Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 43.738
Filtrar
1.
Acta Cir Bras ; 34(12): e201901203, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049184

RESUMEN

PURPOSE: Composite flaps used in reconstructive surgery may intra- and postoperatively suffer from hypoperfusion and/or ischemia-reperfusion influencing wound healing. We aimed to follow-up the effect of ischemia on adipocutaneous flaps' wound healing and microcirculation. METHODS: In anesthetized rats groin flaps were formed bilaterally. In Control group the flaps were repositioned and sutured back. In Ischemia-Reperfusion (I/R) group before repositioning and suturing the flap pedicles were clamped for 60 minutes. Laser Doppler (LD) fluxmetry and temperature probes were applied on the cranial, central and caudal flap regions before/after preparation and ischemia, re-suturing, and on the 1st-3rd-5th-7th-14th postoperative days, before the final examinations and biopsies for histology. RESULTS: Flaps' skin temperature quickly recovered after repositioning. LD values were lower in the I/R group, reaching a significant level by the 3rd postoperative day, and remained lowered till the 14th day. The magnitude of alterations differed in the flap regions. Histologically normal wound healing process was seen, except for some I/R flaps, where hypertrophized mammary glands were found. CONCLUSIONS: Short-term ischemia could influence flap microcirculation and wound healing, and may result in hypertrophized mammary glands. Laser Doppler could be used to evaluate intra- and postoperative microcirculatory changes and may have significance in predicting complications.


Asunto(s)
Procedimientos Quirúrgicos Dermatologicos/efectos adversos , Microcirculación/fisiología , Colgajo Miocutáneo/irrigación sanguínea , Daño por Reperfusión/complicaciones , Piel/irrigación sanguínea , Cicatrización de Heridas/fisiología , Animales , Biopsia , Temperatura Corporal , Modelos Animales de Enfermedad , Flujometría por Láser-Doppler , Masculino , Colgajo Miocutáneo/patología , Periodo Posoperatorio , Ratas , Valores de Referencia , Daño por Reperfusión/patología , Reproducibilidad de los Resultados , Piel/patología , Factores de Tiempo , Resultado del Tratamiento
3.
Euro Surveill ; 25(5)2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32046816

RESUMEN

We evaluated effectiveness of thermal passenger screening for 2019-nCoV infection at airport exit and entry to inform public health decision-making. In our baseline scenario, we estimated that 46% (95% confidence interval: 36 to 58) of infected travellers would not be detected, depending on incubation period, sensitivity of exit and entry screening, and proportion of asymptomatic cases. Airport screening is unlikely to detect a sufficient proportion of 2019-nCoV infected travellers to avoid entry of infected travellers.


Asunto(s)
Viaje en Avión , Temperatura Corporal , Infecciones por Coronavirus/diagnóstico , Fiebre/diagnóstico , Tamizaje Masivo , Neumonía Viral/diagnóstico , Enfermedades Transmisibles Emergentes , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Toma de Decisiones , Humanos , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Modelos Teóricos , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Vigilancia de la Población , Salud Pública
4.
Br J Nurs ; 29(3): 160-164, 2020 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-32053433

RESUMEN

BACKGROUND: Hypothermia is a common problem in the surgical context and can lead to serious consequences for the patient and increased costs for society. AIMS: To study day-surgery patients' peripheral and core temperatures during the preoperative phase. METHODS: In total, 50 day-surgery patients participated in the study. Two sets of measurements of temperatures were made: core temperature and peripheral temperatures (two measuring points on the upper body and lower extremities respectively) were measured on arrival at the day-surgery unit, as well as on arrival at the operating theatre. The data were normally distributed and a paired t-test was used for statistical analysis. FINDINGS: Peripheral temperatures had significant changes, with measuring points on the upper body decreasing and measuring points on the lower extremities increasing in temperature. The results show no significant change in core temperature. CONCLUSION: The measurements show that 28% of the patients were below recommended preoperative temperature on arrival at the operating theatre. Further research is needed to study the development of body temperature perioperatively as well as at what point reheating interventions should be introduced.


