Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 373
Filtrar
Mais filtros

Base de dados
Tipo de documento
Intervalo de ano de publicação
1.
Nature ; 563(7731): 374-378, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30429543

RESUMO

High-temperature copper oxide superconductors consist of stacked CuO2 planes, with electronic band structures and magnetic excitations that are primarily two-dimensional1,2, but with superconducting coherence that is three-dimensional. This dichotomy highlights the importance of out-of-plane charge dynamics, which has been found to be incoherent in the normal state3,4 within the limited range of momenta accessible by optics. Here we use resonant inelastic X-ray scattering to explore the charge dynamics across all three dimensions of the Brillouin zone. Polarization analysis of recently discovered collective excitations (modes) in electron-doped copper oxides5-7 reveals their charge origin, that is, without mixing with magnetic components5-7. The excitations disperse along both the in-plane and out-of-plane directions, revealing its three-dimensional nature. The periodicity of the out-of-plane dispersion corresponds to the distance between neighbouring CuO2 planes rather than to the crystallographic c-axis lattice constant, suggesting that the interplane Coulomb interaction is responsible for the coherent out-of-plane charge dynamics. The observed properties are hallmarks of the long-sought 'acoustic plasmon', which is a branch of distinct charge collective modes predicted for layered systems8-12 and argued to play a substantial part in mediating high-temperature superconductivity10-12.

2.
Clin Radiol ; 79(1): 10-18, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37926649

RESUMO

Orbital lesions compose a heterogeneous group of pathologies that often present with non-specific imaging findings on conventional magnetic resonance imaging (MRI) sequences (T1-and T2-weighted). Accordingly, the application of diffusion MRI offers an opportunity to further distinguish between lesions along this spectrum. Diffusion-weighted imaging (DWI) represents the simplest and most frequent clinically utilised diffusion imaging technique. Recent advances in DWI techniques have extended its application to the evaluation of a wider spectrum of neurological pathology, including orbital lesions. This review details the manifestations of select orbital pathology on DWI and underscores specific situations where diffusion imaging allows for increased diagnostic sensitivity compared to more conventional MRI techniques. These examples also describe preferred management for orbital lesions identified by DWI.


Assuntos
Imagem de Difusão por Ressonância Magnética , Órbita , Humanos , Órbita/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/métodos
3.
Public Health ; 185: 15-17, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32516621

RESUMO

This article describes the rapid mitigation strategies in addressing the rising number of coronavirus disease 2019 (COVID-19) cases in Singapore. Learning from the severe acute respiratory syndrome experience in 2003, early preparation started in January 2020 when Wuhan was declared as the epicentre of the epidemic. The government had constructed a three-pronged approach which includes travel, healthcare and community measures to curb the spread of COVID-19.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , COVID-19 , Infecções Comunitárias Adquiridas/prevenção & controle , Infecções por Coronavirus/epidemiologia , Atenção à Saúde/organização & administração , Governo , Humanos , Pneumonia Viral/epidemiologia , Singapura/epidemiologia , Viagem
4.
J Viral Hepat ; 25(7): 874-877, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29431877

RESUMO

Indications of liver transplantation are extensive, but deceased donation does not meet the demand. Hepatitis B surface antigen (HBsAg)-positive grafts used to be discarded in the past. The aim of this study was to examine viral activity and outcome of HBsAg-positive deceased grafts transplanted to HBsAg-positive recipients. Eleven HBsAg-positive deceased grafts were transplanted to HBsAg-positive patients with acute liver failure (3 patients), hepatocellular carcinoma (6 patients) and repeatedly bleeding varices (2 patients). Postoperatively, hepatitis B virus (HBV) infection was treated by a combination of antiviral nucleoside and nucleotide analogues. HBV DNA and HBsAg were measured periodically. The median (interquartile) model of end-stage liver disease score for the recipients was 19 (16-32) with a range from 11 to 40. HBV DNA was detected in 6 patients with a range from 61 to 1083 IU/mL before transplantation. After transplantation, HBV DNA was detected in 4 patients in the first month and 2 patients in the 6th month and became undetectable for all patients at end of the first year. The quantitative HBsAg ranged from 0.86 to 241.1 IU/mL at 6 months and 0.34 to 238.5 IU/mL at 24 months (P = .135). Three of the patients died in the early phase, and the other patients were followed up for 40.0 ± 19.2 months with normal liver function. In conclusion, HBsAg-positive deceased liver grafts function well with minimal viral activity under treatment of combined antiviral nucleoside and nucleotide analogues. Use of HBsAg-positive deceased grafts is feasible and increases the donor pool to rescue dying patients.


Assuntos
Antivirais/uso terapêutico , Antígenos de Superfície da Hepatite B/sangue , Hepatite B Crônica/tratamento farmacológico , Transplante de Fígado , Nucleosídeos/uso terapêutico , Nucleotídeos/uso terapêutico , Transplantados , Adulto , Idoso , Carcinoma Hepatocelular/cirurgia , DNA Viral/sangue , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Falência Hepática Aguda/cirurgia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
5.
Eur J Appl Physiol ; 118(8): 1635-1640, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29804139

RESUMO

PURPOSE: This study aims to compare the isometric strength of hip abductors and external rotators in male athletes with and without patellar tendinopathy (PT), and to examine the correlation between hip strength, pain, and functional scores. METHODS: Sixty male athletes (30 with PT and 30 controls) were recruited from local volleyball and basketball teams. The isometric strength of the hip abductors and external rotators was quantified using a belt-stabilized handheld dynamometer. This study used the visual analog scale (VAS) and the Victorian Institute of Sport Assessment-Patella (VISA-p) questionnaire to measure the intensity of pain and functional scores in athletes with PT, respectively. RESULTS: The normalized isometric strength of the hip abductors and external rotators was significantly less in the PT group compared with controls. In subjects with PT, the normalized isometric strength was decreased by 22.0% (p = 0.000) in the hip abductors and by 20.0% in the hip external rotators (p = 0.004), compared with controls. Significant correlations were found between the normalized isometric strength of the hip abductors and intensity of pain (r = - 0.70; p < 0.05) and VISA-p score (r = 0.63; p < 0.05) in the affected leg in athletes with unilateral PT. CONCLUSIONS: Athletes with PT have decreased isometric strength in their hip abductors and external rotators when compared with controls. In subjects with unilateral PT, decreased isometric strength in the hip abductors is associated with greater intensity of pain and lower functional scores. Results of this study implied that hip muscle assessment and strengthening should be included for reconditioning and rehabilitation in athletes with PT.


Assuntos
Contração Isométrica , Força Muscular , Músculo Esquelético/fisiologia , Ligamento Patelar/fisiologia , Tendinopatia/fisiopatologia , Adolescente , Adulto , Estudos de Casos e Controles , Quadril/fisiologia , Humanos , Masculino , Ligamento Patelar/lesões
6.
Orthod Craniofac Res ; 21(1): 4-11, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29283499

RESUMO

The aim of this meta-analysis was to investigate the changes in airway dimensions after rapid maxillary expansion (RME) and facemask (FM) protraction. Using PubMed, Medline, ScienceDirect and Web of Science, only controlled clinical trials, published up to November 2016, with RME and/or FM as keywords that had ≥6 months follow-up period were included in this meta-analysis. The changes in pharyngeal airway dimension in both two-dimensional and three-dimensional images were included in the analysis. Nine studies met the criteria. There are statically significant changes in upper airway and nasal passage airway in the intervention groups as compared to the control groups, assessed in two-dimensional and three-dimensional images. However , in the lower airway and the airway below the palatal plane, no statistically significant changes are seen in 2D and 3D images. RME/FM treatments might increase the upper airway space in children and young adolescents. However, more RCTs and long-term cohort studies are needed to further clarify the effects on pharyngeal airway changes.


