe the steps taken to actively manage and mitigate delays. METHODS: This was an IRB exempt retrospective review of our county safety-net breast imaging practice analyzed for 4 distinct time periods: (1) "Shut-down period": March 17, 2020 to May 17, 2020; (2) "Phased re-opening": May 18, 2020 to June 30, 2020; (3) "Ramp-up": July 1, 2020 to September 30, 2020; and (4) "Current state": October 1, 2020 to September 30, 2021. These time periods were compared to identical time periods 1 year prior. For "Current state," given that the 1-year prior comparison encompassed the first 3 periods of the pandemic, the identical time period 2 years prior was also compared. RESULTS: Our safety-net practice sustained significant volume losses during the first 3 time periods with a 99% reduction in screening mammography in the shut-down period. Cancers diagnosed decreased by 17% in 2020 (n = 229) compared to 2019 (n = 276). By implementing multiple initiatives that targeted improved access to care, including building community-hospital partnerships and engagement through outreach events and a community education roadshow, we were able to recover and significantly exceed our pandemic screening volumes by 48.1% (27,279 vs 18,419) from October 1, 2020 to September 30, 2021 compared to the identical time period 1 year prior, and exceed our pre-pandemic screening volume by 17.4% (27,279 vs 23,234) compared to the identical time period 2 years prior. CONCLUSION: Through specific community outreach programs and optimized navigation, our safety-net breast imaging practice was able to mitigate the impact of COVID-19 on our patient population by increasing patient engagement and breast imaging services.


Asunto(s)
Neoplasias de la Mama , COVID-19 , Humanos , Femenino , COVID-19/epidemiología , Mamografía , Proveedores de Redes de Seguridad , Pandemias/prevención & control , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/epidemiología , Detección Precoz del Cáncer
4.
Int J Clin Pract ; 2022: 1878705, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35936068

RESUMEN

This randomized prospective clinical study aimed to investigate the effects of dexmedetomidine or ketamine administration to total intravenous anesthesia (TIVA) on postoperative analgesia in subjects undergoing elective laparoscopic cholecystectomy procedures. 90 adults, American Society of Anesthesiologists (ASA) physical status 1 and II patients, who underwent elective laparoscopic cholecystectomy procedures were included in the study and randomized into three groups equally. Remifentanil, propofol, and rocuronium infusions were used for TIVA guided by the bispectral index. In group KETA, 10 µg/kg/min ketamine was added to TIVA before surgery, and in group DEX, 0.5 µg/kg/h dexmedetomidine was added to TIVA before surgery. Normal saline infusions were infused in the control group. Postoperative analgesia was provided with intravenous patient-controlled analgesia (PCA) morphine (1 mg bolus morphine, 5 min lockout time). Hemodynamic parameters, scores of visual analogue scale (VAS) for pain, rescue morphine requirements, and side effects such as sedation, nausea, and vomiting were recorded for 48 hours after surgery. Postoperative first analgesic requirement time was longer in group KETA (P < 0.001), and it was longer in group DEX than in the control group (P < 0.001). Pain scores were lower in group KETA and group DEX than in the control group at all corresponding times throughout the 48 h period of observation. Intravenous PCA morphine consumptions were higher in the control group than in group KETA (P < 0.001 for all followed-up times), and they were higher in group DEX than in group KETA (P < 0.001 for all followed-up times). It is concluded that the use of dexmedetomidine or ketamine infusions can be suitable as an additive for TIVA in the intraoperative period. Furthermore, the addition of both drugs to the TIVA protocol may improve postoperative pain relief and decrease opioid consumption.


Asunto(s)
Colecistectomía Laparoscópica , Dexmedetomidina , Ketamina , Adulto , Anestesia Intravenosa/métodos , Colecistectomía Laparoscópica/métodos , Dexmedetomidina/uso terapéutico , Humanos , Ketamina/uso terapéutico , Derivados de la Morfina/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/prevención & control , Estudios Prospectivos
5.
Diabet Med ; 38(4): e14406, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-32961611

RESUMEN

AIM: To describe the prevalence and characteristics of polypharmacy in a Dutch cohort of individuals with type 2 diabetes. METHODS: We included people with type 2 diabetes from the Diabetes Pearl cohort, of whom 3886 were treated in primary care and 2873 in academic care (secondary/tertiary). With multivariable multinomial logistic regression analyses stratified for line of care, we assessed which sociodemographic, lifestyle and cardiometabolic characteristics were associated with moderate (5-9 medications) and severe polypharmacy (≥10 medications) compared with no polypharmacy (0-4 medications). RESULTS: Mean age was 63 ± 10 years, and 40% were women. The median number of daily medications was 5 (IQR 3-7) in primary care and 7 (IQR 5-10) in academic care. The prevalence of moderate and severe polypharmacy was 44% and 10% in primary care, and 53% and 29% in academic care respectively. Glucose-lowering and lipid-modifying medications were most prevalent. People with severe polypharmacy used a relatively large amount of other (i.e. non-cardiovascular and non-glucose-lowering) medication. Moderate and severe polypharmacy across all lines of care were associated with higher age, low educational level, more smoking, longer diabetes duration, higher BMI and more cardiovascular disease. CONCLUSIONS: Severe and moderate polypharmacy are prevalent in over half of people with type 2 diabetes in primary care, and even more in academic care. People with polypharmacy are characterized by poorer cardiometabolic status. These results highlight the significance of polypharmacy in type 2 diabetes.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Polifarmacia , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/tratamiento farmacológico , Enfermedades Cardiovasculares/epidemiología , Estudios de Cohortes , Comorbilidad , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Polifarmacia/estadística & datos numéricos , Prevalencia , Factores Socioeconómicos
6.
Diabet Med ; 34(11): 1623-1628, 2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-28703888

RESUMEN

AIMS: Individual indicators of socio-economic status have been associated with glycaemic control in people with Type 2 diabetes, but little is known about the association between partner's socio-economic status and HbA1c levels. We therefore examined the cross-sectional association between individual and partner's level of occupation on HbA1c levels in people with Type 2 diabetes in the Netherlands. METHODS: We included people with Type 2 diabetes with a partner who were treated in primary, secondary and tertiary care in the Diabetes Pearl cohort. Occupational level was classified according to International Standard Classification of Occupations (ISCO)-08 skill levels. Linear regression analyses were performed stratified for sex, and corrected for age, recruitment centre and diabetes medication. RESULTS: In total, 3257 participants (59.8% men, mean 62.2±9.4 years) were included. For men, having a partner with an intermediate level of occupation was associated with lower HbA1c levels [e.g. ISCO level 3: -2 mmol/mol (95% CI -4;-1) or -0.2% (95% CI -0.4;-0.1)], compared with having a partner of the highest occupational level (ISCO level 4). In women, having an unemployed partner was associated with higher HbA1c levels [14 mmol/mol (95% CI 6; 22) or 1.3% (95% CI 0.6; 2.0)], compared with having a partner of the highest occupational level. CONCLUSIONS: Partner's occupational status provided additional information on the association between socio-economic status and HbA1c levels in people with Type 2 diabetes. Women seemed to benefit from a partner with a higher occupational status, while men seemed to benefit from a partner with a lower status. Because of the cross-sectional nature of the present study, more research is necessary to explore this association.


Asunto(s)
Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/epidemiología , Hemoglobina Glucada/análisis , Ocupaciones , Esposos , Adulto , Anciano , Anciano de 80 o más Años , Glucemia/análisis , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Ocupaciones/estadística & datos numéricos , Clase Social , Apoyo Social , Esposos/estadística & datos numéricos , Adulto Joven
7.
Genet Couns ; 27(3): 367-371, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-30204965

RESUMEN

The Joubert syndrome is characterized by hypotonia, ataxia, facial dysmorphism, abnormal eye movement, irregular breathing pattern and cognitive impairment. The molar tooth sign is the pathognomonic midbrain-hindbrain malformation for Joubert syndrome. Joubert syndrome and related disorders (JSRD), are the clinically and genetically heterogen disorders in which the obligatory hallmark is the molar tooth sign (MTS). In this report, it was described the association of the molar tooth sign, absence of pituitary gland and corpus callosum agenesis on an infant with JSRD. To the best of our knowledge, this is the first case diagnosed as JSRD and panhypopituitarism without features of OFD VI.


Asunto(s)
Anomalías Múltiples/genética , Cerebelo/anomalías , Anomalías del Ojo/genética , Hipopituitarismo/genética , Enfermedades Renales Quísticas/genética , Retina/anomalías , Anomalías Múltiples/diagnóstico , Agenesia del Cuerpo Calloso/diagnóstico , Agenesia del Cuerpo Calloso/genética , Agenesia del Cuerpo Calloso/patología , Encéfalo/anomalías , Encéfalo/patología , Anomalías del Ojo/diagnóstico , Humanos , Hipopituitarismo/diagnóstico , Recién Nacido , Enfermedades Renales Quísticas/diagnóstico , Imagen por Resonancia Magnética , Masculino , Pronóstico
8.
Acad Radiol ; 31(1): 121-130, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37748954

RESUMEN

RATIONALE AND OBJECTIVES: To evaluate the cost-effectiveness of utilizing supplemental optoacoustic ultrasound (OA/US) versus gray-scale ultrasound (US) alone to differentiate benign and malignant breast masses in a diagnostic setting. MATERIALS AND METHODS: We created a decision-tree model to compare the cost-effectiveness of OA/US and US from the perspective of the US healthcare system. We utilized diagnostic test performance parameters from the PIONEER-01(NCT01943916) clinical trial and cost parameters (USD) from the Truven Health MarketScan Databases. Utility (quality adjusted life year, QALY) values were determined following published patient-reported outcomes. Cost-effectiveness was calculated through incremental cost-effectiveness ratio (USD/QALY, ICER) and net monetary benefit (NMB) in a Markov chain model. Deterministic and probabilistic sensitivity analyses were performed to determine the significance of variation in input parameters. A willingness-to-pay (WTP) threshold of $100,000/QALY was used for the study. RESULTS: OA/US had an estimated cumulative cost of $16,617.36 and the outcome of 16.85 QALYs in the 25-year period. The incremental NMB for OA/US was $1495.36, and the ICER was -$31,715.82/QALY, indicating that supplemental use of OA/US was more cost-effective than US alone. In the deterministic sensitivity analysis, when the cost of OA/US exceeded $1030.61 or the sensitivity of OA/US fell below 79.7%, or the specificity fell below 30.5%, the US alone strategy yielded higher NMB values compared to supplemental OA/US. According to probabilistic sensitivity analysis, OA/US was the better strategy in 98.69% of 10,000 iterations. CONCLUSION: OA/US is more cost-effective than US to differentiate benign or malignant breast masses in the diagnostic setting. It can reduce costs while improving patients' quality of life, primarily by reducing false-positive results with consequent benign biopsies.


Asunto(s)
Análisis de Costo-Efectividad , Calidad de Vida , Humanos , Análisis Costo-Beneficio , Mama , Diagnóstico por Imagen
9.
J Clin Lipidol ; 18(3): e423-e429, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38627169

RESUMEN

BACKGROUND: This study aims to show the clinical and biochemical features in patients with severe hypertriglyceridemia (HTG) associated with rare variants in the apolipoprotein A-V (APOA5) gene. MATERIALS AND METHODS: Demographics, blood lipid levels, body mass index (BMI) and APOA5 mutation subtypes were collected from the endocrinology clinic registry and analyzed for a retrospective cohort study of ten patients with severe HTG and APOA5 gene variants. RESULTS: Of the 10 cases, four were female, and six were male. The median age was 45.0 years (min-max: 21-60 years), the median triglyceride was 2429.5 mg/dL (27.5 mmol/L) (min-max: 1351-4087 mg/dL, 15.3-46.2 mmol/L), and the mean BMI was calculated as 30.4 ± 4.4 kg/m2 (min-max: 24.9-41.0 kg/m2). Four cases had diabetes mellitus (DM); two were on intensive insulin therapy, and two were on basal insulin therapy. The mean hemoglobin A1c was 9.2 ± 1.2 % (min-max: 8.3-11.0 %). Among the study group, eight different APOA5 gene mutations were detected. These variants were heterozygous in 2 patients and homozygous (bi-allelic) in 8 patients. One patient was homozygous for APOA5 p.Ser19Trp, a relatively common polymorphism that is a risk variant for HTG. CONCLUSION: We report a cohort of patients with biallelic and single copy APOA5 variants, who were diagnosed later in life. Most had secondary factors, such as DM or obesity with increased BMI. Most rare APOA5 variants found in our patients were of uncertain significance. Our results add to the growing evidence that rare variants in certain candidate genes may predispose to developing HTG, together with secondary factors such as obesity. The genetic basis of HTG in many other patients is still unknown and remains the subject of further investigation.


Asunto(s)
Apolipoproteína A-V , Hipertrigliceridemia , Humanos , Apolipoproteína A-V/genética , Masculino , Femenino , Persona de Mediana Edad , Adulto , Hipertrigliceridemia/genética , Adulto Joven , Mutación , Estudios Retrospectivos , Estudios de Cohortes , Índice de Masa Corporal , Variación Genética
10.
Acad Radiol ; 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38365491

RESUMEN

RATIONALE AND OBJECTIVES: To compare rates of guideline-concordant care, imaging surveillance, recurrence and survival outcomes between a safety-net (SNH) and tertiary-care University Hospital (UH) served by the same breast cancer clinical teams. MATERIALS AND METHODS: 647 women with newly diagnosed breast cancer treated in affiliated SNH and UH between 11.1.2014 and 3.31.2017 were reviewed. Patient demographics, completion of guideline-concordant adjuvant chemotherapy, radiation and hormonal therapy were recorded. Two multivariable logistic regression models were performed to investigate the effect of hospital and race on cancer stage. Kaplan-Meier log-rank and Cox-regression were used to analyze five-year recurrence-free (RFS) and overall survival (OS) between hospitals and races, (p < 0.05 significant). RESULTS: Patients in SNH were younger (mean SNH 53.2 vs UH 57.9, p < 0.001) and had higher rates of cT3/T4 disease (SNH 19% vs UH 5.5%, p < 0.001). Patients in the UH had higher rates of bilateral mastectomy (SNH 17.6% vs UH 40.1% p < 0.001) while there was no difference in the positive surgical margin rate (SNH 5.0% vs UH 7.6%, p = 0.20), completion of adjuvant radiation (SNH 96.9% vs UH 98.7%, p = 0.2) and endocrine therapy (SNH 60.8% vs UH 66.2%, p = 0.20). SNH patients were less compliant with mammography surveillance (SNH 64.1% vs UH 75.1%, p = 0.02) and adjuvant chemotherapy (SNH 79.1% vs UH 96.3%, p < 0.01). RFS was lower in the SNH (SNH 54 months vs UH 57 months, HR 1.90, 95% CI: 1.18-3.94, p = 0.01) while OS was not significantly different (SNH 90.5% vs UH 94.2%, HR 1.78, 95% CI: 0.97-3.26, p = 0.06). CONCLUSION: In patients experiencing health care disparities, having access to guideline-concordant care through SNH resulted in non-inferior OS to those in tertiary-care UH.

11.
Pediatr Diabetes ; 14(7): 519-25, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23710907

RESUMEN

OBJECTIVE: The compound muscle action potential (CMAP) scan is a novel neurophysiological technique that appears more sensitive in detecting peripheral motor neuropathy than conventional methods. This study explores the value of the CMAP scan for the detection of subclinical diabetic peripheral motor neuropathy. METHODS: In this cross-sectional pilot study, CMAP scanning of the peroneal nerve was performed in (i) 13 well-controlled patients (8-25 yr old) with type 1 diabetes mellitus (T1DM) duration between 2.5 and 5 yr; (ii) 17 patients (10-25 yr old) with a duration of T1DM of at least 10 yr, poorly controlled and/or with microvascular complications and (iii) 13 adults with T1DM and established clinical diabetic peripheral neuropathy (DPN). Various CMAP scan variables, including measures of axonal excitability and axonal loss and reinnervation, were compared between patients and healthy controls. RESULTS: Axonal excitability was significantly decreased in the young patient groups as compared to their controls. The CMAP scan measures of axonal loss and reinnervation differed only between patients with clinical DPN and their controls. CONCLUSIONS: Motor nerve axonal excitability seems to be reduced early in T1DM, even in well-controlled young patients, and probably before (irreversible) axonal damage occurs. These changes can be measured by the CMAP scan, which makes this a promising tool for detecting nerve dysfunction in T1DM.


Asunto(s)
Potenciales de Acción , Diabetes Mellitus Tipo 1/fisiopatología , Conducción Nerviosa/fisiología , Nervio Peroneo/fisiología , Adolescente , Adulto , Axones/fisiología , Niño , Estudios Transversales , Angiopatías Diabéticas/fisiopatología , Neuropatías Diabéticas/fisiopatología , Femenino , Humanos , Masculino , Proyectos Piloto
12.
J Breast Imaging ; 5(3): 248-257, 2023 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38416888

RESUMEN

Artificial intelligence (AI) in breast imaging is a rapidly developing field with promising results. Despite the large number of recent publications in this field, unanswered questions have led to limited implementation of AI into daily clinical practice for breast radiologists. This paper provides an overview of the key limitations of AI in breast imaging including, but not limited to, limited numbers of FDA-approved algorithms and annotated data sets with histologic ground truth; concerns surrounding data privacy, security, algorithm transparency, and bias; and ethical issues. Ultimately, the successful implementation of AI into clinical care will require thoughtful action to address these challenges, transparency, and sharing of AI implementation workflows, limitations, and performance metrics within the breast imaging community and other end-users.


Asunto(s)
Inteligencia Artificial , Diagnóstico por Imagen , Humanos , Algoritmos , Benchmarking , Radiólogos
13.
J Cyst Fibros ; 22(3): 577-579, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36693768

RESUMEN

Cystic fibrosis (CF) is incurable and chronic, causing severe multisystemic damage and long-term complications. The most prominent extrapulmonary long-term complication is CF-related diabetes, which is the most reported form of diabetes in individuals with cystic fibrosis. Here we present the first case of an individual with cystic fibrosis who developed type 2 diabetes due to obesity rather than CF-related diabetes. The type 2 diabetes went into remission due to extreme weight loss after gastric bypass surgery. To our knowledge, this case is also the first report describing the effect of bariatric surgery in a patient with CF. This case demonstrates that patients with CF may present with type 2 diabetes instead of CF-related diabetes. Differential diagnosis of these two types of diabetes is essential for optimal treatment and quality of life.


Asunto(s)
Cirugía Bariátrica , Fibrosis Quística , Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico , Fibrosis Quística/complicaciones , Fibrosis Quística/diagnóstico , Fibrosis Quística/cirugía , Calidad de Vida , Cirugía Bariátrica/efectos adversos , Obesidad/complicaciones
14.
Eur Rev Med Pharmacol Sci ; 15(8): 900-5, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21845800

RESUMEN

BACKGROUND AND OBJECTIVES: The present study was performed to evaluate the in vitro antimicrobial and antioxidant properties of various extracts of Verbascum (V.) pinetorum, a member of Scrophulariaceae family. While the antimicrobial activity of various extracts of V. pinetorum was determined with agar-well diffusion method, the antioxidant activity was examined with two complementary test systems, namely 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging and beta-carotene/linoleic acid test systems. RESULTS: The hexane extract exhibits antimicrobial activity against few microorganisms. However, dichloromethane, direct methanol and methanol/chloroform extracts are effective on a broad range of microorganisms. Among the tested bacteria Haemophilus influenzae was found to be the most sensitive bacterium. The 50% (IC50) inhibition activity of the methanolic extract of V. pinetorum on the free radical DPPH was determined as 13.04 mg/ml. In the case of the linoleic acid system, oxidation of linoleic acid was inhibited by methanolic extract of V. pinetorum, which showed 89.39% inhibition that is quite close to the value of the synthetic antioxidant reagent butylhydroxytoluene (BHT), 92.46%. Iridoid glycosides, flavonoids and saponins were determined as the major natural compounds in the methanolic extracts. The total phenolic components of V. pinetorum were found as 42.45 mg/g gallic acid equivalent. CONCLUSION: The results provide evidence that the extracts of V. pinetorum contained iridoid glycosides, flavonoids, saponins and phenolic compounds which may be responsible for the substantial antimicrobial and antioxidant activities.


Asunto(s)
Antiinfecciosos/farmacología , Antioxidantes/farmacología , Extractos Vegetales/farmacología , Verbascum/química , Animales , Antiinfecciosos/química , Antioxidantes/química , Compuestos de Bifenilo/química , Hexanos/química , Técnicas In Vitro , Ácido Linoleico/química , Metanol/química , Cloruro de Metileno/química , Pruebas de Sensibilidad Microbiana/métodos , Fenoles/química , Picratos/química , Extractos Vegetales/química , beta Caroteno/química
15.
J Neonatal Perinatal Med ; 13(1): 47-54, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31594258

RESUMEN

BACKGROUND: Early onset bacterial sepsis in neonates (EOS) is recognized as an important health condition. Early diagnosis is crucial. However, blood culture results are released in 48-72 hours. Many biomarkers have been investigated but none have been accepted as the gold standard. This study aimed to investigate the diagnostic value of the molecules: soluble form of triggering receptor expressed on myeloid cells-1 (sTREM-1), pentraxin-3 (PTX-3) and pro adrenomedullin (pro-ADM) in EOS and compare with currently used biomarkers. METHODS: In this multicenter prospective study, patients were enrolled from different NICUs around the Turkey. Patient data were collected via web-based registry system from attending centers. Neonates, hospitalized with a suspicion of EOS were enrolled. Blood culture and routine blood tests were collected and a serum sample was obtained and kept in - 80°C for studying the molecules. According to laboratory results, patients were divided into three groups as; proven sepsis, clinical sepsis and control group. Groups were compared in terms of demographic, clinical and laboratory findings. The primary outcome of the study was to assess any difference between groups in terms of the diagnostic value of the markers aforementioned. RESULTS: A total of 130 patients were enrolled; proven sepsis (n = 36), clinical sepsis (n = 53) and control (n = 41) groups. Groups were similar in terms of demographic findings; mean WBC (P = 0.445), procalcitonin (PCT) (P = 0.083) and IL-6 (P = 0.814) levels. Mean C-reactive protein (CRP) level was significantly higher in clinical sepsis and proven sepsis groups compared to control group (P < 0.001). Mean PTX-3 (P = 0.547), pro-ADM (P = 0.766) and sTREM-1 (P = 0.838) levels were similar between groups. CONCLUSION: These promising molecules failed to help in early diagnosis of EOS. Their relation to correlation with disease progression may make more sense as they seem to be expressed in higher amounts with the progression of the disease in previous studies. CRP was the most frequently used biomarker for detecting the sepsis in our study population.


Asunto(s)
Adrenomedulina/sangre , Proteína C-Reactiva/metabolismo , Sepsis Neonatal/diagnóstico , Precursores de Proteínas/sangre , Componente Amiloide P Sérico/metabolismo , Receptor Activador Expresado en Células Mieloides 1/sangre , Estudios de Casos y Controles , Diagnóstico Precoz , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recien Nacido Prematuro , Interleucina-6/sangre , Recuento de Leucocitos , Masculino , Sepsis Neonatal/sangre , Polipéptido alfa Relacionado con Calcitonina/sangre , Curva ROC
16.
Neth J Med ; 73(1): 46-8, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26219944

RESUMEN

Nutmeg ingestion in large amounts can cause toxic symptoms such as hallucinations, tachycardia and anticholinergic effects. We describe a case of a 37-year-old woman who experienced an unintentional autointoxication of nutmeg. It is likely that nutmeg intoxication is underreported. We suggest to specifically think of nutmeg ingestion in case of symptoms as mentioned above.


Asunto(s)
Myristica/envenenamiento , Trastornos Relacionados con Sustancias/etiología , Adulto , Femenino , Humanos , Trastornos Relacionados con Sustancias/diagnóstico
17.
J Emerg Med ; 18(4): 405-8, 2000 May.
Artículo en Inglés | MEDLINE | ID: mdl-10802415

RESUMEN

Hemorrhage is a potent stimulus for the release of vasopressin (VP), renin, and adrenocorticotropic hormone (ACTH). The goal of this study was to analyze changes in plasma VP, renin, and ACTH levels during hemorrhagic shock and resuscitation with two different solutions: hypertonic acetate dextran (HAD) and lactated Ringer's (LR) solution. Eight randomized dogs were shocked by removing 37 +/- 9 mL/kg of blood while maintaining the mean arterial pressure (MAP) at 45 +/- 5 mmHg for 1 h. Test solutions were randomized and infused as needed with the hemorrhaged blood to restore the MAP and cardiac index to baseline. Blood samples for hormone analyses were taken in baseline, shock, and resuscitation periods. For each experiment, all hormone levels increased in the postshock period and then returned to baseline values after resuscitation with both solutions. VP and renin levels rapidly returned to baseline values after resuscitation in the LR dogs compared with the HAD dogs (p < 0.05). By contrast, there was no significant difference in ACTH levels between the two solutions. High-volume infusion with LR achieves more rapid restoration than small-volume infusion with HAD for VP and renin levels.


Asunto(s)
Hormona Adrenocorticotrópica/sangre , Dextranos/uso terapéutico , Modelos Animales de Enfermedad , Fluidoterapia/métodos , Soluciones Hipertónicas/uso terapéutico , Soluciones Isotónicas/uso terapéutico , Sustitutos del Plasma/uso terapéutico , Renina/sangre , Resucitación/métodos , Choque Hemorrágico/sangre , Choque Hemorrágico/terapia , Vasopresinas/sangre , Animales , Presión Sanguínea/efectos de los fármacos , Gasto Cardíaco/efectos de los fármacos , Dextranos/farmacología , Perros , Evaluación Preclínica de Medicamentos , Monitoreo de Drogas , Soluciones Hipertónicas/farmacología , Soluciones Isotónicas/farmacología , Sustitutos del Plasma/farmacología , Distribución Aleatoria , Lactato de Ringer
18.
J Int Med Res ; 29(3): 252-5, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11471863

RESUMEN

Pneumonia is a rare but serious complication of varicella in adults. We report a case of a previously healthy 32-year-old man with varicella pneumonia that was complicated by acute respiratory distress syndrome. He was treated successfully with acyclovir and intravenous immunoglobulin in addition to mechanical ventilation. We conclude that intravenous immunoglobulin, in combination with acyclovir, is a safe and probably effective therapy for adult varicella pneumonia that is complicated by acute respiratory distress syndrome.


Asunto(s)
Herpesvirus Humano 3/aislamiento & purificación , Inmunoglobulinas Intravenosas/uso terapéutico , Neumonía Viral/terapia , Síndrome de Dificultad Respiratoria/terapia , Adulto , Humanos , Masculino , Neumonía Viral/complicaciones , Neumonía Viral/virología , Síndrome de Dificultad Respiratoria/complicaciones
19.
Math Model Nat Phenom ; 9(5): 177-193, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-28804225

RESUMEN

Recent advances in high-resolution fluorescence microscopy have enabled the systematic study of morphological changes in large populations of cells induced by chemical and genetic perturbations, facilitating the discovery of signaling pathways underlying diseases and the development of new pharmacological treatments. In these studies, though, due to the complexity of the data, quantification and analysis of morphological features are for the vast majority handled manually, slowing significantly data processing and limiting often the information gained to a descriptive level. Thus, there is an urgent need for developing highly efficient automated analysis and processing tools for fluorescent images. In this paper, we present the application of a method based on the shearlet representation for confocal image analysis of neurons. The shearlet representation is a newly emerged method designed to combine multiscale data analysis with superior directional sensitivity, making this approach particularly effective for the representation of objects defined over a wide range of scales and with highly anisotropic features. Here, we apply the shearlet representation to problems of soma detection of neurons in culture and extraction of geometrical features of neuronal processes in brain tissue, and propose it as a new framework for large-scale fluorescent image analysis of biomedical data.

20.
Mikrobiologiia ; 81(2): 205-13, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22693829

RESUMEN

Five isolates designated as B45, D83A, A206A, A85 and E49 and found to possess a activity were taxonomically classified on the basis of their phylogenetic, phenotypic and chemotaxonomic characteristics. The isolates were determined to be Gram-negative, catalase and oxidase positive, hydrolyzing Tween 80 and 60 but not starch, need 3.5-4 M NaCl for optimal growth and lack of anaerobic growth with arginine or DMSO. All isolates had the highest lipolytic activity at pH 8.5. Lipase and esterase activities increased with salt concentration up to 3-4.5 M NaCl, and decreased at 5 M NaCl. Esterase and lipase showed their maximal activities at 50-55 degrees C and 60-65 degrees C, respectively. The phylogenetic tree constructed by the neighbor-joining method indicated that the strain B45 and A85 were closely related to the members of genera Halovivax and Natrinema, respectively. The closest relative of the strain A206A and D83A were found to be Haloterrigena saccharevitans. The strain E49 displayed a more distant relationship to known strains.


Asunto(s)
Proteínas Arqueales/genética , Halobacteriales/genética , Lipasa/genética , Filogenia , Proteínas Arqueales/metabolismo , Halobacteriales/enzimología , Lipasa/metabolismo , Lipólisis/genética
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