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1.
Eur J Pain ; 2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38528589

RESUMEN

BACKGROUND: Persistent postsurgical pain (PPSP) after lung cancer surgery is common and current definitions are based on evaluations at a single time point after surgery. Pain intensity and symptoms may however fluctuate and change over time, and be impacted by multiple and shifting factors. Studies of postoperative recovery patterns and transition from acute to chronic pain are needed for further investigation of preventive measures and treatments to modify unfavourable recovery paths. METHODS: In this explorative study, 85 patients undergoing surgery due to either presumptive or confirmed lung cancer reported pain intensities bi-monthly for 12 months. Pain trajectories during recovery were investigated, using group-based trajectory modelling. Associations with possible risk factors for PPSP, including clinical variables and anxiety and depression score (HADS), were also explored. RESULTS: A trajectory model containing three 12-month pain recovery groups was computed. One group without PPSP fully recovered (50%) within two to three months. Another group with mild-intensity PPSP followed a protracted recovery trajectory (37%), while incomplete recovery was observed in the last group (13%). Acute postoperative pain and younger age were associated with a less favourable recovery trajectory. More neuropathic pain symptoms were observed in patients with incomplete recovery. CONCLUSIONS: Three clinically relevant recovery trajectories were identified, based on comprehensive pain tracking. Higher acute postoperative pain intensity was associated with an unfavourable pain recovery trajectory. SIGNIFICANCE STATEMENT: Understanding the transition from acute to chronic postoperative pain and identifying preoperative risk factors is essential for the development of targeted treatments and the implementation of preventive measures. This study (1) identified distinct recovery trajectories based on frequent pain assessment follow-ups for 12 months after surgery and (2) evaluated risk factors for unfavourable postoperative pain recovery paths. Findings suggest that early higher postoperative pain intensity is associated with an unfavourable long-term recovery path.

2.
Psychopharmacology (Berl) ; 240(8): 1651-1666, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37378887

RESUMEN

RATIONALE: Dopaminergic dysfunction is implicated in disorders of impulsivity and inattention. The rodent continuous performance test (rCPT) has been used to quantify changes in attention and impulsivity. OBJECTIVE: To examine the roles of dopamine receptors in attention and impulsivity behaviours measured in the rCPT variable stimulus duration (vSD) and the variable intertrial interval schedules (vITI) using DA receptor antagonists. METHODS: Two cohorts of 35 and 36 female C57BL/6JRj mice were examined separately in the rCPT, vSD, and vITI schedules, respectively. Both cohorts received antagonists of the following receptors: D1/5 (SCH23390, SCH: 0.01, 0.02, 0.04 mg/kg) and D2/3 (raclopride, RAC 0.03, 0.10, 0.30 mg/kg) in consecutive balanced Latin square designs with flanking reference measurements. The antagonists were subsequently examined for effects on locomotor activity. RESULTS: SCH showed similar effects in both schedules, and the effects were reference-dependent in the vITI schedule. SCH reduced responding, but improved response accuracy, impulsivity, discriminability, and locomotor activity. RAC showed mixed effects on responsivity, but improved accuracy and discriminability. The discriminability improvement was driven by an increase in hit rate in the vITI schedule and a reduction in false alarm rate in the vSD schedule. RAC also decreased locomotor activity. CONCLUSION: Both D1/5 and D2/3 receptor antagonism reduced responding, but the outcome on discriminability differed, stemming from individual effects on hit and false alarm rate, and the weight of omissions within the calculation. The effects of SCH and RAC suggest that endogenous DA increases responding and impulsivity, but reduces accuracy and shows mixed effects on discriminability.


Asunto(s)
Antagonistas de Dopamina , Roedores , Ratones , Animales , Femenino , Antagonistas de Dopamina/farmacología , Ratones Endogámicos C57BL , Receptores de Dopamina D1 , Atención , Conducta Impulsiva , Antagonistas de los Receptores de Dopamina D2/farmacología , Benzazepinas/farmacología , Relación Dosis-Respuesta a Droga
3.
Psychopharmacology (Berl) ; 240(8): 1629-1650, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37329343

RESUMEN

RATIONALE: Noradrenergic dysfunction is associated with disorders of impulsivity and inattention. The rodent continuous performance test (rCPT) quantifies changes in attention and impulsivity. OBJECTIVE: To use NA receptor antagonists to examine the roles of NA on attention and impulsivity behaviours measured in the rCPT variable stimulus duration (vSD) and the variable intertrial interval (vITI) schedules. METHODS: Two cohorts of 36 female C57BL/6JRj mice were examined separately in the rCPT vSD and vITI schedules. Both cohorts received antagonists of the following adrenoceptors: α1 (doxazosin, DOX: 1.0, 3.0, 10.0 mg/kg), α2 (yohimbine, YOH: 0.1, 0.3, 1.0 mg/kg), and ß1/2 (propranolol, PRO: 1.0, 3.0, 10.0 mg/kg) in consecutive balanced Latin square designs with flanking reference measurements. The antagonists were subsequently examined for effects on locomotor activity. RESULTS: DOX showed similar effects in both schedules, improving discriminability and accuracy, and reducing responding and impulsivity, and DOX also reduced locomotor activity. YOH showed prominent effects in the vSD schedule to increase responding and impulsivity, while impairing discriminability and accuracy. YOH did not affect locomotor activity. PRO increased responding and impulsivity, decreased accuracy, but did not affect discriminability or locomotor activity. CONCLUSION: Antagonism of α2 or ß1/2 adrenoceptors caused similar increases in responding and impulsivity and worsened attentional performance, while α1 adrenoceptor antagonism showed the opposite effects. Our results suggest that endogenous NA exerts bidirectional control of most behaviours in the rCPT. The parallel vSD and vITI studies showed a substantial overlap in effects, but also some differences that indicate differing sensitivity towards noradrenergic manipulations.


Asunto(s)
Norepinefrina , Roedores , Ratones , Animales , Femenino , Norepinefrina/farmacología , Ratones Endogámicos C57BL , Atención , Conducta Impulsiva/fisiología , Receptores Adrenérgicos
4.
J Neurosci Methods ; 384: 109749, 2023 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-36414103

RESUMEN

BACKGROUND: Rodent operant tests that include premature responses (PR) as a measure of impulsivity commonly use variable intertrial interval (vITI) schedules. The rodent continuous performance test (rCPT) is suitable for a vITI schedule. NEW METHOD: We optimised the analysis for a rCPT vITI schedule with intertrial intervals (ITIs) of 3, 6, and 12 s. Examining the nature of first (FiT) and following touches (FoT) to the blank screen led to a separate quantification of these two behaviours into the first touches level (%FiT) and the following-to-first touches ratio (FoT/FiT). RESULTS: FiTs occurred more frequently in the 12 s ITIs than at shorter ITIs. Within 12 s ITIs, %FiT was only moderately higher during the last half than the first half, suggesting that long ITIs have a minimal effect on impulsivity, but allow a longer time for its detection. %FiT and the FoT/FiT ratio were uncorrelated. %FiT was negatively correlated with response criterion (C) and uncorrelated with discriminability. Conversely, FoT/FiT ratio was negatively correlated with discriminability, without correlation to C. Atomoxetine decreased %FiT but did not affect FoT/FiT ratio. Amphetamine increased %FiT and decreased the FoT/FiT ratio. COMPARISON WITH EXISTING METHOD(S): The results suggest that %FiT is analogous to %PR in related tasks and is a more suitable measure of waiting impulsivity in the rCPT. FoT/FiT ratio is unrelated to %FiT. CONCLUSIONS: Long ITIs increase the detectability of, but has minimal effect on, waiting impulsivity. %FiT is analogous to %PR in related tasks, while the FoT/FiT ratio is a separate behaviour requiring further characterization.


Asunto(s)
Anfetamina , Roedores , Animales , Clorhidrato de Atomoxetina , Conducta Impulsiva
5.
J Endod ; 47(6): 865-872, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33975756

RESUMEN

The etiology of surface and inflammatory root resorption after the replantation of incisors was examined in green vervet monkeys. The teeth were examined histologically and histobacteriologically for pulpal healing and root resorption 2 and 8 weeks after replantation. In contrast to surface resorption, inflammatory resorption was related to infected necrotic tissue or an infected leukocyte zone in the root canal. The following theory for surface and inflammatory resorption is presented. Damaged periodontal ligament areas and damaged parts of the root surface are attacked by a resorption process whereby resorption of cementum and dentin may occur. Inflammatory resorption or surface resorption will then occur depending on the pulpal status and the depth of the resorption cavity. If the resorption cavity penetrates the intermediate layer of cementum and contacts dentinal tubules that are in communication with infected necrotic pulp tissue or an infected leukocyte zone, then inflammatory resorption will take place as a result of the diffusion of toxic elements from the pulp canal to the resorption cavity. However, if the resorption cavity is shallow and does not penetrate the intermediate layer of cementum, a tooth that displays similar pulpal changes will elicit only surface resorption because the intermediate layer of cementum will tend to arrest the diffusion of toxic elements. Finally, if the pulp contains vital, inflamed, or noninflamed tissue or if root canal treatment has been performed, surface resorption will occur regardless of the depth of the cavity.


Asunto(s)
Incisivo , Resorción Radicular , Animales , Chlorocebus aethiops , Pulpa Dental , Haplorrinos , Ligamento Periodontal , Resorción Radicular/etiología , Reimplante Dental , Raíz del Diente
6.
Neurosci Lett ; 728: 134970, 2020 05 29.
Artículo en Inglés | MEDLINE | ID: mdl-32302700

RESUMEN

BACKGROUND: Gabor patterns are defined as the product of a sinusoid function and a Gaussian envelope and are commonly used in visual and attentional research due to their ability to selectively stimulate the primary visual cortex. The aim of this study was to investigate whether Gabor patterns can be used as visual stimuli in the rodent continuous performance test (rCPT), a newly developed task to study attentional function and impulsivity. METHODS: Sixteen male C57BL/6 J mice were trained in the rCPT using Gabor patterns as visual stimuli and their performance was compared to sixteen mice that were trained using traditional high-contrast pattern stimuli. Mice were compared during training, baseline, and a variable stimulus duration probe. RESULTS: The Gabor pattern group required more training sessions to reach criteria than the group with high-contrast patterns. At baseline, the Gabor pattern group showed a higher false alarm rate and a lower discriminability index. As task difficulty increased during the variable stimulus duration probe, differences between groups became more pronounced. Specifically, the Gabor pattern group showed decreased hit rate and discriminability index, as well as increased false alarm rate and premature responses compared to the high-contrast pattern group. CONCLUSION: This feasibility study showed that it is possible to use Gabor patterns as visual stimuli in the rCPT, although it increases task demands. We discuss the differences between Gabor patterns and high-contrast patterns in the context of translatability of animal models in visual and cognitive research and give two examples of applicability.


Asunto(s)
Atención/fisiología , Estimulantes del Sistema Nervioso Central/farmacología , Reconocimiento Visual de Modelos/fisiología , Estimulación Luminosa , Percepción Visual/efectos de los fármacos , Animales , Conducta Impulsiva/efectos de los fármacos , Masculino , Ratones Endogámicos C57BL , Estimulación Luminosa/métodos
7.
Eur Arch Paediatr Dent ; 21(1): 119-127, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31190243

RESUMEN

PURPOSE: Ectopic second premolars may lead to impaction and loss of space in the jaws, and in rare cases even to resorption of the first permanent molar. The aim of this study was to analyse different treatment strategies of ectopic second premolars and if possible give guidelines on when to favour different treatment approaches. MATERIALS AND METHODS: The study was a retrospective, non-randomised, outcome analysis of treatment on 41 ectopic second premolars in 37 patients (24 females and 13 males). In all cases oral examination, radiographs (pre-, peri-, and post) and full medical history were obtained. The treatment options included: (a) spontaneous eruption, (b) spontaneous eruption + extraction of primary tooth, (c) surgical exposure, (d) surgical uprighting, and (e) surgical uprighting + orthodontic extrusion. For evaluation each tooth was scored according to: (1) stage of root development, (2) distance between edges of the premolar and first permanent molar, (3) depth of impaction, (4) inclination, (5) horizontal position of the tooth. The level of significance was set to 5%. RESULTS: Only mild cases of ectopic second premolars are self-correcting. Based on the position of the tooth in the jaw different treatment options may be chosen, these may include: extraction of primary predecessor (impaction depth < 5 mm, inclination < 55°), surgical exposure of tooth germ (impaction depth < 5.5 mm, inclination < 95°) or surgical uprighting (impaction depth > 5.5 mm with no inclination limit). CONCLUSION: If there is no sign of self-correction after a short observation period, it is important to consider active treatment to help guiding the tooth into the correct eruption pathway.


Asunto(s)
Erupción Ectópica de Dientes , Diente Impactado , Diente Premolar , Femenino , Humanos , Masculino , Diente Molar , Estudios Retrospectivos , Erupción Dental
8.
Artículo en Inglés | MEDLINE | ID: mdl-31765714

RESUMEN

BACKGROUND: The rodent Continuous Performance Test (rCPT) is an analogue of human CPTs where mice have to discriminate between target and non-target stimuli. The rCPT offers a readout of attentional performance and impulsive behaviour. This study aimed to determine if female C57BL/6 J mice could be trained in the rCPT since previously published rCPT studies have only used male mice and to study whether the effects of methylphenidate (MPH), atomoxetine (ATX), and dexamphetamine (AMPH) on attention and impulsivity depend on baseline (reference) levels of performance. METHODS: 48 female mice underwent rCPT training. Effects of MPH (1, 2, and 3 mg/kg), ATX (1, 3, and 5 mg/kg) and AMPH (0.3, 0.6, and 1 mg/kg) were assessed in a variable stimulus duration probe. Drugs were administered intraperitoneally and sequentially tested following a Latin-square design. Data were analysed using a repeated measurements mixed effect model and reference-dependent effects were studied. RESULTS: ATX and AMPH improved performance as seen by increases in discriminability. These improvements were a result of a decreased false-alarm rate. AMPH showed a reference-dependent effect, improving the task performance of low-performing mice and decreasing the performance of high-performing mice. MPH also showed this reference-dependent effects, albeit to a lesser extent. ATX and AMPH decreased premature responses and increased response criterion, but no reference-dependent effects were observed for these parameters. CONCLUSION: This study presents a novel method to analyse baseline-dependent effects. It shows that the rCPT can be successfully used in pharmacological studies in female mice and demonstrates that the effect of ADHD medication is in line with the inverted U-shape theory of performance-arousal relationship.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Trastorno por Déficit de Atención con Hiperactividad/psicología , Estimulantes del Sistema Nervioso Central/farmacología , Aprendizaje Discriminativo/efectos de los fármacos , Desempeño Psicomotor/efectos de los fármacos , Anfetamina/farmacología , Anfetamina/uso terapéutico , Animales , Clorhidrato de Atomoxetina/farmacología , Clorhidrato de Atomoxetina/uso terapéutico , Estimulantes del Sistema Nervioso Central/uso terapéutico , Aprendizaje Discriminativo/fisiología , Femenino , Metilfenidato/farmacología , Metilfenidato/uso terapéutico , Ratones , Ratones Endogámicos C57BL , Desempeño Psicomotor/fisiología , Roedores
9.
Psychopharmacology (Berl) ; 236(6): 1839-1851, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30656365

RESUMEN

RATIONALE: The rodent Continuous Performance Test (rCPT) is a novel rodent paradigm to assess attention and impulsivity that resembles the human CPT. This task measures the rodents' ability to discriminate between target and non-target stimuli. The effect of attention-deficit/hyperactivity disorder (ADHD) medication on rCPT performance in mice remains to be fully characterized. OBJECTIVE: To investigate the predictive validity of the mouse rCPT by studying the effects of ADHD medication methylphenidate, atomoxetine, amphetamine, guanfacine, and modafinil in four behavioral subgroups based on performance and impulsivity levels. METHODS: Two cohorts of male C57BL/6J mice were used, and the effect of treatment was tested in a variable stimulus duration probe. Performance and impulsive subgroups were made based on discriminability and percentage premature responses, respectively. RESULTS: Methylphenidate, atomoxetine, and amphetamine improved performance in the low-performing animals, with no effect in the high-performers. These improvements were a result of increased hit rate and/or decreased false-alarm rate. Furthermore, these drugs decreased percentage premature responses in the high-impulsive group. Methylphenidate, guanfacine, and modafinil increased premature responses in the low-impulsive group. Modafinil impaired performance in the high-performers by increasing false-alarm rate. CONCLUSION: The effect of ADHD treatment was dependent on baseline, as seen by increases in performance for the low-performers and decreases in impulsivity for the high-impulsive animals. These results agree with clinical data and may support the inverted U-shaped arousal-performance theory. The rCPT combined with behavioral separation into subgroups has high predictive validity, and our study is a step forward towards establishing the clinical translatability of the rCPT.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/psicología , Estimulantes del Sistema Nervioso Central/farmacología , Estimulantes del Sistema Nervioso Central/uso terapéutico , Conducta Impulsiva/efectos de los fármacos , Pruebas Neuropsicológicas , Anfetamina/farmacología , Anfetamina/uso terapéutico , Animales , Clorhidrato de Atomoxetina/farmacología , Clorhidrato de Atomoxetina/uso terapéutico , Atención/efectos de los fármacos , Atención/fisiología , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Conducta Impulsiva/fisiología , Masculino , Metilfenidato/farmacología , Metilfenidato/uso terapéutico , Ratones , Ratones Endogámicos C57BL , Roedores
10.
Artículo en Inglés | MEDLINE | ID: mdl-29158914

RESUMEN

BACKGROUND: Frailty is a serious condition frequently present in geriatric inpatients that potentially causes serious adverse events. Strength training is acknowledged as a means of preventing or delaying frailty and loss of function in these patients. However, limited hospital resources challenge the amount of supervised training, and unsupervised training could possibly supplement supervised training thereby increasing the total exercise dose during admission. A new valid and reliable technology, the BandCizer, objectively measures the exact training dosage performed. The purpose was to investigate feasibility and acceptability of an unsupervised progressive strength training intervention monitored by BandCizer for frail geriatric inpatients. METHODS: This feasibility trial included 15 frail inpatients at a geriatric ward. At hospitalization, the patients were prescribed two elastic band exercises to be performed unsupervised once daily. A BandCizer Datalogger enabling measurement of the number of sets, repetitions, and time-under-tension was attached to the elastic band. The patients were instructed in performing strength training: 3 sets of 10 repetitions (10-12 repetition maximum (RM)) with a separation of 2-min pauses and a time-under-tension of 8 s. The feasibility criterion for the unsupervised progressive exercises was that 33% of the recommended number of sets would be performed by at least 30% of patients. In addition, patients and staff were interviewed about their experiences with the intervention. RESULTS: Four (27%) out of 15 patients completed 33% of the recommended number of sets. For the total sample, the average percent of performed sets was 23% and for those who actually trained (n = 12) 26%. Patients and staff expressed a general positive attitude towards the unsupervised training as an addition to the supervised training sessions. However, barriers were also described-especially constant interruptions. CONCLUSIONS: Based on the predefined criterion for feasibility, the unsupervised training was not feasible, although the criterion was almost met. The patients and staff mainly expressed positive attitudes towards the unsupervised training. As even a small training dosage has been shown to improve the physical performance of geriatric inpatients, the proposed intervention might be relevant if the interruptions are decreased in future large-scale trials and if the adherence is increased. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02702557, February 29, 2016. Data Protection Agency: 2016-42, February 25, 2016. Ethics Committee: No registration needed, December 8, 2015 (e-mail correspondence).

11.
J Opt Soc Am A Opt Image Sci Vis ; 34(10): 1830-1843, 2017 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-29036054

RESUMEN

X-ray computerized tomography (CT) is a 3D imaging technique that makes use of x-ray illumination and image reconstruction techniques to reproduce the internal cross-sections of a sample. Tomographic projection data usually require an initial relative alignment or knowledge of the exact object position and orientation with respect to the detector. As tomographic imaging reaches increasingly better resolution, thermal drifts, mechanical instabilities, and equipment limitations are becoming the main dominant factors contributing to sample positioning uncertainties that will further introduce reconstruction artifacts and limit the attained resolution in the final tomographic reconstruction. Alignment algorithms that require manual interaction impede data analysis with ever-increasing data acquisition rates, supplied by more brilliant sources. We present in this paper an iterative reconstruction algorithm for wrapped phase projection data and an alignment algorithm that automatically takes 5 degrees of freedom, including the possible linear and angular motion errors, into consideration. The presented concepts are applied to simulated and real measured phase-contrast data, exhibiting a possible improvement in the reconstruction resolution. A MATLAB implementation is made publicly available and will allow robust analysis of large volumes of phase-contrast tomography data.

12.
Psychopharmacology (Berl) ; 234(5): 845-855, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28070619

RESUMEN

RATIONALE: The 5-choice serial reaction time task (5-CSRTT) is widely used to measure rodent attentional functions. In humans, many attention studies in healthy and clinical populations have used testing based on Bundesen's Theory of Visual Attention (TVA) to estimate visual processing speeds and other parameters of attentional capacity. OBJECTIVES: We aimed to bridge these research fields by modifying the 5-CSRTT's design and by mathematically modelling data to derive attentional parameters analogous to human TVA-based measures. METHODS: C57BL/6 mice were tested in two 1-h sessions on consecutive days with a version of the 5-CSRTT where stimulus duration (SD) probe length was varied based on information from previous TVA studies. Thereafter, a scopolamine hydrobromide (HBr; 0.125 or 0.25 mg/kg) pharmacological challenge was undertaken, using a Latin square design. Mean score values were modelled using a new three-parameter version of TVA to obtain estimates of visual processing speeds, visual thresholds and motor response baselines in each mouse. RESULTS: The parameter estimates for each animal were reliable across sessions, showing that the data were stable enough to support analysis on an individual level. Scopolamine HBr dose-dependently reduced 5-CSRTT attentional performance while also increasing reward collection latency at the highest dose. Upon TVA modelling, scopolamine HBr significantly reduced visual processing speed at both doses, while having less pronounced effects on visual thresholds and motor response baselines. CONCLUSIONS: This study shows for the first time how 5-CSRTT performance in mice can be mathematically modelled to yield estimates of attentional capacity that are directly comparable to estimates from human studies.


Asunto(s)
Atención/fisiología , Conducta de Elección/fisiología , Tiempo de Reacción/fisiología , Percepción Visual/fisiología , Animales , Atención/efectos de los fármacos , Conducta Animal , Conducta de Elección/efectos de los fármacos , Antagonistas Colinérgicos/farmacología , Masculino , Ratones , Ratones Endogámicos C57BL , Modelos Teóricos , Teoría Psicológica , Tiempo de Reacción/efectos de los fármacos , Recompensa , Escopolamina/farmacología , Percepción Visual/efectos de los fármacos
13.
Clin Transl Allergy ; 6(1): 35, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27610217

RESUMEN

BACKGROUND: Asthma affects an estimated 300 million people worldwide with the condition associated with significant healthcare utilisation costs and a large impact on patient quality of life. The SQ(®) HDM SLIT-tablet (ACARIZAX(®), Hørsholm, Denmark) is a sublingually administered allergy immunotherapy tablet for house dust mite allergic asthma and allergic rhinitis and has recently been licensed in Europe. OBJECTIVE: To assess the cost-effectiveness of ACARIZAX plus pharmacotherapy versus placebo plus pharmacotherapy in patients with house dust mite allergic asthma that is uncontrolled by inhaled corticosteroids, in a German setting. Eligible patients should also have symptoms of mild to severe allergic rhinitis. METHODS: A cost utility analysis was undertaken, based on the results of a European phase III randomised controlled trial, in which ACARIZAX was compared with placebo with both treatment groups also receiving pharmacotherapy in the form of inhaled corticosteroids and short-acting ß2-agonists. Cost and quality-adjusted life years from the trial were extrapolated over a nine year time horizon and the incremental cost-effectiveness ratio calculated to compare treatment options. RESULTS: ACARIZAX plus pharmacotherapy was estimated to generate 6.16 quality-adjusted life years per patient at a cost of €5658, compared with 5.50 quality-adjusted life years (QALYs) at a cost of €2985 for placebo plus pharmacotherapy. This equated to an incremental cost of €2673, incremental QALYs of 0.66 and an incremental cost-effectiveness ratio (ICER) of €4041. The ICER was, therefore, substantially lower than the €40,000 willingness-to-pay threshold per QALY adopted for the analysis. Deterministic sensitivity analyses indicate the results are most sensitive to the utility score of ACARIZAX patients during years 2 and 3 of treatment. CONCLUSION: This analysis indicates that ACARIZAX plus pharmacotherapy is cost-effective compared with placebo plus pharmacotherapy for house dust mite allergic asthma patients in Germany. If a disease-modifying effect can be proven the results of this analysis may underestimate the true benefits of ACARIZAX.

14.
Eur J Clin Nutr ; 70(9): 1039-45, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27302668

RESUMEN

BACKGROUND/OBJECTIVES: Bed rest and decreased nutrition intake in hospitalized patients have been shown to impair the clinical course negatively, including reduced function after hospital stay. Recent reviews have shown that early physical rehabilitation for acute hospitalized old adults leads to functional benefits. The aim of our study was to assess whether it was possible to influence nutrition intake, loss of muscle function and quality of life, with an evidence-based intervention in acutely ill hospitalized infectious medical patients. SUBJECTS/METHODS: For potentially frail patients, functional training three times weekly, and an individually adjusted self-training program for use 1-2 times daily, was given by a physiotherapist. Oral nutritional supplement with 5-10 g whey protein was timed straight after training 2 times daily, and dietetic advice was provided. A historical control group was used to compare nutrition intake. Functional measures and health-related quality of life (HRQoL) were done on admission and discharge. RESULTS: The study included 59 patients in the intervention group. Historic control included 145. Energy and protein intake increased by 3053 kJ (P<0.001) and 28 g of protein (P<0.001), compared with historic controls. Functional parameters (De Mortons Mobility Index (DEMMI), Timed Up and Go and the 30-s chair test) and HRQoL improved significantly for the overall group, most remarkably in patients >70 years of age, from hospitalization to discharge. CONCLUSION: The intervention with dietician and timed oral supplement to functional training by physiotherapist in hospitalized infectious medical patients improved function as well as nutrition intake and HRQoL.


Asunto(s)
Proteínas en la Dieta/administración & dosificación , Ejercicio Físico , Hospitalización , Infecciones , Músculo Esquelético/fisiología , Calidad de Vida , Recuperación de la Función , Actividades Cotidianas , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Proteínas en la Dieta/farmacología , Suplementos Dietéticos , Ingestión de Energía , Prueba de Esfuerzo , Femenino , Humanos , Infecciones/complicaciones , Infecciones/terapia , Masculino , Persona de Mediana Edad , Fuerza Muscular , Terapia Nutricional , Alta del Paciente , Estudios Prospectivos , Proteína de Suero de Leche/administración & dosificación , Proteína de Suero de Leche/farmacología
15.
J Neurosci Methods ; 262: 85-92, 2016 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-26820902

RESUMEN

BACKGROUND: The place escape/avoidance paradigm (PEAP) has been used to assess the affective component of pain in rats. Using the Complete Freund's Adjuvant (CFA) model of inflammatory pain, the current study aimed at developing a mouse version of PEAP and investigating the relation between PEAP and other behavioural responses, namely anxiety-like behaviour, locomotor activity, and hedonic state. NEW METHOD: A novel paradigm assessing the affective component of pain in mice was developed by modifying the setup known from rat studies: Animals were forced to stay 2 × 5 min in the light and the dark area of a box while being stimulated with a suprathreshold filament on the untreated or treated paw, respectively. This was followed by a 30-min test with unrestricted movement. Anxiety-like behaviour, locomotor activity, and hedonic state were assessed with the elevated zero maze (EZM), an open field setup, and a saccharin preference test, respectively, and correlated with the PEAP behaviour to examine potentially confounding parameters of the novel paradigm. RESULTS: In the PEAP, CFA-treated animals spent more time in the light area. CFA also increased anxiety-like behaviour significantly, whereas locomotor activity was unaffected. A significant, albeit modest, reduction in saccharin preference was observed. PEAP responses showed no significant correlations with any other behavioural measure. COMPARISON WITH EXISTING METHOD AND CONCLUSIONS: The PEAP results suggest that this paradigm might be successfully applied in mice to study affective pain. CFA treatment was associated with increased anxiety-like behaviour and anhedonia; however, this appeared unrelated to the PEAP responses.


Asunto(s)
Trastornos de Ansiedad/etiología , Reacción de Prevención/fisiología , Modelos Animales de Enfermedad , Inflamación/complicaciones , Dolor , Análisis de Varianza , Animales , Trastornos de Ansiedad/diagnóstico , Femenino , Preferencias Alimentarias , Adyuvante de Freund/toxicidad , Hiperalgesia/fisiopatología , Inflamación/inducido químicamente , Locomoción/efectos de los fármacos , Locomoción/fisiología , Aprendizaje por Laberinto/fisiología , Ratones , Ratones Endogámicos C57BL , Dolor/diagnóstico , Dolor/etiología , Dolor/psicología , Dimensión del Dolor , Umbral del Dolor/fisiología , Sacarina/administración & dosificación , Edulcorantes/administración & dosificación , Factores de Tiempo
16.
Scand J Med Sci Sports ; 26(12): 1391-1397, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26631937

RESUMEN

The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O) and the Oslo Sports Trauma Research Centre questionnaire on Health Problems (The OSTRC-H) make it possible to monitor illness and injury at regular intervals capturing prevalence and incidence of acute injury, overuse injury, and illnesses. The aim of this study was to translate, culturally adapt, and establish the face validity of the OSTRC-O and the OSTRC-H into a Danish context (DK) through cognitive interviews and the assessment of test-retest reliability. The OSTRC-O.DK was distributed to 57 heterogenous respondents; response rate was 89%. The OSTRC-H was distributed to 58 heterogenous respondents; response rate was 86%. No major disagreements were observed between the original and translated versions of the questionnaires. The OSTRC-O had high internal consistency (Cronbach's alpha 0.80-0.93). The primary reliability analyses including all participants, showed reliability ICC: 0.62 (95% CI: 0.42-0.77. The secondary reliability analyses that only included subjects who did not change injury region from the test to the retest showed an ICC of 0.86 (95% CI: 0.77-0.92).The questionnaires were found to be valid, reliable, and acceptable for use in a Danish population.


Asunto(s)
Traumatismos en Atletas/epidemiología , Trastornos de Traumas Acumulados/epidemiología , Enfermedad Aguda , Adulto , Dinamarca/epidemiología , Femenino , Estado de Salud , Humanos , Masculino , Prevalencia , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Traducciones , Adulto Joven
17.
Nanoscale ; 7(32): 13765-74, 2015 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-26220159

RESUMEN

Organic solar cells have great potential for upscaling due to roll-to-roll processing and a low energy payback time, making them an attractive sustainable energy source for the future. Active layers coated with water-dispersible Landfester particles enable greater control of the layer formation and easier access to the printing industry, which has reduced the use of organic solvents since the 1980s. Through ptychographic X-ray computed tomography (PXCT), we image quantitatively a roll-to-roll coated photovoltaic tandem stack consisting of one bulk heterojunction active layer and one Landfester particle active layer. We extract the layered morphology with structural and density information including the porosity present in the various layers and the silver electrode with high resolution in 3D. The Landfester particle layer is found to have an undesired morphology with negatively correlated top- and bottom interfaces, wide thickness distribution and only partial surface coverage causing electric short circuits through the layer. By top coating a polymer material onto the Landfester nanoparticles we eliminate the structural defects of the layer such as porosity and roughness, and achieve the increased performance larger than 1 V expected for a tandem cell. This study highlights that quantitative imaging of weakly scattering stacked layers of organic materials has become feasible by PXCT, and that this information cannot be obtained by other methods. In the present study, this technique specifically reveals the need to improve the coatability and layer formation of Landfester nanoparticles, thus allowing improved solar cells to be produced.

18.
Scand J Med Sci Sports ; 25(4): e408-13, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25367744

RESUMEN

The objective of this study was to translate the Foot Function Index (FFI) for use in Danish-speaking patients with foot complaints. The FFI consists of 23 items scored on a numeric rating scale from 0 to 10. The 23 items are grouped into three subscales: pain (nine items), activity limitation (five items), and disability (nine items). The Danish FFI was developed according to the recommended forward/backward translation protocol. The data analysis included reliability [intraclass correlation coefficient (ICC) 2.1] and internal consistency (Cronbach's alpha). Excellent internal consistency was shown for the three subscales: pain (0.99), disability (0.98), and activity limitation (0.98), as for the total score (0.97). The test-retest reliability was excellent: pain subscale: ICC 0.98 [95% confidence interval (CI): 0.97-0.99]; activity limitation subscale: ICC: 0.95 (95% CI: 0.91-0.98); disability subscale: ICC 0.97 (95% CI: 0.95-0.98); total score: ICC: 0.95 (95% CI: 0.91 to 0.98). The mean difference between test and retest was below 1 point and P > 0.08. Bland-Altman plots showed no significant or clinically relevant differences from test to retest in any of the subscales or in the total score. The Danish version of the FFI was found to be valid and reliable and therefore acceptable for use in the Danish population.


Asunto(s)
Evaluación de la Discapacidad , Enfermedades del Pie/complicaciones , Dolor Musculoesquelético/etiología , Encuestas y Cuestionarios , Adulto , Anciano , Dinamarca , Femenino , Enfermedades del Pie/fisiopatología , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Traducción , Adulto Joven
19.
Opt Express ; 22(21): 25756-67, 2014 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-25401609

RESUMEN

An economic, space- and time-resolved method to model ultra-short, intense pulse propagation in waveguides is described. Simulations of supercontinuum generation on a chip demonstrate the utility of the approach. Comparisons with the generalized nonlinear Schrödinger equation elucidate spatial effects, which influence pulse dynamics and the generation of new spectral components.


Asunto(s)
Fenómenos Ópticos , Simulación por Computador , Modelos Teóricos , Dinámicas no Lineales
20.
Refuat Hapeh Vehashinayim (1993) ; 31(2): 42-55, 89, 2014 Apr.
Artículo en Hebreo | MEDLINE | ID: mdl-25252471

RESUMEN

Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and follow up are important for improving a favorable outcome. Guidelines should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the best current evidence based on literature search and professional opinion. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented. The Hebrew Edition is part of the IADT global effort to provide accessibility to these guidelines worldwide.


Asunto(s)
Avulsión de Diente/terapia , Corona del Diente/lesiones , Fracturas de los Dientes/terapia , Niño , Dentición Permanente , Humanos , Israel , Lenguaje , Avulsión de Diente/diagnóstico , Fracturas de los Dientes/diagnóstico , Adulto Joven
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