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1.
Hipertens. riesgo vasc ; 39(2): 62-68, abr.-jun. 2022. tab, graf
Artículo en Español | IBECS | ID: ibc-LC-222

RESUMEN

Introducción: La hipertensión es el factor de riesgo más importante para la muerte cardiovascular a nivel mundial. En Argentina cerca del 44% de las personas desconocen ser hipertensos, y posiblemente sea debido a que no se les mide de la presión arterial (PA) en la consulta médica. Nuestra hipótesis es que la medición y el registro de la PA (MRPA) es omitida durante la consulta médica en Argentina. Objetivo: Determinar la frecuencia de MRPA en la consulta médica en Argentina. Métodos: Estudio multicéntrico, retrospectivo de punto de prevalencia. Se analizaron todas las consultas externas realizadas el 19/09/2019 en mayores de 18 años, en 9 instituciones sanitarias de Argentina y se evaluó la MRPA. Resultados: Se analizaron 2.982 consultas. La edad promedio fue de 52,1 años (18-103), 1.780 (59,7%) eran mujeres y 702 (36,1%) tenían antecedentes de hipertensión arterial (HTA). La PA se midió y registró en 420 consultas (14,1%; IC 95%: 12,8-15,4). En un modelo de regresión logística multivariado el antecedente de HTA (OR: 1,91; p<0,001) y de enfermedad cardiovascular (OR: 1,76; p<0,001) fueron las variables que más se asociaron a la MRPA. La presencia de cáncer se asoció un descenso de MRPA (OR: 0,51; p<0,01). Cardiología fue la especialidad que más midió la PA 49,5% (144/291 consultas), seguida por clínica médica 30% (152/507 consultas). Conclusión: La MRPA en la consulta médica ambulatoria es deficitaria y constituye una oportunidad perdida en salud. Se necesitan estrategias que mejoren la detección y el control de la HTA.


Introduction: Hypertension (HTN) is the leading cause of mortality and disability in the world. In Argentina, almost 44% of hypertensives do not know about their condition and this may be due to the low rate of blood pressure (BP) measurements during the office visit. Our hypothesis is that the measurement and electronic recording of BP (BPMR) is not a routine practice in Argentina. Objective: To describe the rate of office BP measurement in Argentina. Methods: This is a retrospective, multicentre, point prevalence study. We analysed all office visits on 9/19/2019 at 9 medical institutions in 6 provinces of Argentina. Results: Two thousand and eighty-two office visits were analysed. The patients’ mean age was 52.1 years (18-103), 1790 (59.7%) were female, and 702 (36.1%) were hypertensives. BP was measured in 420 visits (14.1%; 95% CI 12.8-15.4). In a multivariate logistic regression model, history of HTN (OR 1.91, P<.001) and previous cardiovascular event (OR 1.76, P<.001) were associated with more odds of BPMR. The presence of cancer was associated with fewer odds of BPMR (OR .51, P<.01). Cardiology measured BP up to 49.5% (144/291 visits), followed by internal medicine 30% (152/507 visits). Conclusion: BPMR during office visits is deficient in Argentina and represents a missed healthcare opportunity. Different strategies are needed to detect hypertensive patients and reduce cardiovascular events.


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Monitoreo Ambulatorio de la Presión Arterial , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/epidemiología , Presión Arterial , Estudios Retrospectivos , Registros , Determinación de la Presión Sanguínea
3.
AJNR Am J Neuroradiol ; 43(4): 611-619, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35332014

RESUMEN

BACKGROUND AND PURPOSE: Former preterm born males are at higher risk for neurodevelopmental disabilities compared with female infants born at the same gestational age. This retrospective study investigated sex-related differences in the maturity of early myelinating brain regions in infants born <28 weeks' gestational age using diffusion tensor- and relaxometry-based MR imaging. MATERIALS AND METHODS: Quantitative MR imaging sequence acquisitions were analyzed in a sample of 35 extremely preterm neonates imaged at term-equivalent ages. Quantitative MR imaging metrics (fractional anisotropy; ADC [10-3mm2/s]; and T1-/T2-relaxation times [ms]) of the medulla oblongata, pontine tegmentum, midbrain, and the right/left posterior limbs of the internal capsule were determined on diffusion tensor- and multidynamic, multiecho sequence-based imaging data. ANCOVA and a paired t test were used to compare female and male infants and to detect hemispheric developmental asymmetries. RESULTS: Seventeen female (mean gestational age at birth: 26 + 0 [SD, 1 + 4] weeks+days) and 18 male (mean gestational age at birth: 26 + 1 [SD, 1 + 3] weeks+days) infants were enrolled in this study. Significant differences were observed in the T2-relaxation time (P = .014) of the pontine tegmentum, T1-relaxation time (P = .011)/T2-relaxation time (P = .024) of the midbrain, and T1-relaxation time (P = .032) of the left posterior limb of the internal capsule. In both sexes, fractional anisotropy (P [♀] < .001/P [♂] < .001) and ADC (P [♀] = .017/P [♂] = .028) differed significantly between the right and left posterior limbs of the internal capsule. CONCLUSIONS: The combined use of various quantitative MR imaging metrics detects sex-related and interhemispheric differences of WM maturity. The brainstem and the left posterior limb of the internal capsule of male preterm neonates are more immature compared with those of female infants at term-equivalent ages. Sex differences in WM maturation need further attention for the personalization of neonatal brain imaging.


Asunto(s)
Recien Nacido Extremadamente Prematuro , Imagen por Resonancia Magnética , Anisotropía , Encéfalo/diagnóstico por imagen , Femenino , Edad Gestacional , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética/métodos , Masculino , Estudios Retrospectivos
4.
Hipertens Riesgo Vasc ; 39(2): 62-68, 2022.
Artículo en Español | MEDLINE | ID: mdl-35305932

RESUMEN

INTRODUCTION: Hypertension (HTN) is the leading cause of mortality and disability in the world. In Argentina, almost 44% of hypertensives do not know about their condition and this may be due to the low rate of blood pressure (BP) measurements during the office visit. Our hypothesis is that the measurement and electronic recording of BP (BPMR) is not a routine practice in Argentina. OBJECTIVE: To describe the rate of office BP measurement in Argentina. METHODS: This is a retrospective, multicentre, point prevalence study. We analysed all office visits on 9/19/2019 at 9 medical institutions in 6 provinces of Argentina. RESULTS: Two thousand and eighty-two office visits were analysed. The patients' mean age was 52.1 years (18-103), 1790 (59.7%) were female, and 702 (36.1%) were hypertensives. BP was measured in 420 visits (14.1%; 95% CI 12.8-15.4). In a multivariate logistic regression model, history of HTN (OR 1.91, P<.001) and previous cardiovascular event (OR 1.76, P<.001) were associated with more odds of BPMR. The presence of cancer was associated with fewer odds of BPMR (OR .51, P<.01). Cardiology measured BP up to 49.5% (144/291 visits), followed by internal medicine 30% (152/507 visits). CONCLUSION: BPMR during office visits is deficient in Argentina and represents a missed healthcare opportunity. Different strategies are needed to detect hypertensive patients and reduce cardiovascular events.


Asunto(s)
Determinación de la Presión Sanguínea , Hipertensión , Presión Sanguínea , Monitoreo Ambulatorio de la Presión Arterial , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad , Sistema de Registros , Estudios Retrospectivos
5.
ESMO Open ; 7(1): 100388, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35121522

RESUMEN

BACKGROUND: Pulmonary metastasis (M1-PUL) as first site of dissemination in pancreatic ductal adenocarcinoma (PDAC) is a rare event and may define a distinct biological subgroup. PATIENTS AND METHODS: Arbeitsgemeinschaft Internistische Onkologie-Young Medical Oncologists-Pankreas-0515 study (AIO-YMO-PAK-0515) was a retrospective German multicenter study investigating clinical and molecular characteristics of M1-PUL PDAC patients; 115 M1-PUL PDAC patients from 7 participating centers were included. Clinical characteristics and potential prognostic factors were defined within the M1-PUL cohort. Archival tumor samples were analyzed for Her2/neu, HNF1A and KRT81 expression. Additionally, messenger RNA (mRNA) expression analysis (using a 770-gene immune profiling panel) was carried out in the M1-PUL and in a control cohort (M1-ANY). RESULTS: Median overall survival in the entire M1-PUL cohort was 20 months; the most favorable prognosis (median survival: 28 months) was observed in the subgroup of 66 PDAC patients with metachronous lung metastases after previous curative-intent surgery. The number of metastatic lesions, uni- or bilateral lung involvement as well as metastasectomy were identified as potential prognostic factors. Her2/neu expression and PDAC subtyping (by HNF1A and KRT81) did not differ between the M1-PUL and the M1-ANY cohort. mRNA expression analysis revealed significant differentially expressed genes between both cohorts: CD63 and LAMP1 were among the top 20 differentially expressed genes and were identified as potential mediators of organotropism and favorable survival outcome of M1-PUL patients. CONCLUSION: M1-PUL represents a clinically favorable cohort in PDAC patients. Site of relapse might already be predetermined at the time of surgery and could potentially be predicted by gene expression profiling.


Asunto(s)
Neoplasias Pulmonares , Neoplasias Pancreáticas , Biología , Humanos , Neoplasias Pulmonares/genética , Recurrencia Local de Neoplasia , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patología , Pronóstico , Estudios Retrospectivos
6.
J Orthop Surg Res ; 16(1): 722, 2021 Dec 20.
Artículo en Inglés | MEDLINE | ID: mdl-34930350

RESUMEN

BACKGROUND: This study evaluates whether a circumferential cast compared to a plaster splint leads to less fracture redisplacement in reduced extra-articular distal radius fractures (DRFs). METHODS: This retrospective multicentre study was performed in four hospitals (two teaching hospitals and two academic hospitals). Adult patients with a displaced extra-articular DRF, treated with closed reduction, were included. Patients were included from a 5-year period (January 2012-January 2017). According to the hospital protocol, fractures were immobilized with a below elbow circumferential cast (CC) or a plaster splint (PS). The primary outcome concerned the difference in the occurrence of fracture redisplacement at one-week follow-up. RESULTS: A total of 500 patients were included in this study (PS n = 184, CC n = 316). At one-week follow-up, fracture redisplacement occurred in 52 patients (17%) treated with a CC compared to 53 patients (29%) treated with a PS. This difference was statistically significant (p = 0.001). CONCLUSION: This study suggests that treatment of reduced DRFs with a circumferential cast might cause less fracture redisplacement at 1-week follow-up compared to treatment with a plaster splint. Level of Evidence Level III, Retrospective study.


Asunto(s)
Moldes Quirúrgicos , Fractura-Luxación/cirugía , Fijación Interna de Fracturas/métodos , Fijación de Fractura/métodos , Fracturas del Radio/cirugía , Férulas (Fijadores) , Adulto , Moldes Quirúrgicos/efectos adversos , Fijación de Fractura/efectos adversos , Humanos , Fracturas del Radio/diagnóstico por imagen , Estudios Retrospectivos
7.
Phys Rev E ; 104(4-1): 044125, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34781507

RESUMEN

We investigate experimentally as well as theoretically the dynamic magnetic phase diagram and its associated order parameter Q upon the application of a non-antisymmetric magnetic field sequence composed of a fundamental harmonic component H_{0}, a constant bias field H_{b}, and a second-harmonic component H_{2}. The broken time antisymmetry introduced by the second-harmonic field component H_{2} leads to an effective bias effect that is superimposed onto the influence of the static bias H_{b}. Despite this interference, we can demonstrate the existence of a generalized conjugate field H^{*} for the dynamic order parameter Q, to which both the static bias field and the second-harmonic Fourier amplitude of the field sequence contribute. Hereby, we observed that especially the conventional paramagnetic dynamic phase is very susceptible to the impact of the second-harmonic field component H_{2}, whereas this additional field component leads to only very minor phase-space modifications in the ferromagnetic and anomalous paramagnetic regions. In contrast to prior studies, we also observe that the critical point of the phase transition is shifted upon introducing a second-harmonic field component H_{2}, illustrating that the overall dynamic behavior of such magnetic systems is being driven by the total effective amplitude of the field sequence.

8.
Ultraschall Med ; 2021 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-34768305

RESUMEN

PURPOSE: To assess the longitudinal variation of the ratio of umbilical and cerebral artery pulsatility index (UCR) in late preterm fetal growth restriction (FGR). MATERIALS AND METHODS: A prospective European multicenter observational study included women with a singleton pregnancy, 32+ 0-36+ 6, at risk of FGR (estimated fetal weight [EFW] or abdominal circumference [AC] < 10th percentile, abnormal arterial Doppler or fall in AC from 20-week scan of > 40 percentile points). The primary outcome was a composite of abnormal condition at birth or major neonatal morbidity. UCR was categorized as normal (< 0.9) or abnormal (≥ 0.9). UCR was assessed by gestational age at measurement interval to delivery, and by individual linear regression coefficient in women with two or more measurements. RESULTS: 856 women had 2770 measurements; 696 (81 %) had more than one measurement (median 3 (IQR 2-4). At inclusion, 63 (7 %) a UCR ≥ 0.9. These delivered earlier and had a lower birth weight and higher incidence of adverse outcome (30 % vs. 9 %, relative risk 3.2; 95 %CI 2.1-5.0) than women with a normal UCR at inclusion. Repeated measurements after an abnormal UCR at inclusion were abnormal again in 67 % (95 %CI 55-80), but after a normal UCR the chance of finding an abnormal UCR was 6 % (95 %CI 5-7 %). The risk of composite adverse outcome was similar using the first or subsequent UCR values. CONCLUSION: An abnormal UCR is likely to be abnormal again at a later measurement, while after a normal UCR the chance of an abnormal UCR is 5-7 % when repeated weekly. Repeated measurements do not predict outcome better than the first measurement, most likely due to the most compromised fetuses being delivered after an abnormal UCR.

9.
Nat Med ; 27(10): 1789-1796, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34608333

RESUMEN

Talimogene laherparepvec (T-VEC) is a herpes simplex virus type 1-based intralesional oncolytic immunotherapy approved for the treatment of unresectable melanoma. The present, ongoing study aimed to estimate the treatment effect of neoadjuvant T-VEC on recurrence-free survival (RFS) of patients with advanced resectable melanoma. An open-label, phase 2 trial (NCT02211131) was conducted in 150 patients with resectable stage IIIB-IVM1a melanoma who were randomized to receive T-VEC followed by surgery (arm 1, n = 76) or surgery alone (arm 2, n = 74). The primary endpoint was a 2-year RFS in the intention-to-treat population. Secondary and exploratory endpoints included overall survival (OS), pathological complete response (pCR), safety and biomarker analyses. The 2-year RFS was 29.5% in arm 1 and 16.5% in arm 2 (overall hazard ratio (HR) = 0.75, 80% confidence interval (CI) = 0.58-0.96). The 2-year OS was 88.9% for arm 1 and 77.4% for arm 2 (overall HR = 0.49, 80% CI = 0.30-0.79). The RFS and OS differences between arms persisted at 3 years. In arm 1, 17.1% achieved a pCR. Increased CD8+ density correlated with clinical outcomes in an exploratory analysis. Arm 1 adverse events were consistent with previous reports for T-VEC. The present study met its primary endpoint and estimated a 25% reduction in the risk of disease recurrence for neoadjuvant T-VEC plus surgery versus upfront surgery for patients with resectable stage IIIB-IVM1a melanoma.


Asunto(s)
Productos Biológicos/administración & dosificación , Inmunoterapia , Melanoma/terapia , Terapia Neoadyuvante , Adulto , Anciano , Productos Biológicos/inmunología , Terapia Combinada , Supervivencia sin Enfermedad , Femenino , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/inmunología , Humanos , Masculino , Melanoma/genética , Melanoma/patología , Melanoma/virología , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/terapia , Recurrencia Local de Neoplasia/virología , Estadificación de Neoplasias , Viroterapia Oncolítica/tendencias , Virus Oncolíticos/genética , Virus Oncolíticos/inmunología
10.
Science ; 373(6558): 1035-1040, 2021 08 27.
Artículo en Inglés | MEDLINE | ID: mdl-34446606

RESUMEN

Abrupt cooling is observed at the end of interglacials in many paleoclimate records, but the mechanism responsible remains unclear. Using model simulations, we demonstrate that there exists a threshold in the level of astronomically induced insolation below which abrupt changes at the end of interglacials of the past 800,000 years occur. When decreasing insolation reaches the critical value, it triggers a strong, abrupt weakening of the Atlantic meridional overturning circulation and a cooler mean climate state accompanied by high-amplitude variations lasting for several thousand years. The mechanism involves sea ice feedbacks in the Nordic and Labrador Seas. The ubiquity of this threshold suggests its fundamental role in terminating the warm climate conditions at the end of interglacials.

11.
Ann Chir Plast Esthet ; 66(3): 201-209, 2021 Jun.
Artículo en Francés | MEDLINE | ID: mdl-33966906

RESUMEN

INTRODUCTION: This work relates the experience of three French surgical missions in the care of the war wounded during the armed conflict in Nagorno Karabakh which took place from September 27 to November 10, 2020. MATERIALS AND METHODS: Three surgical missions were carried out in Armenia between October 2020 and January 2021. Surgeons intervened in different hospitals, at different times of the conflict and on various war wounds. RESULTS: The presence of a plastic surgeon proved to be essential in the care of war wounded, especially in delayed emergency and secondary care. The ortho-plastic treatment offered during these missions has proven to be effective in the reconstruction of limbs. These missions made it possible to introduce the induced membrane technique of Masquelet AC in Armenia. During our visit to the Yerevan burn center, we mentioned the very probable use of white phosphorus as an etiology in several of the cases analyzed. CONCLUSION: We relate the particular experience of civilian surgeons in the context of a modern armed conflict. The presence of a plastic surgeon proved to be indispensable in the care of war wounded and especially in their secondary reconstructions.


Asunto(s)
Procedimientos Quirúrgicos Reconstructivos , Cirujanos , Cirugía Plástica , Armenia , Humanos
12.
Int J Legal Med ; 135(5): 2055-2060, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33665704

RESUMEN

The duration of infectivity of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in living patients has been demarcated. In contrast, a possible SARS-CoV-2 infectivity of corpses and subsequently its duration under post mortem circumstances remain to be elucidated. The aim of this study was to investigate the infectivity and its duration of deceased COVID-19 (coronavirus disease) patients. Four SARS-CoV-2 infected deceased patients were subjected to medicolegal autopsy. Post mortem intervals (PMI) of 1, 4, 9 and 17 days, respectively, were documented. During autopsy, swabs and organ samples were taken and examined by RT-qPCR (real-time reverse transcription-polymerase chain reaction) for the detection of SARS-CoV-2 ribonucleic acid (RNA). Determination of infectivity was performed by means of virus isolation in cell culture. In two cases, virus isolation was successful for swabs and tissue samples of the respiratory tract (PMI 4 and 17 days). The two infectious cases showed a shorter duration of COVID-19 until death than the two non-infectious cases (2 and 11 days, respectively, compared to > 19 days), which correlates with studies of living patients, in which infectivity could be narrowed to about 6 days before to 12 days after symptom onset. Most notably, infectivity was still present in one of the COVID-19 corpses after a post-mortem interval of 17 days and despite already visible signs of decomposition. To prevent SARS-CoV-2 infections in all professional groups involved in the handling and examination of COVID-19 corpses, adequate personal safety standards (reducing or avoiding aerosol formation and wearing FFP3 [filtering face piece class 3] masks) have to be enforced for routine procedures.


Asunto(s)
COVID-19/transmisión , Cadáver , ARN Viral/aislamiento & purificación , SARS-CoV-2/aislamiento & purificación , Anciano , Anciano de 80 o más Años , COVID-19/diagnóstico , Prueba de Ácido Nucleico para COVID-19 , Femenino , Humanos , Masculino
13.
AJNR Am J Neuroradiol ; 42(4): 794-800, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33632733

RESUMEN

BACKGROUND AND PURPOSE: Percutaneous cervical cordotomy offers relief of unilateral intractable oncologic pain. We aimed to find anatomic and postoperative imaging features that may correlate with clinical outcomes, including pain relief and postoperative contralateral pain. MATERIALS AND METHODS: We prospectively followed 15 patients with cancer who underwent cervical cordotomy for intractable pain during 2018 and 2019 and underwent preoperative and up to 1-month postoperative cervical MR imaging. Lesion volume and diameter were measured on T2-weighted imaging and diffusion tensor imaging (DTI). Lesion mean diffusivity and fractional anisotropy values were extracted. Pain improvement up to 1 month after surgery was assessed by the Numeric Rating Scale and Brief Pain Inventory. RESULTS: All patients reported pain relief from 8 (7-10) to 0 (0-4) immediately after surgery (P = .001), and 5 patients (33%) developed contralateral pain. The minimal percentages of the cord lesion volume required for pain relief were 10.0% on T2-weighted imaging and 6.2% on DTI. Smaller lesions on DWI correlated with pain improvement on the Brief Pain Inventory scale (r = 0.705, P = .023). Mean diffusivity and fractional anisotropy were significantly lower in the ablated tissue than contralateral nonlesioned tissue (P = .003 and P = .001, respectively), compatible with acute-phase tissue changes after injury. Minimal postoperative mean diffusivity values correlated with an improvement of Brief Pain Inventory severity scores (r = -0.821, P = .004). The average lesion mean diffusivity was lower among patients with postoperative contralateral pain (P = .037). CONCLUSIONS: Although a minimal ablation size is required during cordotomy, larger lesions do not indicate better outcomes. DWI metrics changes represent tissue damage after ablation and may correlate with pain outcomes.


Asunto(s)
Cordotomía , Dolor Intratable , Imagen de Difusión Tensora , Humanos , Imagen por Resonancia Magnética , Dolor Intratable/diagnóstico por imagen , Dolor Intratable/cirugía , Dolor Postoperatorio , Periodo Posoperatorio
14.
AJNR Am J Neuroradiol ; 42(3): 581-589, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33478940

RESUMEN

BACKGROUND AND PURPOSE: Preterm birth interferes with regular brain development. The aim of this study was to investigate the impact of prematurity on the physical tissue properties of the neonatal brain stem using a quantitative MR imaging approach. MATERIALS AND METHODS: A total of 55 neonates (extremely preterm [n = 30]: <28 + 0 weeks gestational age; preterm [n = 10]: 28 + 0-36 + 6 weeks gestational age; term [n = 15]: ≥37 + 0 weeks gestational age) were included in this retrospective study. In most cases, imaging was performed at approximately term-equivalent age using a standard MR protocol. MR data postprocessing software SyMRI was used to perform multidynamic multiecho sequence (acquisition time: 5 minutes, 24 seconds)-based MR postprocessing to determine T1 relaxation time, T2 relaxation time, and proton density. Mixed-model ANCOVA (covariate: gestational age at MR imaging) and the post hoc Bonferroni test were used to compare the groups. RESULTS: There were significant differences between premature and term infants for T1 relaxation time (midbrain: P < .001; pons: P < .001; basis pontis: P = .005; tegmentum pontis: P < .001; medulla oblongata: P < .001), T2 relaxation time (midbrain: P < .001; tegmentum pontis: P < .001), and proton density (tegmentum pontis: P = .004). The post hoc Bonferroni test revealed that T1 relaxation time/T2 relaxation time in the midbrain differed significantly between extremely preterm and preterm (T1 relaxation time: P < .001/T2 relaxation time: P = .02), extremely preterm and term (T1 relaxation time/T2 relaxation time: P < .001), and preterm and term infants (T1 relaxation time: P < .001/T2 relaxation time: P = .006). CONCLUSIONS: Quantitative MR parameters allow preterm and term neonates to be differentiated. T1 and T2 relaxation time metrics of the midbrain allow differentiation between the different stages of prematurity. SyMRI allows for a quantitative assessment of incomplete brain maturation by providing tissue-specific properties while not exceeding a clinically acceptable imaging time.


Asunto(s)
Tronco Encefálico/diagnóstico por imagen , Tronco Encefálico/crecimiento & desarrollo , Recien Nacido Prematuro , Femenino , Edad Gestacional , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Recién Nacido , Recien Nacido Prematuro/crecimiento & desarrollo , Imagen por Resonancia Magnética/métodos , Masculino , Embarazo , Estudios Retrospectivos
15.
Hernia ; 25(6): 1529-1535, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33400028

RESUMEN

INTRODUCTION: Several management strategies exist for the treatment of infected abdominal mesh. Using the American Hernia Society Quality Collaborative, we examined management patterns and 30-day outcomes of infected mesh removal with concomitant incisional hernia repair. METHODS: All patients undergoing incisional hernia repair with removal of infected mesh were identified. A complete repair (CR) was defined as fascial closure with mesh; a partial repair (PR) was defined as fascial closure without mesh or no fascial closure with mesh. A two-tailed p value less than or equal to 0.05 was considered statistically significant. RESULTS: A total of 282 patients were identified: 136 patients in CR group and 146 patients in PR group. Patients had similar comorbidities but differed in wound class (class IV: 55% CR vs 83% SR, p < 0.001) and incidence of associated concomitant colorectal procedures (5% CR vs 18% SR, p = 0.015). Sublay placement was used primarily in CR (94%) compared to PR (52% inlay, 48% sublay). When comparing CR to PR, length of stay (median 6, p = 0.69), complications (40% vs 44%, p = 0.44), surgical site infections (16% vs 21%, p = 0.27), surgical site occurrence (30% vs 35%, p = 0.45), and readmission within 30 days (9% vs. 13%) were not statistically different. CONCLUSIONS: Analysis of data from a multicenter hernia registry comparing CR and PR during infected mesh removal and concurrent incisional hernia repair has not identified higher rates of short-term complications between groups in the presence of infection.


Asunto(s)
Pared Abdominal , Hernia Ventral , Hernia Incisional , Pared Abdominal/cirugía , Hernia Ventral/etiología , Hernia Ventral/cirugía , Herniorrafia/efectos adversos , Herniorrafia/métodos , Humanos , Hernia Incisional/complicaciones , Hernia Incisional/cirugía , Complicaciones Posoperatorias/epidemiología , Mallas Quirúrgicas/efectos adversos , Resultado del Tratamiento
16.
J Atten Disord ; 25(2): 217-232, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-29896994

RESUMEN

Objective: Recent discussions of aetiological overlap between ADHD and Autism Spectrum Disorder (ASD) require comparative studying of these disorders. METHOD: We examined performance of ASD patients with (ASD+) and without (ASD-) comorbid ADHD, ADHD patients, and controls for selected putative endophenotypes of ADHD: Intrasubject Variability (ISV) of reaction times, working memory (WM), inhibition, and temporal processing. RESULTS: We found that patients with ADHD or ASD+, but not ASD-, had elevated ISV across the entire task battery and temporal processing deficits, and that none of the groups were impaired in WM or inhibition. High levels of ISV and generally poor performance in ASD+ patients were only partially due to additive effects of the pure disorders. CONCLUSION: Overall, we conclude that, within our limited but heterogeneous task battery, ISV and temporal processing deficits are most sensitive to ADHD symptomatology and that controlling for ADHD comorbidity is mandatory when assessing ISV in autism.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Trastorno del Espectro Autista , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Comorbilidad , Endofenotipos , Humanos , Memoria a Corto Plazo , Tiempo de Reacción
17.
Phys Rev E ; 102(2-1): 022804, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32942401

RESUMEN

We study dynamic magnetic behavior in the vicinity of the dynamic phase transition (DPT) for a suitable series of samples that have different Curie temperatures T_{C}, which thus enables us to experimentally explore the role of the reduced temperature T/T_{C} in the DPT. For this purpose, we fabricate Co_{1-x}Ru_{x} epitaxial thin films with uniaxial in-plane anisotropy by means of sputter deposition in the concentration range 0.0≤x≤0.26. All samples are ferromagnetic at room temperature, exhibit an abrupt magnetization reversal along their easy axis, and represent a unique T_{C} and thus T/T_{C} ratio according to their Ru concentration. The dynamic magnetic behavior is measured by using an ultrasensitive transverse magneto-optical detection method and the resulting dynamic states are explored as a function of the applied magnetic field amplitude H_{0} and period P, as well as an additional bias field H_{b}, which is the conjugate field of the dynamic order parameter Q. Our experimental results demonstrate that the qualitative behavior of the dynamic phase diagram is independent of the T/T_{C} ratio and that for all T/T_{C} values we observe metamagnetic anomalies in the dynamic paramagnetic state, which do not exist in the corresponding thermodynamic phase diagram. However, quantitatively, these metamagnetic anomalies are very strongly dependent on the T/T_{C} ratio, leading to an about 20-fold increase of large metamagnetic fluctuations in the paramagnetic regime as the T/T_{C} ratio increases from 0.37 to 0.68. Also, the phase space range in which these anomalous metamagnetic fluctuations occur extends closer and closer to the critical point as T/T_{C} increases.

18.
Eur J Oncol Nurs ; 48: 101797, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32862096

RESUMEN

PURPOSE: Glycemic variability is associated with risks for adverse events in patients with cancer. Several studies have evaluated the presence and impact of hyperglycemia and/or hypoglycemia in patients with cancer; however, few studies have evaluated glycemic variability. The purpose of this integrative review of studies in patients with gastrointestinal cancers was to investigate the presence and methods of reporting glycemic variability during and following treatments. METHODS: A comprehensive review of the literature was conducted. PubMed, CINAHL, EMBASE, and Cochrane databases were searched for publications between 1/1/1969 and 7/24/2019. Studies of patients with gastrointestinal cancer following surgery, during treatment, and <5 years following treatment were included and evaluated by cancer type and method of glucose and glycemic variability measurement. RESULTS: Among 1526 patients with gastrointestinal cancer across 19 studies, gastric and pancreatic cancers were most prevalent. Timing of glucose testing and methods of analyzing glycemic variability varied. Most analyses used the standard deviation or interquartile range. Glycemic variability was more prevalent among patients with Type 2 Diabetes and among those with pancreatic cancer. In some patients glycemic variability remained notable > one year following surgery despite improvements in glycemic control. CONCLUSION: Patients with gastrointestinal cancer experience glycemic variability during and up to one year following treatment. There was heterogeneity in methods related to timing of testing and reporting glycemic variability among the 19 studies in this review. Future investigations need to identify the presence and define the methods of measuring glycemic variability in patients with gastrointestinal cancer.


Asunto(s)
Glucemia/análisis , Neoplasias Gastrointestinales/complicaciones , Neoplasias Gastrointestinales/tratamiento farmacológico , Neoplasias Gastrointestinales/fisiopatología , Control Glucémico/métodos , Hiperglucemia/inducido químicamente , Hipoglucemia/inducido químicamente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad
19.
Theriogenology ; 157: 33-41, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32799125

RESUMEN

Dairy farms face many challenges and changes. With increasing herd sizes and fewer farmers or employees per cow, new strategies to maintain or improve reproductive management are required. One of the major challenges is to detect cows in estrus and to estimate the perfect time for artificial insemination (AI). Several estrus and ovulation synchronization programs with timed AI as well as estrus detection aids, e.g., tail-paint, pedometer, accelerometer, and others are available. A combination of ovulation synchronization programs and technical solutions, however, has rarely been tested. This study was designed to gain insights into behavioral patterns of cows subjected to an Ovsynch program and to test if behavioral data could be used to optimize the timing of insemination within an Ovsynch program. In this study, we used an ear-tag based 3D-accelerometer system (SMARTBOW, Smartbow GmbH, Weibern, Austria) to generate data of behavioral patterns, i.e., rumination and activity. In Part 1 of this study, behavioral patterns during the peri-estrus period were compared between cows with physiological estrus and cows subjected to an Ovsynch protocol. On the day before estrus and on the day of estrus/AI, cows with natural estrus showed a clear drop in rumination and "inactivity" and an increase in "high activity", based on an algorithm of the accelerometer system, whereas, cows in the Ovsynch protocol showed only minor changes in behavioral patterns. In Part 2, we analyzed behavioral patterns between synchronized cows that became pregnant after AI and synchronized cows that remained open. As a result, no differences were detected between these two Ovsynch groups before AI. Thus, in this study we found no evidence that behavioral patterns can be used to improve conception rates within an Ovsynch protocol.


Asunto(s)
Sincronización del Estro , Lactancia , Acelerometría/veterinaria , Animales , Bovinos , Dinoprost , Estro , Femenino , Hormona Liberadora de Gonadotropina , Inseminación Artificial/veterinaria , Ovulación , Embarazo
20.
Neuroscience ; 443: 71-83, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32682826

RESUMEN

There is converging evidence that both aerobic exercise (AE) and transcranial direct current stimulation (tDCS) can acutely modulate executive functions (EF). In addition, recent studies have proposed the beneficial effects of applying tDCS during AE on physical performance. This study aimed to investigate whether tDCS applied during an AE session additionally or differently effects EF. Therefore, five experiments were conducted in a counterbalanced pre-post-retention crossover design to explore the acute effects of tDCS and AE on EF (inhibition and updating) once in isolation (i.e., either cathodal, anodal tDCS or AE alone as controls) and once in a combined application (i.e., anodal and cathodal tDCS during AE versus sham tDCS during AE). No differences were found in any experiment in the cognitive test parameters. However, in the case of anodal tDCS vs. sham during AE, heart rate was significantly affected. For cathodal tDCS vs. sham during AE, a significant Anova interaction indicated that cathodal tDCS during AE slightly reduced ratings of perceived exertion. The nonsignificant effects of tDCS on EFs are in contrast to previous studies, as no replication of existing observations could be achieved. Thus, the protocol applied in this study does not provide any strong evidence that a combination of AE and tDCS has any effects on EFs, but indicates effects on physiological parameters and subjective exhaustion ratings. Further research should consider changes in AE and tDCS parameters (e.g., intensity or exercise mode) and sequence of applications (online vs. offline).


Asunto(s)
Estimulación Transcraneal de Corriente Directa , Función Ejecutiva , Ejercicio Físico , Pruebas Neuropsicológicas , Corteza Prefrontal
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