Asunto(s)
Temperatura Corporal , Periodo Preoperatorio , Adulto , Anciano , Anciano de 80 o más Años , Procedimientos Quirúrgicos Ambulatorios , Femenino , Unidades Hospitalarias , Humanos , Masculino , Persona de Mediana Edad , Temperatura Cutánea , Adulto Joven
5.
Arch Insect Biochem Physiol ; 103(4): e21651, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31943343

RESUMEN

DNA methylation refers to the addition of cytosine residues in a CpG context (5'-cytosine-phosphate-guanine-3'). As one of the most common mechanisms of epigenetic modification, it plays a crucial role in regulating gene expression and in a diverse range of biological processes across all multicellular organisms. The relationship between temperature and DNA methylation and how it acts on the adaptability of migratory insects remain unknown. In the present work, a 5,496 bp full-length complementary DNA encoding 1,436 amino acids (named MsDnmt1) was cloned from the devastating migratory pest oriental armyworm, Mythimna separata Walker. The protein shares 36.8-84.4% identity with other insect Dnmt1 isoforms. Spatial and temporal expression analysis revealed that MsDnmt1 was highly expressed in adult stages and head tissue. The changing temperature decreased the expression of MsDnmt1 in both high and low temperature condition. Besides, we found that M. separata exhibited the shortest duration time from the last instar to pupae under 36°C environment when injected with DNA methylation inhibitor. Therefore, our data highlight a potential role for DNA methylation in thermal resistance, which help us to understand the biological role adaptability and colonization of migratory pest in various environments.


Asunto(s)
ADN (Citosina-5-)-Metiltransferasa 1/genética , Proteínas de Insectos/genética , Mariposas Nocturnas/fisiología , Secuencia de Aminoácidos , Animales , Temperatura Corporal , ADN (Citosina-5-)-Metiltransferasa 1/química , ADN (Citosina-5-)-Metiltransferasa 1/metabolismo , Proteínas de Insectos/química , Proteínas de Insectos/metabolismo , Larva/genética , Larva/crecimiento & desarrollo , Larva/fisiología , Mariposas Nocturnas/genética , Mariposas Nocturnas/crecimiento & desarrollo , Óvulo/crecimiento & desarrollo , Óvulo/fisiología , Filogenia , Pupa/genética , Pupa/crecimiento & desarrollo , Pupa/fisiología , Alineación de Secuencia
6.
J Agric Food Chem ; 68(4): 1007-1014, 2020 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-31914311

RESUMEN

Induction of beige adipocytes in white adipose tissue (WAT) is a potential therapeutic target for the treatment of obesity because beige adipocytes release excess energy via uncoupling-protein-1-associated thermogenesis. In this study, we investigated how artepillin C (ArtC) promotes thermogenesis in vivo. We demonstrated that 28 day administration of ArtC (10 mg/kg of body weight) to mice significantly induced thermogenesis in beige adipocytes in inguinal WAT (iWAT) and suppressed reductions in core body temperature induced by cold exposure at 4 °C. Moreover, ArtC-induced thermogenesis in iWAT was significantly inhibited by treatment with a creatine metabolism inhibitor, and ArtC significantly upregulated the expression of creatine-metabolism-related enzymes in the thermogenic pathway. These results indicate that ArtC induces thermogenesis in beige adipocytes in iWAT, and the observed ArtC-induced thermogenesis is associated with the creatine-metabolism-related thermogenic pathway, which is characteristically observed in beige adipocytes.


