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1.
Pediatr Int ; 2021 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-34606653

RESUMEN

BACKGROUND: With the coronavirus disease 2019 (COVID-19) pandemic lasting for more than a year, it is imperative to identify the associated changes in the use of emergency medical care for efficient operation of the PED. This study was conducted to determine the long-term impact of the COVID-19 pandemic on the patterns of PED visits. METHODS: This is a retrospective observational study of visits to the PED of six hospitals, between January 1, 2017, and December 31, 2020. We compared changes in the characteristics of patients before and during the COVID-19 pandemic. RESULTS: A total of 245,022 visits were included in this analysis. After the first case of COVID-19 was reported in Korea, we observed a significant decrease (54.2%) in PED visits compared to the annual average number of visits in the previous three years. Since then, the weekly number of PED visits decreased by 11.9 person/week (95% CI: -15.3 to -8.4, P<0.001), which included an increase of 0.21% (95% CI: 0.15% to 0.26%, P<0.001) per week in high acuity patients. From 2017 to 2020, the proportion of infectious respiratory diseases by year was 25.9%, 27.0%, 28.6%, and 16.3%, respectively, demonstrating a significant decrease in 2020 (P<0.001). CONCLUSIONS: During the COVID-19 pandemic, the number of patient visits to PEDs continues to decline, especially among those with infectious diseases. However, the disease severity of patients has gradually increased. There has been a change in the characteristics of visits to PEDs after COVID-19 which will require an appropriate response from a long-term perspective.

2.
Korean J Pain ; 34(4): 375-393, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34593656

RESUMEN

Percutaneous osteoplasty (POP) is defined as the injection of bone cement into various painful bony lesions, refractory to conventional therapy, as an extended technique of percutaneous vertebroplasty (PVP). POP can be applied to benign osteochondral lesions and malignant metastatic lesions throughout the whole skeleton, whereas PVP is restricted to the vertebral body. Common spinal metastases occur in the thoracic (70%), lumbosacral (20%), and cervical (10%) vertebrae, in order of frequency. Extraspinal metastases into the ribs, scapulae, sternum, and humeral head commonly originate from lung and breast cancers; extraspinal metastases into the pelvis and femoral head come from prostate, urinary bladder, colon, and uterine cervical cancers. Pain is aggravated in the dependent (or weight bearing) position, or during movement (or respiration). The tenderness and imaging diagnosis should match. The supposed mechanism of pain relief in POP is the augmentation of damaged bones, thermal and chemical ablation of the nociceptive nerves, and local inhibition of tumor invasion. Adjacent (facet) joint injections may be needed prior to POP (PVP). The length and thickness of the applied needle should be chosen according to the targeted bone. Bone cement is also selected by its osteoconduction, osteoinduction, and osteogenesis. Needle route should be chosen as a shortcut to reach the target bony lesions, without damage to the nerves and vessels. POP is a promising minimally invasive procedure for immediate pain relief. This review provides a technical survey for POPs in painful bony lesions.

3.
J Korean Med Sci ; 36(35): e248, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34490756

RESUMEN

BACKGROUND: Prediction of mortality in patients with coronavirus disease 2019 (COVID-19) is a key to improving the clinical outcomes, considering that the COVID-19 pandemic has led to the collapse of healthcare systems in many regions worldwide. This study aimed to identify the factors associated with COVID-19 mortality and to develop a nomogram for predicting mortality using clinical parameters and underlying diseases. METHODS: This study was performed in 5,626 patients with confirmed COVID-19 between February 1 and April 30, 2020 in South Korea. A Cox proportional hazards model and logistic regression model were used to construct a nomogram for predicting 30-day and 60-day survival probabilities and overall mortality, respectively in the train set. Calibration and discrimination were performed to validate the nomograms in the test set. RESULTS: Age ≥ 70 years, male, presence of fever and dyspnea at the time of COVID-19 diagnosis, and diabetes mellitus, cancer, or dementia as underling diseases were significantly related to 30-day and 60-day survival and mortality in COVID-19 patients. The nomogram showed good calibration for survival probabilities and mortality. In the train set, the areas under the curve (AUCs) for 30-day and 60-day survival was 0.914 and 0.954, respectively; the AUC for mortality of 0.959. In the test set, AUCs for 30-day and 60-day survival was 0.876 and 0.660, respectively, and that for mortality was 0.926. The online calculators can be found at https://koreastat.shinyapps.io/RiskofCOVID19/. CONCLUSION: The prediction model could accurately predict COVID-19-related mortality; thus, it would be helpful for identifying the risk of mortality and establishing medical policies during the pandemic to improve the clinical outcomes.


