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1.
J Biochem Mol Toxicol ; 38(1): e23589, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37985964

RESUMO

In this study, a zebrafish embryo toxicity model was employed, utilizing 24 h postfertilization (hpf) zebrafish embryos. These embryos were treated with varying concentrations of mercuric chloride for 96 h under static conditions. We assessed multiple parameters that reflected developmental abnormalities, behavioral alterations, morphological anomalies, antioxidant enzyme activities, including those of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and glutathione S-transferase (GST), immune messenger RNA transcription levels of key factors such as tumor necrosis factor α (TNF-α), interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and cyclooxygenase 2 (COX-2), as well as protein expression of TNF-α. The results revealed that embryos exposed to higher concentrations of mercury exhibited reduced hatchability and increased rates of morphological abnormalities and mortality at 48, 72, and 96 hpf. In addition, a concentration-dependent increase in developmental abnormalities, including cardiac edema, reduced body length, yolk sac edema, scoliosis, and bent tails, was observed. Larval behaviors, such as touch-induced escape responses, startle reactions, and turning actions, were found to be diminished in a concentration-dependent manner. Additionally, the activities of various antioxidative enzymes, such as SOD, CAT, and GST, exhibited an increase at higher mercury concentrations, with the exception of GPX activity, which decreased significantly in a dose-dependent manner (p < 0.05). Pro-inflammatory cytokine transcription levels, specifically TNF-α, IL-1ß, IL-6, and COX-2, were significantly upregulated in a dose-dependent manner in the mercuric (II) chloride (HgCl2 ) treatment group compared with the control group. TNF-α protein expression was notably elevated in the larvae group treated with 300 and 400 nM HgCl2 .


Assuntos
Antioxidantes , Peixe-Zebra , Animais , Antioxidantes/farmacologia , Peixe-Zebra/metabolismo , Cloreto de Mercúrio/toxicidade , Cloretos/farmacologia , Estresse Oxidativo , Citocinas/metabolismo , Interleucina-6/metabolismo , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo , Ciclo-Oxigenase 2/genética , Ciclo-Oxigenase 2/metabolismo , Embrião não Mamífero , Superóxido Dismutase/metabolismo
2.
Phys Rev Lett ; 130(16): 160401, 2023 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-37154634

RESUMO

From an open system perspective non-Markovian effects due to a nearby bath or neighboring qubits are dynamically equivalent. However, there is a conceptual distinction to account for: neighboring qubits may be controlled. We combine recent advances in non-Markovian quantum process tomography with the framework of classical shadows to characterize spatiotemporal quantum correlations. Observables here constitute operations applied to the system, where the free operation is the maximally depolarizing channel. Using this as a causal break, we systematically erase causal pathways to narrow down the progenitors of temporal correlations. We show that one application of this is to filter out the effects of crosstalk and probe only non-Markovianity from an inaccessible bath. It also provides a lens on spatiotemporally spreading correlated noise throughout a lattice from common environments. We demonstrate both examples on synthetic data. Owing to the scaling of classical shadows, we can erase arbitrarily many neighboring qubits at no extra cost. Our procedure is thus efficient and amenable to systems even with all-to-all interactions.

3.
J Assoc Physicians India ; 68(12[Special]): 25-30, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33247660

RESUMO

Fueled by perceptions regarding Indian dietary patterns and premixed insulin's claim to fame of providing dual fasting and post-prandial control, there was a greater inclination towards using premixed insulins in clinical practice until the last decade. However, the advent of insulin glargine 100 U/mL (Gla-100) opened up a new dimension in insulin therapy landscape in India. The data from the last 5 years reveal that Gla-100 has gained more traction among Indian clinical practitioners. Basis evidences that have emerged from various clinical studies, this present review elaborates on certain key issues which have helped Gla-100 carve its own niche and effected a progressive shift in insulin prescription pattern in India.