Asunto(s)
Tejido Adiposo Blanco/efectos de los fármacos , Creatina/metabolismo , Obesidad/tratamiento farmacológico , Fenilpropionatos/administración & dosificación , Própolis/análisis , Termogénesis/efectos de los fármacos , Adipocitos Beige/efectos de los fármacos , Adipocitos Beige/metabolismo , Tejido Adiposo Blanco/metabolismo , Animales , Temperatura Corporal , Brasil , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Obesidad/metabolismo , Obesidad/fisiopatología , Própolis/administración & dosificación
7.
8.
Crit Care ; 24(1): 6, 2020 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-31907075

RESUMEN

Targeted temperature management (TTM) is a complex intervention used with the aim of minimizing post-anoxic injury and improving neurological outcome after cardiac arrest. There is large variability in the devices used to achieve cooling and in protocols (e.g., for induction, target temperature, maintenance, rewarming, sedation, management of post-TTM fever). This variability can explain the limited benefits of TTM that have sometimes been reported. We therefore propose the concept of "high-quality TTM" as a way to increase the effectiveness of TTM and standardize its use in future interventional studies.


Asunto(s)
Paro Cardíaco , Hipotermia Inducida , Temperatura Corporal , Fiebre , Humanos , Temperatura Ambiental
9.
Int J Biometeorol ; 64(1): 39-45, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31473810

RESUMEN

We investigated the validity of infrared tympanic temperature (IR-Tty) during exercise in the heat with variations in solar radiation. Eight healthy males completed stationary cycling trials at 70% peak oxygen uptake until exhaustion in an environmental chamber maintained at 30°C with 50% relative humidity. Three solar radiation conditions, 0, 250 and 500 W/m2, were tested using a ceiling-mounted solar simulator (metal-halide lamps) over a 3 × 2 m irradiated area. IR-Tty and rectal temperature (Tre) were similar before and during exercise in each trial (P > 0.05). Spearman's rank correlation coefficient (rs) demonstrated very strong (250 W/m2, rs = 0.87) and strong (0 W/m2, rs = 0.73; 500 W/m2, rs = 0.78) correlations between IR-Tty and Tre in all trials (P < 0.001). A Bland-Altman plot showed that mean differences (SD; 95% limits of agreement; root mean square error) between IR-Tty and Tre were - 0.11°C (0.46; - 1.00 to 0.78°C; 0.43 ± 0.16°C) in 0 W/m2, - 0.13°C (0.32; - 0.77 to 0.50°C; 0.32 ± 0.10°C) in 250 W/m2 and - 0.03°C (0.60; - 1.21 to 1.14°C; 0.46 ± 0.27°C) in 500 W/m2. A positive correlation was found in 500 W/m2 (rs = 0.51; P < 0.001) but not in 250 W/m2 (rs = 0.04; P = 0.762) and 0 W/m2 (rs = 0.04; P = 0.732), indicating a greater elevation in IR-Tty than Tre in 500 W/m2. Percentage of target attainment within ± 0.3°C between IR-Tty and Tre was higher in 250 W/m2 (100 ± 0%) than 0 (93 ± 7%) and 500 (90 ± 10%; P < 0.05) W/m2. IR-Tty is acceptable for core temperature monitoring during exercise in the heat when solar radiation is ≤ 500 W/m2, and its accuracy increases when solar radiation is 250 W/m2 under our study conditions.


Asunto(s)
Regulación de la Temperatura Corporal , Calor , Temperatura Corporal , Ejercicio , Masculino , Temperatura Ambiental
10.
Arch Virol ; 165(1): 201-206, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31745716

RESUMEN

Neuraminidase (NA) thermostability of influenza A and B viruses isolated from birds, swine and humans was measured to evaluate its variability associated with host body temperature. The highest 50% inactivation temperature (IT50) was observed with H3N8 avian influenza virus (74 °C), and the lowest IT50 was observed with the seasonal human H3N2 virus (45.5 °C). The IT50 values of A(H1N1)pdm09 viruses 56.4-58.5 °C were statistically higher than that of the prepandemic strain A/Solomon Islands/03/06 (52.5 °C). An analysis of Ca2+ binding sites revealed the correspondence of amino acid changes to NA thermostability. This study demonstrates that changes in NA thermostability correspond to differences in host body temperature.