Asunto(s)
COVID-19/mortalidad , Nomogramas , SARS-CoV-2 , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Modelos Logísticos , Masculino , Persona de Mediana Edad , Probabilidad , Modelos de Riesgos Proporcionales , Índice de Severidad de la Enfermedad , Adulto Joven
4.
Pediatr Int ; 2021 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-34582093

RESUMEN

BACKGROUND: Auscultation is an easy way to evaluate and diagnose patients with lung conditions, but has the shortcoming of being subjective. Using the spectrogram, it is possible to visualize wheezing. We therefore conducted a study to compare the efficacy of diagnosing wheezing by auscultation versus diagnosing wheezing by spectrogram. METHODS: This was an investigation of interrater reliability and agreement in which the subject population consisted of children, and the rater population consisted of pediatric pulmonologists. We recorded 55 respiratory sound files from June to November 2019. Three pediatric pulmonologists listened to the respiratory sound files and assessed whether wheezing was present. Additionally, all respiratory sound files were converted into spectrograms; the same pulmonologists viewed these and assessed whether wheezing was present. We performed interrater reliability and agreement testing as between the auscultation results and spectrographic results and investigated the diagnostic reliability of auscultation versus spectrogram. RESULTS: As between the three raters of our auscultation respiratory recordings, agreement was 88% and reliability was good (kappa=0.76, p<0.001). As between the three raters of our spectrograms, agreement was 83% and reliability was good (kappa=0.66, p<0.001). Agreement between each rater's spectrographic findings and diagnosed wheezing was 91%, 75%, and 93%, respectively. On that subject, reliability was very good, moderate, and very good (kappa=0.82, 0.49, 0.85, p<0.001), respectively. CONCLUSIONS: A spectrogram may be a valuable tool for evaluating wheezing in children. It may also be used to improve a young clinician's ability to accurately diagnose wheezing in the future.

5.
Environ Sci Technol ; 55(16): 11155-11165, 2021 08 17.
Artículo en Inglés | MEDLINE | ID: mdl-34347462

RESUMEN

Little is known about temporal trends of pregnant women's exposures to environmental phenols and parabens. We quantified four phenols [bisphenol A (BPA), bisphenol F, bisphenol S, and triclosan), four parabens [butyl paraben, ethyl paraben (ETPB), methyl paraben (MEPB), and propyl paraben (PRPB)], and triclocarban in 760 urine samples collected during 2007-2014 from 218 California pregnant women participating in a high-familial risk autism spectrum disorder cohort. We applied multiple regression to compute least square geometric means of urinary concentrations and computed average annual percent changes. We compared our urinary concentrations with those of other study populations to examine geographic variations in pregnant women's exposure to these target compounds. Urinary concentrations of BPA, MEPB, ETPB, and PRPB in this study population decreased over the study period [percent change per year (95% confidence interval): -5.7% (-8.2%, -3.2%); -13.0% (-18.1%, -7.7%); -5.5% (-11.0%, 0.3%); and -13.3% (-18.3%, -8.1%), respectively] and were consistently lower than those in pregnant women in other U.S. regions during the same study period. In recent years, certain phenols and parabens with known adverse health effects are being regulated or replaced with alternatives, which explains decreased body burdens observed in this study population. Either the national regulations or the advocacy campaigns in California may have influenced exposures or consumer product choices.


Asunto(s)
Trastorno del Espectro Autista , Parabenos , Carbanilidas , Exposición a Riesgos Ambientales/análisis , Femenino , Humanos , Parabenos/análisis , Fenol , Fenoles , Embarazo , Mujeres Embarazadas
6.
Children (Basel) ; 8(7)2021 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-34356547

RESUMEN

The total number of pediatric emergency department (PED) visitors has decreased worldwide since the coronavirus disease (COVID-19) outbreak. We hypothesized that this might also affect the number of PED visits due to injuries. Therefore, we investigated these changes in PED visits after the COVID-19 outbreak through a long-term multicenter observational study. We assessed the changes in the proportion of injured pediatric patients' weekly visits and the trend in the rate changes since the COVID-19 epidemic began by segmented regression analysis. We also evaluated the weekly change in the distribution of detailed diagnostic codes among pediatric patients with injuries before and after the COVID-19 pandemic. The proportion of injury-related PED visits increased when COVID-19 was first confirmed in Korea. After the COVID-19 epidemic, the proportion of foreign body ingestions and fracture patients among all pediatric patients with injuries increased significantly every week. The changes in the proportion of injured pediatric patients after the COVID-19 outbreak may have been the result of social distancing to prevent the spread of the virus. The risk of pediatric infections decreased but the risk of injury remained. Therefore, parents should take precautions to prevent infectious diseases and be careful to prevent children's injuries at home.

7.
Nutrients ; 13(5)2021 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-34063216

RESUMEN

The objective of this systematic review and meta-analysis was to summarize the effects of early initiation and achievement of a high dose of parenteral lipids (≥1.5 g/kg/day reached within the first 24 h of birth) on growth and adverse outcomes in preterm infants. PubMed, EMBASE, and Cochrane databases were utilized to search for publications for this meta-analysis. Randomized controlled trials were eligible if data on growth or clinical outcome was available. The search returned nine studies. The mean proportion of postnatal weight loss (%) was lower (mean difference [MD]: -2.73; 95% confidence interval [CI]: -3.69, -1.78), and the mean head circumference near the term equivalent age (cm) was higher in the early high lipid treatment group (MD: 0.67; 95% CI: 0.25, 1.09). There was a favorable association of early high lipid administration with the incidence of extrauterine growth restriction (relative risk [RR]: 0.27; 95% CI: 0.15, 0.48). Generally, there were no differences in morbidities or adverse outcomes with early high lipid administration. Early initiation of parenteral lipids and high dose achieved within the first 24 h of life appear to be safe and endurable and offer benefits in terms of growth.


Asunto(s)
Suplementos Dietéticos , Recien Nacido Prematuro/crecimiento & desarrollo , Lípidos/administración & dosificación , Nutrición Parenteral/métodos , Femenino , Humanos , Lactante , Recién Nacido , Masculino
8.
Environ Pollut ; 286: 117195, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-33975218

RESUMEN

The characteristics of primary gas/aerosol and secondary aerosol emissions were identified for small passenger vehicles using typical fuel types in South Korea (gasoline, liquefied petroleum gas (LPG), and diesel). The generation of secondary organic aerosol (SOA) was explored using the potential aerosol mass (PAM) oxidation flow reactor. The primary emissions did not vary significantly between fuel types, combustion technologies, or aftertreatment systems, while the amount of NH3 was higher in gasoline and LPG vehicle emissions than that in diesel vehicle emissions. The SOA emission factor was 11.7-66 mg kg-fuel-1 for gasoline vehicles, 2.4-50 mg kg-fuel-1 for non-diesel particulate filter (non-DPF) diesel vehicles (EURO 2-3), 0.4-40 mg kg-fuel-1 for DPF diesel vehicles (EURO 4-6), and 3-11 mg kg-fuel-1 for LPG vehicles (lowest). The carbonaceous aerosols (equivalent black carbon (eBC) + primary organic aerosol + SOA) of diesel vehicles in EURO 4-6 were reduced by up to 95% compared to those in EURO 2-3. The expected SOA yield increased through the hot-condition combustion section of a vehicle, over the SOA range of 0.2-155 µg m-3. These results provide the necessary data to analyze all types of SOA generated by the gas-phase oxidation in vehicle emissions in metropolitan areas.


Asunto(s)
Contaminantes Atmosféricos , Petróleo , Aerosoles/análisis , Contaminantes Atmosféricos/análisis , Gasolina/análisis , Vehículos a Motor , Tecnología , Emisiones de Vehículos/análisis
9.
Biosensors (Basel) ; 11(4)2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33918811

RESUMEN

Sensing targeted tumor markers with high sensitivity provides vital information for the fast diagnosis and treatment of cancer patients. A vascular endothelial growth factor (VEGF165) have recently emerged as a promising biomarker of tumor cells. The electrochemical aptasensor is a promising tool for detecting VEGF165 because of its advantages such as a low cost and quantitative analysis. To produce a sensitive and stable sensor electrode, nanocomposites based on polyaniline (PANI) and carbon nanotube (CNT) have potential, as they provide for easy fabrication, simple synthesis, have a large surface area, and are suitable in biological environments. Here, a label-free electrochemical aptasensor based on nanocomposites of CNT and PANI was prepared for detecting VEGF165 as a tumor marker. The nanocomposite was assembled with immobilized VEGF165 aptamer as a highly sensitive VEGF165 sensor. It exhibited stable and wide linear detection ranges from 0.5 pg/mL to 1 µg/mL, with a limit of detection of 0.4 pg/mL because of the complementary effect of PANI/CNT. The fabricated aptasensor also exhibited good stability in biological conditions, selectivity, and reproducibility after several measurement times after the dissociation process. Thus, it could be applied for the non-invasive determination of VEGF, in biological fluid diagnosis kits, or in an aptamer-based biosensor platform in the near future.


Asunto(s)
Técnicas Biosensibles , Nanocompuestos , Factor A de Crecimiento Endotelial Vascular/análisis , Compuestos de Anilina , Biomarcadores de Tumor , Electrodos , Humanos , Nanotubos de Carbono , Reproducibilidad de los Resultados
10.
Bone Marrow Transplant ; 56(8): 1929-1936, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33782549

RESUMEN

This study aimed to evaluate the pretransplant diffusing capacity as a predictor of outcomes in pediatric allogeneic hematopoietic stem cell transplantation (allo-HSCT). Retrospective cohort study of 176 children followed outcomes for 5 years after allo-HSCT. We conducted an analysis of PFTs include spirometry, body plethysmography, and diffusing capacity prior to allo-HSCT. We analyzed the probabilities of overall survival (OS), disease-related mortality (DRM), and non-relapse mortality (NRM). Of all carbon monoxide diffusing capacity (DLCO) parameters obtained using the Global Lung Function Initiative (GLI)-2017, univariate analysis showed that the grade 3, 4 of DLCOadj and Category III, IV of LFS significantly increase NRM (p = 0.003 and p = 0.008). Multivariate analysis indicated that a significant increase in the risk of NRM is associated with grades 3, 4 DLCOadj (hazard ratio [HR] = 4.90, p = 0.020). Kaplan-Meier analyses showed that a significant stepwise increase in NRM was observed with both worse pretransplant DLCOadj grades and LFS categories (p < 0.001 and p = 0.003). A compromised pretransplant diffusing capacity and a high LFS significantly increase the risk of NRM. Especially, DLCOadj before transplantation can be used as an important predictor of NRM after allo-HSCT in children with malignancy.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Recurrencia Local de Neoplasia , Niño , Humanos , Estimación de Kaplan-Meier , Estudios Retrospectivos , Trasplante Homólogo
11.
Pediatr Allergy Immunol ; 32(5): 872-879, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33583098

RESUMEN

INTRODUCTION: Children with allergies are at greater risk of becoming sensitized to allergenic pollens in response to environmental changes. This study investigated the relationship between changes in pollination associated with meteorologic changes and the sensitization rates of children to tree pollen allergens in the metropolitan area of Seoul, Korea. METHODS: The study population consisted of 8,295 children who visited the pediatric allergy clinics at Hanyang University Seoul and Guri Hospital for allergy symptoms between January 1, 1998, and December 31, 2019. Pollen was collected at the two hospitals during the study using a Burkard 7-day sampler. Meteorologic data were obtained from the National Weather Service. RESULTS: Among the major tree pollens, the largest increase in allergic sensitization was to oak, hazel, and alder pollens (0.28% annually). The pollen-sensitization rates increased annually within younger age groups. The duration of the pollen season was 98 days in 1998 and 140 days in 2019. Positive correlations were determined between the duration of the pollen season and the rates of sensitization to tree pollens, as well as between the pollen-sensitization rates and increasing temperature. CONCLUSIONS: This study demonstrated the correlation between weather changes and the resulting changes in the pollen season with sensitization rates to allergenic pollens in children living in the Seoul metropolitan area. An annual increase in sensitization rates in younger children was determined. This pattern is expected to continue due to continuing climate change.


Asunto(s)
Hipersensibilidad , Árboles , Adolescente , Alérgenos , Niño , Humanos , Hipersensibilidad/epidemiología , Polen , República de Corea/epidemiología , Estaciones del Año , Seúl/epidemiología
12.
Sci Rep ; 11(1): 1263, 2021 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-33441845

RESUMEN

The aim of this study was to develop a predictive model of pediatric mortality in the early stages of intensive care unit (ICU) admission using machine learning. Patients less than 18 years old who were admitted to ICUs at four tertiary referral hospitals were enrolled. Three hospitals were designated as the derivation cohort for machine learning model development and internal validation, and the other hospital was designated as the validation cohort for external validation. We developed a random forest (RF) model that predicts pediatric mortality within 72 h of ICU admission, evaluated its performance, and compared it with the Pediatric Index of Mortality 3 (PIM 3). The area under the receiver operating characteristic curve (AUROC) of RF model was 0.942 (95% confidence interval [CI] = 0.912-0.972) in the derivation cohort and 0.906 (95% CI = 0.900-0.912) in the validation cohort. In contrast, the AUROC of PIM 3 was 0.892 (95% CI = 0.878-0.906) in the derivation cohort and 0.845 (95% CI = 0.817-0.873) in the validation cohort. The RF model in our study showed improved predictive performance in terms of both internal and external validation and was superior even when compared to PIM 3.


Asunto(s)
Mortalidad del Niño , Mortalidad Hospitalaria , Mortalidad Infantil , Unidades de Cuidado Intensivo Pediátrico , Aprendizaje Automático , Modelos Biológicos , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Admisión del Paciente , Estudios Retrospectivos
13.
Chemosphere ; 271: 129349, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33429263

RESUMEN

BACKGROUND/OBJECTIVE: Polyurethane foam (PUF), a proven sampling medium for measuring air concentrations of organic compounds, is widely used in upholstered home furniture. We evaluated the potential utility of couch PUF as a passive sampler and as a reservoir for non-flame retardant semivolatile organic compounds (SVOCs). METHODS: We collected PUF samples from 13 California home couches, measured concentrations (CPUF) of 64 SVOCs at three different depths (i.e., top, top-middle, and middle from couch surfaces facing outward), and examined concentration changes with depth. To calculate the PUF-air partition coefficient (KPUF-air = CPUF/Cair = CPUF × Kdust-air/Cdust), we used the calculated dust-air partition coefficient (Kdust-air) with the octanol-air partition coefficient (Koa) and dust concentrations (Cdust) simultaneously collected and measured. We used KPUF-air to compute fugacity capacity of PUF and chemical mass distribution among various indoor compartments and PUF. RESULTS: Among 29 detected compounds, 11 compounds were detected in more than 50% of the samples at all depths. Among the 11 compounds, concentrations of phenanthrene, 2-benzylideneoctanal, galaxolide, tonalide, and homosalate decreased with depth. Among the studied SVOCs, more than 20% of the total mass was distributed to couch PUF for phenol and compounds in skin-applied products (i.e., 2-benzylideoneoctanal, galaxolide, and homosalate). CONCLUSIONS: Our results showed that couch PUF can absorb many SVOCs and may be an important reservoir for some SVOCs. However, it may not be an effective passive sampling medium for those that have relatively high Koa values. Direct dermal contact with couch seats may be an important exposure route for non-users of skin-applied compounds.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire Interior , Compuestos Orgánicos Volátiles , Contaminantes Atmosféricos/análisis , Contaminación del Aire Interior/análisis , Polvo , Monitoreo del Ambiente , Poliuretanos/análisis , Compuestos Orgánicos Volátiles/análisis
14.
Indoor Air ; 31(3): 693-701, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33022817

RESUMEN

The determinants of the temporal variability of indoor dust concentrations of semivolatile organic compounds (SVOCs) remain mostly unexplored. We examined temporal variability of dust concentrations and factors affecting dust concentrations for a wide range of SVOCs. We collected dust samples three times from 29 California homes during a period of 22 months and quantified concentrations of 47 SVOCs in 87 dust samples. We computed intraclass correlation coefficients (ICCs) using three samples collected within the same house. We calculated correlation coefficients (r) between two seasons with similar climate (spring and fall) and between two seasons with opposite climate (summer and winter). Among 26 compounds that were detected in more than 50% of the samples at all three visits, 20 compounds had ICCs above 0.50 and 6 compounds had ICCs below 0.50. For 19 out of 26 compounds, correlation coefficients between spring and fall (r = 0.48-0.98) were higher than those between summer and winter (r = 0.09-0.92), implying seasonal effects on dust concentrations. Our study showed that within-home temporal variability of dust concentrations was small (ICC > 0.50) for most SVOCs, but dust concentrations may vary over time for some SVOCs with seasonal variations in source rates, such as product use.

15.
J Pediatr Hematol Oncol ; 43(1): e90-e94, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32427706

RESUMEN

Obstructive lung disease (OLD) that develops after hematopoietic stem cell transplantation (HSCT) has a significant impact on morbidity and mortality. We investigated the role of pulmonary function tests (PFTs) in the prediction of prognosis of OLD in children who have undergone HSCT. We retrospectively reviewed 538 patients who underwent allogenic HSCT in the Department of Pediatrics, Seoul St. Mary's Hospital, South Korea, from April 2009 to July 2017. OLD was identified on PFTs or chest computed tomography scans obtained from 3 months after HSCT onwards. OLD developed after HSCT in 46 patients (28 male individuals, median age: 11.2 y). The group that developed OLD with an unfavorable prognosis (n=23) had a lower forced vital capacity (FVC) (% of predicted, 78.53±24.00 vs. 97.71±16.96, P=0.01), forced expiratory volume in 1 second (FEV1) (% of predicted, 52.54±31.77 vs. 84.44±18.59, P=0.00), FEV1/FVC (%, 59.28±18.68 vs. 79.94±9.77, P=0.00), and forced expiratory flow at 25% to 75% of forced vital capacity (FEF25-75) (% of predicted, 30.95±39.92 vs. 57.82±25.71, P=0.00) at diagnosis than the group that developed OLD with a favorable prognosis (n=23). The group that developed OLD with an unfavorable prognosis had significant reductions in FVC, FEV1, FEV1/FVC, and FEF25-75 at 2 years after diagnosis. Children who develop OLD with an unfavorable prognosis after HSCT already have poor lung function at the time of diagnosis. Additional treatment should be considered in patients who develop OLD after HSCT according to their PFTs at diagnosis.


Asunto(s)
Neoplasias Hematológicas/terapia , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Enfermedades Pulmonares Obstructivas/mortalidad , Pulmón/fisiopatología , Adolescente , Niño , Preescolar , Femenino , Estudios de Seguimiento , Volumen Espiratorio Forzado , Neoplasias Hematológicas/patología , Humanos , Enfermedades Pulmonares Obstructivas/diagnóstico , Enfermedades Pulmonares Obstructivas/etiología , Masculino , Pronóstico , Pruebas de Función Respiratoria , Estudios Retrospectivos , Tasa de Supervivencia , Capacidad Vital
16.
Korean J Pain ; 34(1): 4-18, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33380563

RESUMEN

Except for carbamazepine for trigeminal neuralgia, gabapentinoid anticonvulsants have been the standard for the treatment of neuropathic pain. Pregabalin, which followed gabapentin, was developed with the benefit of rapid peak blood concentration and better bioavailability. Mirogabalin besylate (DS-5565, Tarlige®) shows greater sustained analgesia due to a high affinity to, and slow dissociation from, the α2δ-1 subunits in the dorsal root ganglion (DRG). Additionally, it produces a lower level of central nervous system-specific adverse drug reactions (ADRs), due to a low affinity to, and rapid dissociation from, the α2δ-2 subunits in the cerebellum. Maximum plasma concentration is achieved in less than 1 hour, compared to 1 hour for pregabalin and 3 hours for gabapentin. The plasma protein binding is relatively low, at less than 25%. As with all gabapentinoids, it is also largely excreted via the kidneys in an unchanged form, and so the administration dose should also be adjusted according to renal function. The equianalgesic daily dose for 30 mg of mirogabalin is 600 mg of pregabalin and over 1,200 mg of gabapentin. The initial adult dose starts at 5 mg, given orally twice a day, and is gradually increased by 5 mg at an interval of at least a week, to 15 mg. In conclusion, mirogabalin is anticipated to be a novel, safe gabapentinoid anticonvulsant with a greater therapeutic effect for neuropathic pain in the DRG and lower ADRs in the cerebellum.

17.
Nano Converg ; 7(1): 36, 2020 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-33191443

RESUMEN

Water is a significant natural resource for humans. As such, wastewater containing heavy metals is seen as a grave problem for the environment. Currently, adsorption is one of the common methods used for both water purification and wastewater treatment. Adsorption relies on the physical and chemical interactions between heavy metal ions and adsorbents. Adsorptive membranes (AMs) have demonstrated high effectiveness in heavy metal removal from wastewater owing to their exclusive structural properties. This article examines the applications of adsorptive membranes such as polymeric membranes (PMs), polymer-ceramic membranes (PCMs), electrospinning nanofiber membranes (ENMs), and nano-enhanced membranes (NEMs), which demonstrate high selectivity and adsorption capacity for heavy metal ions, as well as both advantages and disadvantages of each one all, are summarized and compared shortly. Moreover, the general theories for both adsorption isotherms and adsorption kinetics are described briefly to comprehend the adsorption process. This work will be valuable to readers in understanding the current applications of various AMs and their mechanisms in heavy metal ion adsorption, as well as the recycling methods in heavy ions desorption process are summarized and described clearly. Besides, the influences of morphological and chemical structures of AMs are presented and described in detail as well.

18.
Children (Basel) ; 7(8)2020 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-32764263

RESUMEN

To effectively use vital signs as indicators in children, the magnitude of deviation from expected vital sign distribution should be determined. The purpose of this study is to derive age-specific centile charts for the heart rate and respiratory rate of the children who visited the emergency department. This study used the Korea's National Emergency Department Information System dataset. Patients aged <16 years visiting the emergency department between 1 January 2016 and 31 December 2017 were included. Heart rate and respiratory rate centile charts were derived from the population with normal body temperature (36 to <38 °C). Of 1,901,816 data points retrieved from the database, 1,454,372 sets of heart rates and 1,458,791 sets of respiratory rates were used to derive centile charts. Age-specific centile charts and curves of heart rates and respiratory rates showed a decline in heart rate and respiratory rate from birth to early adolescence. There were substantial discrepancies in the reference ranges of Advanced Paediatric Life Support and Pediatric Advanced Life Support guidelines. Age-based heart rate and respiratory rate centile charts at normal body temperature, derived from children visiting emergency departments, serve as new evidence-based data and can be used in follow-up studies to improve clinical care for children.

19.
Environ Res ; 186: 109491, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32361076

RESUMEN

BACKGROUND/OBJECTIVE: Human exposure to per- and polyfluoroalkyl substances (PFAS) has changed since the early 2000s, in part, because of the phase-out and replacement of some long-chain PFAS. Studies of PFAS exposure and its temporal changes have been limited to date mostly to adults and pregnant women. We examined temporal trends and determinants of PFAS serum concentrations among mothers with a young child who participated in the CHARGE (CHildhood Autism Risk from Genetics and Environment) case-control study. METHODS: We quantified nine PFAS in serum samples collected from 2009 to 2016 in 450 Northern California mothers when their child was 2-5 years old. With five compounds that were detected in more than 50% of the samples, we performed multiple regression to estimate least square geometric means (LSGMs) of PFAS concentrations with adjustment for sampling year and other characteristics that may affect maternal concentrations (e.g., breastfeeding duration). We also used time-related regression coefficients to calculate percent changes over the study period. RESULTS: LSGM concentrations of perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), and perfluorohexane sulfonate (PFHxS) decreased over the study period [percent change (95% confidence interval): -10.7% (-12.7%, -8.7%); -10.8% (-12.9%, -8.5%); -8.0% (-10.5%, -5.5%), respectively]. On the other hand, perfluorononanoate (PFNA) and perfluorodecanoate (PFDA) showed mixed time trends. Among the selected covariates, longer breastfeeding duration was associated with decreased maternal serum concentrations of PFOA, PFOS, PFHxS, PFNA and PFDA. CONCLUSIONS: Our study demonstrated that body burden of some common long-chain PFAS among California mothers with a young child decreased over the study period and that breastfeeding appears to contribute to the elimination of PFAS in lactating mothers.


Asunto(s)
Ácidos Alcanesulfónicos , Contaminantes Ambientales , Fluorocarburos , Adulto , Ácidos Alcanesulfónicos/análisis , Carga Corporal (Radioterapia) , California , Caprilatos/análisis , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Fluorocarburos/análisis , Humanos , Lactancia , Madres , Embarazo
20.
Korean J Pain ; 33(2): 108-120, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32235011

RESUMEN

From the perspective of the definition of pain, pain can be divided into emotional and sensory components, which originate from potential and actual tissue damage, respectively. The pharmacologic treatment of the emotional pain component includes antianxiety drugs, antidepressants, and antipsychotics. The anti-anxiety drugs have anti-anxious, sedative, and somnolent effects. The antipsychotics are effective in patients with positive symptoms of psychosis. On the other hand, the sensory pain component can be divided into nociceptive and neuropathic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are usually applied for somatic and visceral nociceptive pain, respectively; anticonvulsants and antidepressants are administered for the treatment of neuropathic pain with positive and negative symptoms, respectively. The NSAIDs, which inhibit the cyclo-oxygenase pathway, exhibit anti-inflammatory, antipyretic, and analgesic effects; however, they have a therapeutic ceiling. The adverse reactions (ADRs) of the NSAIDs include gastrointestinal problems, generalized edema, and increased bleeding tendency. The opioids, which bind to the opioid receptors, present an analgesic effect only, without anti-inflammatory, antipyretic, or ceiling effects. The ADRs of the opioids start from itching and nausea/vomiting to cardiovascular and respiratory depression, as well as constipation. The anticonvulsants include carbamazepine, related to sodium channel blockade, and gabapentin and pregabalin, related to calcium blockade. The antidepressants show their analgesic actions mainly through inhibiting the reuptake of serotonin or norepinephrine. Most drugs, except NSAIDs, need an updose titration period. The principle of polypharmacy for analgesia in case of mixed components of pain is increasing therapeutic effects while reducing ADRs, based on the origin of the pain.

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