Assuntos
Diabetes Mellitus Tipo 2 , Hipoglicemia , Insulinas , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes , Índia , Insulina , Insulina Glargina
4.
J Assoc Physicians India ; 67(12): 44-49, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31801331

RESUMO

BACKGROUND: This study evaluated the adherence and swallowing experience with novel oval-shaped, compact-sized metformin (500 mg/1000 mg)-glimepiride (1mg/2mg) combination, sustained-release tablet (Gluformin G1/Gluformin G2 SR; GM-new-SR) in Indian patients with T2DM, previously treated with conventional metformin-glimepiride combination tablet. METHODS: Patients' adherence, swallowing experience, and satisfaction were assessed at baseline and month-3 by Adherence to Refills and Medication Scale (ARMS12; adherent: ARMS12 score=12; nonadherent: ARMS12 score >12) and questionnaire based 5-point Likert scale, respectively. Safety was also assessed. RESULTS: Of 1550 patients enrolled, 1547 (99.8%) completed the study. After 3 months of switching to GM-new-SR tablets, adherence rate increased from 4.38% to 91.1%, with concurrent reduction in mean ARMS-12 score by 6.3±4.36 (p<0.0001). Compared to baseline, all glycemic indices, HbA1c, PPG, and FPG, significantly improved (p<0.0001) in the overall population. Reduction in HbA1c levels was significant only in patients who were adherent to therapy as opposed to nonadherent patients (7.8±1.74 to 7.1±0.85, p<0.0001 vs. 7.7±1.39 to 6.7±0.77, p=0.4276). Most patients attributed ease of swallowing of GM-new-SR tablets to its modified shape (95.5%) and size (94.9%). Most patients (90.4%) were satisfied with the new tablet formulation. Size of the tablet was the most common reason for patients' nonadherence with conventional tablets, which was reported to be less frequent with GM-new-SR tablets (2.5% vs 53.4%). CONCLUSION: Treatment with GM-new-SR tablets significantly increased adherence and was associated with improvement in glycemic indices, which could be attributed to the compact shape and size of the new tablet formulation.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Metformina/uso terapêutico , Compostos de Sulfonilureia/uso terapêutico , Glicemia , Deglutição , Quimioterapia Combinada , Hemoglobinas Glicadas , Humanos , Adesão à Medicação , Comprimidos
5.
Phys Chem Chem Phys ; 20(3): 1914-1922, 2018 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-29297524

RESUMO

This communication presents a detailed study on a Fe3+ modified CaCu3Ti4O12 cubic perovskite system (CaCu3-xTi4-xFe2xO12 with x = 0.0-0.7) by performing X-ray powder diffractometry, DC SQUID magnetization and 57Fe Mössbauer spectroscopy. The first ever Mössbauer studies on the system supported the reported peculiarity of the structure. Mössbauer analysis for the compositions x = 0.1, 0.3, and 0.5 suggest Fe3+ ions in two different environments. The site with larger quadrupole splitting corresponds to Fe3+ in the octahedral symmetry, while the site with lower chemical shift and quadrupole splitting belongs to Fe3+ in the square-planar (A'-) configuration. With the increase in Fe-substitution, Fe3+ appears to prefer A'- symmetry. Antiferromagnetic features are retained up to x = 0.3, but weak ferromagnetic characteristics appear with higher Fe3+ substitution. The switching of antiferromagnetic to ferromagnetic behavior was related to the preferential occupation of Fe3+ in square-planar symmetry accommodating Cu2+.

6.
Eur Ann Allergy Clin Immunol ; 49(5): 231-234, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28884991

RESUMO

SUMMARY: We describe the case of a 24-year-old male with hyper-IgE syndrome (HIES) which was diagnosed at 4 years of age and died from a very rare cardiac complication. He had typical clinical and laboratory manifestations of HIES, including total serum IgE as high as > 100,000 IU/mL. Stem cell transplantation was not available. During the 20-year follow-up, he suffered numerous various infections of the skin and deep organs, partial lung resection, as well as multiple bone fractures. At age 24, he developed acute decompensated heart failure associated with elevated serum troponin I and brain natriuretic protein. Two-dimensional echocardiogram revealed global hypokinesis of the left ventricle with estimated ejection fraction 20-25%, and catheterization revealed ectasia of multiple coronary arteries. Endomyocardial biopsy showed lymphocytic myocarditis, focal necrosis, mild fibrosis, and myxoid degeneration, but cultures were negative. The patient improved on corticosteroid therapy and was discharged on heart failure therapy and external defibrillator. Six weeks later, he developed supraventricular tachycardia and persistent global hypokinesis and was treated with amiodarone. A trial of intravenous immunoglobulin was initiated and was repeated as outpatient every four weeks for four times. However, his cardiac function did not improve and he developed severe hypotension and pulseless electrical activity arrest. Resuscitation was unsuccessful. To the best of our knowledge, this is the first reported case of HIES complicated with lymphocytic myocarditis. Both immunologists and cardiologists need to be aware of such a complication and practice caution in using immunosuppressants when the patient's immune status is markedly compromised.