Asunto(s)
Influenzavirus A/enzimología , Influenzavirus B/enzimología , Neuraminidasa/química , Animales , Aves/virología , Temperatura Corporal , Estabilidad de Enzimas , Humanos , Porcinos , Termodinámica , Proteínas Virales/química , Zoonosis/virología
11.
Gen Comp Endocrinol ; 285: 113287, 2020 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-31563645

RESUMEN

Hormones can mediate suites of correlated traits. Melanocortins regulate melanin synthesis and elements of the melanocortin system can directly, and indirectly, affect a number of other traits, such as stress reactivity. Trait correlations within the melanocortin system have been studied mainly in birds and mammals but less so in reptiles. We examined adult male western fence lizards (Sceloporus occidentalis) and if melanization was correlated with plasma levels of three hormones, including peptide hormone α-melanocyte stimulating hormone (α-MSH), testosterone and corticosterone, and ectoparasite loads. This lizard is darker at higher elevations in California, and we compared five high-elevation and four low-elevation populations during comparable periods of the breeding season at each site. We first validated use of an α-MSH assay kit with lizard plasma. Since Anolis carolinensis is one of the few species with published values for α-MSH plasma levels, we assayed both Anolis and Sceloporus plasma and compared hormone values to those we generated for Anolis to the publish values. We also evaluated effects of different methods of storing spiked plasma pools on resulting α-MSH concentrations. Plasma levels of α-MSH did not differ significantly, but some populations differed significantly in mean corticosterone and mean testosterone. Combining all individuals from the nine populations, we found that individual variation in α-MSH was not associated with individual variation in melanization, but levels of α-MSH were positively associated with plasma testosterone and negatively associated with corticosterone. The lack of association between individual levels of melanization and expression of most other traits differs from a growing number of within-population studies of melanization, and we discuss what differences in physiological mechanisms could produce different hypothetical patterns. Circulating levels of -MSH are only one element of the melanocortin system; in situ synthesis of α-MSH by the skin and the diversity of melanocortin receptors could also contribute to variation in traits mediated by the melanocortin system and should be examined.


Asunto(s)
Lagartos/metabolismo , Melaninas/metabolismo , Esteroides/metabolismo , alfa-MSH/metabolismo , Animales , Temperatura Corporal , California , Corticosterona/sangre , Lagartos/parasitología , Masculino , Parásitos/fisiología , Receptores de Melanocortina/metabolismo , Testosterona/sangre , alfa-MSH/sangre
12.
Gen Comp Endocrinol ; 285: 113295, 2020 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-31580883

RESUMEN

Life history transitions and hormones are known to interact and influence many aspects of animal physiology and behavior. The South-American tegu lizard (Salvator merianae) exhibits a profound seasonal shift in metabolism and body temperature, characterized by high daily activity during warmer months, including reproductive endothermy in spring, and metabolic suppression during hibernation in winter. This makes S. merianae an interesting subject for studies of interrelationships between endocrinology and seasonal changes in physiology/behavior. We investigated how plasma concentrations of hormones involved in regulation of energy metabolism (thyroid hormones T4 and T3; corticosterone) and reproduction (testosterone in males and estrogen/progesterone in females) correlate with activity and body temperature (Tb) across the annual cycle of captive held S. merianae in semi-natural conditions. In our initial model, thyroid hormones and corticosterone showed a positive relationship with activity and Tb with independent of sex: T3 positively correlated with activity and Tb, while T4 and corticosterone correlated positively with changes in Tb only. This suggests that thyroid hormones and glucocorticoids may be involved in metabolic transitions of annual cycle events. When accounting for sex-steroid hormones, our sex separated models showed a positive relationship between testosterone and Tb in males and progesterone and activity in females. Coupling seasonal endocrine measures with activity and Tb may expand our understanding of the relationship between animal's physiology and its environment. Manipulative experiments are required in order to unveil the directionality of influences existing among abiotic factors and the hormonal signaling of annual cyclicity in physiology/behavior.


