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1.
Int Wound J ; 21(1): e14334, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37555290

RESUMEN

Optimal management of burns begins with first aid from the first hours of injury. Adequate knowledge of how to perform first aid for burns can reduce the consequences of injury. Therefore, this study aims to determine the knowledge, attitude, and sources of information assessment towards burn First aid among people referred to a burn centre in the north of Iran. A questionnaire-based survey was conducted to assess knowledge, attitude, and sources of information towards burn first aid among people referred to a burn centre in the north of Iran in 2023. In this survey, a convenience sampling method was adopted. The variables consisted of four items on socio-demographic information, 15 items on knowledge, ten items on attitude, and one item on sources of information related to burn First aid. A total of 371 individuals responded to the survey. The mean age of participants was 31.90 ± 8.49 years old. The mean score of the total knowledge of the participants in the research was 6.04 ± 3.05. There was a statistically significant relationship between the variables of age, sex, marital status, place of residence, level of education, and history of receiving first aid training with the participants' knowledge level. The average score of the total attitude of the participants was 44.08 ± 3.88. Out of 371 participants, 214 people (57.7%) had an average attitude, and 157 people (42.3%) had a good attitude towards burn first aid. There was a statistically significant relationship between place of residence, level of education, and history of receiving first aid training with the participants' attitudes in the research. In addition, the level of knowledge had a statistically significant relationship with the participants' attitude level in the research (p-value <0.001). The majority of participants have limited knowledge of burn first aid. This lack of knowledge could lead to severe consequences. Therefore, healthcare organizations should review and promote consistent guidelines for burn first aid to tackle and minimize the effect of this grave injury.


Asunto(s)
Quemaduras , Primeros Auxilios , Humanos , Adulto Joven , Adulto , Primeros Auxilios/métodos , Conocimientos, Actitudes y Práctica en Salud , Unidades de Quemados , Irán , Quemaduras/terapia , Fuentes de Información
2.
Int Wound J ; 21(3): e14786, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38385765

RESUMEN

In the ongoing challenge to reduce burn-associated mortality rates, this study explores the predictive capacity of clinical factors in burn patients, focusing on vitamin D, calcium, and serum albumin levels during hospitalisation in cases with Pseudomonas aeruginosa infection. Our research involves a comprehensive analysis of 100 burn patients, encompassing crucial clinical parameters such as the burn severity index, serum albumin, vitamin D, and calcium levels at admission. Data were meticulously entered into IBM Statistics SPSS software version 28 and subjected to statistical analysis. The study reveals an average patient age of 39.75 years and a notable 34% mortality rate. Additionally, the average lengths of hospital and intensive care unit (ICU) stays are determined to be 11.33 and 7.79 days, respectively. Significantly, a correlation between calcium and albumin variables and treatment outcomes is established, showcasing their potential to predict variable changes in patient mortality rates. Furthermore, a noteworthy association is observed between serum calcium levels and the duration of ICU hospitalisation. In conclusion, albumin and calcium variables emerge as sensitive and specific indicators for predicting outcomes in burn patients. Importantly, the independence of these factors from the physician's experience and diagnosis reduces human error and thus increases the accuracy of mortality prediction in this patient population.


Asunto(s)
Quemaduras , Infecciones por Pseudomonas , Humanos , Adulto , Albúmina Sérica , Calcio , Infecciones por Pseudomonas/diagnóstico , Vitamina D , Quemaduras/terapia
3.
Int Wound J ; 21(2): e14641, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38379253

RESUMEN

Evaluating complications and mortality risks in burn patients is crucial for effective treatment planning and improving survival rates. This study investigated the relationship between the serum vitamin D level and the clinical outcomes of adult burns patients. This was a prospective cohort of adult patients hospitalized due to thermal burns at a burn centre in the north of Iran. Based on the level of 25 hydroxyvitamin D measured upon admission, patients were divided into two groups of patients with sufficient 25 hydroxyvitamin D level and insufficient 25 hydroxyvitamin D level. Descriptive statistics were used for baseline demographics. Univariate analysis was conducted using Mann-Whitney U, Chi-square, independent samples, and Fisher's exact tests. A multivariate logistic regression was performed to adjust for the effects of confounding variables. Statistical analyses were conducted using SPSS 28.0 software. A total of 220 patients were included in the study. The average total body surface area burned was 30.52 ± 9.34. Patients with insufficient vitamin D levels had longer hospital stays (12.53 vs. 11.45) and longer stays in the intensive care unit (ICU) (3.32 vs. 2.40) than those with appropriate vitamin D levels. Participants with insufficient vitamin D levels exhibited a numerically higher incidence of infections than those with adequate levels (p < 0.05). The multivariate regression found that vitamin D deficiency levels were associated with increased infection rates and prolonged hospital stay. This study suggests that vitamin D deficiency is a significant risk factor for adverse clinical outcomes in burn patients. Further research is needed to confirm these associations and to explore potential interventions to optimize vitamin D status in this patient population.


