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1.
JACC Heart Fail ; 12(9): 1528-1539, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39152985

RESUMEN

Atrial fibrillation (AF) and heart failure (HF)-specifically, heart failure with reduced ejection fraction (HFrEF)-often coexist, and each contributes to the propagation of the other. This relationship extends from the mechanistic and physiological to clinical syndromes, quality of life, and long-term cardiovascular outcomes. The risk factors for AF and HF overlap and create a critical opportunity to prevent adverse outcomes among patients at greatest risk for either condition. Increasing recognition of the linkages between AF and HF have led to widespread interest in designing diagnostic, predictive, and interventional strategies targeting all aspects of disease, from identifying genetic predisposition to addressing social determinants of health. Advances across this spectrum culminated in updated multisociety guidelines for management of AF, which includes specific consideration of comorbid AF and HF. This review expands on these guidelines by further highlighting relevant clinical trial findings and providing additional context for the evolving recommendations for management in this important and growing population.


Asunto(s)
Fibrilación Atrial , Insuficiencia Cardíaca , Volumen Sistólico , Humanos , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/diagnóstico , Fibrilación Atrial/fisiopatología , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/terapia , Fibrilación Atrial/complicaciones , Volumen Sistólico/fisiología , Factores de Riesgo , Calidad de Vida , Comorbilidad , Guías de Práctica Clínica como Asunto
2.
Polymers (Basel) ; 16(14)2024 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-39065277

RESUMEN

Unidirectional carbon fiber-reinforced polymer (CFRP) may exhibit significant mechanical softening in the transverse direction at an elevated temperature. While significant transverse compressive stress exists on CFRP due to the clamping force from anchorage, a CFRP cable may exhibit anchorage failure when suffering an accidental fire disaster. The high-temperature resistance of a CFRP cable anchorage is critical, and clarifying the performance deterioration and failure mechanism of a CFRP cable anchorage system at elevated temperature is fundamental for clarifying its fire resistance. This paper reviews the current research status of the high-temperature resistance of CFRP cable anchorage systems from two aspects, including the high-temperature resistance of the comprising materials and the anchorage system. The reviews on the high-temperature properties of the comprising materials are summarized from two aspects. Firstly, the mechanical performance degradation of bonding epoxy resin at elevated temperatures and the effect of a filler on its mechanical-thermal properties are analyzed. Secondly, the mechanical performances of CFRP composites at elevated temperatures are summarized, with consideration of the stress state of the CFRP cable under the constraint of an anchorage device. The reviews on the high-temperature resistance of the anchorage system also include two aspects. Firstly, the temperature field solution method for the anchorage system is summarized and discussed. Secondly, the current research status of the anchorage performance at elevated temperatures is also summarized and discussed. Based on these reviews, the research shortage of the high-temperature resistance of CFRP cable anchorage systems is summarized, and further research is recommended.

3.
Med Image Anal ; 97: 103264, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39013207

RESUMEN

Natural Image Captioning (NIC) is an interdisciplinary research area that lies within the intersection of Computer Vision (CV) and Natural Language Processing (NLP). Several works have been presented on the subject, ranging from the early template-based approaches to the more recent deep learning-based methods. This paper conducts a survey in the area of NIC, especially focusing on its applications for Medical Image Captioning (MIC) and Diagnostic Captioning (DC) in the field of radiology. A review of the state-of-the-art is conducted summarizing key research works in NIC and DC to provide a wide overview on the subject. These works include existing NIC and MIC models, datasets, evaluation metrics, and previous reviews in the specialized literature. The revised work is thoroughly analyzed and discussed, highlighting the limitations of existing approaches and their potential implications in real clinical practice. Similarly, future potential research lines are outlined on the basis of the detected limitations.


Asunto(s)
Procesamiento de Lenguaje Natural , Humanos , Sistemas de Información Radiológica , Aprendizaje Profundo , Diagnóstico por Imagen/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Interpretación de Imagen Asistida por Computador/métodos
4.
Expert Opin Pharmacother ; 25(6): 695-703, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38717605

RESUMEN

INTRODUCTION: About one-fifth of cannabis users, the most commonly used illicit substance, have cannabis use disorder (CUD). Psychiatric disorders and suicide are more common in these patients, and the disability-adjusted life years were reported to be 0.69 million. Pharmacotherapy for CUD is an unmet public health need, as current evidence-based therapies have limited efficacy. AREAS COVERED: After explaining the pathophysiology of CUD, the effects of emerging pharmacological interventions in its treatment obtained from randomized controlled trials were reviewed in light of mechanisms of action. Superiority over control of cannabidiol, gabapentin, galantamine, nabilone plus zolpidem, nabiximols, naltrexone, PF-04457845, quetiapine, varenicline, and topiramate were observed through the cannabinoid, glutamatergic, γ-aminobutyric acidergic, serotonergic, noradrenergic, dopaminergic, opioidergic, and cholinergic systems. All medications were reported to be safe and tolerable. EXPERT OPINION: Adding pharmacotherapy to psychotherapy is the optimal treatment for CUD on a case-by-case basis. Drug development to add to psychotherapy is the main path, but time and cost suggest repurposing and repositioning existing drugs. Considering sample size, follow-up, and effect size, further studies using objective tools are necessary. The future of CUD treatment is promising.


Asunto(s)
Abuso de Marihuana , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Abuso de Marihuana/tratamiento farmacológico , Psicoterapia/métodos , Desarrollo de Medicamentos , Reposicionamiento de Medicamentos , Terapia Combinada
5.
S Afr J Physiother ; 80(1): 1978, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38725967

RESUMEN

Self-management is an important strategy to improve quality of life, appropriately manage long-term health conditions, and reduce the economic burden of long-term health conditions. However, equitable healthcare access remains an issue, and the focus on 'self' in self-management is problematic. Our review aims to explore the conceptualisation and evolution of supported self-management in an African context and its relevance to physiotherapy. A state-of-the-art review of the literature was undertaken by the authors. The authors knowledge of the subject area and a database search retrieved recent articles exploring patients' and healthcare providers' understanding of supported self-management in Africa. Relevant articles were read, and data summaries of included studies were extracted and tabulated. Findings were organised deductively. Sixteen studies, 11 primary research, and 5 reviews (2016-2023) undertaken in a variety of sub-Saharan countries with healthcare workers (~n = 177) and people (~n = 16 115) living with a mix of non-communicable and communicable conditions were considered in this state-of-the-art review. Self-management perceptions were drawn from Western authors spanning development research and understanding of the concepts in Western thinking. We conclude that imported concepts, such as supported self-management for long-term conditions, should be considered within local health delivery solutions. These should be embedded in an understanding of traditional African health systems. Clinical implications: There is a need to develop locally derived African solutions. Self-management strategies for long-term health conditions should be developed, considering traditional holistic African health systems.

6.
Diagnostics (Basel) ; 14(6)2024 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-38535085

RESUMEN

Elastography is a noninvasive method that utilizes ultrasound imaging to assess the elasticity and stiffness of soft tissue. Peyronie's disease (PD) is a chronic inflammatory condition that affects the male penis, causing the formation of fibrous plaques. This alters the penis's elasticity and can lead to changes in its shape. Ultrasound elastography (UE) is an important advancement in the diagnosis of PD. It not only identifies plaques, but it also measures their rigidity, providing crucial information to monitor changes during and after treatment. We conducted a narrative review of the scientific literature to identify articles that discuss the use of elastography in the diagnostic study of PD. The purpose of this study was to describe the "state of the art" in the diagnostic use of ultrasound in combination with elastography to highlight any benefits in the diagnosis of PD. We found 12 relevant articles after searching PubMed, Embase, and Google Scholar using the keywords "ultrasound elastography" and "Peyronie's disease", including eight clinical studies, two case reports, and two review articles. The results of our review indicate that UE is a useful technique for identifying Peyronie-related plaques, particularly when they are not detectable using a standard ultrasound or physical examination. It is also helpful in monitoring improvements during and after conservative treatments. More research is required to confirm the effectiveness of ultrasound elastography in diagnosing Peyronie's disease and to determine whether it is better than traditional ultrasound.

8.
Environ Sci Pollut Res Int ; 31(15): 22319-22338, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38430439

RESUMEN

Advanced oxidation processes (AOPs) are wastewater treatment technologies that stand out for their ability to degrade Contaminants of Emerging Concern (CECs). The literature has extensively investigated these removal processes for different aqueous matrices. Once technically mature, some of these systems have become accredited to be applied on a large scale, and therefore, their systemic performances in the environmental and cost spheres have also become essential requirements. This study proposed corroborating this trend, analyzing the available literature on the subject to verify how experts in the AOP area investigated this integration during 2015-2023. For this purpose, a sample of publications was treated by applying the Systematic Review (SR) methodology. This resulted in an extract of 83 studies that adopted life-cycle logic to estimate environmental impacts and process costs or evaluated them as complementary to the technical dimension of each treatment technology. This analysis found that both dimensions can be used for selecting or sizing AOPs at the design scale. However, the appropriate choice of the impact categories for the environmental assessment and establishing a methodology for cost analysis can make the approach still more effective. In addition, a staggering number of processes would broaden the reality and applicability of the estimates, and adopting multicriteria analysis methodologies could address essential aspects of decision-making processes during the design of the arrangements. By meeting the original purposes, the study broadened the requirements for designing AOPs and disseminating their use in mitigating the discharge of CECs.


Asunto(s)
Bibliometría , Oxidación-Reducción , Aguas Residuales/química , Purificación del Agua/métodos , Eliminación de Residuos Líquidos/métodos
9.
Expert Opin Emerg Drugs ; 29(1): 45-56, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38296815

RESUMEN

INTRODUCTION: Autism spectrum disorder (ASD) is an early-onset disorder with a prevalence of 1% among children and reported disability-adjusted life years of 4.31 million. Irritability is a challenging behavior associated with ASD, for which medication development has lagged. More specifically, pharmacotherapy effectiveness may be limited against high adverse effects (considering side effect profiles and patient medication sensitivity); thus, the possible benefits of pharmacological interventions must be balanced against potential adverse events in each patient. AREAS COVERED: After reviewing the neuropathophysiology of ASD-associated irritability, the benefits and tolerability of emerging medications in its treatment based on randomized controlled trials were detailed in light of mechanisms and targets of action. EXPERT OPINION: Succeeding risperidone and aripiprazole, monotherapy with memantine may be beneficial. In addition, N-acetylcysteine, galantamine, sulforaphane, celecoxib, palmitoylethanolamide, pentoxifylline, simvastatin, minocycline, amantadine, pregnenolone, prednisolone, riluzole, propentofylline, pioglitazone, and topiramate, all adjunct to risperidone, and clonidine and methylphenidate outperformed placebo. These effects were through glutamatergic, γ-aminobutyric acidergic, inflammatory, oxidative, cholinergic, dopaminergic, and serotonergic systems. All medications were reported to be safe and tolerable. Considering sample size, follow-up, and effect size, further studies are necessary. Along with drug development, repositioning and combining existing drugs supported by the mechanism of action is recommended.


Asunto(s)
Antipsicóticos , Trastorno del Espectro Autista , Niño , Humanos , Risperidona/efectos adversos , Antipsicóticos/efectos adversos , Trastorno del Espectro Autista/tratamiento farmacológico , Trastorno del Espectro Autista/inducido químicamente , Aripiprazol/uso terapéutico , Riluzol
10.
Cardiovasc Res ; 2023 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-37632337

RESUMEN

Carotid atherosclerotic disease continues to be an important cause of stroke, often disabling or fatal. Such strokes could be largely prevented through optimal medical therapy and carotid revascularization. Advancements in discovery research and imaging along with evidence from recent pharmacology and interventional clinical trials and registries and the progress in acute stroke management have markedly expanded knowledge base for clinical decisions in carotid stenosis. Nevertheless, there is variability in carotid-related stroke prevention and management strategies across medical specialities. Optimal patient care can be achieved by (1) establishing a unified knowledge foundation and (2) fostering multi-specialty collaborative guidelines. The emergent Neuro-Vascular Team concept, mirroring the multi-disciplinary Heart Team, embraces diverse specializations, tailores personalized, stratified medicine approaches to individual patient needs, and integrates innovative imaging and risk-assessment biomarkers. Proposed approach integrates collaboration of multiple specialists central to carotid artery stenosis management such as neurology, stroke medicine, cardiology, angiology, ophthalmology, vascular surgery, endovascular interventions, neuroradiology and neurosurgery. Moreover, patient education regarding current treatment options, their risks and advantages, is pivotal, promting patient's active role in clinical care decisions. This enables optimization of interventions ranging from lifestyle modification, carotid revascularization by stenting or endarterectomy, as well as pharmacological management encompassing statins, novel lipid-lowering and antithrombotic strategies and targeting inflammation and vascular dysfunction. This consensus document provides a harmonized multi-specialty approach to multimorbidity prevention in carotid stenosis patients, based on comprehensive knowledge review, pinpointing research gaps in an evidence-based medicine approach. It aims to be a foundational tool for interdisciplinary collaboration and prioritized patient-centric decision-making.

11.
Front Immunol ; 14: 1219083, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37304272
12.
J Prof Nurs ; 45: 35-50, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36889892

RESUMEN

BACKGROUND: An integral part of both undergraduate and postgraduate nursing and midwifery programmes, is the teaching and assessment of clinical psychomotor skills. In order to provide safe care, there is an expectation that technical nursing procedures are performed competently and effectively. Due to limited opportunities to practice clinical skills there is a challenge to advance and implement innovative teaching approaches. Technological advances provide us with alternative options, outside of the traditional teaching approaches, to teach these skills. OBJECTIVE: The aim of this state-of-the-art review was to examine and provide an overview of the current use of educational technologies in nursing and midwifery education in teaching clinical psychomotor skills. METHODS: A-state-of -the-art literature review was carried out, as this type of evidence synthesis design reveals the current knowledge on a topic and identifies gaps for future research. We used a focused search strategy with the expertise of a research librarian. Data extraction included research designs and educational theories guiding the included studies along with the type of technologies studied. A descriptive summary of each study's findings in relation to the educational outcomes was performed. FINDINGS: Sixty studies were sourced which met this reviews' eligibility criteria. Technologies in which most research was carried out included; simulation, video and virtual reality. The most common research design noted included randomized or quasi-experimental studies. The vast majority of studies (n = 47) did not elaborate whether educational theories guided them, while of the remaining thirteen studies, eleven theoretical frameworks were reported. CONCLUSION: Technology use in nursing and midwifery educational research surrounding psychomotor skills education is present. The educational outcomes reported by the majority of studies on the use of educational technology in teaching and/or assessing clinical psychomotor skills are encouraging. Additionally, the majority of studies noted that students evaluated the technology positively and were satisfied with its use in their education. Future research may include evaluating the technologies in both undergraduate and postgraduate populations. Finally, opportunities exist to expand the evaluation of student learning or assessment of these skills using technologies from the educational environment to the clinical environment. REGISTRATION: Not registered.


Asunto(s)
Bachillerato en Enfermería , Partería , Estudiantes de Enfermería , Humanos , Embarazo , Femenino , Partería/educación , Bachillerato en Enfermería/métodos , Escolaridad , Tecnología Educacional , Competencia Clínica
13.
Ciênc. Saúde Colet. (Impr.) ; Ciênc. Saúde Colet. (Impr.);28(1): 143-154, jan. 2023. tab
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1421126

RESUMEN

Resumo O estudo teve como objetivo a revisão de trabalhos científicos publicados sobre a hanseníase como problema de saúde pública no Brasil e o marcador de vulnerabilidade para os portadores da enfermidade. Foi realizada uma scoping review com o descritor "hanseníase AND vulnerabilidade" na base de dados da Biblioteca Virtual em Saúde (BVS). Foram selecionados 29 artigos publicados entre janeiro de 2016 e dezembro de 2020 que atenderam aos critérios de inclusão. Os resultados apontaram para trabalhos científicos publicados em revistas indexadas e com diferentes fatores de impacto, com destaque para a maioria das publicações selecionadas constarem em periódicos com métricas de impacto pouco significativas aos olhos da comunidade internacional, ainda que elas tenham impacto nacional. A maioria dos estudos teve abrangência municipal, com destaque para cidades do Norte e do Nordeste brasileiro. Os trabalhos trataram a vulnerabilidade na hanseníase utilizando distintas tipologias.


Abstract The objective of this work was to review published scientific works on leprosy as a public health problem in Brazil, and the marker of vulnerability for people with the disease. A scoping review was carried out with the descriptor 'leprosy AND vulnerability', on the Virtual Health Library (BVS) database. A total of 29 articles published between January 2016 and December 2020 that met the inclusion criteria were selected. The results pointed to scientific papers published in indexed journals and with different impact factors, with emphasis on the fact that most of the selected publications appear in journals with impact metrics that are not very significant in the eyes of the international community, even though they have national impact. The majority of the studies had municipal coverage, with emphasis on cities in the North and Northeast of Brazil. The works addressed vulnerability in leprosy using different typologies.

14.
Cad. Bras. Ter. Ocup ; 31: e3347, 2023. tab, graf
Artículo en Portugués | LILACS-Express | LILACS, Index Psicología - Revistas | ID: biblio-1420981

RESUMEN

Resumo O mundo rural é um território de extrema importância para a sociedade como um todo; não obstante, tende ainda a ser visto como algo separado desta e, muitas vezes marginalizado em relação ao meio urbano. Além disso, é tido como um espaço atrasado, desatualizado e rústico em alguns contextos, como no brasileiro. A falta de acesso a bens sociais acaba por limitar as perspectivas da pessoa que vive nesse território, diminuindo sua autonomia e oportunidade de escolhas com relação à sua própria vida. Tanto no âmbito mundial quanto nacional, a terapia ocupacional, em suas diferentes subáreas, tem buscado contribuir para a resolução de problemáticas que envolvem contextos e sujeitos diversos que ocupam e vivem no meio rural. Assim, o objetivo primário deste estudo foi realizar uma revisão de escopo que abrangesse publicações nacionais e estrangeiras, procurando apreender, sistematizar e divulgar a produção científica na interface da terapia ocupacional com o mundo rural, analisando-a criticamente, de modo a perceber suas potencialidades e fragilidades, considerando as diversas ruralidades e contextos mundo afora. Foram encontrados resultados dos cinco continentes com dados necessários para essa sistematização e para uma síntese dessa produção. Tais resultados foram estudados, analisados e distribuídos em seis categorias configuradas a partir dos assuntos específicos abordados. Conclui-se que estudos relevantes foram realizados na interface terapia ocupacional-mundo rural, voltando-se a fatores que influenciam a atuação profissional nesses territórios, ao mesmo tempo em que propõem métodos, estratégias e programas de prática e formação para superar importantes desafios.


Abstract The rural world is a territory of extreme importance for society as a whole; nevertheless, it still tends to be seen as something separate from it and often marginalized in relation to the urban environment. In addition, it is seen as a backward, outdated and rustic space in some contexts, such as the Brazilian one. The lack of access to social goods ends up limiting the perspectives of people living in this territory, reducing their autonomy and opportunity to make choices about their own lives. Both worldwide and nationally, occupational therapy, in its different subareas, has sought to contribute to the resolution of problems involving different contexts and subjects who occupy and live in rural areas. Thus, the primary objective of this study was to carry out a scope review that covered national and foreign publications, seeking to apprehend, systematize and disseminate scientific production in the interface of occupational therapy with the rural world, critically analyzing it, in order to perceive its potential and weaknesses, considering the different ruralities and contexts around the world. Results from five continents were found with data necessary for this systematization and for a synthesis of this production. Such results were studied, analyzed and distributed in six categories configured from the specific subjects addressed. It is concluded that relevant studies were carried out in the occupational therapy-rural world interface, focusing on factors that influence professional performance in these territories, while proposing methods, strategies and practice, and training programs to overcome important challenges.

15.
Intensive Care Med ; 48(10): 1382-1396, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35960275

RESUMEN

In this narrative review, we discuss the relevant issues of therapeutic plasma exchange (TPE) in critically ill patients. For many conditions, the optimal indication, device type, frequency, duration, type of replacement fluid and criteria for stopping TPE are uncertain. TPE is a potentially lifesaving but also invasive procedure with risk of adverse events and complications and requires close monitoring by experienced teams. In the intensive care unit (ICU), the indications for TPE can be divided into (1) absolute, well-established, and evidence-based, for which TPE is recognized as first-line therapy, (2) relative, for which TPE is a recognized second-line treatment (alone or combined) and (3) rescue therapy, where TPE is used with a limited or theoretical evidence base. New indications are emerging and ongoing knowledge gaps, notably regarding the use of TPE during critical illness, support the establishment of a TPE registry dedicated to intensive care medicine.


Asunto(s)
Unidades de Cuidados Intensivos , Intercambio Plasmático , Enfermedad Crítica/terapia , Humanos , Intercambio Plasmático/efectos adversos , Intercambio Plasmático/métodos , Plasmaféresis , Respiración Artificial , Estudios Retrospectivos
16.
Sensors (Basel) ; 22(16)2022 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-36016040

RESUMEN

Currently, abnormality detection and/or prediction is a very hot topic. In this paper, we addressed it in the frame of activity monitoring of a human in bed. This paper presents a comprehensive formulation of a requirements engineering dossier for a monitoring system of a "human in bed" for abnormal behavior detection and forecasting. Hereby, practical and real-world constraints and concerns were identified and taken into consideration in the requirements dossier. A comprehensive and holistic discussion of the anomaly concept was extensively conducted and contributed to laying the ground for a realistic specifications book of the anomaly detection system. Some systems engineering relevant issues were also briefly addressed, e.g., verification and validation. A structured critical review of the relevant literature led to identifying four major approaches of interest. These four approaches were evaluated from the perspective of the requirements dossier. It was thereby clearly demonstrated that the approach integrating graph networks and advanced deep-learning schemes (Graph-DL) is the one capable of fully fulfilling the challenging issues expressed in the real-world conditions aware specification book. Nevertheless, to meet immediate market needs, systems based on advanced statistical methods, after a series of adaptations, already ensure and satisfy the important requirements related to, e.g., low cost, solid data security and a fully embedded and self-sufficient implementation. To conclude, some recommendations regarding system architecture and overall systems engineering were formulated.


Asunto(s)
Concienciación , Seguridad Computacional , Humanos
17.
MAGMA ; 35(4): 645-665, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35445307

RESUMEN

In this paper, we review the developments of 1H-MR spectroscopic imaging (MRSI) methods designed to investigate prostate cancer, covering key aspects such as specific hardware, dedicated pulse sequences for data acquisition and data processing and quantification techniques. Emphasis is given to recent advancements in MRSI methodologies, as well as future developments, which can lead to overcome difficulties associated with commonly employed MRSI approaches applied in clinical routine. This includes the replacement of standard PRESS sequences for volume selection, which we identified as inadequate for clinical applications, by sLASER sequences and implementation of 1H MRSI without water signal suppression. These may enable a new evaluation of the complementary role and significance of MRSI in prostate cancer management.


Asunto(s)
Neoplasias de la Próstata , Protones , Humanos , Imagen por Resonancia Magnética/métodos , Espectroscopía de Resonancia Magnética/métodos , Masculino , Neoplasias de la Próstata/diagnóstico por imagen , Espectroscopía de Protones por Resonancia Magnética/métodos
18.
Front Vet Sci ; 9: 789898, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35372534

RESUMEN

Osteoarthritis (OA) is the most common orthopedic condition in dogs, characterized as the chronic, painful end-point of a synovial joint with limited therapeutic options other than palliative pain control or surgical salvage. Since the 1970s, radiography has been the standard-of-care for the imaging diagnosis of OA, despite its known limitations. As newer technologies have been developed, the limits of detection have lowered, allowing for the identification of earlier stages of OA. Identification of OA at a stage where it is potentially reversible still remains elusive, however, yet there is hope that newer technologies may be able to close this gap. In this article, we review the changes in the imaging of canine OA over the past 50 years and give a speculative view on future innovations which may provide for earlier identification, with the ultimate goal of repositioning the limit of detection to cross the threshold of this potentially reversible disease.

19.
J Am Coll Cardiol ; 79(12): 1199-1211, 2022 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-35331415

RESUMEN

Interatrial block (IAB) is an electrocardiographic pattern describing the conduction delay between the right and left atria. IAB is classified into 3 degrees of block that correspond to decreasing conduction in the region of Bachmann's bundle. Although initially considered benign in nature, specific subsets of IAB have been associated with atrial arrhythmias, elevated thromboembolic stroke risk, cognitive impairment, and mortality. As the pathophysiologic relationships between IAB and stroke are reinforced, investigation has now turned to the potential benefit of early detection, atrial imaging, cardiovascular risk factor modification, antiarrhythmic pharmacotherapy, and stroke prevention with oral anticoagulation. This review provides a contemporary overview of the epidemiology, pathophysiology, diagnosis, and management of IAB, with a focus on future directions.


Asunto(s)
Fibrilación Atrial , Accidente Cerebrovascular , Fibrilación Atrial/complicaciones , Electrocardiografía/métodos , Atrios Cardíacos/diagnóstico por imagen , Bloqueo Cardíaco/diagnóstico , Bloqueo Cardíaco/epidemiología , Bloqueo Cardíaco/etiología , Humanos , Bloqueo Interauricular/complicaciones , Bloqueo Interauricular/diagnóstico , Bloqueo Interauricular/epidemiología , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/prevención & control
20.
Rev. bras. educ. méd ; 46(4): e163, 2022. tab, graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1423133

RESUMEN

Resumo: Introdução: É notória a crescente importância dada à formação em pesquisa na educação médica por todo o mundo, o que é refletido na crescente produção científica com essa temática. Nesse cenário, o estado da questão (EQ) surge como uma ferramenta de produção bibliográfica que promove um panorama das pesquisas produzidas sobre um determinado tema, sendo capaz de proporcionar uma maior aproximação ao objeto de pesquisa e uma estimativa dos avanços que a pesquisa naquele campo pode alcançar. Objetivo: Este estudo teve como objetivos identificar as investigações feitas sobre a formação em pesquisa na educação médica e classificá-las considerando o local, o tipo e as intencionalidades delas. Método: Trata-se de um EQ cujo objeto de estudo é a formação em pesquisa na educação médica. Utilizaram-se descritores relacionados à formação em pesquisa e à educação médica nos idiomas português, espanhol e inglês. Foram pesquisadas duas bases de dados para dissertações e teses nacionais (Biblioteca Digital de Teses e Dissertações e Catálogos de Teses e Dissertações da Capes) e duas bases de dados para periódicos científicos internacionais (Portal de Periódicos da Capes e PubMed). Resultado: Identificaram-se 33 artigos científicos de 17 países de cinco continentes. Quatro trabalhos (12%) apresentavam-se como artigos de opinião em que os autores teorizavam sobre a importância da inserção de elementos da pesquisa nos níveis curricular e disciplinar. Sete artigos (21%) retrataram, por meio de relatos de casos, as modificações estruturais e os percursos traçados em suas instituições, assim como as implicações dessas ações na educação médica e no processo educativo. Os demais 22 artigos (67%) documentavam pesquisas empíricas com diversas intencionalidades, sendo a temática mais recorrente a identificação dos fatores que influenciam a busca do corpo discente pela participação em pesquisa. Conclusão: A formação em pesquisa na educação médica conta com um corpo de pesquisadores qualificados e periódicos especializados para sua veiculação em nível global. Ressaltamos que, a partir das buscas realizadas, não foram encontrados estudos no contexto de teses e dissertações, tornando este um campo aberto para pesquisadores aprofundarem e acumularem conhecimento.


Abstract: Introduction: The growing importance given to research training in medical education globally is notorious and reflects the growing scientific production on this topic. In this scenario, the state of the question (EQ) emerges as a bibliographic production tool that promotes an overview of the re-search produced on a given topic, being able to provide a closer approach to the research object and to estimate the possible advances that research in that field can reach. Objective: This study aimed to identify what has been studied about research training in medical education and classify them considering the location, type, and intentions of the research. Method: This is a EQ whose object of study is research training in medical education. Descriptors related to research training and medical education in Portuguese, Spanish, and English were used. Two databases for national dissertations and theses (Biblioteca Digital de Teses e Dissertações and Catálogos de Teses e Dissertações da Capes) and two databases for international scientific journals (Portal de Periódicos da Capes and PubMed) were searched. Result: We identified 33 scientific articles from 18 countries on all continents. Four articles (12%) were presented as opinion articles where the authors theorized about the importance of inserting research elements at the curricular and disciplinary level. Seven articles (21%) portrayed, through case reports, the structural changes and the paths traced in their institutions, as well as the implications of these actions in medical education and the educational process. The remaining 22 articles (67%) documented empirical research with different intentions, with the most recurrent theme being the identification of factors that influence the student body's search for participation in research. Conclusion: Research training in medical education has a body of qualified researchers and spe-cialized periodicals for its dissemination on a global level. We emphasize that no studies were found in the context of theses and dissertations, making this an open field for researchers to deepen and accumulate knowledge.

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