Asunto(s)
Temperatura Corporal , Hormonas/metabolismo , Lagartos/fisiología , Animales , Corticosterona/sangre , Sistema Endocrino/metabolismo , Metabolismo Energético , Femenino , Glucocorticoides/metabolismo , Masculino , Progesterona/metabolismo , Estaciones del Año , Testosterona/metabolismo , Hormonas Tiroideas/metabolismo
13.
Med. intensiva (Madr., Ed. impr.) ; 43(9): 556-568, dic. 2019. graf
Artículo en Español | IBECS | ID: ibc-185902

RESUMEN

La presente revisión narrativa se centra en el diagnóstico, el tratamiento y la gestión de la hipotermia accidental. Si bien todos estos procesos son continuos, en el presente manuscrito las recomendaciones se organizan con fines descriptivos en prehospitalarias y hospitalarias. En el ámbito prehospitalario se recomienda: a) reanimación de alta calidad de toda víctima en parada cardiaca, independientemente de la temperatura corporal; b) instaurar medidas para detener la pérdida de calor; c) iniciar el recalentamiento; d) prevenir el colapso del rescate y el efecto de recaída (afterdrop) y e) elegir adecuadamente el hospital de referencia de acuerdo con la situación clínica y hemodinámica de la víctima. El soporte vital extracorpóreo ha revolucionado, con tasas de supervivencia que han llegado al 100%, el recalentamiento de víctimas con inestabilidad hemodinámica o paro cardiaco. Las nuevas evidencias indican que la gestión de la hipotermia accidental ha evolucionado y ha conseguido mejorar sustancialmente el pronóstico final


A narrative review is presented on the diagnosis, treatment and management of accidental hypothermia. Although all these processes form a continuum, for descriptive purposes in this manuscript the recommendations are organized into the prehospital and in-hospital settings. At prehospital level, it is advised to: a) perform high-quality cardiopulmonary resuscitation for cardiac arrest patients, regardless of body temperature; b) establish measures to minimize further cooling; c) initiate rewarming; d) prevent rescue collapse and continued cooling (afterdrop); and (e) select the appropriate hospital based on the clinical and hemodynamic situation of the patient. Extracorporeal life support has revolutionized rewarming of the hemodynamically unstable victim or patients suffering cardiac arrest, with survival rates of up to 100%. The new evidences indicate that the management of accidental hypothermia has evolved favorably, with substantial improvement of the final outcomes


Asunto(s)
Humanos , Hipotermia/diagnóstico , Hipotermia/tratamiento farmacológico , Medicina Narrativa , Reanimación Cardiopulmonar/métodos , Recalentamiento/métodos , Mortalidad Hospitalaria , Temperatura Corporal/fisiología , Regulación de la Temperatura Corporal , Enfriamiento , Avalanchas , Atención Prehospitalaria/métodos , Fluidoterapia
14.
Pol J Vet Sci ; 22(4): 685-693, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31867921

RESUMEN

The objective of this study was to determine the association between subclinical acidosis (SARA) and subclinical ketosis (SCK) with biomarkers from an automatic milking system (AMS) measuring in relation to rumination time (RT), milk yield (MY), bodyweight (BW), milk temperature, the milk fat-to-protein ratio, and the electrical conductivity of milk at the udder quarters-level which can be read in fresh dairy cows. During the course of the study, all of the fresh dairy cows (n=711) were examined according to a general clinical investigation plan. The cows were selected for 1-30 days of milk (DIM) and were milked using Lely Astronaut® A3 milking robots with free traffic. Rumination time shows a statistically significant positive correlation with milk yield (milk temperature) and is negatively correlated with the fat and protein ratio. Healthy cows demonstrated the highest level of rumination time and the lowest milk temperature. The average BW for these cows was 1.64% lower than for the SARA group and the BW kg was 2.10% higher than SCK cows. MY was 14.01% lower in comparison with SARA and 6.42% higher in comparison with SCK. According to these results, some biomarkers from the AMS have an association with SARA and SCK. However, further research with a higher number of cows is needed to confirm this conclusion.


Asunto(s)
Acidosis/veterinaria , Crianza de Animales Domésticos/instrumentación , Enfermedades de los Bovinos/diagnóstico , Cetosis/veterinaria , Animales , Biomarcadores , Temperatura Corporal , Peso Corporal , Bovinos , Femenino , Lactancia , Leche/química
15.
J Cardiothorac Surg ; 14(1): 184, 2019 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-31684975

RESUMEN

BACKGROUND: Traditional aortic arch replacement surgery must be performed under moderate or deep hypothermia (22-28 °C) and circulatory arrest. Hypothermia and hypoperfusion can cause damage to the nervous system; therefore, postoperative brain and spinal cord complications are common. Improvements in surgical techniques are necessary to solve this problem. Herein, we report a method of total aortic arch replacement that can be performed at a core temperature of 34 °C, similar to other simple cardiac operations. CASE PRESENTATION: Four patients underwent surgery with this technique (3 males and 1 female, aged 48 to 67 years). Computed tomography angiography performed at admission showed a total aortic dissection, resulting in a diagnosis of Stanford type A aortic dissection. The patients underwent emergency aortic sinus remodelling, ascending aortic replacement, modified aortic arch replacement, and elephant trunk stenting. No patients had neurological complications. During a follow-up of more than 1-month, no patients had aortic valve regurgitation or anastomotic leak. CONCLUSIONS: This technique can increase the operating temperature by approximately 6 to 12 °C and reduce the circulatory arrest time by approximately 18 to 28 min. All of the patients recovered well without any neurological complications, demonstrating the feasibility and safety of this technique. We believe that this technique can serve as a good alternative strategy for managing aortic dissection and aneurysm, especially for young surgeons who are acquiring experience in arch replacement surgery.


Asunto(s)
Aneurisma Disecante/cirugía , Aneurisma de la Aorta Torácica/cirugía , Anciano , Aneurisma Disecante/diagnóstico por imagen , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Implantación de Prótesis Vascular , Temperatura Corporal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Stents , Tomografía Computarizada por Rayos X , Procedimientos Quirúrgicos Vasculares/métodos
16.
Oecologia ; 191(4): 803-815, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31673766

RESUMEN

Central to understanding animal ecology is how prey cope with the interacting risks of starvation and predation. This trade-off is modulated by the energy requirements of prey, yet relatively few studies have incorporated physiological mechanisms for energy savings when considering the behavioural response of prey to predation risk. In our study, we aimed to determine individual variation in behaviour, resting metabolism, body temperature and response to 24-h starvation within a captive population of fat-tailed dunnarts (Sminthopsis crassicaudata; 15-g insectivorous marsupials), and then, using semi-outdoor enclosures, test whether foraging effort and thermal energetics are adjusted in response to manipulation of ground cover, which for small mammals can simulate predation risk. We found that, under the low cover (high predation risk) treatment, dunnarts consumed less food and employed a greater daily reduction in body temperature between their active and rest phase. This result supports the hypothesis that rest-phase thermoregulatory energy savings are employed, even when food is available, if predation risk is perceived to increase the cost of foraging. Individuals exhibited correlated variation along two orthogonal axes incorporating the measured behavioural and metabolic variables, but these differences were not correlated with responses to starvation and predation risk. Our experiment demonstrates that flexibility in daily energy requirements provided by heterothermy can have important consequences for how small mammals respond to both starvation and predation risks. Such challenges are amplified in degraded habitat with introduced predators, making the capacity for heterothermy an even more important mechanism for survival.


Asunto(s)
Marsupiales , Inanición , Animales , Temperatura Corporal , Ecosistema , Conducta Predatoria
17.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(10): 1219-1223, 2019 Oct.
Artículo en Chino | MEDLINE | ID: mdl-31771718

RESUMEN

OBJECTIVE: To observe the effects of abnormal body temperature and the area under temperature curve on the prognosis of patients with septic shock. METHODS: A retrospective cohort study was conducted. Patients with septic shock admitted to intensive care unit (ICU) of Wuxi People's Hospital Affiliated to Nanjing Medical University from September 2013 to June 2019 were enrolled. Data were obtained from the hospital case database, including the gender, age, infection source, the length of ICU stay, sequential organ failure assessment (SOFA) score, 21-day prognosis; within the first 24 hours and throughout the period in ICU, the maximum temperature (24 h Tmax, Tmax), lowest temperature (24 h Tmin, Tmin), and the temperature range (24 h Tmax-min, Tmax-min) were aggregated. The area under temperature curve when body temperature was higher than T (A> T), or lower than T (A< T), and area section between T1 and T2 (AT1-T2) was calculated respectively. Patients were divided into survival group and death group according to 21-day prognosis. Binary Logistic regression was used to analyze the effect of the above temperature indices on the prognosis. RESULTS: 635 septic shock patients were enrolled in the study. 476 patients were survived and 159 died within 21 days. Compared with the survival group, the age, SOFA score were higher in the death group, while the length of ICU stay was shorter. There was no significant difference in gender or infection source between two groups. After adjusting for gender, age, the length of ICU stay and SOFA score, binary Logistic regression analysis showed that the increase of Tmax, decrease of Tmin, and increase of Tmax-min were risk factors for 21-day mortality [Tmax: odds ratio (OR) = 2.959, 95% confidence interval (95%CI) was 1.620-5.398, P > 0.001; Tmin: OR = 0.329, 95%CI was 0.140-0.790, P = 0.012; Tmax-min: OR = 3.258, 95%CI was 1.840-5.471, P > 0.001], while 24 h Tmax, 24 h Tmin and 24 h Tmax-min were not related to prognosis. A< 36.0 centigrade (OR = 1.335, 95%CI was 1.102-1.745, P = 0.014), and A> 38.0 centigrade (OR = 1.041, 95%CI was 1.019-1.077, P = 0.001) showed positive correlation with 21-day mortality. When the T level was set at 38.0-40.0 centigrade, for every 1 centigrade×hour increase in A> T, the 21-day relative risk of death increased by 4.1%-83.2%. CONCLUSIONS: When the body temperature of patients with septic shock is lower than 36.0 centigrade, or higher than 38.0 centigrade, the 21-day relative risk of death rose with the increase of the magnitude and duration of abnormal body temperature.


Asunto(s)
Temperatura Corporal , Choque Séptico/diagnóstico , Humanos , Unidades de Cuidados Intensivos , Pronóstico , Estudios Retrospectivos , Sepsis , Temperatura Ambiental
18.
Am Surg ; 85(11): 1209-1212, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31775960

RESUMEN

Prompt appendectomy has long been the standard of care for acute appendicitis because of the risk of progression to perforation. Recently, studies have suggested nonemergent management of acute appendicitis. Our study aimed to determine changes in risk of rupture and complications in patients with appendicitis, with increasing time from symptom onset to treatment. Retrospective study of patients aged ≥18 years presenting to the University of North Carolina Hospitals with signs and symptoms of acute appendicitis who subsequently underwent appendectomy from 2011 to 2015 was performed. Demographic, clinical, laboratory, and pathologic data were reviewed. Bivariate analysis was performed to assess variables associated with increased risk of perforation. Poisson regression modeling was completed to evaluate the risk of perforation and postoperative abscess based on time from symptoms to treatment. Within our database of 1007 patients, the mean time from onset of symptoms to operative intervention was 3.24 ± 2.2 days. Modified Poisson regression modeling demonstrated the relative risk for perforation increases by 9% (RR 1.09, P < 0.001) for each day delay. Age (RR 1.03), male gender (RR 1.50), temperature on admission (RR 1.32), and the presence of fecalith (RR 1.89) statistically significantly increased the risk of perforation. Furthermore, for each day delay, there is an 8% increased risk of postoperative abscess (RR 1.08, P = 0.027). The relative risk for appendiceal perforation is 9 per cent per day delay with a resultant 8 per cent increased risk of postoperative abscess. Thus, appendectomy for acute appendicitis should remain an emergent procedure, given that delays in operative management lead to complications and increases in cost of care.


Asunto(s)
Absceso/etiología , Apendicitis/complicaciones , Apendicitis/cirugía , Perforación Intestinal/etiología , Enfermedad Aguda , Adulto , Factores de Edad , Temperatura Corporal , Estudios de Casos y Controles , Urgencias Médicas , Impactación Fecal/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Distribución de Poisson , Estudios Retrospectivos , Factores de Riesgo , Rotura Espontánea/etiología , Factores Sexuales , Tiempo de Tratamiento
19.
An Bras Dermatol ; 94(5): 542-548, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31777354

RESUMEN

BACKGROUND: There is an obvious need for more prompt and specific biomarkers of bacterial infections in generalized pustular psoriasis patients. OBJECTIVE: The aim of this study was to evaluate the diagnostic properties and define appropriate cut-off values of procalcitonin and C-reactive protein in predicting bacterial infection in generalized pustular psoriasis patients. METHODS: Sixty-four generalized pustular psoriasis patients hospitalized from June 2014 to May 2017 were included in this retrospective study. The values of procalcitonin, C-reactive protein, details of infection, and other clinical parameters were analyzed. RESULTS: Receiver operating characteristic curve analysis generated similar areas (p=0.051) under the curve for procalcitonin 0.896 (95% CI 0.782-1.000) and C-reactive protein 0.748 (95% CI 0.613-0.883). A cut-off value of 1.50ng/mL for procalcitonin and 46.75mg/dL for C-reactive protein gave the best combination of sensitivity (75.0% for procalcitonin, 91.7% for C-reactive protein) and specificity (100% for procalcitonin, 53.8% for C-reactive protein). Procalcitonin was significantly positively correlated with C-reactive protein levels both in the infected (r=0.843, p=0.040) and non-infected group (r=0.799, p=0.000). STUDY LIMITATIONS: The sample size and the retrospective design are limitations. CONCLUSIONS: The serum levels of procalcitonin and C-reactive protein performed equally well to differentiate bacterial infection from non-infection in generalized pustular psoriasis patients. The reference value of procalcitonin and C-reactive protein applied to predicting bacterial infection in most clinical cases may not be suitable for generalized pustular psoriasis patients. C-reactive protein had better diagnostic sensitivity than procalcitonin; however, the specificity of procalcitonin was superior to that of C-reactive protein.


Asunto(s)
Infecciones Bacterianas/sangre , Proteína C-Reactiva/análisis , Polipéptido alfa Relacionado con Calcitonina/sangre , Psoriasis/sangre , Psoriasis/microbiología , Adulto , Biomarcadores/sangre , Temperatura Corporal , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Neutrófilos , Valores de Referencia , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Adulto Joven
20.
An Acad Bras Cienc ; 91(4): e20190055, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31778459

RESUMEN

The immune state is an essential component of survival as it directly influences physiological performance and health status. Variation in the leukocyte profile, a significantly increase in body temperature, and a detriment of the eco-physiological performance are among the possible consequences of an unhealthy state. In this study we analyse and discuss how field body temperature, preferred body temperature, the speed for sprint and long runs, locomotor stamina, and body condition can be affected by the immunological state (i.e. leukocyte profile) in a wild population of Liolaemus sarmentoi. Juveniles and adult males with a high percentage of eosinophils, basophils, and a low percentage of monocytes preferred higher body temperatures in a thermal gradient, while pregnant females maintained thermal preferences independently of leukocyte profile. Although juveniles with a high percentage of heterophils showed less locomotor stamina, adult males and pregnant females showed no differences in locomotor performance in relation to leukocyte profile. This study represents a starting point in eco-immunology of a wild lizard population of Liolaemus in cold and temperate environments of Patagonia where the southward shift in the geographic ranges of pathogen populations due to global warming represents a threat to resident host populations.


Asunto(s)
Conducta Animal/fisiología , Temperatura Corporal/inmunología , Lagartos/sangre , Lagartos/inmunología , Actividad Motora/inmunología , Aclimatación , Animales , Temperatura Corporal/fisiología , Femenino , Lagartos/fisiología , Masculino , Actividad Motora/fisiología , Embarazo
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA