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1.
Neurobiol Dis ; 200: 106645, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39179121

RESUMEN

Nicotinamide riboside (NR), a precursor of nicotinamide adenine dinucleotide (NAD+), has robust cognitive benefits and alleviates neuroinflammation in Alzheimer's Disease (AD) mouse models without decreasing beta-amyloid plaque pathology. Such effects may be mediated by the reactive species interactome (RSI), at the metabolome level. In this study, we employed in vitro and in vivo models of oxidative stress, aging and AD to profile the effects of NR on neuronal survival, RSI, and the whole proteome characterization of cortex and hippocampus. RSI analysis yielded a complex modulation upon NR treatment. We constructed protein co-expression networks and correlated them to NR treatment and all measured reactive species. We observed brain-area specific effects of NR on co-expressed protein modules of oxidative phosphorylation, fatty acid oxidation, and neurotransmitter regulation pathways, which correlated with RSI components. The current study contributes to the understanding of modulation of the metabolome, specifically after NR treatment in AD and how it may play disease-modifying roles.

2.
J Behav Med ; 47(5): 849-863, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38980458

RESUMEN

Research has pointed to myriad cultural and socio-psychological factors associated with HIV testing, such as acculturation, social norms about HIV testing, masculinity, homonegativity, and constructs from the Theory of Planned Behavior. However, the interrelationships of these factors on the intentions of HIV testing among the population of Asian American men remains unknown. A dataset of 425 Asian American men in the U.S., collected online with convenience sampling method during 2020-2021, was analyzed to test a conceptual framework that aimed to fill this gap. Results from a path model with two endogenous variables (homonegativity and HIV testing intention) indicated that perceived social norms about HIV testing, attitude about HIV testing, and perceived HIV risk had directandindirect relationships with the intentions of HIV testing in the study population. However, social norms about HIV testing and perceived HIV risk showed stronger direct effects (standardized estimates = 0.37 and 0.34, respectively, p-value < 0.001). Additionally, we found that the relationships of these factors with HIV testing intention were also mediated by homonegativity. Findings from this study advance our understanding of pathways of associations between a host of cultural and socio-psychological factors with HIV testing intention among an understudied population - Asian American men. Our results will help inform the development of future intervention programs to increase HIV testing in this population.


Asunto(s)
Asiático , Infecciones por VIH , Prueba de VIH , Intención , Humanos , Masculino , Asiático/psicología , Adulto , Infecciones por VIH/psicología , Infecciones por VIH/etnología , Infecciones por VIH/diagnóstico , Persona de Mediana Edad , Normas Sociales , Estados Unidos , Adulto Joven , Conocimientos, Actitudes y Práctica en Salud/etnología , Aculturación
3.
Arch Virol ; 167(10): 2011-2026, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35794492

RESUMEN

We conducted nucleotide and amino acid sequence alignment and phylogenetic analysis of porcine circovirus ORF2 (Cap protein) from 17 PCV2-positive clinical samples from nine different northern Vietnamese provinces (Mar 2018-Nov 2020), four local vaccines, and 77 reference strains. We identified one PCV2a (1/17 = 5.9%), five PCV2b (5/17 = 29.9%), and 11 PCV2d (11/17 = 64.7%) isolates, while only PCV2d was detected in 2020. Timeline analysis indicated an increasing predominance of PCV2d nationwide (2018-2020). With strong nodal support (98% for nucleotides and 74% for amino acids), the phylogenetic tree topology revealed a distinct PCV2h clade including recombinant/intermediate strains and local vaccines. The Cap protein sequences from 11 PCV2d field strains had the 2d-genotype-typical motif 86SNPLSV91 in loop CD, the motif TGID in loop GH-HI, and the motif 230PLNPK234 in loop CT. The PCV2h isolates (and vaccines) had the 86SNPLSV91, SAID, and 230L(N/H)PK234 motifs. Selection pressure analysis indicated positive selection at seven sites: A68N in immunoreactive region (IRR)-A; 119G and 130V in IRR-B; and 167L, T190(A/S), 194D and 202F in IRR-C. We identified PCV2h as the genotype of the recombinant strains, which resulted from intergenotype recombination of PCV2a, PCV2b, and PCV2d. The current data provide new information about the diversity, distribution, and dominance of the PCV2 genotype in Vietnam.


Asunto(s)
Infecciones por Circoviridae , Circovirus , Enfermedades de los Porcinos , Vacunas , Animales , Pueblo Asiatico , Infecciones por Circoviridae/epidemiología , Infecciones por Circoviridae/prevención & control , Infecciones por Circoviridae/veterinaria , Genotipo , Humanos , Filogenia , Porcinos , Enfermedades de los Porcinos/epidemiología , Enfermedades de los Porcinos/prevención & control , Vietnam/epidemiología
4.
Cult Health Sex ; 22(6): 630-645, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31184271

RESUMEN

Global research reveals that gender-role norms have a profound effect on socio- and psycho-sexual expression (e.g. sexual positioning) among gay and bisexual men, which in turn may affect mental health and sexual risks. However, little is known about these factors among gay and bisexual men in Muslim-majority countries such as Tajikistan. Using a combination of in-depth individual interviews and focus-group assessments, this exploratory, qualitative study examined how gender roles might function as a social determinant for the practice of sexual positioning, which in turn may influence intimate partner violence (IPV), sexual risk and relational power. Results suggest that being the 'active' partner in sexual relationships closely aligns with the construct of hegemonic masculinity, affording actives more power in male-male relationships which may in some cases result in IPV directed against 'passives'. Despite this imbalance, passives also hold power in some cases, such as easier access to public resources such as the police and gay and bisexual focused services. Further research should examine gender norms and sexual positioning relative to IPV and sexual risks among Muslim men in Tajikistan.


Asunto(s)
Dominación-Subordinación , Homosexualidad Masculina/psicología , Violencia de Pareja/psicología , Masculinidad , Parejas Sexuales/psicología , Adulto , Víctimas de Crimen/psicología , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Violencia de Pareja/estadística & datos numéricos , Masculino , Conducta Sexual/psicología , Factores Socioeconómicos , Tayikistán
5.
Surg Endosc ; 32(9): 3943-3948, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29523984

RESUMEN

INTRODUCTION: The revised Tokyo Guidelines include criteria for determining the severity of acute cholecystitis with treatment algorithms based on severity. The aim of this study was to investigate the relationship of the revised Tokyo Guidelines severity grade to clinical outcomes of cholecystectomy for acute cholecystitis. METHODS: We identified 66 patients with acute cholecystitis from a prior study of difficult cholecystectomy cases. We examined the relationship between severity grade and multiple variables related to perioperative and postoperative outcomes. RESULTS: A more severe revised Tokyo Guidelines grade was associated with a higher number of complications (p = 0.03) and a higher severity of complications (p = 0.01). Severity grade did not predict operative time, estimated blood loss, intensive care unit admission or length of stay. Compared to planned open cholecystectomy, intended laparoscopic cholecystectomy was associated with significantly fewer total and Clavien-Dindo grade 3 complications, fewer intensive care unit admissions, and shorter length of stay (p values range from 0.03 to < 0.0001). CONCLUSION: In technically difficult operations for acute cholecystitis, the revised Tokyo guidelines severity grade correlates with the number and severity of complications. However, intended performance of laparoscopic cholecystectomy rather than open cholecystectomy in difficult operations predicts broader beneficial outcomes than severity grade.


Asunto(s)
Colecistectomía Laparoscópica , Colecistectomía , Colecistitis Aguda/clasificación , Colecistitis Aguda/cirugía , Índice de Severidad de la Enfermedad , Adulto , Anciano , Anciano de 80 o más Años , Algoritmos , Pérdida de Sangre Quirúrgica , Femenino , Humanos , Unidades de Cuidados Intensivos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Tempo Operativo , Admisión del Paciente/estadística & datos numéricos , Complicaciones Posoperatorias , Estudios Retrospectivos , Adulto Joven
6.
Environ Monit Assess ; 190(2): 67, 2018 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-29308572

RESUMEN

Planktons are a major component of food web structure in aquatic ecosystems. Their distribution and community structure are driven by the combination and interactions between physical, chemical, and biological factors within the environment. In the present study, water quality and the community structure of phytoplankton and zooplankton were monthly investigated from January to December 2015 at 11 sampling sites along the gradient course of the Day River (Red River Delta, northern Vietnam). The study demonstrated that the Day River was eutrophic with the average values of total phosphorus concentration 0.17 mg/L, total nitrogen concentration 1.98 mg/L, and Chl a 54 µg/L. Microscopic plankton analysis showed that phytoplankton comprised 87 species belonging to seven groups in which Chlorophyceae, Bacillariophyceae, and Cyanobacteria accounted for the most important constituents of the river's phytoplankton assemblage. A total 53 zooplankton species belonging to three main groups including Copepoda, Cladocera, and Rotatoria were identified. Plankton biomass values were greatest in rainy season (3002.10-3 cell/L for phytoplankton and 12.573 individuals/m3 for zooplankton). Using principal correspondence and Pearson correlation analyses, it was found that the Day River was divided into three main site groups based on water quality and characteristics of plankton community. Temperature and nutrients (total phosphorus and total nitrogen) are key factors regulating plankton abundance and distribution in the Day River.


Asunto(s)
Monitoreo del Ambiente , Plancton/fisiología , Contaminación del Agua/análisis , Animales , Biomasa , Chlorophyta , Cladóceros , Cianobacterias , Diatomeas , Ecosistema , Cadena Alimentaria , Nitrógeno/análisis , Fósforo/análisis , Fitoplancton/fisiología , Lluvia , Ríos/química , Estaciones del Año , Vietnam , Contaminación del Agua/estadística & datos numéricos , Calidad del Agua , Zooplancton/fisiología
7.
Trop Med Int Health ; 22(9): 1196-1203, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28653418

RESUMEN

OBJECTIVE: To present the findings of the Pan American Health Organization's 2014 survey on syphilis testing policies and practices in the Americas. METHODS: Representatives of national/regional reference and large, lower-level laboratories from 35 member states were invited to participate. A semi-structured, electronically administered questionnaire collected data on syphilis tests, algorithms, equipment/commodities, challenges faced and basic quality assurance (QA) strategies employed (i.e. daily controls, standard operating procedures, technician training, participating in external QA programmes, on-site evaluations). RESULTS: The 69 participating laboratories from 30 (86%) member states included 41 (59%) national/regional reference and 28 (41%) lower-level laboratories. Common syphilis tests conducted were the rapid plasma reagin (RPR) (62% of surveyed laboratories), venereal disease research laboratory (VDRL) (54%), fluorescent treponemal antibody absorption (FTA-ABS) (41%) and Treponema pallidum haemagglutination assay (TPHA) (32%). Only three facilities reported using direct detection methods, and 28 (41% overall, 32% of lower-level facilities) used rapid tests. Most laboratories (62%) used only traditional testing algorithms (non-treponemal screening and treponemal confirmatory testing); however, 12% used only a reverse sequence algorithm (treponemal test first), and 14% employed both algorithms. Another nine (12%) laboratories conducted only one type of serologic test. Although most reference (97%) and lower-level (89%) laboratories used at least one QA strategy, only 16% reported using all five basic strategies. Commonly reported challenges were stock-outs of essential reagents or commodities (46%), limited staff training (73%) and insufficient equipment (39%). CONCLUSIONS: Many reference and clinical laboratories in the Americas face challenges in conducting appropriate syphilis testing and in ensuring quality of testing.


Asunto(s)
Laboratorios , Control de Calidad , Sífilis/diagnóstico , Treponema pallidum , Algoritmos , Américas , Recursos en Salud , Humanos , Técnicas para Inmunoenzimas , Encuestas y Cuestionarios , Sífilis/microbiología , Serodiagnóstico de la Sífilis
8.
Surg Endosc ; 31(6): 2661-2666, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-27752819

RESUMEN

INTRODUCTION: Tobacco smoking is a known risk factor for complications after major surgical procedures. The full effect of tobacco use on these complications has not been studied over large populations for ventral hernia repairs. This effect is more important as the preoperative conditioning, and optimization of patients is adopted. We sought to use the prospectively collected ACS-NSQIP dataset to evaluate respiratory and infectious complications for patients undergoing both laparoscopic and open ventral hernia repairs. METHODS: The ACS-NSQIP dataset was queried for patients who underwent open or laparoscopic ventral hernia repairs, by primary procedure CPT codes, between years 2009-2012. Smoking use was registered as defined by the ACS-NSQIP, as both a current smoker (within the prior 12 months) or as a history of smoking (having ever smoked). Univariate and multivariate analyses were used to investigate postoperative complications for 30-day morbidity and mortality by smoking status while adjusting for preoperative risk factors. RESULTS: The majority of cases were open, 82 %, compared to laparoscopic 18 %. Sex was evenly distributed with 58 % female and 42 % male; however, there was a difference in the distribution of current smokers (p = 0.03). On analysis there were significantly more respiratory complications (p = 0.0003) and infectious complications (p < 0.0001). When controlling for sex, age, and type of surgery, using logistic regression, there were associations between smoking in the prior 12 months and respiratory complications, including pneumonia (p < 0.0001), and re-intubation (p < 0.0001). Similar associations were seen on logistic regression if a patient ever smoked; including pneumonia (p < 0.0001), re-intubation (p < 0.0001), and failure to wean (p < 0.0001). CONCLUSION: Smoking tobacco, both current and historical use, leads to an increase in both respiratory and infectious complications. As more centers try to preoperatively condition patients for elective hernia repairs, it is important to note that patients may never return to the baseline outcomes of patients who never smoked.


Asunto(s)
Hernia Ventral/cirugía , Herniorrafia/métodos , Neumonía/epidemiología , Complicaciones Posoperatorias/epidemiología , Fumar/epidemiología , Adulto , Angina de Pecho/epidemiología , Comorbilidad , Bases de Datos Factuales , Diabetes Mellitus/epidemiología , Femenino , Hernia Ventral/epidemiología , Humanos , Hipertensión/epidemiología , Laparoscopía/métodos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Enfermedades Vasculares Periféricas/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Factores de Riesgo , Infección de la Herida Quirúrgica/epidemiología , Fumar Tabaco , Estados Unidos/epidemiología
9.
Surg Endosc ; 31(2): 917-921, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-27351659

RESUMEN

BACKGROUND: As the effort to reduce postoperative morbidity and mortality continues, the search for modifiable patient risk factors to reduce complications is ongoing. Tobacco use is associated with impaired wound healing, but its effect on inguinal hernia repair has not been studied in a large population. An ACS-NSQIP dataset was used to evaluate the effect of tobacco use on outcomes of inguinal hernia repairs. METHODS: The ACS-NSQIP dataset was queried for patients who underwent open or laparoscopic inguinal hernia repairs, by primary procedure CPT codes, between years 2009-2012. Tobacco use was registered, as defined by the ACS-NSQIP, in two ways: current smoking (within the past 12 months), or history of smoking (having ever smoked). Univariate and multivariate analyses were used to investigate outcome variables for 30-day morbidity by type of smoking status, while adjusting for preoperative risk factors. RESULTS: During the study period, 90,162 patients underwent inguinal hernia repair. 76 % of the cases were open compared to 24 % laparoscopic. The population was overwhelmingly male, 91 %, compared to 9 % female. The average age of patients was 42.5 years. Of the available data (69 % of patients), 38.5 % had a history of smoking. 18 % had smoked within the 12 months prior to surgery (current smokers). Their average number of pack years was 27.2 (SD 24.0) compared to 4.5 pack years (SD 14.7) for those who had not smoked 12 months prior to surgery (historical smokers). Using Fisher's exact test, having ever smoked was found to be significantly associated with pneumonia (p = 0.0008) and return to the operating room (p = 0.010). This relationship held when preoperative variables were controlled for using logistic regression (pneumonia, p = 0.002; return to the operating room, p = 0.002). When preoperative variables were controlled for and logistic regression was performed for current smokers, there was also a significant association with pneumonia (p = 0.005) and return to the operating room (p = 0.01). CONCLUSION: Current smoking status is a modifiable risk of patients undergoing laparoscopic and open inguinal hernia repair. Failure to quit smoking prior to surgical repair is associated with complications like pneumonia and return to the operating room.


Asunto(s)
Hernia Inguinal/cirugía , Herniorrafia , Complicaciones Posoperatorias/epidemiología , Fumar , Adulto , Factores de Edad , Bases de Datos Factuales , Femenino , Herniorrafia/métodos , Humanos , Laparoscopía/métodos , Modelos Logísticos , Masculino , Neumonía/epidemiología , Reoperación , Factores de Riesgo , Factores Sexuales , Resultado del Tratamiento , Estados Unidos/epidemiología
10.
Clin Transplant ; 30(5): 641-8, 2016 05.
Artículo en Inglés | MEDLINE | ID: mdl-27000519

RESUMEN

Ensuring fair and equitable allocation of donor hearts in the US is the charge of the Organ Procurement and Transplantation Network (OPTN). However, the recent increase of candidates waiting without a corresponding increase in available donors, higher waitlist mortality rates in higher status patients, the presence of disadvantaged subgroups, and the changing management of heart failure patients with increased VAD usage, has necessitated review of allocation policy. Therefore, the Heart Subcommittee of the OPTN/UNOS Thoracic Committee is exploring a further-tiered allocation system, devising a "straw man" model as a starting point for modeling analyses and public discussion. On May 4, 2015, an American Society of Transplantation (AST)-endorsed forum to discuss these potential proposed changes took place. Attendees included 41 people, mostly highly experienced transplant cardiologists and cardiothoracic surgeons, representing 19 heart transplant centers across the US, UNOS, and the Scientific Registry of Transplant Recipients (SRTR). There was unanimous agreement that the potential proposed policy will require careful wording to avoid ambiguity and "gaming" of the system, and strong support for abolishment of local organ sharing in favor of geographic sharing. However, contention existed concerning the appropriate prioritization levels of ECMO, temporary VAD/TAH patients as well as the 30-day LVAD listing.


Asunto(s)
Asignación de Recursos para la Atención de Salud , Cardiopatías/cirugía , Trasplante de Corazón , Asignación de Recursos , Obtención de Tejidos y Órganos , Congresos como Asunto , Donación Directa de Tejido , Humanos , Estados Unidos , Listas de Espera
11.
Surg Endosc ; 30(8): 3345-50, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-26541721

RESUMEN

INTRODUCTION: Since the widespread adoption of laparoscopic techniques in biliary surgery, the incidence of bile duct injures (BDI) has not significantly declined despite increased operative experience and recognition of the critical view of safety (CVS) method for anatomic identification. We hypothesized that operative approaches in clinical practice may vary from well-described technical recommendations. The objective of this study was to access how practicing surgeons commonly identify anatomy during laparoscopic cholecystectomy (LC). METHODS: We performed a cohort study assessing practices in biliary surgery among current practicing surgeons. Surgeons belonging to the Midwest Surgical Association and the Society of American Gastrointestinal and Endoscopic Surgeons were surveyed. Items surveyed include preferred methods for cystic duct identification, recognition of the CVS, and use of intraoperative imaging. RESULTS: In total, 374 of 849 surgeons responded. The CVS was not correctly identified by 75 % of surgeons descriptively and by 21 % of surgeons visually. 56 % of surgeons practiced the infundibular method for identification of the cystic duct; 27 % practiced the CVS method. Intraoperative cholangiography was used by 16 % and laparoscopic ultrasound by <1 %. CONCLUSION: A majority of surgeons preferably do not use the CVS method of identification during LC. A large percentage of practicing surgeons are unable to describe or visually identify the CVS. These results suggest an urgent need to reexamine the tenets of how LC is being taught and disseminated and present a clear target for improvement to reduce BDI.


Asunto(s)
Colecistectomía Laparoscópica/métodos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Adulto , Colangiografía/estadística & datos numéricos , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Ultrasonografía Intervencional/estadística & datos numéricos , Estados Unidos
12.
J Surg Res ; 196(2): 209-15, 2015 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-25868779

RESUMEN

BACKGROUND: Residency applicants commonly complete visiting student electives (VSEs) hoping to increase their odds of matching at host institutions. Existing evidence on Match outcomes for applicants who complete VSEs is limited. As VSEs involve monetary and opportunity costs to students and administrators, data on their utility are vital for student well-being, preparedness for residency, and, ultimately, success in the Match. We investigated the utilization and impact of VSEs for all applicants. We hypothesized that completion of VSEs would increase the likelihood of matching at a host institution. MATERIALS AND METHODS: A retrospective review was conducted of academic records and National Resident Matching Program outcomes for the graduates of one institution and visiting students to that institution over the course of 7 y. RESULTS: Utilization of VSEs varied significantly among specialties. Across all specialties and in general surgery, applicants were more likely to match into host programs than others. The size of the effect of VSEs on outcomes varied by specialty. Host programs were applicants' top choice for residency in 48% of cases. CONCLUSIONS: Completion of VSEs may give surgical applicants increased control over Match outcomes. Our findings may assist future students in strategic decision making when determining whether and where to use VSEs.


Asunto(s)
Cirugía General/estadística & datos numéricos , Internado y Residencia/estadística & datos numéricos , Femenino , Humanos , Solicitud de Empleo , Masculino
13.
Surg Endosc ; 29(5): 1099-104, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25249146

RESUMEN

BACKGROUND: Numerous prospective studies and randomized controlled trials have demonstrated shorter length of stay, lower morbidity rates, and similar recurrence rates with laparoscopic ventral hernia repair (VHR) when compared to open VHR. Despite these promising results, previous data showed low utilization of laparoscopic VHR. The aim of our study was to evaluate the utilization of laparoscopic VHR using the most updated information from the American College of Surgeons-National Surgical Quality Improvement Project (NSQIP) dataset. The secondary aim was to evaluate the outcomes from NSQIP for patients undergoing open versus laparoscopic VHR for the outcome of 30-day mortality and the peri-operative morbidities listed in the NSQIP dataset. METHODS: We performed this study using 2009-2012 data from the ACS-NSQIP database. The study population included patients who had undergone an open or laparoscopic ventral hernia repair as their primary procedure based on CPT codes. Demographic characteristics, overall morbidity, and complications were compared using Chi-square tests for categorical variables and two-sided t tests for continuous variables. Secondary outcomes (mortality and any complications) were further analyzed using logistic regression. RESULTS: Utilization of laparoscopic VHR was 22%. While adjusted mortality was similar, overall morbidity was increased in the open VHR group (OR 1.63; CI 95% 1.38-1.92). The open group had a higher rate of return to the OR, pneumonia, re-intubation, ventilator requirement, renal failure/insufficiency, transfusion, DVT, sepsis, and superficial and deep incisional wound infections. CONCLUSIONS: The utilization of laparoscopic VHR remained low from 2009 to 2012 and continued to lag behind the use of laparoscopy in other complex surgical procedures. The mortality rate between laparoscopic and open VHR was similar, but laparoscopic repair was associated with lower overall complication rates.


Asunto(s)
Hernia Ventral/cirugía , Herniorrafia/métodos , Laparoscopía/estadística & datos numéricos , Mejoramiento de la Calidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Recurrencia , Cicatrización de Heridas
14.
Surg Endosc ; 29(9): 2496-9, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25492451

RESUMEN

INTRODUCTION: To date, no study has compared laparoscopy (LB) to percutaneous (PB) biopsy for the diagnosis of abdominal lymphoma. The objective of this study is to compare the success rate and safety profile of laparoscopic lymph node biopsy to the percutaneous approach in patients with intra-abdominal lymphadenopathy concerning for lymphoma. MATERIALS AND METHODS: We performed a multi-institution, retrospective review of patients undergoing lymph node biopsy for suspected intra-abdominal lymphoma between 2005 and 2013. Our primary outcome was adequate tissue yield between the two techniques, both for histologic diagnosis and for ancillary studies such as flow cytometry. Secondary outcomes included 30-day morbidity, 30-day readmission rates, the need for additional lymph node biopsy procedures, and length of stay. RESULTS: All 34 of the LB patients had adequate specimen for histologic diagnosis compared to 92.3% of patients with a PB (p = 0.18). Significantly more patients in the LB group had sufficient tissue for ancillary studies when needed than in the PB group, 95.5 and 68.2%, respectively (p = 0.04). A second biopsy was pursued in 23.1% of failed PB patients, 0% with success on second attempt. DISCUSSION: When index of suspicion is high or when biopsy is performed for patient previously diagnosed with lymphoma and recurrence/transformation is suspected, LB safely and consistently provides adequate tissue for initial diagnosis and for ancillary studies. In contrast, image-guided PB may be more appropriate for patients for whom ancillary studies are unlikely to add to planned treatments or when there is a high risk of complications from either general anesthesia or patient comorbidities.


Asunto(s)
Neoplasias Abdominales/diagnóstico , Biopsia Guiada por Imagen/métodos , Laparoscopía/métodos , Linfoma/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
15.
Clin Transplant ; 28(7): 802-7, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24801014

RESUMEN

BACKGROUND: To expand the donor pool, older donors (≥50 yr) are frequently used in older recipients (≥60 yr). Older recipients and those receiving older donor hearts have independently displayed decreased post-transplant survival. However, outcomes in older patients receiving older donor hearts are contentious. METHODS: Eight hundred and seventy-nine heart transplant patients between 2000 and 2010 were analyzed, excluding patients with donor coronary artery disease. From 380 patients ≥60 yr, 327 patients with donors <50 yr old were compared with 53 patients with donors ≥50 yr old for: five-yr actuarial survival, freedom from cardiac allograft vasculopathy (CAV: stenosis ≥30%), non-fatal major adverse cardiac events (NF-MACE: MI, CHF, stroke, need for pacemaker/ICD), one-yr freedom from any treated rejection. RESULTS: The older vs. younger donor group demonstrated significantly lower five-yr survival (57% vs. 85%, p < 0.001) and freedom from CAV (83% vs. 92%, p = 0.03). No difference was observed in five-yr freedom from NF-MACE and one-yr freedom from any treated rejection. Multivariate analysis found donor age ≥50 to be an independent risk factor for death (HR 1.8, CI 1.1-2.9, p = 0.008) and CAV (HR 1.9, CI 1.2-2.9, p = 0.004). CONCLUSIONS: Use of older donors (≥50 yr) in older recipients (≥60 yr) results in lower five-yr survival and freedom from CAV. Caution is required in these cases. Larger studies are warranted to confirm findings.


Asunto(s)
Rechazo de Injerto , Supervivencia de Injerto , Cardiopatías/cirugía , Trasplante de Corazón , Complicaciones Posoperatorias , Donantes de Tejidos , Factores de Edad , Anciano , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Factores de Riesgo , Tasa de Supervivencia , Factores de Tiempo
16.
Surg Endosc ; 28(5): 1648-52, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24442677

RESUMEN

OBJECTIVES: Surgeon case volume has been utilized in the credentialing process as a surrogate for surgeon skill. The purpose of this study was to compare objective outcome measures of laparoscopic partial colectomies performed by laparoscopically skilled surgeons with varying annual case census. METHODS: We performed a retrospective cohort review of all patients (n = 255) undergoing elective laparoscopic partial colectomy. Patients were grouped according to surgeon's annual case volume as low annual case volume (LV; n = 48) and high annual case volume (HV; n = 207). HV is defined as performing >20 total cases and >25 cases per year. All demographic and clinical variables were evaluated with univariate logistic regression followed by a multivariate logistic regression model for variables approaching significance. RESULTS: Demographic variables were found to be similar between groups. Only median estimated blood loss (100 vs. 150 mL for HV; p = 0.040) was found to be significantly different between groups. However, this was clinically insignificant, as it did not lead to an increased rate of blood transfusions (0.0 vs. 3.9 % for HV surgeons; p = 0.184). All other variables were similar in both univariate and multivariate logistic regression models. CONCLUSIONS: Among surgeons with advanced laparoscopic training, the data suggest that LV surgeons are able to achieve similar outcomes as those who perform the operation routinely. Annual case volume should not be given undue emphasis when deciding whether to award privileges for laparoscopic partial colectomy.


Asunto(s)
Colectomía/métodos , Habilitación Profesional , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Laparoscopía/estadística & datos numéricos , Médicos/estadística & datos numéricos , Colectomía/estadística & datos numéricos , Enfermedades del Colon/cirugía , Femenino , Estudios de Seguimiento , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
17.
Urologia ; 91(1): 42-48, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37916769

RESUMEN

OBJECTIVES: The aim of this study is to analyze the compositions of urinary stones and investigate their distributions in different ages, genders, seasons, and clinical features of Northern Vietnamese patients. METHODS: A total of 231 patients with urinary stones from Northern Vietnam were collected and analyzed composition from 1/2021-12/2022. For all patients, age, sex, stone location, stone side, urine pH, and hospitalized date (month) were collected. RESULTS: Kidney stones are more frequently found in men than women with the male: female urinary stones ratio in this study being 1.96:1. The highest stone prevalence appeared between 60 and 69 years old. The most common stone composition was calcium oxalate, followed by calcium phosphate, uric acid, struvite, and cysteine. Mix stones of CaOx and CaP were more prevalent than pure stones. Males submitted more CaOx, CaP, and UA stones, whereas females were susceptible to infectious stones. Stones were more frequently found on the left side of the upper urinary tract (51.9%) than on the right side (27.3%) and lower urinary tract (7.8%). Cultural tendency leads to a smaller number of stones during the Lunar new year (February), and Ghost month (August).


Asunto(s)
Cálculos Renales , Cálculos Urinarios , Sistema Urinario , Urolitiasis , Humanos , Femenino , Masculino , Persona de Mediana Edad , Anciano , Vietnam , Oxalato de Calcio , Estaciones del Año , Cálculos Renales/química
18.
Chemosphere ; 350: 141069, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38160949

RESUMEN

Deodorization and, in a broader sense, the removal of volatile organic compounds (VOCs) from plastic waste have become increasingly important in the field of plastic recycling, and various new decontamination techniques have been developed. Both in research and industrial practice, the selection of VOCs has been random or unsubstantiated, making it difficult to compare studies and assess decontamination processes objectively. Thus, this study proposes the use of Statistical Molecular Design (SMD) and Quantitative Structure - Activity Relationship (QSAR) as chemometric tools for the selection of representative VOCs, based on physicochemical properties. Various algorithms are used for SMD; hence, several frequently used D-Optimal Onion Design (DOOD) and Space-Filling (SF) algorithms were assessed. Hereby, it was validated that DOOD, by dividing the layers based on the equal-distance approach without so-called 'Adjacent Layer Bias', results in the most representative selection of VOCs. QSAR models that describe VOC removal by water-based washing of plastic waste as a function of molecular weight, polarizability, dipole moment and Hansen Solubility Parameters Distance were successfully established. An adjusted-R2 value of 0.77 ± 0.09 and a mean absolute error of 24.5 ± 4 % was obtained. Consequently, by measuring a representative selection of VOCs compiled using SMD, the removal of other unanalyzed VOCs was predicted on the basis of the QSAR. Another advantage of the proposed chemometric selection procedure is its flexibility. SMD allows to extend or modify the considered dataset according to the available analytical techniques, and to adjust the considered physicochemical properties according to the intended process.


Asunto(s)
Compuestos Orgánicos Volátiles , Relación Estructura-Actividad Cuantitativa , Quimiometría
19.
Front Physiol ; 14: 1207280, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37405135

RESUMEN

Alzheimer's disease (AD) and Parkinson's disease (PD) represent the most prevalent neurodegenerative disorders severely impacting life expectancy and quality of life of millions of people worldwide. AD and PD exhibit both a very distinct pathophysiological disease pattern. Intriguingly, recent researches, however, implicate that overlapping mechanisms may underlie AD and PD. In AD and PD, novel cell death mechanisms, encompassing parthanatos, netosis, lysosome-dependent cell death, senescence and ferroptosis, apparently rely on the production of reactive oxygen species, and seem to be modulated by the well-known, "old" second messenger cAMP. Signaling of cAMP via PKA and Epac promotes parthanatos and induces lysosomal cell death, while signaling of cAMP via PKA inhibits netosis and cellular senescence. Additionally, PKA protects against ferroptosis, whereas Epac1 promotes ferroptosis. Here we review the most recent insights into the overlapping mechanisms between AD and PD, with a special focus on cAMP signaling and the pharmacology of cAMP signaling pathways.

20.
Trends Pharmacol Sci ; 44(12): 917-933, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37783643

RESUMEN

Exposure to environmental pollutants contributes to diverse pathologies, including pulmonary disease, lower respiratory infections, cancer, and stroke. Pollutants' entry can occur through inhalation, traversing endothelial and epithelial barriers, and crossing the blood-brain barrier, leading to a wide distribution throughout the human body via systemic circulation. Pollutants cause cellular damage by multiple mechanisms encompassing oxidative stress, mitochondrial dysfunction, (neuro)inflammation, and protein instability/proteotoxicity. Sensing pollutants has added a new dimension to disease progression and drug failure. Understanding the molecular pathways and potential receptor binding/signaling that underpin 'sensing' could contribute to ways to combat the detrimental effects of pollutants. We highlight key points of pollutant signaling, crosstalk with receptors acting as drug targets for chronic diseases, and discuss the potential for future therapeutics.


Asunto(s)
Contaminantes Ambientales , Humanos , Contaminantes Ambientales/toxicidad , Inflamación , Estrés Oxidativo
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