Assuntos
Hipergamaglobulinemia/imunologia , Imunoglobulina E/imunologia , Síndrome de Job/imunologia , Miocardite/imunologia , Biópsia , Evolução Fatal , Humanos , Hipergamaglobulinemia/complicações , Hipergamaglobulinemia/diagnóstico , Hospedeiro Imunocomprometido , Imunoglobulina E/sangue , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Síndrome de Job/complicações , Síndrome de Job/diagnóstico , Masculino , Miocardite/diagnóstico , Miocardite/fisiopatologia , Miocardite/terapia , Resultado do Tratamento , Adulto Jovem
7.
Phys Rev Lett ; 114(9): 090402, 2015 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-25793785

RESUMO

We fully characterize the reduced dynamics of an open quantum system initially correlated with its environment. Using a photonic qubit coupled to a simulated environment, we tomographically reconstruct a superchannel-a generalized channel that treats preparation procedures as inputs-from measurement of the system alone. We introduce novel quantitative measures for determining the strength of initial correlations, and to allow an experiment to be optimized in regard to its environment.

8.
J Assoc Physicians India ; 63(5 Suppl): 15-20, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26548030

RESUMO

In patients with diabetes, treatment intensification requires basal and bolus insulin injections to control the fasting and prandial insulin needs. To overcome the burden of multiple daily injections, co-formulating basal and bolus insulins in single injection could allow a simple regimen with fewer injections. Current premixed insulin analogues are limited by the protaminated insulin component, which cannot provide effective basal coverage. While, long-acting insulin analogues like insulin glargine and insulin detemir cannot be combined with rapid-acting insulin analogues due to physicochemical incompatibility. Insulin degludec/insulin aspart (IDegAsp) is a soluble co-formulation of two distinct insulin analogues in the ratio of 70% ultra-long-acting insulin degludec (IDeg) and 30% rapid-acting insulin aspart (IAsp). The distinct PK/PD properties of IDeg and IAsp components are preserved in the co-formulation, with the rapid absorption characteristics of IAsp and flat and stable profile of IDeg maintained separately. Size exclusion chromatography studies of IDegAsp indicate that IDeg and lAsp exist as stable di-hexamers and hexamers, respectively in the formulation. Moreover, at steady state, the prandial and basal glucose lowering effects of IDeg and IAsp were distinct and clearly separated. A clear dose-response relationship was observed in patients with type 1 and type 2 diabetes treated with IDegAsp. The glucose lowering effects of basal and prandial components of IDegAsp are maintained in elderly (≥ 65 years of age) patients with type 1 diabetes. In addition, the PK and clearance of IDeg and IAsp are not affected by mild, moderate or severe renal or hepatic impairment. Presence of two distinct insulin analogues, as a soluble co-formulation with basal component with an ultra-long duration of action makes IDegAsp an advance to premix insulins.


Assuntos
Glicemia/análise , Diabetes Mellitus , Insulina de Ação Prolongada , Cromatografia , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/metabolismo , Relação Dose-Resposta a Droga , Combinação de Medicamentos , Composição de Medicamentos , Interações Medicamentosas , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes/química , Hipoglicemiantes/farmacocinética , Hipoglicemiantes/uso terapêutico , Insulina de Ação Prolongada/química , Insulina de Ação Prolongada/farmacocinética , Insulina de Ação Prolongada/uso terapêutico
9.
Global Health ; 10: 13, 2014 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-24612523

RESUMO

BACKGROUND: The UK government committed to undertaking impact assessments of its policies on the health of populations in low and middle-income countries in its cross-government strategy "Health is Global". To facilitate this process, the Department of Health, in collaboration with the National Heart Forum, initiated a project to pilot the use of a global health impact assessment guidance framework and toolkit for policy-makers. This paper aims to stimulate debate about the desirability and feasibility of global health impact assessments by describing and drawing lessons from the first stage of the project. DISCUSSION: Despite the attraction of being able to assess and address potential global health impacts of policies, there is a dearth of existing information and experience. A literature review was followed by discussions with policy-makers and an online survey about potential barriers, preferred support mechanisms and potential policies on which to pilot the toolkit. Although policy-makers were willing to engage in hypothetical discussions about the methodology, difficulties in identifying potential pilots suggest a wider problem in encouraging take up without legislative imperatives. This is reinforced by the findings of the survey that barriers to uptake included lack of time, resources and expertise. We identified three lessons for future efforts to mainstream global health impact assessments: 1) Identify a lead government department and champion--to some extent, this role was fulfilled by the Department of Health, however, it lacked a high-level cross-government mechanism to support implementation. 2) Ensure adequate resources and consider embedding the goals and principles of global health impact assessments into existing processes to maximise those resources. 3) Develop an effective delivery mechanism involving both state actors, and non-state actors who can ensure a "voice" for constituencies who are affected by government policies and also provide the "demand" for the assessments. SUMMARY: This paper uses the initial stages of a study on global health impact assessments to pose the wider question of incentives for policy-makers to improve global health. It highlights three lessons for successful development and implementation of global health impact assessments in relation to stewardship, resources, and delivery mechanisms.


Assuntos
Saúde Global , Avaliação do Impacto na Saúde/métodos , Formulação de Políticas , Políticas , Órgãos Governamentais/organização & administração , Avaliação do Impacto na Saúde/economia , Prioridades em Saúde , Humanos , Liderança , Reino Unido
10.
J Assoc Physicians India ; 61(7): 448-53, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24772746

RESUMO

Non-alcoholic fatty liver disease (NAFLD) is a distinct hepatic condition and one of the most common causes of chronic liver disease globally. Prevalence of the disease is estimated to be around 9-32% in the general Indian population, with a higher incidence rate amongst obese and diabetic patients. We conducted this study to determine frequency and risk factors of NAFLD in nonalcoholic Indian type 2 diabetic (T2DM) patients, based on elevated aminotransferase levels, defined as per NHANES III criteria. Out of 924 patients (355 female/569 male), in age group of 25-84 years, enrolled at 189 centers across 101 cities in India, a cohort of 522(56.5%) T2DM patients were identified as having NAFLD. Prevalence of the disease was found to be higher in females (60%) than in males (54.3%) T2DM patients; with prevalence of NAFLD varying from 44.1% in western India to 72.4% in northern states. In our study the prevalence of NAFLD increased with increasing age, with 239(45.8%) identified patients in age group of 25-50 years and 283(54.2%) among those aged 51 years (OR:0.71, 95%CI: 0.54-0.92, p=0.005); with highest prevalence recorded in 61-70 year age group, at 61.8%. The results from the study reinforced the well established clinical association of NAFLD with elements of metabolic syndrome (MetS) including dyslipidemia, hypertension and obesity; as T2DM population with these co-morbid conditions had 38%, 17% and 14% higher risk respectively, for NAFLD. The mean AST and ALT levels were 54.8+/-36.1 IU/L and 55.6+/-39.8 IU/L, respectively in NAFLD population and highest in age group of 25-40 years and lowest in 71-84 years age group. Mean ALT levels were found to be higher than mean AST levels across all age groups in identified T2DM NAFLD cohort, with 340(65.3%) patients having elevation of both AST and ALT levels. The results from this study besides demonstrating the prevalence pattern of NAFLD and associated risk factors in Indian T2DM patients, also point out that even mild elevation in aminotransferase levels warrants attention, since it might more often than not point to previously unsuspected liver disease.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Fígado Gorduroso/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Dislipidemias/complicações , Feminino , Humanos , Hipertensão/complicações , Índia , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica , Obesidade/complicações , Fatores de Risco , Fatores Sexuais
11.
Indian J Endocrinol Metab ; 27(1): 50-55, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37215271

RESUMO

Background and Objectives: Transient thyroid hormone alterations are common during critical illness and are termed non-thyroidal illness syndrome (NTIS). We studied the prevalence of NTIS in the ICU setting and its impact on predicting mortality and other outcomes and compared it to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Materials and Methods: The study included 119 consecutive patients admitted with a critical illness. APACHE II score was calculated. Total T3, total T4, TSH, free T3, and free T4 were measured at admission and after six weeks of discharge. NTIS and euthyroid groups were studied for ICU, hospital stays, mortality, readmission, and recovery. Predictors of mortality were compared between survivors and non-survivors. Results: The mean age was 60.15 ± 14.50 years with M:F = 84 (71%):35 (29%). NTIS was observed in 84 (71%), low T3 being the most common abnormality in 53 (63%). The occurrence of NTIS was significantly higher among non-survivors (28/30, 93%) versus survivors (56/89, 63%) (P = 0.002). Non-survivors showed significantly lower T3, TSH, and FT3/FT4 ratios and higher readmissions. NTIS group showed significantly greater ICU stay (P = 0.02) and had higher readmission rates (P = 0.032). Baseline T3 had the greatest power to predict mortality. APACHE II score also correlated significantly with mortality (19.60 ± 10.58 vs 11.99 ± 6.80, P < 0.001). The area under the curve (0.677) for the T3 level was lower than the APACHE II score (0.760). After six weeks, 61% had recovered from NTIS. Conclusions: NTIS was common amongst critically ill patients (71.5%), which reversed in 61% at six weeks. Low T3 was the most common abnormality and independently predicted mortality. Free T3/free T4 also significantly predicted mortality. The correlation between thyroid dysfunction and the severity of primary illness makes it an additional attractive low-cost marker of mortality.

12.
Phys Rev Lett ; 109(7): 070501, 2012 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-23006347

RESUMO

The ability to distribute quantum entanglement is a prerequisite for many fundamental tests of quantum theory and numerous quantum information protocols. Two distant parties can increase the amount of entanglement between them by means of quantum communication encoded in a carrier that is sent from one party to the other. Intriguingly, entanglement can be increased even when the exchanged carrier is not entangled with the parties. However, in light of the defining property of entanglement stating that it cannot increase under classical communication, the carrier must be quantum. Here we show that, in general, the increase of relative entropy of entanglement between two remote parties is bounded by the amount of nonclassical correlations of the carrier with the parties as quantified by the relative entropy of discord. We study implications of this bound, provide new examples of entanglement distribution via unentangled states, and put further limits on this phenomenon.

13.
Metabol Open ; 14: 100184, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35496980

RESUMO

Objective: This post-authorization safety study (PASS) was conducted to evaluate the long-term safety and effectiveness of insulin degludec in patients with diabetes mellitus (DM) requiring insulin therapy in routine clinical practice in India. Methods: Data on glycated hemoglobin (HbA1c) and adverse events (AEs) were collected up to 12 months after insulin degludec initiation. Results: A total of 1057 adult patients with DM were enrolled, including 60.07% males with the mean duration of 22.2 ± 21.90 years with type 1 DM and 10.1 ± 7.37 years with type 2 DM and the mean HbA1c of 9.6 ± 1.9%. Insulin degludec was prescribed to improve HbA1c and fasting plasma glucose (FPG). Insulin degludec daily dose was increased from 14.8 ± 8.0 U to 18.0 ± 9.46 U over 12 months resulting in a significant decrease of HbA1c by 1.8 ± 1.68% compared with baseline. There were 84 events of confirmed hypoglycemia in 51 patients during the 12-month follow-up period, and 44 AEs were reported in 2.6% of patients, of which 2 AEs were serious and unrelated to the drug. Conclusion: Insulin degludec is well tolerated in patients with DM. It improves glycemic control with reduced HbA1c, FPG, and postprandial glucose, with a low risk of hypoglycemia.

14.
Cureus ; 13(1): e13020, 2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-33665047

RESUMO

Background Type 2 diabetes mellitus (T2DM) is associated with a significant burden on both patients and the healthcare system. This study aimed to evaluate the demographics of patients with T2DM receiving different strengths of glimepiride and metformin combination along with insulin. This study also examined the concomitant conditions and therapies, duration of therapies, dosage titration, glycated hemoglobin (HbA1c) levels, hypoglycemic events, and weight changes during the course of therapy. Methods This retrospective, multicenter (347), observational study included adult patients with T2DM who received glimepiride and metformin combination along with insulin. Data related to demographic characteristics, duration of disease, co-morbidities, concomitant medications, and dosage pattern was collected from medical records authenticated by physicians during routine care. Results A total of 7058 patients were included in the study. The median age of included patients was 55 years and around 29% were aged >60 years and 60% were men. The majority of patients (83.3%) had insulin treatment initiation after glimepiride and metformin combination while other patients (16.7%) received glimepiride and metformin combination after insulin initiation. The mean HbA1c levels significantly decreased with a mean change of 1.33%. In one-third of the patients, down-titration of the insulin dose was done, indicating the insulin-sparing effect with the addition of the glimepiride and metformin combination. The most common comorbid condition was hypertension (64.7%). Of 3705 patients, 33.2% patients had weight loss and 66.8% had weight gain. A total of 432 patients reported hypoglycemic events. Physician global evaluation of efficacy and tolerability showed a good to excellent on the scale (97.3% and 96.6%). Conclusion This study presented good HbA1c lowering with glimepiride and metformin combination with insulin, ensuring a positive clinical outcome. Good to excellent efficacy and tolerability were observed in patients with T2DM across the age groups, in early as well as long-standing disease.

15.
Nat Commun ; 11(1): 6301, 2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33298929

RESUMO

In the scale-up of quantum computers, the framework underpinning fault-tolerance generally relies on the strong assumption that environmental noise affecting qubit logic is uncorrelated (Markovian). However, as physical devices progress well into the complex multi-qubit regime, attention is turning to understanding the appearance and mitigation of correlated - or non-Markovian - noise, which poses a serious challenge to the progression of quantum technology. This error type has previously remained elusive to characterisation techniques. Here, we develop a framework for characterising non-Markovian dynamics in quantum systems and experimentally test it on multi-qubit superconducting quantum devices. Where noisy processes cannot be accounted for using standard Markovian techniques, our reconstruction predicts the behaviour of the devices with an infidelity of 10-3. Our results show this characterisation technique leads to superior quantum control and extension of coherence time by effective decoupling from the non-Markovian environment. This framework, validated by our results, is applicable to any controlled quantum device and offers a significant step towards optimal device operation and noise reduction.

16.
Indian J Endocrinol Metab ; 24(4): 366-372, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33088762

RESUMO

BACKGROUND: Persistent elevation of serum parathyroid hormone (PTH) despite normocalcemia have been documented in 8- 40% of patients after parathyroidectomy. We hereby report our experience from different centers across India to determine clinical significance of postoperatively elevated PTH levels and review relevant literature. METHODS: We conducted a retrospective case series study and reviewed all the patients who underwent surgery for primary hyperparathyroidism (PHPT) from April 2010 to January 2020. RESULTS: Total of 201 patients was diagnosed as PHPT. Out of available follow-up data of 180 patients, a total of 54 patients (30%) had persistently elevated PTH (PePTH) at 1 month. Patients with PePTH were older with higher preoperative serum calcium, iPTH, alkaline phosphatase and lower serum phosphate and 25-hydroxy vitamin D3 levels. Creatinine clearance was found to be significantly lower in patients with PePTH. Multiple linear regression analysis revealed that preoperative 25-OH D3 concentration, creatinine clearance and iPTH are the factors influencing persistent elevation of PTH levels. Significantly lower serum calcium and higher alkaline phosphatase levels were observed in PePTH patients with preoperative 25-OH D3 levels <20 ng/mL. Thirty patients at 6 months, 24 patients at 1 year, 18 patients at 2 years and 9 patients at 3 years had eucalcemic PTH elevation. Nine out of 126 (7%) patients with normal initial postoperative calcium and iPTH levels developed PePTH, with none culminating into recurrent hyperparathyroidism. CONCLUSION: Though the pathogenesis of such a phenomenon still remains to be elucidated, a multifactorial mechanism appears to play a role.

17.
West Indian Med J ; 58(6): 566-70, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20583684

RESUMO

OBJECTIVE: Assessment of thyroid blood flow gives valuable information about underlying functional status. Colour Flow Doppler Sonography (CFDS) is a powerful tool which displays tissue blood flow and vascularity. Colour Flow Doppler Sonography of the thyroid gland in different subsets of patients with Graves' disease was studied to define its role in initial diagnosis and management. METHODS: Eighty consecutive patients with Graves' disease (both treated and untreated) presented to hospital between August 2007 and February 2008. All patients were evaluated with CFDS of the thyroid for size, vascularity and peak systolic velocity (PSV) of the Inferior Thyroid Artery (ITA). Pertechnate scan and thyroidal autoantibody levels were done in selected cases. The patients were divided into Untreated Graves' disease (n = 31), Graves' disease on treatment but hyperthyroid (n = 26) and euthyroid Graves' disease on therapy (n = 23). Mann-Whitney U-test was used for statistical analysis and a p-value of less than 0.05 was considered significant. RESULTS: Thyroid blood flow, as assessed by PSV of ITA, was significantly higher in untreated Graves' disease than in Graves disease on treatment but hyperthyroid and euthyroid Graves respectively (61.5 +/- 19.5 versus 42.9 +/- 24.7 versus 32.2 +/- 12.9 cm/s, p < 0.05). Parenchymal vascularity of the thyroid gland was higher in hyperthyroid patients than in euthyroid patients irrespective of therapy. In both groups on therapy, the dose of carbimazole correlated with the vascularity of the gland (r = 0.492 versus 0.564, p < 0.05). Colour Flow Doppler Sonography parameters correlated significantly with pertechnate scan results giving comparable sensitivity and specificity. CONCLUSION: Assessment of thyroid blood flow by CFDS is an effective marker in the initial diagnosis of Graves' disease. Vascularity of the gland can predict long term disease course while on medical therapy.