Assuntos
Aparelhos de Tração Extrabucal , Técnica de Expansão Palatina , Faringe/anatomia & histologia , Adolescente , Cefalometria , Criança , Ensaios Clínicos Controlados como Assunto , Humanos , Faringe/diagnóstico por imagem
7.
J Oral Rehabil ; 45(6): 476-484, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29663483

RESUMO

Oral health and hygiene are crucial parameters in stroke patients. However, few studies have evaluated the oral health status and oral hygiene practices according to the level of function in stroke patients. The aim of this study was to evaluate the oral health status and oral hygiene practices according to ambulation and personal hygiene levels in patients with stroke. Data from the fifth (2010-2012) and sixth (2013-2015) editions of the Korea National Health and Nutrition Examination Survey (KNHANES) for 6 years were combined. A total of 700 stroke patients were enrolled in our study. Subjective oral health was significantly poorer in patients who experienced a moderate problem with walking (adjusted OR [AOR], 1.68; 95% CI, 1.21-2.33) and bed-bound patients (AOR, 2.92; 95% CI, 1.01-8.44) than in patients who could walk without difficulty. Patients who were unable to bathe or dress independently exhibited a significantly higher risk of dental caries than did those who could perform the same activities unassisted. The probability of brushing teeth ≥2 times daily was 69% lower in bed-bound patients (AOR, 0.31; 95% CI, 0.11-0.87) than in patients who could walk without difficulty and 76% lower in patients who were unable to bathe or dress independently (AOR, 0.24; 95% CI, 0.09-0.62) than in those who could perform the same activities without difficulty. There were differences in oral health status and oral hygiene practices, according to ambulation level and functional independence, in the stroke patient group. These results indicate the need for oral care for stroke patients who exhibit ambulatory and functional limitations.


Assuntos
Cárie Dentária/epidemiologia , Saúde Bucal/normas , Higiene Bucal/normas , Acidente Vascular Cerebral/fisiopatologia , Sobreviventes , Adulto , Idoso , Análise de Variância , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , República da Coreia/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Reabilitação do Acidente Vascular Cerebral , Escovação Dentária , Adulto Jovem
8.
Osteoporos Int ; 28(4): 1453-1459, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28083665

RESUMO

Because the rate of bone loss is an important risk factor for fracture, we studied longitudinal changes in bone mineral density (BMD). Although the BMD of the hip decreased over time, spine BMD remained largely stable or increased. Therefore, spine BMD may not be appropriate for assessing BMD change. INTRODUCTION: The rate of age-dependent bone loss has been shown to be an important risk factor for fracture. However, longitudinal rates of BMD loss in Korea have not yet been reported. The objective of this study was to evaluate longitudinal changes in BMD in Korea. METHODS: This cohort study was performed in a population of individuals 40 years of age or older living in the rural area of Chungju City, Korea. A second BMD examination was conducted approximately 4 years after a baseline examination. A total of 3755 of the 6007 subjects completed the follow-up visit, corresponding to a follow-up rate of 62.51%. RESULTS: The age-standardized osteoporosis prevalence was 12.81% in males and 44.35% in females. In males, the average annual BMD loss at the total hip increased from -0.25% per year in their 40s to -1.12% per year in their 80s. In females, the average annual BMD loss at the total hip increased from -0.69% per year in their 40s to -1.51% per year in their 80s. However, the average annual percentage change in spine BMD in females increased from -0.91% per year in their 40s to +1.39% per year in their 80s. CONCLUSIONS: A substantial number of subjects had osteoporosis, even though we standardized the prevalence of osteoporosis. In total hip, the mean BMD was decreased during the follow-up period; in addition, the annual percentage loss increased with age. However, spine BMD remained approximately stable or increased over time and therefore may not be appropriate for assessing BMD change.


Assuntos
Densidade Óssea/fisiologia , Osteoporose/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Doenças Ósseas Metabólicas/epidemiologia , Doenças Ósseas Metabólicas/fisiopatologia , Estudos de Coortes , Feminino , Colo do Fêmur/fisiopatologia , Articulação do Quadril/fisiopatologia , Humanos , Estudos Longitudinais , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Osteoporose/fisiopatologia , Prevalência , República da Coreia/epidemiologia , Saúde da População Rural/estatística & dados numéricos
9.
Scand J Med Sci Sports ; 27(10): 1099-1104, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27539811

RESUMO

To investigate the passive muscle tension of the quadriceps muscle heads in male athletes clinically diagnosed with patellar tendinopathy (PT) with those of healthy controls and explore the interplay between passive muscle tension and patellar tendon stiffness. Between November 2012 and December 2013, 66 male athletes (mean age of 21.1 ± 4.4 years) were examined using supersonic shear wave imaging technology. The passive tension of the vastus lateralis (VL) and rectus femoris (RF) muscles and patellar tendon stiffness were assessed. The shear elastic modulus of the VL muscle was increased by 26.5% (P < 0.001) in the subjects with PT when compared with the controls. Greater passive tension in the VL was associated with higher patellar tendon stiffness (r = 0.38; P = 0.001). The vastus lateralis muscle of the quadriceps shows increase in passive muscle tension in jumping athletes with patellar tendinopathy. These findings suggest that increase in muscle tension is not similar in the individual muscles of the quadriceps muscle. Traditional stretching of the whole quadriceps muscle might not be targeted to the tight muscle heads.


Assuntos
Tono Muscular , Ligamento Patelar/fisiopatologia , Músculo Quadríceps/fisiopatologia , Tendinopatia/fisiopatologia , Adulto , Atletas , Módulo de Elasticidade , Humanos , Masculino , Adulto Jovem
10.
Eur J Appl Physiol ; 117(5): 1039-1045, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28353085

RESUMO

PURPOSE: To compare tendon strain and stiffness between athletes with patellar tendinopathy and healthy controls, and explore whether the intensity of pain and dysfunction were related to the mechanical properties of the tendon. METHODS: Thirty-four male athletes with patellar tendinopathy and 13 healthy controls matched by age and activity levels were recruited. The in vivo mechanical properties of the patellar tendon were examined by ultrasonography and dynamometry. In subjects with patellar tendinopathy, the intensities of self-perceived pain (maximal pain in the past 7 days and pain during a single-legged declined-squat test) using the visual analogue scale and the assessment of functional disability using the Victorian Institute of Sport Assessment-patellar questionnaire, were collected. RESULTS: In subjects with patellar tendinopathy, tendon strain was significantly reduced by 22% (8.9 ± 3.7 vs. 14.3 ± 4.7%, P = 0.005) when compared with healthy controls. There was no significant group difference in tendon stiffness (P = 0.27). Significant negative correlations between tendon strain and the maximal self-perceived pain over 7 days (r = -0.37, P = 0.03), and pain during a single-legged declined-squat test (r = -0.37, P = 0.03) were detected. A trend of significant positive correlation was found between tendon stiffness and pain during a single-legged declined-squat test (r = 0.30, P = 0.09). CONCLUSION: Our findings show that tendon strain is reduced in athletes with patellar tendinopathy, and a lower tendon strain is associated with a greater magnitude of pain perceived.


Assuntos
Ligamento Patelar/fisiopatologia , Tendinopatia/fisiopatologia , Adulto , Atletas , Traumatismos em Atletas , Fenômenos Biomecânicos , Estudos de Casos e Controles , Humanos , Masculino , Contração Muscular , Medição da Dor , Tendinopatia/etiologia
11.
Diabet Med ; 33(5): 631-8, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26220259

RESUMO

AIM: To determine whether preadipocyte factor 1 could be a predictive marker for the development of diabetes in people without diabetes at baseline. METHODS: We conducted a population-based, nested case-control study of individuals who progressed to diabetes (n = 43) or prediabetes (n = 345) and control participants matched on age, sex and fasting plasma glucose concentration, who maintained normal glucose tolerance (n = 389) during a 4-year follow-up using data from the Chungju Metabolic disease Cohort Study. Circulating levels of preadipocyte factor 1 were measured using an enzyme-linked immunosorbent assay. RESULTS: Baseline serum preadipocyte factor 1 levels showed a stepwise decrease across the glucose tolerance status groups at follow-up (normal glucose tolerance: 10.02 ± 3.02 ng/ml; prediabetes: 9.48 ± 3.35 ng/ml; diabetes: 8.66 ± 3.29 ng/ml; P for trend, 0.0151). Individuals whose fasting plasma glucose level had increased or whose homeostasis model assessment of ß-cell function had decreased at follow-up showed significantly lower levels of preadipocyte factor 1 compared with their control group counterparts. After adjusting for age, BMI, fasting plasma glucose, serum insulin levels, systolic blood pressure and triglycerides, the incidence of diabetes was nearly threefold higher in the lowest vs. the upper three quartiles of circulating preadipocyte factor 1 (relative risk 2.794; 95% CI 1.188-6.571; P = 0.0185). Notably, these findings were significant in women but not in men. CONCLUSIONS: Levels of circulating preadipocyte factor 1 may be a useful biomarker for identifying women at high risk of developing diabetes.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Regulação para Baixo , Resistência à Insulina , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Proteínas de Membrana/sangue , Estado Pré-Diabético/epidemiologia , Saúde da População Rural , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Glicemia/análise , Proteínas de Ligação ao Cálcio , Estudos de Casos e Controles , Estudos de Coortes , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/sangue , Estado Pré-Diabético/metabolismo , República da Coreia/epidemiologia , Risco , Fatores Sexuais
12.
Eur J Neurol ; 23(8): 1289-300, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27160373

RESUMO

BACKGROUND AND PURPOSE: Investigation of the relationship between mitochondrial DNA (mtDNA) variants and Parkinson disease (PD) remains an issue awaiting more supportive evidence. Moreover, an affirming cellular model study is also lacking. METHODS: The index mtDNA variants and their defining mitochondrial haplogroup were determined in 725 PD patients and 744 non-PD controls. Full-length mtDNA sequences were also conducted in 110 cases harboring various haplogroups. Cybrid cellular models, composed by fusion of mitochondria-depleted rho-zero cells and donor mitochondria, were used for a rotenone-induced PD simulation study. RESULTS: Multivariate logistic regression analysis revealed that subjects harboring the mitochondrial haplogroup B5 have resistance against PD (odds ratio 0.50, 95% confidence interval 0.32-0.78; P = 0.002). Furthermore, a composite mtDNA variant group consisting of A10398G and G8584A at the coding region was found to have resistance against PD (odds ratio 0.50, 95% confidence interval 0.33-0.78; P = 0.001). In cellular studies, B4 and B5 cybrids were selected according to their higher resistance to rotenone, in comparison with cybrids harboring other haplogroups. The B5 cybrid, containing G8584A/A10398G variants, showed more resistance to rotenone than the B4 cybrid not harboring these variants. This is supported by findings of low reactive oxygen species generation and a low apoptosis rate in the B5 cybrid, whereas a higher expression of autophagy was observed in the B4 cybrid particularly under medium dosage and longer treatment time with rotenone. CONCLUSIONS: Our studies, offering positive results from clinical investigations and cybrid experiments, provide data supporting the role of variant mtDNA in the risk of PD.


Assuntos
DNA Mitocondrial/genética , Variação Genética , Doença de Parkinson/genética , Idoso , Feminino , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
13.
Nutr Metab Cardiovasc Dis ; 25(12): 1146-51, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26607702

RESUMO

BACKGROUND AND AIMS: Consumption of food and drinks containing high fructose (HF), which is associated with hypertension, is increasing steeply. Moreover, increased salt intake significantly increases hypertension risk. We examined whether maternal HF and postnatal high salt (HS) intake had synergistic effects on blood pressure (BP) elevation in adult offspring and determined the underlying mechanisms. METHODS AND RESULTS: Pregnant Sprague-Dawley rats received regular chow or chow supplemented with 60% fructose during the entire pregnancy and lactation periods. Half of the male offspring received 1% NaCl in drinking water from weaning to 3 months of age. Male offspring were assigned to 4 groups (control, HF, HS, and HF + HS) and were sacrificed at 12 weeks of age. Offspring in HF and HS groups developed hypertension, indicating that HF and HS synergistically increased BP. Postnatal HS intake increased Ace expression and decreased Agtr1b and Mas1 expression in the kidneys. Renal mRNA levels of Ace and Agtr1a were significantly higher in HF + HS group than in control group. Renal levels of Na-K-2Cl cotransporter, type 3 sodium hydrogen exchanger, and Na(+)/Cl(-) cotransporter were higher in HS and HF + HS groups than in control group. CONCLUSION: Postnatal HS intake exacerbated prenatal HF-induced programmed hypertension. HF and HS induced programmed hypertension by differentially inducing renin-angiotensin system and sodium transporters in the kidneys. Better understanding of the effect of the relationship between HF and HS on hypertension development will help prevent hypertension in mothers and children exposed to HF and HS.


Assuntos
Frutose/efeitos adversos , Hipertensão/etiologia , Hipertensão/mortalidade , Prenhez , Cloreto de Sódio na Dieta/efeitos adversos , Análise de Variância , Animais , Animais Recém-Nascidos , Arginina/análogos & derivados , Arginina/sangue , Western Blotting , Cromatografia Líquida de Alta Pressão/métodos , Citrulina/sangue , Feminino , Hipertensão/fisiopatologia , Masculino , Óxido Nítrico/sangue , Gravidez , Proto-Oncogene Mas , Ratos , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase em Tempo Real/métodos , Valores de Referência , Sistema Renina-Angiotensina/fisiologia , Taxa de Sobrevida
14.
Dis Esophagus ; 28(6): 574-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-24835402

RESUMO

The accuracy of endoscopic ultrasound (EUS) is operator-dependent. According to learning curve study, the accuracy of EUS T-staging for esophageal cancer has been reported to be greater in an investigator who had performed at least 100 EUS examinations. We determined comparative study regarding T-staging accuracy of EUS for esophageal squamous cell carcinoma between expert and nonexpert endoscopic ultrasonographers. We retrospectively identified 73 consecutive patients with esophageal squamous cell carcinoma who underwent EUS and endoscopic mucosal resection, endoscopic submucosal dissection, or surgery. EUS was performed by expert (Group 1) and nonexpert (Group 2) endoscopic ultrasonographers in multitertiary hospitals. Groups 1 and 2 were 37 and 36 patients during 2005-2011, respectively. Forty-two patients (57.5%) of the overall patients underwent surgical exploration. Correct endoscopic ultrasonographic T-staging of Group 1 was observed in 34 (91.9%) patients, while that of Group 2 was observed in 26 (72.2%) patients. And there was significant difference in correct endoscopic ultrasonographic T-staging between Group 1 and Group 2 (P = 0.035). The incorrect endoscopic ultrasonographic T-staging of Group 1 were three cases that were overstaging (8.1%), but in Group 2 there were seven overstaging (19.4%) and three understaging (8.3%). There was no significant difference in overstaging or understaging of incorrect endoscopic ultrasonographic T-staging between Group 1 and Group 2 (P = 0.528). This study first provides evidence that endoscopic ultrasonographic T-staging of nonexpert endoscopic ultrasonographers was inferior to be correct, compared with that of expert endoscopic ultrasonographers. EUS staging for esophageal cancer should be performed by expert endoscopic ultrasonographers to provide appropriate management strategy.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Competência Clínica/estatística & dados numéricos , Erros de Diagnóstico/estatística & dados numéricos , Endossonografia/normas , Neoplasias Esofágicas/diagnóstico por imagem , Idoso , Carcinoma de Células Escamosas/patologia , Endossonografia/estatística & dados numéricos , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , República da Coreia , Estudos Retrospectivos
15.
Haemophilia ; 20(4): 541-9, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24472032

RESUMO

Congenital haemophilia is an inherited bleeding disorder typically diagnosed at birth or shortly thereafter. Haemophilia imposes a significant burden on patients and their caregivers. The aim of the study was to quantify the overall burden of haemophilia on caregivers in the USA using a novel disease-specific questionnaire and the previously validated CarerQol. Targeted literature review and a previous survey conducted by the authors was used to develop an online questionnaire with six burden domains of interest to caregivers (emotional stress, financial, sacrifice, medical management, child's pain and transportation) and several visual analogue scales (VAS). Content validity of the questionnaire was confirmed by three haemophilia caregivers. The study sample consisted of caregivers of children with haemophilia identified via a previously developed opt-in research database. Descriptive statistics were employed for demographic and clinical characteristics; a generalized linear model (GLM) was used to identify factors influencing caregiver burden. A total of 310 caregivers completed the survey (45.5% response rate). Most of the participating caregivers were mothers of a child with haemophilia (88%), between 35 and 44 years of age (48%), and with a college education or a postgraduate degree (63%). 'Child's pain' was identified as the most burdensome domain to caregivers (median score = 3.50 out of 5), followed by 'emotional stress' (2.67), 'financial' (2.40), 'transportation' (2.33), 'sacrifice' (2.17) and 'medical management' (2.00) domains. Although higher income exhibited a protective effect, episodes of bleeds, current presence of an inhibitor and lower caregiver productivity in the past month negatively affected caregiver burden per GLM results. Training and educational programs should potentially be developed to address caregiver burden.


Assuntos
Cuidadores/estatística & dados numéricos , Hemofilia A , Hemofilia B , Adolescente , Adulto , Cuidadores/economia , Cuidadores/psicologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pais/psicologia , Estresse Psicológico , Inquéritos e Questionários , Adulto Jovem
16.
Haemophilia ; 20(6): 822-30, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25273645

RESUMO

Inhibitor development complicates haemophilia treatment and may impact caregiver burden. Compare overall burden of caregivers of children with/without inhibitors in the United States using a novel disease-specific questionnaire and the previously validated CarerQol. An on-line questionnaire with six burden domains (i.e. emotional stress, personal sacrifice, financial burden, medical management, child's pain, and transportation) and three visual analogue scales (VAS) was developed based upon a targeted literature review and previous survey findings. The study sample consisted of caregivers of children with haemophilia. The total burden score was calculated by summing the six individual burden domain scores. Higher scores represented greater burden. Descriptive statistics was performed to examine the sample characteristics. The Wilcoxon rank-sum test was performed to compare burden by inhibitor status. All variables were considered significant at P < 0.001. A total of 310 caregivers completed the survey; 30 of them reported caring for a child with an inhibitor. A majority of caregivers of children with inhibitors were mothers (80.0%) and between 35 and 44 years of age (56.7%). Caregivers of children with inhibitors reported significantly higher median total burden scores (99.0 vs. 76.5, P < 0.0001) and median burden-VAS scores (5.5 vs. 3.0, P < 0.0001), as compared to those caring for children without inhibitors. A similar trend was seen across all the six burden domains, with greatest difference in the median burden scores observed in the 'personal sacrifice' (3.2 vs. 2.0) and 'transportation' (3.3 vs. 2.3) domains. Burden of caregivers should be considered when assessing the psychosocial aspects of managing patients with inhibitors.


Assuntos
Inibidores dos Fatores de Coagulação Sanguínea , Cuidadores/psicologia , Efeitos Psicossociais da Doença , Hemofilia A/epidemiologia , Hemofilia B/epidemiologia , Isoanticorpos , Qualidade de Vida , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Hemofilia A/diagnóstico , Hemofilia B/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
17.
Diabetes Obes Metab ; 16(9): 819-26, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24581276

RESUMO

AIM: Liraglutide (LIRA) once-daily has provided greater A1C reductions than either exenatide (EXEN) twice-daily or sitagliptin (SITA) once-daily in head-to-head trials. The objective of this analysis is to compare the real-world clinical effectiveness of these agents in the USA. METHODS: Using the IMS Health (Alexandria, VA, USA) integrated claims database, A1C outcomes in patients aged ≥ 18 years with type 2 diabetes (T2D) who initiated either LIRA, EXEN or SITA (including SITA/metformin) were retrospectively compared. Patients included in the analysis had ≥ 1 prescription for LIRA, EXEN or SITA between January and December 2010 (index period) and persisted with their index treatment regimens for 6 months post-index. Outcomes included changes in A1C from baseline (45 days pre-index through 7 days post-index) to follow-up [6 months post-index (± 45)] and the proportion of patients reaching A1C<7%. Multivariable regression models adjusted for confounding factors (e.g. age, comorbidities, baseline A1C and background antidiabetic therapy). RESULTS: The predicted change in A1C from baseline was greater for LIRA patients compared with both SITA (-1.08 vs. -0.68%; treatment difference 0.40%, p < 0.0001) and EXEN (-1.08 vs. -0.75%; treatment difference 0.32%, p < 0.001). Predicted A1C goal achievement, derived from the multivariate logistic regression model, was higher with LIRA compared with both SITA [64.4% (95% confidence interval, CI: 63.5-65.3) vs. 49.4% (95% CI: 48.5-50.4); p < 0.0001] and EXEN [64.4% (95% CI: 63.5-65.3) vs. 53.6% (95% CI: 52.6-54.6); p < 0.0001]. CONCLUSIONS: In clinical practice, LIRA was associated with significantly greater reductions in A1C and improved glycaemic goal attainment compared with either EXEN or SITA among adult patients with T2D.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Incretinas/uso terapêutico , Liraglutida/uso terapêutico , Peptídeos/uso terapêutico , Fosfato de Sitagliptina/uso terapêutico , Peçonhas/uso terapêutico , Glicemia/efeitos dos fármacos , Análise Custo-Benefício , Diabetes Mellitus Tipo 2/sangue , Exenatida , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
18.
Nanotechnology ; 25(14): 145302, 2014 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-24633016