Asunto(s)
Quemaduras , Deficiencia de Vitamina D , Adulto , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Vitamina D/uso terapéutico , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/complicaciones , Quemaduras/epidemiología
4.
Int Wound J ; 20(10): 4112-4121, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37455022

RESUMEN

The present study investigated the antimicrobial and anti-biofilm effects of indigenous Lactobacillus probiotic strains on Pseudomonas aeruginosa isolated from burn wound infection in laboratory conditions. The effect of 7 probiotic strains isolated from infant faeces on the pathogenicity factors of P. aeruginosa, including protease, elastase, antibiofilm and antipyocyanin was measured. Also, diffusion methods in the well and micro broth dilution were used to evaluate the antimicrobial activity of probiotics. All tests were performed in triplicate. A negative control and a positive control were used for each test. SPSS version 22 software was used for statistical analysis, and a p < 0.05 was considered statistically significant. A total of 30 clinical isolates of P. aeruginosa were isolated. The elastolytic activity of P. aeruginosa isolates decreased after adding Cell free supernatant (CFS) of each Lactobacillus. L1, L4, L5, and L6 strains had a 100% inhibitory effect on pathogen isolates. L3 and L7 strains had the lowest inhibitory effect. The inhibitory effect of CFS extracted from lactobacilli on protease production by P. aeruginosa. L1, L4, L5, and L6 strains had an inhibitory effect on all tested isolates. L2, L3, and L7 strains had a less inhibitory effect. L4 strain had the highest inhibitory effect on pyocyanin production by P. aeruginosa (50%), followed by L5 (43.3%), L1 (40%), and L6 (23.3%) strains. L3 and L7 strains had no inhibitory effect on the pyocyanin production of P. aeruginosa isolates. It was found that the CFS of 4 isolates (L1, L4, L5, and L6) was the most active extract and had a 100% inhibitory effect against biofilm formation of all P. aeruginosa strains. The L3 strain had the least inhibitory effect against the biofilm formation of pathogens. Overall, this study showed that probiotics could be promising alternatives to combat the pathogenicity of P. aeruginosa in burn wounds.


Asunto(s)
Antiinfecciosos , Quemaduras , Infecciones por Pseudomonas , Humanos , Lactobacillus , Pseudomonas aeruginosa , Piocianina/farmacología , Antiinfecciosos/farmacología , Biopelículas , Péptido Hidrolasas , Quemaduras/terapia , Infecciones por Pseudomonas/tratamiento farmacológico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico
5.
Int Wound J ; 20(9): 3523-3530, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37160373

RESUMEN

Burn injuries in children are distressing physical and emotional events with long-term disability. However, there is little research on the epidemiology of paediatric burns. This information is essential for the development of prevention intervention and acute management. This study aimed to describe epidemiologic characteristics and clinical outcomes of paediatric burns in a burn center in the north of Iran. A retrospective, single-center study was conducted of children (<18 years) admitted to the burns center between 2011 and 2021. The data were analysed by SPSS 24.0 software. The chi-squared test and Fisher's exact test were used to assess categorical variables, and Student's t-tests or One-Way ANOVA was used to evaluate continuous variables. 2951 paediatric burns with mean age 5.30 ± 5.27 years, were admitted during the 11 years, with 1777 boys (60.2%) and 1174 girls (39.8%). By age groups, the majority of children (59.7%) were between 0 and 4 years old, followed by 5 to 8 years (15.7%), 13 to 18 years (14.6%), and 9 to 12 years (10.0%), respectively. The most cause of injury was Hot liquids & vapours (1604, 54.4%). The mean age for burns with fire & flames, hot liquids & vapours, contact, chemical, and electrical was 4.46 ± 4.84, 5.70 ± 5.39, 5.44 ± 5.42, 3.93 ± 3.86, and 3.53 ± 4.06 years, respectively. The total body surface area (TBSA) burned was 14.96 ± 11.94. The longest length of stay (LOS) related to fire and flame was 5.63 ± 7.57 days. The mortality rate was 1.56%. There were significant differences among aetiology groups for the cost per % TBSA (F = 15.784, P < 0.001), which correlated with the burn depth, TBSA, aetiology, LOS, and age. The Ministry of Health should establish strategies for burn prevention and incorporate data surveillance for burn injuries. Community education on kitchen and cooking safety could positively impact the prevalence and outcomes of paediatric burns.


Asunto(s)
Unidades de Quemados , Hospitalización , Masculino , Femenino , Niño , Humanos , Recién Nacido , Lactante , Preescolar , Persona de Mediana Edad , Estudios Retrospectivos , Irán/epidemiología , Tiempo de Internación
6.
Int Wound J ; 20(7): 2788-2794, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36931904

RESUMEN

The etiology and outcomes of chemical burns vary worldwide, influenced by the local population structure, industry distribution, and geographical and social environments. The aim of this study was to evaluate the epidemiology of chemical burns among patients referred to a burn centre in the north of Iran. A single-centre, retrospective study was conducted on patients with chemical burns between 2011 and 2021. Data collection was carried out using the hospital information system (HIS), and data collected from medical records included gender, age, marital status, occupations, burn season, place of residence, intention to burn, location of the accident, percent of total body surface area (%TBSA), the primary cause of burns, the body region of the burn, length of hospital stay (days), infection, and discharge status. The data were analysed using descriptive statistical methods and SPSS 24.0 software. Of the 10 133 burn patients treated in a burn centre in the north of Iran between 2011 and 2021, 1.2% had chemical burns. The average age of patients was 34.45 (SD = 22.16) years, and most chemical burns cases were male (70.6%, n = 89). Chemical burns occurred most frequently in patients aged 20 to 49 years (69.8%, n = 107), and most of the burns were accidental (84.9%, n = 107). The home was the most common place of chemical burn injury, accounting for 49.2% (62 cases), followed by the workplace (43.7%, n = 55), respectively. Most chemical burns occurred in the summer season (36.5%, n = 46), and acid (74.6%, n = 94) was the most common cause of chemical burns. The mean TBSA was 16.41 (SD = 15.10). The most common burn area was the lower limb (34.9%, n = 44), and the overall mortality rate was 4.8%. The average length of stay in the hospital was 6.53 (SD = 5.57) days. Community education on household safety, restricting non-specialists' access to chemical substances, and the promotion of early consultation could reduce chemical burn prevalence and improve outcomes.


Asunto(s)
Quemaduras Químicas , Humanos , Masculino , Adulto , Femenino , Estudios Retrospectivos , Quemaduras Químicas/epidemiología , Quemaduras Químicas/etiología , Unidades de Quemados , Irán/epidemiología , Tiempo de Internación , Derivación y Consulta
7.
J Neurochem ; 160(2): 154-171, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34738241

RESUMEN

αO-Conotoxin GeXIVA is a 28 amino acid peptide derived from the venom of the marine snail Conus generalis. The presence of four cysteine residues in the structure of GeXIVA allows it to have three different disulfide isomers, that is, the globular, ribbon or bead isomer. All three isomers are active at α9α10 nicotinic acetylcholine receptors, with the bead isomer, GeXIVA[1,2], being the most potent and exhibiting analgesic activity in animal models of neuropathic pain. The original report of GeXIVA activity failed to observe any effect of the isomers on high voltage-activated (HVA) calcium channel currents in rat dorsal root ganglion (DRG) neurons. In this study, we report, for the first time, the activity of globular GeXIVA[1,3] at G protein-coupled GABAB receptors (GABAB R) inhibiting HVA N-type calcium (Cav2.2) channels and reducing membrane excitability in mouse DRG neurons. The inhibition of HVA Ba2+ currents and neuroexcitability by GeXIVA[1,3] was partially reversed by the selective GABAB R antagonist CGP 55845. In transfected HEK293T cells co-expressing human GABAB R1 and R2 subunits and Cav2.2 channels, both GeXIVA[1,3] and GeXIVA[1,4] inhibited depolarization-activated Ba2+ currents mediated by Cav2.2 channels, whereas GeXIVA[1,2] had no effect. The effects of three cyclized GeXIVA[1,4] ribbon isomers were also tested, with cGeXIVA GAG being the most potent at human GABAB R-coupled Cav2.2 channels. Interestingly, globular GeXIVA[1,3] also reversibly potentiated inwardly-rectifying K+ currents mediated by human GIRK1/2 channels co-expressed with GABAB R in HEK293T cells. This study highlights GABAB R as a potentially important receptor target for the activity of αO-conotoxin GeXIVA to mediate analgesia.


Asunto(s)
Canales de Calcio Tipo N/efectos de los fármacos , Conotoxinas/farmacología , Canales de Potasio Rectificados Internamente Asociados a la Proteína G/efectos de los fármacos , Neuronas/efectos de los fármacos , Receptores de GABA-B/efectos de los fármacos , Analgésicos no Narcóticos/química , Analgésicos no Narcóticos/farmacología , Animales , Canales de Calcio Tipo N/metabolismo , Conotoxinas/química , Canales de Potasio Rectificados Internamente Asociados a la Proteína G/metabolismo , Ganglios Espinales/efectos de los fármacos , Células HEK293 , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Isoformas de Proteínas , Receptores de GABA-B/metabolismo
8.
Int J Gynecol Cancer ; 32(1): 55-61, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-32571889

RESUMEN

OBJECTIVES: Patients with gynecologic malignancies have high rates of post-operative venous thromboembolism. Currently, there is no consensus for peri-operative thromboprophylaxis specific to gynecologic oncology. We aimed to compare rates of symptomatic pulmonary embolus within 30 days post-operatively, and to identify risk factors for pulmonary embolus. METHODS: The Division of Gynecologic Oncology at Sunnybrook Health Sciences Centre implemented dual thromboprophylaxis for laparotomies in December 2017. We conducted a prospective study of laparotomies for gynecologic malignancies from December 2017 to October 2018, with comparison to historical cohort from January 2016 to November 2017 using the institutional National Surgical Quality Improvement Program database (NSQIP). Pre-intervention, patients received low molecular weight heparin during admission and extended 28-day prophylaxis was continued at the surgeon's discretion. Post-intervention, all patients received both mechanical thromboprophylaxis with sequential compression devices during admission and 28-day prophylaxis with low molecular weight heparin. RESULTS: There were 371 and 163 laparotomies pre- and post-intervention, respectively. Patient characteristics (age, body mass index, diabetes, smoking, tumor stage), rate of malignant cases, operative blood loss and duration, and length of stay were similar between groups. After implementation, pulmonary emboli rates decreased from 5.1% to 0% (p=0.001). There were more cytoreductive procedures pre-intervention (p≤0.0001) but surgical complexity scores were similar (p=0.82). Univariate analysis revealed that surgery pre-intervention (OR 4.25, 95% CI 1.04 to 17.43, p=0.04), length of stay ≥5 days (OR 11.94, 95% CI 2.65 to 53.92, p=0.002), and operative blood loss ≥500 mL (OR 2.85, 95% CI 1.05 to 7.8, p=0.04) increased risk of pulmonary embolus. On multivariable analysis, surgery pre-intervention remained associated with more pulmonary emboli (OR 4.16, 95% CI 1.03 to 16.79, p=0.045), when adjusting for operative blood loss. CONCLUSION: Dual thromboprophylaxis after laparotomy significantly reduced rates of pulmonary embolus in this high-risk patient population.


Asunto(s)
Anticoagulantes/administración & dosificación , Neoplasias de los Genitales Femeninos/cirugía , Heparina de Bajo-Peso-Molecular/administración & dosificación , Laparotomía/efectos adversos , Embolia Pulmonar/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Aparatos de Compresión Neumática Intermitente , Persona de Mediana Edad , Estudios Prospectivos , Embolia Pulmonar/etiología , Adulto Joven
9.
Environ Dev Sustain ; : 1-26, 2022 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-35431618

RESUMEN

The suppliers' performance plays a vital role, with a domino effect, in project success, organizational competitiveness, protecting supply chain and construction industry from disruptions and PESTEL risks (political, economic, social, technological, environmental, and legal). Therefore, measuring the performance of the construction suppliers has become the primary focus of project-oriented organizations and the core of business decision-making, especially during global megatrends. The question that may arise here is, "How can the performance of the construction suppliers be determined under uncertainties considering the post-COVID-19 era?" Organizations need eligible suppliers for the rapid recovery of the supply chain and construction sector at this critical stage. Given the importance of the issue, this study aims to propose a novel approach for measuring the performance of construction suppliers using the fuzzy ordinal priority approach (OPA-F). OPA-F is a recent development in multiple criteria decision-making (MCDM) that can determine the criteria weights for performance measurement using fuzzy linguistic variables. We do not always have access to a complete data set in real-world situations and business environments. Nevertheless, OPA-F can handle this dilemma, even with incomplete input data. This research intends to consider three main aspects of the construction suppliers, known as (L-A-D) capabilities, including localization, agility, and digitalization. In this regard, we bring up a case study from the construction industry to demonstrate the application of the proposed framework. The findings show that the most critical criterion is "digitalization" for the case study. This criterion covers "supply chain automation" and "virtualization and dematerialization" of services/products. The proposed approach is practical and straightforward, particularly for academicians and decision-makers; it can also incorporate uncertainties.

10.
Adv Exp Med Biol ; 1349: 3-19, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35138607

RESUMEN

Pain management is a serious worldwide problem that affects the physical and mental health of all affected humans. As an alternative to opioids, pharmaceutical companies are seeking other sources of potential analgesics that have fewer adverse side effects. Animal venoms are a natural cocktail of a complex mixture of salts, peptides, and proteins. Most animals that produce venoms release them for the purpose of prey capture and/or defense against other vertebrates. Over the last 30 years, many venom-derived peptides have been shown to be active against numerous voltage-gated ion channels in the mammalian somatosensory nervous system. Voltage-gated ion channels and in particular sodium, potassium, and calcium channels are fundamental to the transmission of all somatosensory information from the periphery to the central nervous system. This information can be chemical, mechanical, or thermal sensation that can result from touch to a more painful sensation of tissue injury. These voltage-gated ion channels open or close in response to changes in membrane potential to permit ion movement across the cell membrane. In this chapter, we screened the scientific literature characterizing venom-derived peptides that target voltage-gated sodium and calcium channels and exhibit analgesic properties. Depending on peptide activity, these can either inhibit voltage-gated sodium or calcium channels completely by binding to the pore of the channel or modulate the activity by binding to other regions such as the voltage sensor of the channel.


Asunto(s)
Preparaciones Farmacéuticas , Canales de Sodio Activados por Voltaje , Animales , Canales de Calcio , Humanos , Péptidos/farmacología , Células Receptoras Sensoriales , Sodio , Ponzoñas
11.
Gynecol Oncol ; 152(3): 480-485, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30876492

RESUMEN

OBJECTIVE: To assess the impact of a surgical site infection (SSI) prevention bundle for Gynecologic Oncology patients at a large academic tertiary centre in Toronto, Canada. METHODS: A SSI prevention bundle was implemented in February 2017 including: preoperative chlorhexidine shower, prophylactic antibiotics, glycemic control, normothermia, and separate closing tray. Data were collected prospectively using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) institutional data, and chart review of surgeries between January 2016 and September 2017 was performed. The primary outcome was rate of SSIs, secondary outcomes were: superficial, deep and organ space SSIs, sepsis, wound disruption, length of stay, 30-day readmission and reoperation. Logistic regression analysis was conducted to identify predictors of SSIs. RESULTS: 339 baseline and 224 post-intervention patients were included. 53 incurred one or more SSIs: 43 superficial, 6 deep, and 14 organ-space. The bundle decreased overall SSIs by 55% (12.1% to 5.4%, p = 0.008) and superficial SSIs by 54% (9.7% to 4.5%, p = 0.023). Improvement was sustained for 6 quarters. No significant difference was found in other secondary outcomes. On multivariable analysis, surgery in the pre-bundle period, BMI ≥30, laparotomies and longer operative duration were independent risk factors for overall SSIs (OR 2.23, 95% CI 1.06-5.06, -OR 3.01, 95% CI 1.57 - 5.87, OR 3.70, 95% CI 1.56 - 10.18 and - OR 2.16, 95% 1.11 - 4.19, respectively). CONCLUSIONS: This prevention bundle successfully decreased SSIs in patients undergoing gynecologic cancer surgery. We recommend improving quality of care by wide implementation of SSI prevention bundles in Gynecologic Oncology patients.


Asunto(s)
Neoplasias de los Genitales Femeninos/cirugía , Procedimientos Quirúrgicos Ginecológicos/métodos , Infección de la Herida Quirúrgica/prevención & control , Antibacterianos/administración & dosificación , Profilaxis Antibiótica/métodos , Clorhexidina/administración & dosificación , Femenino , Neoplasias de los Genitales Femeninos/metabolismo , Procedimientos Quirúrgicos Ginecológicos/efectos adversos , Humanos , Tiempo de Internación , Persona de Mediana Edad , Reoperación , Sepsis/prevención & control , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/metabolismo , Resultado del Tratamiento
12.
J Stroke Cerebrovasc Dis ; 28(5): 1168-1172, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30683492

RESUMEN

BACKGROUND: Hypertensive emergency is commonly associated with acute ischemic stroke and can be a predictor of poor outcome in these patients. Nicardipine and labetalol are commonly administered for the treatment of acute hypertension following stroke. Yet, data are lacking on the safety of these agents in this setting. OBJECTIVE: This study aimed to determine all-cause in-hospital mortality, medication-related hypotensive episodes, development of hospital acquired infections and hospital length of stay between nicardipine and labetalol use for the management of hypertension after acute ischemic stroke. METHODS: This retrospective study used a prospective database of individuals admitted to the neurointensive care unit at a university-based hospital over 39 months. Patients with confirmed ischemic strokes were included in this analysis. Data were recorded for administration of nicardipine and labetalol following acute stroke. RESULTS: A total of 244 patients with acute ischemic stroke were included in this analysis (mean age, 64.3 ± 15 years; 52.2% males). Nicardipine use after acute ischemic stroke was associated with an increased risk of 30-day mortality (odds ratio [OR]: 4.6, 95% confidence interval [CI] 1.3-15.7; P = .02). A single episode of hypotension in the first 72hours of admission was also significantly associated with mortality (OR 4.35 [95% CI 1.2-14.9]; P = .02). CONCLUSIONS: Nicardipine was associated with an increased risk of short-term mortality after acute ischemic stroke. This may have been due to hypotension, tachycardia, or pulmonary edema which were not apparent in our study. Further studies are required to elucidate the cause of this association.


Asunto(s)
Antihipertensivos/efectos adversos , Isquemia Encefálica/tratamiento farmacológico , Isquemia Encefálica/mortalidad , Mortalidad Hospitalaria , Hipertensión/tratamiento farmacológico , Hipertensión/mortalidad , Nicardipino/efectos adversos , Accidente Cerebrovascular/tratamiento farmacológico , Accidente Cerebrovascular/mortalidad , Anciano , Presión Sanguínea/efectos de los fármacos , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/fisiopatología , Enfermedad Crítica , Bases de Datos Factuales , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Hipotensión/inducido químicamente , Hipotensión/mortalidad , Hipotensión/fisiopatología , Labetalol/efectos adversos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/fisiopatología , Factores de Tiempo , Resultado del Tratamiento
13.
J Med Syst ; 43(6): 145, 2019 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-31011881

RESUMEN

With decreasing inpatient rehabilitation lengths of stay, there may be a greater risk of spinal cord injury (SCI) populations being discharged into the community without the self-management skills needed to prevent secondary complications. Recent advancements in mobile health has made mobile apps a feasible method of delivering population-based, self-management interventions to address SCI-specific secondary complications. The objective of this study is to describe stakeholder perspectives on the development of a functional mobile app to facilitate self-management skills needed to prevent secondary complications following recent SCI during inpatient rehabilitation. A user-centered design approach was used that involved an evolving mobile app and the collection of prospective qualitative data. Stakeholders from three groups were enrolled in the study: individuals admitted for rehabilitation following SCI (n = 20) and informal (n = 7) and formal (n = 48) caregivers. Iterative feedback was gathered from rehabilitation inpatients during ongoing interactions and via post-discharge exit questionnaires, from informal caregivers via one-on-one interviews, and from formal caregivers via series of focus groups at various phases throughout the design process. Three main themes emerged from the analysis: (1) being individualized and user friendly (i.e., developing an app that is simple and easy to use to facilitate universal uptake), (2) targeting goals to promote self-management (i.e., adopting self-management skills relative to personal goals and confidence), and (3) increasing participation and support-seeking to facilitate lifestyle change (i.e., encouraging leisure activities to facilitate community integration). Key stakeholder perspectives contributed to the development of a self-management mobile app that will be evaluated in future research.


Asunto(s)
Aplicaciones Móviles , Automanejo/métodos , Traumatismos de la Médula Espinal/rehabilitación , Adulto , Objetivos , Humanos , Entrevistas como Asunto , Estilo de Vida , Persona de Mediana Edad , Estudios Prospectivos , Prevención Secundaria/métodos , Autoimagen , Telemedicina , Interfaz Usuario-Computador , Adulto Joven
14.
Angew Chem Int Ed Engl ; 55(15): 4692-6, 2016 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-26948522

RESUMEN

α-Conotoxins are disulfide-rich peptides that target nicotinic acetylcholine receptors. Recently we identified several α-conotoxins that also modulate voltage-gated calcium channels by acting as G protein-coupled GABA(B) receptor (GABA(B)R) agonists. These α-conotoxins are promising drug leads for the treatment of chronic pain. To elucidate the diversity of α-conotoxins that act through this mechanism, we synthesized and characterized a set of peptides with homology to α-conotoxins known to inhibit high voltage-activated calcium channels via GABA(B)R activation. Remarkably, all disulfide isomers of the active α-conotoxins Pu1.2 and Pn1.2, and the previously studied Vc1.1 showed similar levels of biological activity. Structure determination by NMR spectroscopy helped us identify a simplified biologically active eight residue peptide motif containing a single disulfide bond that is an excellent lead molecule for developing a new generation of analgesic peptide drugs.


Asunto(s)
Secuencias de Aminoácidos , Bloqueadores de los Canales de Calcio/farmacología , Conotoxinas/química , Cisteína/análisis , Receptores de GABA-B/metabolismo , Secuencia de Aminoácidos , Animales , Conotoxinas/farmacología , Humanos , Receptores de GABA-B/química , Homología de Secuencia de Aminoácido , Relación Estructura-Actividad , Xenopus
15.
Front Microbiol ; 15: 1396308, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38770019

RESUMEN

Bifidobacteria are a prominent type of bacteria that have garnered significant research attention for their exceptional probiotic properties and capacity to produce exopolysaccharides (EPSs). These compounds exhibit diverse physical, chemical, and biological characteristics, prompting numerous investigations into their potential applications. Researchers have noted their beneficial effects as immune modulators within the host's body across various industries. Extensive research has been conducted on the immunomodulatory effects of bifidobacteria-derived EPSs, with emerging engineering strategies aimed at enhancing their immune-modulating capabilities. Understanding the structure, physicochemical properties, and biological activities of these compounds is crucial for their effective utilization across different industries. Our review encompassed numerous studies exploring Bifidobacterium and its metabolites, including EPSs, across various sectors, drawing from diverse databases. The distinctive properties of EPSs have spurred investigations into their applications, revealing their potential to bolster the immune system, combat inflammation, and treat various ailments. Additionally, these compounds possess antioxidant and antimicrobial properties, making them suitable for incorporation into a range of products spanning food, health, and medicine.

16.
Appl Neuropsychol Child ; : 1-11, 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38859564

RESUMEN

Many adolescents with attention-deficit hyperactivity disorder (ADHD) have executive functioning (EF) difficulties that contribute to academic and social-emotional challenges. This pilot explored adherence to and effectiveness of modified Goal Management Training (GMT), an EF intervention, with ADHD youth. Six adolescents with ADHD (14-17 years, 2 female) participated in a 6-session online group. Adherence was tracked via attendance and homework. Reliable change scores gaged pre-post differences on measures before and after training (primary: everyday EF and goal attainment; secondary: EF task performance, functional impairment, emotional adjustment, and self-concept). All youth attended at least 4 sessions, though homework completion was mixed. Four youth achieved their goal, some demonstrated reliable change on outcome measures, and all evidenced a reduction in impairment. Results support the feasibility of modified GMT in adolescents with ADHD and suggest that youth may benefit from this more personalized and holistic approach to EF intervention.

17.
Mol Pain ; 9: 51, 2013 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-24139484

RESUMEN

BACKGROUND: Antagonists of N-type voltage-gated calcium channels (VGCC), Ca(v)2.2, can manage severe chronic pain with intrathecal use and may be effective systemically. A series of novel ω-conotoxins that selectively inhibit N-type VGCCs was isolated from Conus catus. In the present study, the potency and reversibility of ω-conotoxins CVID, CVIE and CVIF to inhibit N-type calcium currents were investigated in mouse isolated dorsal root ganglion (DRG) neurons. The systemic potency of each ω-conotoxin to reverse signs of mouse chronic inflammatory pain was also compared. RESULTS: In DRG neurons, the rank order of potency to inhibit N-type calcium currents was CVIE > CVIF > CVID. After subcutaneous administration, CVID and CVIE, but not CVIF, partially reversed impaired weight bearing in mice injected with Freund's complete adjuvant (CFA) three days prior to testing. No side-effects associated with systemic administration of ω-conotoxins were observed. CONCLUSIONS: The present study indicates a potential for CVID and CVIE to be developed as systemically active analgesics with no accompanying neurological side-effects.


Asunto(s)
Bloqueadores de los Canales de Calcio/uso terapéutico , Canales de Calcio Tipo N/metabolismo , Dolor/tratamiento farmacológico , omega-Conotoxinas/uso terapéutico , Analgésicos/administración & dosificación , Analgésicos/uso terapéutico , Animales , Bloqueadores de los Canales de Calcio/administración & dosificación , Masculino , Ratones , Ratones Endogámicos C57BL , Dolor/metabolismo , Técnicas de Placa-Clamp , omega-Conotoxinas/administración & dosificación
19.
Heliyon ; 9(4): e15386, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37123931

RESUMEN

Carbapenemase enzyme production is responsible for resistance to carbapenem among Gram-negative bacteria. This study aimed to detect common carbapenemase and oxacilinase genes among uropathogenic E. coli (UPEC) isolated from hospitalized patients in Rasht, north of Iran. In the present study, from 2000 urine samples, 263 UPEC strains were isolated from inpatients with urinary tract infections (UTI) in 2020. The Kirby-Bauer disk diffusion susceptibility test was used to determine the sensitivity or resistance of isolates to antimicrobial compounds. The double-disk test confirmed extended-spectrum ß lactamase (ESBL) production phenotypically, and the presence and distribution of genes encoding carbapenemase and oxacilinase were investigated using polymerase chain reaction (PCR). Based on the findings, 13/263 isolates (8 ESBL and five non-ESBL) showed a non-susceptible phenotype to at least one of the studied carbapenem group antibiotics, and 121 (46%) isolates were ESBL-producers. PCR for oxacilinase and carbapenemase genes was done on all 126 isolates, including ESBL-positive and carbapenem-resistant strains, in which 10 (7.9%) and 25 (19.8%) isolates harbored OXA-1 and IMP genes, respectively. Also, OXA-2, OXA-10, OXA-48, VIM, and NDM genes were not found in any studied isolates. IMP and OXA-1 genes among carbapenemase-producing isolates indicate the possible spread of antibiotic-resistant strains. Hence, identification and control of ESBL and carbapenemase-producing strains, although with almost low frequency due to plasmid genes encoding carbapenemase, is essential for infection control.

20.
Heliyon ; 9(8): e19230, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37654446

RESUMEN

Developing and designing efficient wound dressings have gained increasing attention and shown beneficial results in improved wound healing effects. This study was conducted to improve wound healing properties and introduce a novel potential wound dressing. A novel hydrogel based on polyvinylpyrrolidone/poly acrylic acid containing Zinc oxide nanoparticles was prepared as an antibacterial wound dressing and examined in a rat excisional wound model. This hydrogel prepared by free radical polymerization using potassium persulfate (KPS) as an initiator, N, N-methylene bisacrylamide (MBA) as a cross-linker, poly acrylic acid (PAA) as a monomer in the presence of polyvinylpyrrolidone (PVP) and Zinc oxide nanoparticles (ZnO NPs). Analyses such as Scanning Electron Microscope (SEM), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction analysis (XRD), and Thermal gravimetric analysis (TGA) were used to study morphology structure. After choosing the optimal sample, in vivo characterization of excisional wound injury on a rat model was done. The healing rate and histological analysis were calculated and compared among the groups. The therapeutic potential of the PAA-PVP-ZnO-%2 was investigated in a rat model of excisional injury compared to the control group. Results showed that the polyacrylic acid/polyvinylpyrrolidone hydrogel wound dressing containing zinc oxide nanoparticles accelerated wound contraction, had antibacterial effects, and promoted wound healing compared to other groups.

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