Assuntos
Doença de Graves/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto , Velocidade do Fluxo Sanguíneo , Feminino , Doença de Graves/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Glândula Tireoide/irrigação sanguínea , Glândula Tireoide/diagnóstico por imagem , Adulto Jovem
18.
Phys Rev E ; 99(5-1): 050101, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31212510

RESUMO

The work performed on or extracted from a nonautonomous quantum system described by means of a two-point projective-measurement approach is a stochastic variable. We show that the cumulant generating function of work can be recast in the form of quantum Rényi-α divergences, and by exploiting the convexity of this cumulant generating function, derive a single-parameter family of bounds for the first moment of work. Higher order moments of work can also be obtained from this result. In this way, we establish a link between quantum work statistics in stochastic approaches and resource theories for quantum thermodynamics, a theory in which Rényi-α divergences take a central role. To explore this connection further, we consider an extended framework involving a control switch and an auxiliary battery, which is instrumental to reconstructing the work statistics of the system. We compare and discuss our bounds on the work distribution to findings on deterministic work studied in resource-theoretic settings.

19.
J Nanosci Nanotechnol ; 8(8): 4181-7, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19049199

RESUMO

Nanoparticles having particle size in the range 25-40 nm for compositions x = 0.0, 0.2, 0.4 and 0.5 of Mg(x)Mn(1-x)Fe2O4 spinel ferrite system have been prepared by chemical co-precipitation route. The microstructure, infrared spectral and elastic properties have been studied by means of energy dispersive analysis of X-rays (EDAX), transmission electron microscopy (TEM), X-ray diffraction (XRD) and infrared spectroscopic (IR) measurements, before (W) and after high temperature annealing A(w). The force constants for tetrahedral and octahedral sites determined by infrared spectral analysis, lattice constant and X-ray density values by X-ray diffraction pattern analysis; have been used to calculate elastic constants. The magnitude of force constant and elastic moduli for nanocrystalline W-samples are found to be larger as compared to coarse grained A(w)-samples. The results have been explained in the light of redistribution of cations and as a result change in mean ionic charge for such cationic sites, elastic energy and grain size reduction effect of Nanoparticles.

20.
Int J Gynaecol Obstet ; 102(2): 152-5, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18456267

RESUMO

OBJECTIVE: To determine whether color flow Doppler sonography (CFDS) is useful in differentiating Graves vs non-Graves thyrotoxicosis during pregnancy, when nuclear imaging is contraindicated. METHODS: Ten pregnant women with thyrotoxicosis were divided into Graves, and non-Graves, disease groups and were evaluated by CFDS for thyroid volume, vascularity, and inferior thyroid artery (ITA) flow velocity. Each patient was matched with a euthyroid woman of the same pregnancy duration. RESULTS: Of the 10 patients, 3 were diagnosed with Graves disease, 4 with gestational toxicosis, and 3 with destructive thyroiditis. Those in the Graves disease group had a greater thyroid gland volume (18.9+/-1.5 cm3 vs 12.1+/-2.4 cm3; P<0.05), greater thyroid vascularity, and greater ITA flow velocity than those in the non-Graves disease group (92+/-13 cm/s vs 20.4+/-2.4 cm/s; P<0.05). There was no significant difference in the corresponding values between the patients with gestational toxicosis and those with destructive thyroiditis or between them and their healthy controls. CONCLUSION: Thyroid evaluation by CFDS is useful for the differential diagnosis of thyrotoxicosis in pregnant women.


Assuntos
Doença de Graves/diagnóstico por imagem , Complicações na Gravidez/diagnóstico por imagem , Tireotoxicose/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Gravidez
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