RESUMO

We investigate the ability to introduce strain into atomic-scale silicon device fabrication by performing hydrogen lithography and creating electrically active phosphorus δ-doped silicon on strained silicon-on-insulator (sSOI) substrates. Lithographic patterns were obtained by selectively desorbing hydrogen atoms from a H resist layer adsorbed on a clean, atomically flat sSOI(001) surface with a scanning tunnelling microscope tip operating in ultra-high vacuum. The influence of the tip-to-sample bias on the lithographic process was investigated allowing us to pattern feature-sizes from several microns down to 1.3 nm. In parallel we have investigated the impact of strain on the electrical properties of P:Si δ-doped layers. Despite the presence of strain inducing surface variations in the silicon substrate we still achieve high carrier densities (>1.0 × 10(14) cm(-2)) with mobilities of ∼100 cm(2) V(-1) s(-1). These results open up the possibility of a scanning-probe lithography approach to the fabrication of strained atomic-scale devices in silicon.

20.
Musculoskelet Surg ; 108(1): 87-92, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37644317

RESUMO

Most studies comparing medial pivot to the posterior stabilised (PS) systems sacrifice the PCL. It is unknown whether retaining the PCL in the Medial Congruent (MC) system may provide further benefit compared to the more commonly used PS system. A retrospective review of a single-surgeon's registry data comparing 44 PS and 26 MC with PCL retained (MC-PCLR) TKAs was performed. Both groups had similar baseline demographics. The PS and MC-PCLR groups had similar pre-operative range of motion (ROM) (PS:104º ± 20º vs. MC-PCLR: 101º ± 19º, p = 0.70), Oxford Knee Score (OKS) (PS: 27 ± 6 vs. MC-PCLR: 26 ± 7, p = 0.62), and Knee Society Scoring System (KS) Function Score (KS-FS) (PS: 52 ± 24 vs. MC-PCLR: 56 ± 23, p = 0.49). The pre-operative KS Knee Score (KS-KS) was significantly lower in the PS group (PS: 44 ± 14 vs. MC-PLR: 53 ± 18, p < 0.05). At 12-months post-operation, there was significant improvement in all parameters (p < 0.01). Both groups had similar ROM (PS: 115º ± 13º vs. MC-PCLR: 114º ± 10º, p = 0.98), OKS (PS: 41 ± 5 vs. MC-PCLR: 40 ± 4, p = 0.50), KS-FS (PS: 74 ± 22 vs. MC-PCLR: 77 ± 16, p = 0.78), and KS-KS (PS: 89 ± 10 vs. MC-PCLR: 89 ± 10, p = 0.89). The PS group had significant improvement in all parameters from preoperation to 3-month postoperation (p < 0.05), but not from 3-month to 1-year postoperation (p ≥ 0.05). The MC-PCLR group continued to have significant improvement from 3-month to 1-year postoperation (p < 0.05). Preserving the PCL when using MC may paradoxically cause an undesired additional restrain that slows the recovery process of the patients after TKA. Compared to MC-PCLR, a PS TKA may expect significantly faster improvement at 3 months post operation, although they will achieve similar outcomes at 1-year post operation.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Ligamento Cruzado Posterior , Humanos , Ligamento Cruzado Posterior/cirurgia , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA