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1.
J Exp Zool A Ecol Integr Physiol ; 339(9): 803-815, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37422723

ABSTRACT

Urban areas provide a constant and predictable supply of anthropogenic processed food. The House Sparrow (Passer domesticus Linnaeus, 1758), a declining urban bioindicator species, has recently been reported to have a high level of oxidative stress, with urban diet or pollutants proposed as the potential cause. In this study, we aimed to experimentally determine the effects of two urban trophic resource types (bar snack food leftovers and pet food) on sparrows' physical condition, plasma biochemical nutritional parameters, and blood oxidative status in captivity. To exclude the potential previous effect of urban pollutants, 75 House Sparrows were captured from a rural area in SE Spain and kept in outdoor aviaries. Individuals were exposed to one of three diet treatments: control diet (fruit, vegetables, poultry grain mixture), bar snack diet (ultra-processed snacks), or cat food diet (dry pellets) for 20 days. Blood samples were collected before and after diet treatments to analyze the relative change rates of 12 variables, including physical condition, nutritional status, and oxidant-antioxidant status. A principal component analysis was run to identify gradients of variables covariation, and Generalized Linear Mixed Models were used to determine the effect of diets on each selected PC and on raw variables. The bar snack diet led to signs of anemia and malnutrition, and females tended to lose body condition. The cat food diet increased oxidative stress indicators and protein catabolism. Unbalanced urban diets can affect the body condition and nutritional physiology of House Sparrows and may also induce oxidative stress despite the absence of environmental pollution.

2.
J Emerg Trauma Shock ; 15(1): 35-40, 2022.
Article in English | MEDLINE | ID: mdl-35431479

ABSTRACT

Introduction: History is an important component of emergency department risk stratification for chest pain patients. We hypothesized that a significant portion of patients would not be able to accurately report their history of coronary artery disease (CAD) and diagnostic testing. Methods: We prospectively enrolled a convenience sample of a cohort of adult ED patients with a chief complaint of chest pain. They completed a structured survey that included questions regarding prior testing for CAD and cardiac history. Study authors performed a structured chart review within the electronic medical record for our 6-hospital system. Results of testing for CAD, cardiac interventions, and chart diagnoses of CAD/acute myocardial infarction (AMI) were recorded. Categorical data were analyzed by Chi-square and continuous data by logistic regression. Results: About 196 patients were enrolled; mean age 57 ± 15 years, 48% female, 67% Hispanic, 50% income <$20,000/year. About 43% (95% confidence interval [CI] 35%-51%) of patients stated that they did not have CAD, yet medical records indicated that they were CAD+. With increasing age, patients were more likely to accurately report the absence of CAD (P < 0.001). There was no association between patients reporting no CAD, but CAD+ in records with respect to the following characteristics: female gender (P = 0.37), Hispanic race (P = 0.73), income (P = 0.41), less than or equal to high school education (P = 0.11), and private insurance (P = 0.71). For patients with prior AMI, 7.2% (95% CI 2.7%-11%) reported no prior history of AMI. Conclusions: Within our study group from a predominantly poor, Hispanic population, patients had a poor recall for the presence of CAD in their medical history.

3.
Heliyon ; 7(6): e07216, 2021 Jun.
Article in English | MEDLINE | ID: mdl-34159273

ABSTRACT

BACKGROUND: In the face of the opiate addiction epidemic, there is a paucity of research that evaluates limitations for our current pain rating methodologies for patient populations at risk for drug seeking behavior. OBJECTIVE: We hypothesized that VAS scores would be higher and show less serial improvement for patients with a history of frequent ED use. METHODS: This was a prospective, observational cohort study of a convenience sample of adult ED patients with chief complaint of pain. Initial VAS scores were recorded. Pain scores were subsequently updated 30-45 min after pain medication administration. ED frequenter defined as having >4 ED visits over a 1-year time period. Categorical data analyzed by chi-square; continuous data analyzed by t-tests. A multiple linear regression performed to control for confounding. RESULTS: 125 patients were enrolled; 51% ED frequenters. ED frequenters were similar to non-ED frequenters with respect to gender, mean age, Hispanic race, educational level, chief complaint type, and initial pain medication narcotic. ED frequenters more likely to have higher initial VAS score (9.17+/-1.25 vs. 8.51+/-1.68; p = 0.01) and higher second VAS scores (7.48+/-2.56 vs. 5.00+/-3.28; p <0.001) and significantly lower mean change in first to second VAS scores (1.69+/-2.17 vs. 3.51+/-3.25; p <0.001). Within our multiple linear regression model, only ED frequenter group (p < 0.001) and private insurance status (0.04) were associated with differences in mean reduction in pain scores. CONCLUSION: We found that ED frequenters had significantly less improvement between first and second VAS measurements.

4.
Sensors (Basel) ; 20(22)2020 Nov 17.
Article in English | MEDLINE | ID: mdl-33212763

ABSTRACT

Inspecting a 3D object which shape has elastic manufacturing tolerances in order to find defects is a challenging and time-consuming task. This task usually involves humans, either in the specification stage followed by some automatic measurements, or in other points along the process. Even when a detailed inspection is performed, the measurements are limited to a few dimensions instead of a complete examination of the object. In this work, a probabilistic method to evaluate 3D surfaces is presented. This algorithm relies on a training stage to learn the shape of the object building a statistical shape model. Making use of this model, any inspected object can be evaluated obtaining a probability that the whole object or any of its dimensions are compatible with the model, thus allowing to easily find defective objects. Results in simulated and real environments are presented and compared to two different alternatives.

5.
J Emerg Trauma Shock ; 12(2): 141-144, 2019.
Article in English | MEDLINE | ID: mdl-31198282

ABSTRACT

BACKGROUND: Prior research has revealed that cervical collars elevate intracranial pressure (ICP) in patients with traumatic brain injury. Two recent small studies evaluated the change in optic sheath nerve diameter (ONSD) measured by ultrasound as a proxy for ICP following cervical collar placement in healthy volunteers. OBJECTIVE: We sought to validate the finding that ONSD measured by ultrasound increases after cervical collar placement within an independent data set. METHODS: This was a prospective, crossover study involving volunteers. Participants were randomized to either have the ONSD measured first without a cervical collar or initially with a cervical collar. Two sonographers performed independent ONSD diameter measurements. Continuous data were analyzed by matched-paired t-tests. Alpha was set at 0.05. The primary outcome parameter was the overall mean difference between ONSD measurements with the cervical collar on and off. Multiple linear regression was performed to examine the relationship between variables and the primary outcome parameter. RESULTS: There were 30 participants enrolled in the study. Overall mean ONSD for participants without the collar was 0.365 ± 0.071 cm and with the collar was 0.392 ± 0.081 cm. The mean change in ONSD for participants with and without the collar was 0.026 ± 0.064 cm (95% confidence interval of difference: 0.015-0.038; P < 0.001). Multiple regression analysis did not identify any variables associated with the variation in ONSD observed for collar versus noncollar. CONCLUSIONS: We confirmed that ONSD does vary by a measurable amount with placement of a rigid cervical collar on healthy volunteers when assessed by ultrasound.

6.
Sensors (Basel) ; 18(9)2018 Sep 07.
Article in English | MEDLINE | ID: mdl-30205498

ABSTRACT

This work presents a 3D scanner able to reconstruct a complete object without occlusions, including its surface appearance. The technique presents a number of differences in relation to current scanners: it does not require mechanical handling like robot arms or spinning plates, it is free of occlusions since the scanned part is not resting on any surface and, unlike stereo-based methods, the object does not need to have visual singularities on its surface. This system, among other applications, allows its integration in production lines that require the inspection of a large volume of parts or products, especially if there is an important variability of the objects to be inspected, since there is no mechanical manipulation. The scanner consists of a variable number of industrial quality cameras conveniently distributed so that they can capture all the surfaces of the object without any blind spot. The object is dropped through the common visual field of all the cameras, so no surface or tool occludes the views that are captured simultaneously when the part is in the center of the visible volume. A carving procedure that uses the silhouettes segmented from each image gives rise to a volumetric representation and, by means of isosurface generation techniques, to a 3D model. These techniques have certain limitations on the reconstruction of object regions with particular geometric configurations. Estimating the inherent maximum error in each area is important to bound the precision of the reconstruction. A number of experiments are presented reporting the differences between ideal and reconstructed objects in the system.

7.
BMC Res Notes ; 11(1): 225, 2018 Apr 03.
Article in English | MEDLINE | ID: mdl-29615107

ABSTRACT

OBJECTIVE: Healthy habits during childhood has been of prime importance. We aimed to gather baseline information about health habits from children in kindergarten and first grade (typically ages 5-7). Our objectives were to validate the questionnaire in assessing health habits, as well as the electronic audience response system, iClicker (MPS, Gordonsville, VA), in this age group. RESULTS: The questionnaire completed by 75 kindergarteners and 66 first graders. For the first graders, questions involving healthy choices were answered correctly 78% of the time (range 8-94%) and had 84% agreement on repeat testing (range 64-93%). Questions on diabetes were answered correctly 79% of the time (range 65-94%) and had 85% agreement on repeat testing. Crohnbach's alpha was calculated to determine the reliability of the questionnaire: on the revised kindergarten questionnaire, this ranged from 0.79 to 0.81 on Day 1 and 0.84-0.97 on Day 5; for the first graders, this ranged 0.79-0.81 on Day 1 and 0.84-0.97 on Day 5. Both kindergarteners and first graders answered the simplest of the basic knowledge questions correctly > 80% of the time, with acceptable test-retest agreement. Additionally, these children demonstrated acceptable understanding of the use of the iClicker classroom response system.


Subject(s)
Health Knowledge, Attitudes, Practice , Healthy Lifestyle , Psychometrics , Child , Child, Preschool , Female , Humans , Male , Psychometrics/instrumentation , Psychometrics/methods , Psychometrics/standards , Reproducibility of Results , Schools , Surveys and Questionnaires
8.
J Infus Nurs ; 41(3): 176-179, 2018.
Article in English | MEDLINE | ID: mdl-29659465

ABSTRACT

It is not clear whether blood glucose (BG) affects the risk of peripherally inserted central catheter (PICC)-related upper extremity venous thrombosis (PRUEVT). A case-control study was conducted comparing patients with PRUEVT versus patients with PICCs who did not develop PRUEVT. BG on admission was significantly higher among cases with PRUEVT than controls. No significant differences were found between the groups in hemoglobin A1c or BG on the third day of hospitalization. PRUEVT cases were more likely to be diabetic, but this did not reach statistical significance. The time that a PICC was in place before PRUEVT was diagnosed was longer for diabetic patients, but the authors believe this result must be viewed with caution.


Subject(s)
Catheterization, Central Venous/adverse effects , Catheterization, Peripheral/adverse effects , Hyperglycemia/complications , Upper Extremity Deep Vein Thrombosis/etiology , Blood Glucose/analysis , Case-Control Studies , Catheterization, Central Venous/methods , Catheters, Indwelling , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , Upper Extremity/blood supply
9.
J Antimicrob Chemother ; 72(10): 2850-2856, 2017 10 01.
Article in English | MEDLINE | ID: mdl-29091196

ABSTRACT

Background: New direct-acting antiviral agents (DAAs) have shown great efficacy and tolerability in clinical trials and real-life cohorts. However, data are scarce regarding efficacy and safety in cirrhotic HCV/HIV-coinfected patients. Methods: A multicentre prospective analysis was performed in 13 Spanish hospitals, including all cirrhotic HCV/HIV-coinfected patients starting DAA combinations from January to December 2015. Sustained virological response 12 weeks after treatment (SVR12) was analysed. Withdrawal due to toxicity and/or hepatic decompensation and change in liver stiffness measurement (LSM) after HCV treatment were evaluated. Results: Patients (n = 170) were mostly male (n = 125; 74.3%) with the following HCV genotype (Gt) distribution: Gt-1a, 68 (40%); Gt-1b, 21 (12.4%); Gt-4, 47 (27.6%); and Gt-3, 26 (15.3%). Baseline median LSM was 20.6 kPa (IQR 16.1-33.7) and log10 HCV-RNA 6.1 IU/mL (IQR 5.7-6.5). Most patients had a Child-Pugh class A score (n = 127; 74.7%) and 28 (16.5%) had prior hepatic decompensation. There were 89 (52.4%) pretreated patients with 40.4% (n = 36) of null responders. Preferred regimens were as follows: sofosbuvir/ledipasvir + ribavirin, 43 (25.3%) patients; sofosbuvir + simeprevir + ribavirin, 34 (20%); sofosbuvir/ledipasvir, 26 (15.3%) and sofosbuvir + daclatasvir + ribavirin, 25 (14.7%). Overall SVR12 was 92.9% (158/170), without differences between genotypes. Pretreated patients had lower SVR12 rates compared with naive (88.8% versus 97.5%; P = 0.026). Treatment failures were as follows: 7 (4.1%) relapses; 2 (1.2%) lost to follow-up; 1 (0.6%) toxicity-related discontinuation; 1 (0.6%) hepatic decompensation; and 1 (0.6%) viral breakthrough. On-treatment hepatic decompensation was recorded in four (2.4%) patients (encephalopathy and ascites, two each). Paired LSM in 33 patients showed a decrease of 5.6 kPa (95% CI 1.8-9.2; P = 0.004). Conclusions: In our cohort of cirrhotic HCV/HIV-coinfected patients, DAAs were highly safe and efficacious. Viral eradication was associated with a significant decrease in liver stiffness.


Subject(s)
Antiviral Agents/therapeutic use , Coinfection/drug therapy , HIV Infections/drug therapy , Hepatitis C, Chronic/drug therapy , Liver Cirrhosis/complications , RNA, Viral/drug effects , Antiviral Agents/administration & dosage , Antiviral Agents/adverse effects , Benzimidazoles/administration & dosage , Benzimidazoles/adverse effects , Benzimidazoles/therapeutic use , Cohort Studies , Coinfection/virology , Drug Therapy, Combination/adverse effects , Female , Fluorenes/administration & dosage , Fluorenes/adverse effects , Fluorenes/therapeutic use , Genotype , HIV/drug effects , HIV Infections/complications , HIV Infections/epidemiology , Hepacivirus/drug effects , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/epidemiology , Humans , Male , Middle Aged , Prospective Studies , Ribavirin/administration & dosage , Ribavirin/adverse effects , Ribavirin/therapeutic use , Simeprevir/administration & dosage , Simeprevir/adverse effects , Simeprevir/therapeutic use , Sofosbuvir , Spain/epidemiology , Sustained Virologic Response , Treatment Outcome , Uridine Monophosphate/administration & dosage , Uridine Monophosphate/adverse effects , Uridine Monophosphate/analogs & derivatives , Uridine Monophosphate/therapeutic use
10.
Am J Emerg Med ; 34(9): 1783-7, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27431738

ABSTRACT

BACKGROUND: Emergency Department (ED) service evaluations are typically based on surveys of discharged patients. Physicians/administrators benefit from data that quantifies system-based factors that adversely impact the experience of those who represent the survey cohort. OBJECTIVE: While investigators have established that admitted patient boarding impacts overall ED throughput times, we sought to specifically quantify the relationship between throughput times for patients admitted (EDLOS) versus discharged home from the ED (DCLOS). METHODS: We performed a prospective analysis of consecutive patient encounters at an inner-city ED. Variables collected: median daily DCLOS for ED patients, ED daily census, left without being seen (LWBS), median door to doctor, median room to doctor, and daily number admitted. Admitted patients divided into 2 groups based on daily median EDLOS for admits (<6 hours, ≥6 hours). Continuous variables analyzed by t-tests. Multivariate regression utilized to identify independent effects of the co-variants on median daily DCLOS. RESULTS: We analyzed 24,127 patient visits. ED patient DCLOS was longer for patients seen on days with prolonged EDLOS (193.7 minutes, 95%CI 186.7-200.7 vs. 152.8, 144.9-160.5, P< .0001). Variables that were associated with increased daily median EDLOS for admits included: daily admits (P= 0.01), room to doctor time (P< .01), number of patients that left without being seen (P< .01). When controlling for the covariate daily census, differences in DCLOS remained significant for the ≥6 hours group (189.4 minutes, 95%CI 184.1-194.7 vs. 164.8, 155.7-173.9 (P< .0001). CONCLUSION: Prolonged ED stays for admitted patients were associated with prolonged throughput times for patients discharged home from the ED.


Subject(s)
Emergency Service, Hospital , Hospitalization , Hospitals, Urban , Length of Stay/statistics & numerical data , Patient Discharge , Adult , Child , Cohort Studies , Female , Humans , Male , Multivariate Analysis , Patient Admission , Prospective Studies , Regression Analysis , Time Factors
11.
PeerJ ; 4: e1507, 2016.
Article in English | MEDLINE | ID: mdl-27069780

ABSTRACT

Objective. We hypothesized that a significant percentage of patients who are referred to the Emergency Department (ED) after calling their primary care physician's (PCP) office receive such instructions without the input of a physician. Methods. We enrolled a convenience sample of stable adults at an inner-city ED. Patients provided written answers to structured questions regarding PCP contact prior to the ED visit. Continuous data are presented as means ± standard deviation; categorical data as frequency of occurrence. 95% confidence intervals were calculated. Results. The study group of 660 patients had a mean age of 41.7 ± 14.7 years and 72.6% had income below $20,000/year. 472 patients (71.51%; 67.9%-74.8%) indicated that they had a PCP. A total of 155 patients (23.0%; 19.9%-26.4%) called to contact their PCP prior to ED visit. For patients who called their PCP office and were directed by phone to the ED, the referral pattern was observed as follows: 31/98 (31.63%; 23.2%-41.4%) by a non-health care provider without physician input, 11/98 (11.2%; 6.2%-19.1%) by a non-healthcare provider after consultation with a physician, 12/98 (12.3%; 7.7%-20.3%) by a nurse without physician input, and 14/98 (14.3%; 8.6%-22.7%) by a nurse after consultation with physician. An additional 11/98, 11.2%; 6.2-19.1%) only listened to a recorded message and felt the message was directing them to the ED. Conclusion. A relatively small percentage of patients were referred to the ED without the consultation of a physician in our overall population. However, over half of those that contacted their PCP's office felt directed to the ED by non-health care staff.

12.
PeerJ ; 4: e1544, 2016.
Article in English | MEDLINE | ID: mdl-26819839

ABSTRACT

Background. Many proponents for healthcare reform suggest increased cost-sharing by patients as a method to reduce overall expenditures. Prior studies on the effects of co-payments for ED visits have generally not been directed toward understanding patient attitudes/behavior at point of care. Objectives. We conducted a survey at point of care to test our hypothesis that a significant number of patients with urgent chief complaints might have avoided the ED if asked to provide a co-payment. Methods. Cross-sectional study design. Stable, oriented, consenting patients at an inner-city, academic ED were consecutively enrolled at hours in which trained research associates were available to assist with data collection. Enrolled patients completed a written survey providing demographic/chief complaint information, and then were asked whether 13 interval amounts of co-payment ranging from 0 to >500 would have impacted their decision to visit the ED. Categorical data are presented as frequency of occurrence and analyzed by chi-square; continuous data presented as means ± standard deviation, analyzed by t-tests. ORs and 95% confidence intervals provided. Primary outcome parameter was the % of patients who would have avoided the ED if asked to pay any co-payment for several urgent chief complaints: chest pain, SOB, and abdominal pain. Results. A total of 581 patients were enrolled; 63.1% female, mean age 42.4 ± 15.1 years, 65% Hispanic, 71.2% income less than 20,000, 28.6% less than high school graduate, 81.3% had primary care physician, 57.6% had 2 or more ED visits/past year. Overall, 30.2% of patients chose 0 as the maximum they would have been willing to pay if it was required to be seen in the ED. 16/58 (28%; 95% CI [18-40%]) of chest pain patients, 9/43 (20.9%; 95% CI [11-35%]) of SOB patients, and 24/127 (26.8%; 95% CI [13-27%]) of abdominal pain patients would have been unwilling to pay a co-pay. Patients with income >20,000 were more willing to pay a co-payment (OR = 2.55; 95% CI [1.59-4.10]). No significant relationship was identified between willingness to pay for: gender, race, education, established primary care provider, and frequency of ED visits. Conclusion. Overall, 30.2% of our patients would not have accepted a co-pay in order to be seen, including more than 20% of the patients with chest pain, shortness of breath, and abdominal pain respectively.

13.
PeerJ ; 3: e937, 2015.
Article in English | MEDLINE | ID: mdl-26019999

ABSTRACT

Background. Cultural differences and language barriers may adversely impact patients with respect to understanding the risks/benefits of medical testing. Objective. We hypothesized that there would be no difference in Hispanic vs. non-Hispanic patients' knowledge of radiation risk that results from CT of the abdomen/pelvis (CTAP). Methods. We enrolled a convenience sample of adults at an inner-city emergency department (ED). Patients provided written answers to rate agreement on a 10-point scale for two correct statements comparing radiation exposure equality between: CTAP and 5 years of background radiation (question 1); CTAP and 200 chest x-rays (question 3). Patients also rated their agreement that multiple CT scans increase the lifetime cancer risk (question 2). Scores of >8 were considered good knowledge. Multivariate logistic regression analyses were performed to estimate the independent effect of the Hispanic variable. Results. 600 patients in the study group; 63% Hispanic, mean age 39.2 ± 13.9 years. Hispanics and non-Hispanics whites were similar with respect to good knowledge-level answers to question 1 (17.3 vs. 15.1%; OR = 1.2; 95% CI [0.74-2.0]), question 2 (31.2 vs. 39.3%; OR = 0.76; 95% CI [0.54-1.1]), and question 3 (15.2 vs. 16.5%; OR = 1.1; 95% CI [0.66-1.8]). Compared to patients who earned <20,000, patients with income >40,000 were more likely to answer question 2 with good knowledge (OR = 1.96; 95% CI [1.2-3.1]). Conclusion. The study group's overall knowledge of radiation risk was poor, but we did not find significant differences between Hispanic vs. non-Hispanic patients.

14.
Antiviral Res ; 104: 59-61, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24491797

ABSTRACT

Efficacy and tolerability of telaprevir, pegylated interferon and ribavirin combination was assessed in 32 cirrhotic genotype 1 hepatitis C (HCV)-HIV coinfected patients. Undetectability of HCV-RNA was observed in 23/32 (71.9%) patients after 24 weeks. Treatment failure was observed in 9/32 subjects: four of them (45.5%) failed triple therapy due to virological rebound, while 5 patients (55.5%) experienced drug-related side effects driving to treatment interruption. These data suggest that telaprevir-containing triple therapy should be considered for treatment of genotype 1 HCV in HIV coinfected patients with liver cirrhosis, although a close vigilance is required because of potential drug-related side effects.


Subject(s)
Antiviral Agents/therapeutic use , Coinfection/drug therapy , HIV Infections/drug therapy , Hepatitis C, Chronic/drug therapy , Adolescent , Adult , Aged , Antiviral Agents/adverse effects , Drug Therapy, Combination , Female , HIV Infections/pathology , HIV Infections/virology , Hepatitis C, Chronic/pathology , Hepatitis C, Chronic/virology , Humans , Interferons/administration & dosage , Liver Cirrhosis/pathology , Male , Middle Aged , Oligopeptides/administration & dosage , Ribavirin/administration & dosage , Time Factors , Treatment Outcome , Viral Load , Young Adult
15.
Int J Clin Pharm ; 35(5): 727-35, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23695594

ABSTRACT

BACKGROUND: Negative outcomes of medications (NOMs) are a major public health problem that impact on patients' quality of life. As many NOMs are avoidable, it is necessary to determine their causes in each health setting in order to plan preventive strategies. OBJECTIVE: The aims of this study were to assess the frequency, type, severity, and preventability of NOMs that result in emergency department visits, to identify the main medications involved, and to determine factors associated with their development in a general hospital in Spain. SETTING: Emergency department of a 650-bed university tertiary hospital. METHODS: Descriptive, cross-sectional study. On each study day, a pharmacist administered a questionnaire to one in every three patients awaiting consultation. Information was also obtained from the emergency medical records. Emergency department visits were identified as NOMs on the basis of assessment by a pharmacist and a physician. A second pharmacist and physician reassessed the same cases. Discrepancies were adjudicated by an external team of two pharmacists and a physician. MAIN OUTCOME MEASURES: Number of NOMs detected, severity and preventability of the NOMs detected, medications involved in these NOMs, and factors associated with NOMs. RESULTS: A NOM was detected in 221 of 588 patients analyzed (37.6 %). In relation to NOM severity, 59.3 % were mild, 34.4 % were moderate and 6.3 % were severe. One hundred and fifty-seven of the 221 NOMs (71 %) were considered preventable. Drugs most frequently involved in NOMs were nervous system agents (22.1 %), musculo-skeletal system agents (19.1 %), and anti-infective agents for systemic use (17.6 %). Mean number of drugs taken was the only factor associated with NOMs. CONCLUSION: The high number of NOMs detected indicates that closer pharmacotherapy follow up is needed to avoid such events in our setting.


Subject(s)
Drug-Related Side Effects and Adverse Reactions/therapy , Emergency Service, Hospital , Hospitals, University , Adult , Aged , Cross-Sectional Studies , Drug Monitoring , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug-Related Side Effects and Adverse Reactions/physiopathology , Drug-Related Side Effects and Adverse Reactions/prevention & control , Female , Hospitals, General , Hospitals, Urban , Humans , Male , Medical Records , Polypharmacy , Prevalence , Severity of Illness Index , Spain/epidemiology , Surveys and Questionnaires , Tertiary Care Centers
16.
Tree Physiol ; 31(2): 169-77, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21367744

ABSTRACT

Photosynthesis down-regulation due to an imbalance between sources and sinks in Citrus leaves could be mediated by excessive accumulation of carbohydrates. However, there is limited understanding of the physiological role of soluble and insoluble carbohydrates in photosynthesis regulation and the elements triggering the down-regulation process. In this work, the role of non-structural carbohydrates in the regulation of photosynthesis under a broad spectrum of source-sink relationships has been investigated in the Salustiana sweet orange. Soluble sugar and starch accumulation in leaves, induced by girdling experiments, did not induce down-regulation of the photosynthetic rate in the presence of sinks (fruits). The leaf-to-fruit ratio did not modulate photosynthesis but allocation of photoassimilates to the fruits. The lack of strong sink activity led to a decrease in the photosynthetic rate and starch accumulation in leaves. However, photosynthesis down-regulation due to an excess of total soluble sugars or starch was discarded because photosynthesis and stomatal conductance reduction occurred prior to any significant accumulation of these carbohydrates. Gas exchange and fluorescence parameters suggested biochemical limitations to photosynthesis. In addition, the expression of carbon metabolism-related genes was altered within 24 h when strong sinks were removed. Sucrose synthesis and export genes were inhibited, whereas the expression of ADP-glucose pyrophosphorylase was increased to cope with the excess of assimilates. In conclusion, changes in starch and soluble sugar turnover, but not sugar content per se, could provide the signal for photosynthesis regulation. In these conditions, non-stomatal limitations strongly inhibited the photosynthetic rate prior to any significant increase in carbohydrate levels.


Subject(s)
Carbohydrate Metabolism/physiology , Citrus sinensis/metabolism , Biological Transport , Carbohydrate Metabolism/genetics , Citrus sinensis/genetics , Down-Regulation , Fruit/metabolism , Photosynthesis , Plant Leaves/metabolism , Starch/metabolism
17.
Histol Histopathol ; 25(5): 577-87, 2010 05.
Article in English | MEDLINE | ID: mdl-20238296

ABSTRACT

This study assesses the effects of a vitamin E analogue, Trolox, on the oxidative state, endothelial function and morphology in experimental heart transplantation. Heterotopic heart transplantation was carried out in pigs: untreated after 2 and 24 hours of ischemia and treated with Trolox after 24 hours of ischemia. Prolonged preservation of donor hearts was achieved with continuous perfusion and University of Wisconsin solution, in which acid-base balance and enzymes were determined during the procedure. In recipients, hemodynamic and biochemical parameters were determined at baseline and during reperfusion. Trolox diminished the pH of the preservation solution (p<0.01), the left ventricle of the transplanted heart recovered a systolic pressure equaling that of the 2h group and higher than that of the untreated 24h group (p<0.01), the antioxidant levels were not decreased and the glutathione reductase level was maintained throughout the first part of reperfusion. In this group also there was a direct correlation between the concentration of this enzyme and the antioxidant levels (p<0.001). Although the endothelin concentrations increased, the change was less marked in the Trolox group than in the untreated 24h group (p<0.01). Morphologically, mitochondria and myocardial vessels presented a normal structure in the Trolox group, and interstitial edema, inflammatory infiltrate and contraction bands were less prominent than in the untreated group. All these effects indicate that Trolox protected the transplanted heart, at least partially, against ischemia-reperfusion injury.


Subject(s)
Antioxidants/pharmacology , Chromans/pharmacology , Heart Transplantation , Organ Preservation/methods , Vitamin E/analogs & derivatives , Adenosine , Allopurinol , Animals , Endothelium/drug effects , Endothelium/physiology , Glutathione , Heart/anatomy & histology , Heart/drug effects , Heart/physiology , Hemodynamics , In Vitro Techniques , Insulin , Microscopy, Electron, Transmission , Myocardial Reperfusion Injury/prevention & control , Organ Preservation Solutions , Oxidation-Reduction , Perfusion , Raffinose , Sus scrofa , Time Factors , Transplantation, Heterotopic , Vitamin E/pharmacology
18.
Planta Med ; 74(10): 1316-20, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18622904

ABSTRACT

The effect of Bacillus subtilis FZB24 on saffron ( Crocus sativus L.) was studied using saffron corms from Spain and the powdered form of B. SUBTILIS FZB24(R). Corms were soaked in water or in B. subtilis FZB24 spore solution for 15 min before sowing. Some corms were further soil drenched with the spore solution 6, 10 or 14 weeks after sowing. Growth and saffron stigma chemical composition were measured. Compared to untreated controls, application of B. subtilis FZB24 significantly increased leaf length, flowers per corm, weight of the first flower stigma, total stigma biomass; microbe addition also significantly decreased the time required for corms to sprout and the number of shoot sprouts. Compared to the controls, picrocrocin, crocetin and safranal compounds were significantly increased when the plants were soil drenched with the spore solution 14 weeks after sowing; in contrast crocin was highest in untreated controls. Results of this study suggest that application of B. subtilis FZB24 may provide some benefit to saffron growers by speeding corm growth (earlier shoot emergence) and increasing stigma biomass yield by 12 %. While some treatment conditions also increased saffron chemical composition, these were generally not the same treatments that simultaneously improved growth yields and thus, more study is required.


Subject(s)
Bacillus subtilis/physiology , Crocus/microbiology , Flowers/growth & development , Biomass , Carotenoids/metabolism , Crocus/growth & development , Crocus/metabolism , Cyclohexenes/metabolism , Glucosides/metabolism , Terpenes/metabolism , Vitamin A/analogs & derivatives
19.
Conf Proc IEEE Eng Med Biol Soc ; 2006: 1653-6, 2006.
Article in English | MEDLINE | ID: mdl-17945656

ABSTRACT

Electroenterogram (EEnG), which is the myoelectrical activity of the small bowel, can be non-invasively recorded from abdominal external surface. However, this bioelectrical signal is weak and noisy compared to internal recording from bowel serous layers, because of bioelectric transmission through abdominal layers. Furthermore, it is contaminated with several interferences from other biological activities as cardiac muscle (ECG), skeletal muscles (EMG), or respiration movements. The goal of present work is to study abdominal recording of EEnG and its signal-to-noise ratio by means of the coherence estimation technique. External and internal recordings were obtained simultaneously in 12 sessions, which went on more than two hours in six beagle dogs. Coherence function, based on periodograms, is estimated in periods of 15 minutes. Thus, SNR is calculated from coherence estimation for each recording session. Results show that SNR reaches a maximum value of 8.8 dB for 0.31 Hz, which corresponds to fundamental frequency of the EEnG slow wave. However, SNR is weak at frequencies upper 2 Hz, which corresponds to rapid action potentials (spike bursts) of the EEnG. In conclusion, slow wave can be clearly identified in abdominal recording; however spike bursts are contaminated by noise, attenuation and biological interferences.


Subject(s)
Algorithms , Diagnosis, Computer-Assisted/methods , Electromyography/methods , Gastrointestinal Motility/physiology , Intestine, Small/physiology , Muscle, Smooth/physiology , Animals , Dogs , Reproducibility of Results , Sensitivity and Specificity
20.
Conf Proc IEEE Eng Med Biol Soc ; 2006: 6080-3, 2006.
Article in English | MEDLINE | ID: mdl-17945935

ABSTRACT

The first aim of this study was to obtain the discrete Laplacian of the myoelectric small intestine signal (electroenterogram, EEnG) from bipolar recordings on the abdominal surface in humans. In addition, the objective was to identify the slow wave (SW) component of the EEnG in the estimated Laplacian, as well as to compare this signal with the bipolar surface recordings. It was carried out 8 recording sessions in 6 healthy volunteers. The discrete Laplacian of the surface potential was performed using Hjorth's Laplacian estimation method. In order to identify the SW component of the EEnG, an adaptive filter, which removes breath interference from abdominal surface recordings, was designed. After that, periodograms and their dominant frequency were obtained. The results show that this frequency, in all surface recording channels and in their corresponding Laplacian, ranges from 0.12 to 0.16 Hz (7.3 to 9.8 cycles per minute) inside of the SW frequency range, whereas the frequencies of the respiration ranges from 0.21 to 0.31 Hz (12.9-18.4 cpm). Furthermore abdominal surface Laplacian potential contains averaged SW, information unless any bipolar surface channel do not record properly this signal. Consequently EEnG surface recordings can become a low cost technique to study bowel motility non-invasively.


Subject(s)
Electromyography/instrumentation , Monitoring, Ambulatory/instrumentation , Abdomen/pathology , Adult , Computer Simulation , Diagnosis, Computer-Assisted , Electric Conductivity , Electromyography/methods , Equipment Design , Female , Gastrointestinal Motility , Humans , Intestine, Small/pathology , Male , Middle Aged , Monitoring, Ambulatory/methods , Muscle Contraction , Signal Processing, Computer-Assisted
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