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1.
J Asian Econ ; 84: 101576, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36569448

RESUMO

In this paper, we examine the impact of policy actions undertaken by governments during the COVID-19 pandemic on Consumer Price Index (CPI) in five major South Asian nations, namely, Bangladesh, India, Nepal, Pakistan and Sri Lanka. Using panel fixed effects regression with robust standard errors, we show the relative importance of monetary and financial interventions on reducing CPI while fiscal interventions, direct grants and aid are insignificant. Further, delving into nature of policy interventions, our study finds evidence of negative impact of Credit Support, and Healthcare Support on CPI in South Asian nations. While our investigation is preliminary, it provides insights into additional understanding of effectiveness of policy actions on inflation targeting.

2.
Financ Innov ; 8(1): 21, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35261875

RESUMO

Faced with a persistent pandemic, investors are concerned about portfolio diversification. While the literature on COVID-19 has evolved impressively, limited work remains on diversification opportunities. We contribute to the literature by exploring the volatility and co-movement of different sovereign debt instruments, including green sukuk, sukuk, bond and Islamic and conventional equity indices for Indonesia. Our results consistently point towards increased asset co-movement and weak profitability during the pandemic. Interestingly, sukuk and green sukuk have a 14% correlation with stocks, suggesting potential diversification prospects in times of extreme shocks.

3.
Endosc Int Open ; 9(3): E496-E504, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33655056

RESUMO

Background and study aims Endoscopic and surgical techniques have been utilized for palliation of gastric outlet obstruction (GOO). Enteral stenting (ES) is an established technique with high clinical success and low morbidity rate. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel approach that aims to provide sustained palliation of GOO. We conducted a comprehensive review and meta-analysis to evaluate the effectiveness in terms of clinical and technical success, as well as the safety profile of EUS-GE and ES. Methods We searched multiple databases from inception through July 2020 to identify studies that reported on safety and effectiveness of EUS-GE in comparison to ES. Pooled rates of technical success, clinical success, and adverse events (AEs) were calculated. Study heterogeneity was assessed using I 2 % and 95 % confidence interval. Results Five studies including 659 patients were included in our final analysis. Pooled rate of technical and clinical success for EUS-GE was 95.2 % (CI 87.2-.98.3, I 2  = 42) and 93.3 % (CI 84.4-97.3, I 2  = 59) while for ES it was 96.9 % (CI 90.9-99, I 2  = 64) and 85.6 % (CI 73-92.9, I 2  = 85), respectively. Pooled rate of re-intervention was significantly lower with EUS-GE i. e. 4 % (CI 1.8-8.7, I 2  = 35) compared to ES, where it was 23.6 % (CI 17.5-31, I 2  = 35), p = 0.001 . Pooled rates of overall and major AEs were comparable between the two techniques. Conclusion EUS-GE is comparable in terms of technical and clinical effectiveness and has a similar safety profile when compared to ES for palliation of GOO.

4.
MethodsX ; 8: 101198, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33425689

RESUMO

This research attempts to explore the total of 21 potential internal and external shocks to the European market during the Covid-19 Crisis. Using the time series of 1 Jan 2020 to 26 June 2020, I employ a machine learning technique, i.e. Least Absolute Shrinkage and Selection Operator (LASSO) to examine the research question for its benefits over the traditional regression methods. This further allows me to cater to the issue of limited data during the crisis and at the same time, allows both variable selection and regularization in the analysis. Additionally, LASSO is not susceptible to and sensitive to outliers and multi-collinearity. The European market is mostly affected by indices belonging to Singapore, Switzerland, Spain, France, Germany, and the S&P500 index. There is a significant difference in the predictors before and after the pandemic announcement by WHO. Before the Pandemic period announcement by WHO, Europe was hit by the gold market, EUR/USD exchange rate, Dow Jones index, Switzerland, Spain, France, Italy, Germany, and Turkey and after the announcement by WHO, only France and Germany were selected by the lasso approach. It is found that Germany and France are the most predictors in the European market.•A LASSO approach is used to predict the European stock market index during COVID-19•European market is mostly affected by the indices belonging to Singapore, Switzerland, Spain, France, Germany, and the S&P500 index.•There is a significant difference in the predictors before and after the pandemic announcement by WHO.

5.
Gastrointest Endosc ; 93(1): 68-76.e2, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32540312

RESUMO

BACKGROUND AND AIMS: Colonoscopy is the preferred modality for colorectal cancer screening because it has both diagnostic and therapeutic capabilities. Current consensus states that colonoscopy should be performed with initial rapid passage of the instrument to the cecum, followed by thorough evaluation for and removal of all polyps during a deliberate slow withdrawal. Reports have suggested that polyps that are seen but not removed during insertion are sometimes quite difficult to find during withdrawal. METHODS: We performed a comprehensive literature search of several major databases (from inception to March 2020) to identify randomized controlled trials comparing inspection and polypectomy during the insertion phase as opposed to the traditional practice of inspection and polypectomy performed entirely during the withdrawal phase. We examined differences in terms of adenoma detection rate (ADR), polyps detected per patient (PDPP), cecal intubation time (CIT), withdrawal time, and total procedure time. RESULTS: Seven randomized controlled trials, including 3834 patients, were included in our final analysis. The insertion/withdrawal cohort had 1951 patients and the withdrawal-only cohort 1883 patients. Pooled odds of adenoma detection in the insertion/withdrawal cohort was .99 (P = .8). ADR was 47.2% in the insertion/withdrawal cohort and 48.6% in the withdrawal-only cohort. Although total procedure and withdrawal times were shorter in the insertion/withdrawal cohort, PDPP in both cohorts were not statistically significant (1.4 vs 1.5, P = .7). CONCLUSIONS: Additional inspection and polypectomy during the insertion and withdrawal phases of colonoscopy offer no additional benefit in terms of ADR or PDPP.


Assuntos
Adenoma , Pólipos do Colo , Neoplasias Colorretais , Adenoma/diagnóstico , Ceco , Pólipos do Colo/diagnóstico , Colonoscopia , Neoplasias Colorretais/diagnóstico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Financ Res Lett ; 38: 101701, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32837381

RESUMO

This study investigates the impact of COVID-19 pandemic on the microstructure of US equity markets. In particular, we explain the liquidity and volatility dynamics via indexes that capture multiple dimensions of the pandemic. Our results suggest that increases in confirmed cases and deaths due to coronavirus are associated with a significant increase in market illiquidity and volatility. Similarly, declining sentiment and the implementations of restrictions and lockdowns contribute to the deterioration of liquidity and stability of markets.

7.
Endosc Int Open ; 8(11): E1611-E1622, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33140017

RESUMO

Background and study aims Endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) has limitations of inadequate sampling and false-negative results for malignancy. It has been performed using conventional smear (CS) cytology with rapid on-site evaluation (ROSE) with reasonable diagnostic accuracy. An alternative to ROSE is liquid-based cytology (LBC). Commonly used LBC techniques include precipitation-based (SurePath™) and filtration-based (ThinPrep ® , CellPrep ® ). Data regarding the diagnostic efficacy of LBC compared with CS are limited. Methods Multiple databases were searched through March 2020 to identify studies reporting diagnostic yield of EUS-guided CS and LBC in pancreatic lesions. Pooled diagnostic odds and rates of performance for the cytologic diagnoses of benign, suspicious, and malignant lesions were calculated. Diagnostic efficacy was evaluated by pooled rates of accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results Nine studies with a total of 1308 patients were included in our final analysis. Pooled diagnostic odds of CS cytology were 1.69 (CI 1.02-2.79) and 0.39 (CI 0.19-0.8) for malignant lesions when compared to filtration-based and precipitation-based LBC techniques, respectively. For CS, precipitation-based and filtration-based LBC, pooled diagnostic accuracy was 79.7 %, 85.2 %, 77.3 %, sensitivity was 79.2 %, 83.6 %, 68.3 %, and specificity was 99.4 %, 99.5 %, 99.5 %, respectively. Conclusions The precipitation-based LBC technique (SurePath™) had superior diagnostic odds for malignant pancreatic lesions compared with CS cytology in the absence of ROSE. It showed superior accuracy and sensitivity, but comparable specificity and PPV. Diagnostic odds of CS cytology in the absence of ROSE were superior to the filtration-based LBC technique (ThinPrep ® , Cellprep ® ) for diagnosing malignant pancreatic lesions.

8.
J Behav Exp Finance ; 27: 100343, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32427152

RESUMO

We analyze the relationship between sentiment generated by coronavirus-related news and volatility of equity markets. The ongoing coronavirus outbreak (COVID-19) resulted in unprecedented news coverage and outpouring of opinions in this age of swift propagation of information. Ensuing uncertainty in financial markets leads to heightened volatility in prices. We find that overwhelming panic generated by the news outlets are associated with increasing volatility in the equity markets. Our results for individual economic sectors demonstrate that panic-laden news contributed to a greater extent to volatility in the sectors perceived to be most affected by coronavirus outbreak.

9.
J Behav Exp Finance ; 27: 100341, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32427215

RESUMO

The novel Coronavirus disease (COVID-19) has quickly evolved from a provincial health scare to a global meltdown. While it has brought nearly half the world to a standstill it has affected the financial markets in unseen ways by eroding a quarter of wealth in nearly a month. This paper investigates the reaction of financial markets globally in terms of their decline and volatility as Coronavirus epicentre moved from China to Europe and then to the US. Findings suggest that the earlier epicentre China has stabilized while the global markets have gone into a freefall especially in the later phase of the spread. Even the relatively safer commodities have suffered as the pandemic moves into the US.

10.
Cureus ; 11(5): e4761, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31363442

RESUMO

Acute esophageal necrosis (AEN) is a rare life-threatening illness that is being increasingly recognized in the past two decades. It usually develops in the setting of severe systemic illness due to a combination of tissue hypoperfusion, impaired mucosal defenses and gastric reflux. The most common presentation is with upper gastrointestinal bleeding complicating diabetic ketoacidosis, sepsis, pancreatitis, trauma, shock, renal failure, alcohol poisoning or other states of hemodynamic compromise. The classic finding on endoscopy is of necrosis of the distal esophagus with a sharp transition to normal gastric mucosa at the gastroesophageal junction. Management is aimed at treating the underlying insult and providing supportive care. We report a case of "black esophagus" complicating an episode of diabetic ketoacidosis in a 34-year-old male. The patient was treated with broad-spectrum antibiotics, antifungals and a high-dose proton pump inhibitor in addition to the treatment of ketoacidosis. No serious acute or long-term complication was identified and follow-up endoscopy showed resolution of necrosis.

11.
Cureus ; 11(5): e4607, 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31309030

RESUMO

A 37-year-old female, a known epileptic, presented to the neurology clinic with a seven-day history of persistent bilateral headache not improving with analgesics. Her neurological and systemic examinations were unremarkable except for right optic disc edema. Magnetic resonance imaging (MRI) brain and magnetic resonance venography (MRV) were normal but her cerebrospinal fluid (CSF) opening pressure was 280 mm of water with a CSF white cell count of 214. The patient showed improvement following treatment with intravenous antibiotics and acyclovir. She returned a week later with double vision and blurring in both eyes. Examination showed bilateral sixth nerve palsies and bilateral optic disc edema with left fundal hemorrhages. The spinal tap was repeated again, which showed a CSF opening pressure of 500 mm of water and the white cell count was 48. Extensive investigations for etiologies were mostly unrevealing. The patient was started on acetazolamide and topiramate combined with a large-volume therapeutic CSF tap. She continued to improve subsequently and was at the baseline functional state at three months, with complete resolution of hemorrhages and optic disc edema. Idiopathic intracranial hypertension (IIH) may present with persistent abnormal CSF with a high white cell count. Therefore, this must be diagnosed with caution, as it may be misdiagnosed and wrongly treated for other causes.

12.
Cardiovasc Surg ; 6(4): 358-66, 1998 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9725514

RESUMO

OBJECTIVE: To evaluate duplex ultrasonography for diagnosis of arterial trauma in limbs and neck. METHOD: Fifty-one wounds in 47 patients, with indication for arteriography, were prospectively studied and grouped according to the presence (PCS group: 21 wounds, 41.2%) or absence (ACS group: 30 wounds, 58.8%) of clinical signs of arterial injury. All underwent duplex ultrasonography and arteriography. RESULTS: Arteriography disclosed arterial injury in 21 wounds, of which 19 were visualized by duplex ultrasonography. In the other 30 wounds neither methods disclosed any arterial injury. The sensitivity of duplex ultrasonography was 90.5%, the specificity was 100% and the accuracy was 96.1%. In PCS group duplex ultrasonography showed 14 injuries (93.3%) and one false-negative result, and in ACS group, five injuries (83.3%) and one false-negative result in the ACS group. CONCLUSIONS: Duplex ultrasonography reproduces the results of arteriography as a non-invasive diagnostic method in trauma of the limbs and neck.


Assuntos
Traumatismos do Braço/diagnóstico por imagem , Artérias/diagnóstico por imagem , Artérias/lesões , Traumatismos da Perna/diagnóstico por imagem , Lesões do Pescoço/diagnóstico por imagem , Ultrassonografia Doppler Dupla , Adolescente , Adulto , Angiografia , Braço/irrigação sanguínea , Criança , Pré-Escolar , Feminino , Humanos , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Pescoço/irrigação sanguínea , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade
13.
J Mal Vasc ; 23(2): 102-5, 1998 Apr.
Artigo em Francês | MEDLINE | ID: mdl-9608922

RESUMO

An experimental canine model was developed in order to evaluate the role of endothelialization of aortic prostheses for protection against septicemic infection and the utilization of 131I radiolabeled bacteria for vascular experimentation. Two groups of dogs were submitted to insertion of a dacron prosthesis segment in the abdominal aorta with subsequent infusion of inert 131I radiolabeled bacteria. In the first group ("A"), formed by five dogs, the infusion was made 30 minutes after the insertion of the prosthesis and in the second group ("B"), formed by four dogs, in a new surgery performed 12 weeks after. Fragments of the animals' prostheses and aortas were collected after 30 minutes of septicemia and analyzed by scan electron microscopy and submitted to reading of radioactivity uptake by a well-type counter. The microscopy recognized a complete endothelialization of the prostheses of dogs of group "B" 12 weeks after their insertion. Statistical analysis comparing fragments of non-endothelialized prostheses, of endothelialized prostheses and aortas demonstrated that the lower radioactivity uptake of the endothelialized prostheses in relation to non-endothelialized ones was significant (p = 0.0143) and that there was no significant statistical difference in uptake in the aortas and in endothelialized prosthesis (p = 0.3173). It was, therefore, concluded that prosthesis endothelialization fully protected them against septicemic infection; bacteremia contaminated all the non-endothelialized prostheses; there was no bacterial adhesion in the endothelialized prostheses and the use of bacteria labeled with radioisotope 131I is appropriate for the study of infections in vascular prosthetic devices.


Assuntos
Aorta Abdominal , Prótese Vascular , Endotélio Vascular/citologia , Sepse/prevenção & controle , Animais , Cães , Radioisótopos do Iodo , Masculino , Microscopia Eletrônica de Varredura
14.
Biopharm Drug Dispos ; 19(9): 571-5, 1998 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9872338

RESUMO

This study was conducted to determine the uptake of dihydroergotamine (DHE) into the brain after intravenous and intranasal administration in rats. Eight anesthetized rats received either an intravenous (i.v.) or two successive intranasal (i.n.) doses of tritium labeled dihydroergotamine (3H-DHE) with 14C-inulin as a non-BBB (blood-brain barrier) permeable marker. Radioactivity concentrations in plasma were determined at designated times within 30 min postdose, and in blood and seven brain regions (olfactory bulb, frontal cortex, parietal cortex, occipital cortex, cerebellum, mid-brain areas, and brain stem) at 30 min. The plasma-to-brain permeability*area product (PeA) following an i.v. dose was calculated based on the 30-min brain tissue concentration and the area under the plasma concentration-time curve (AUC0-30 min, i.v.) assuming unidirectional transport from plasma to brain. Direct transport from nasal cavity to brain was assessed based on the amount of radioactivity in brain determined experimentally and predicted based on plasma AUC0-30 min, i.n. and PeA obtained from i.v. data. Following an i.v. dose, DHE distributed into the brain with a brain-to-plasma concentration ratio of approximately 5% at 30 min postdose. The PeA value of DHE ranged from 8.6 x 10(-4) to 37.5 x 10(-4) mL min(-1) g(-1) in different brain regions. Following i.n. doses the experimentally determined concentration in olfactory bulb was approximately 51 times, and in other regions three to seven times, greater than predicted values based only on PeA and plasma AUC, suggesting a direct transport pathway from the nasal cavity to the brain. As a result, the brain tissue concentrations at 30 min were similar to (0.31-1.04 times) those following an i.v. dose except for the olfactory bulb, in which the concentration was approximately four times greater than that following an i.v. dose. In conclusion, 3H-DHE penetrated the BBB following intravenous administration. Following i.n. doses, 3H-DHE was able to enter the brain directly from the nasal cavity, with the olfactory bulb being a part of the direct passage from nasal cavity to brain.


Assuntos
Encéfalo/metabolismo , Di-Hidroergotamina/farmacocinética , Vasoconstritores/farmacocinética , Administração Intranasal , Animais , Injeções Intravenosas , Masculino , Ratos , Ratos Sprague-Dawley , Distribuição Tecidual
15.
Sao Paulo Med J ; 116(3): 1721-6, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9876450

RESUMO

OBJECTIVE: To analyze variations in leukocyte count and thromboxane B2 production in the femoral vein of patients with chronic venous hypertension (CVH). DESIGN: Prospective clinical study, controlled, non randomized and open. LOCATION: Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, referral center, university hospital. PARTICIPANTS: 15 patients with recurring stasis ulcer were analyzed, selected randomly from the venous diseases outpatient center, and 4 without lower limb venous alterations were also analyzed. INTERVENTION: Blood samples from the femoral and brachial veins were drawn following supine and 45 degrees reverse Trendelenburg. MAIN OUTCOMES MEASURES: Direct leukocyte count and analysis of the thromboxane B2 with enzyme linked immunosorbent assay test. RESULTS: After 30 minutes in reverse Trendelenburg, patients with CVH showed a leukocyte count reduced by +/- 27% (p = 0.02) and thromboxane B2 levels increased by +/- 158% (p = 0.02). CONCLUSIONS: We suggest that future studies of medications for stasis ulcers include their effects on leukocyte entrapment and thromboxane B2 production in the lower limb venous system.


Assuntos
Hematócrito , Contagem de Leucócitos , Tromboxano B2/sangue , Úlcera Varicosa/sangue , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tromboxano B2/metabolismo , Úlcera Varicosa/metabolismo
16.
Rev Hosp Clin Fac Med Sao Paulo ; 53(3): 139-45, 1998.
Artigo em Português | MEDLINE | ID: mdl-10436647

RESUMO

Thirty patients, submitted to 34 carotid endarterectomies, from September, 1992 to April, 1996, on Hospital Albert Einstein, São Paulo, have been studied. In these surgeries, Middle Cerebral Artery (MCA) was miniaturized with Transcranial Doppler (TCD). The purpose of this study were to verify the relationship between MCA blood flow velocity with postoperative neurologic complications: studying the velocity variations with risk of cerebral low perfusion and carotid stump back pressure, during carotid clamping; confirming that the TCD information, could show when it is necessary to use shunting, and its efficiency; and to know whether the method could detect intraoperative embolization. The equipment used was a Transpect TCD-EME 2000. During surgery, when carotid stump back pressure was bellow of 54.4 mmHg, Pruitt-Inahara shunt was applied. The flow velocity value observed with TCD was divided in 3 parts: phase 1, basal, since anesthesy induction until carotid clamping; phase 2, clamping, during the period when the carotid artery was occluded; phase 3, post-declamping, from the time the carotid artery was declamping until the end of surgery. The MCA flow velocity was available on three phases, in cm/s and percentually on phases 2 and 3, in relation to basal phase. The embolizations, detected by TCD, were classified in: a) a few embolizations in less than 10 second period, b) many embolizations in more than 10 second period. Based on the results obtained, its possible to conclude that the MCA flow velocity is related to the risk of cerebral low perfusion during carotid clamping; it was not possible to stablish any relation of MCA flow velocity to carotid stump back pressure; the TCD informs when the use of shunt is necessary and its efficiency; the postoperative neurologic complications were caused by embolizations. The conclusion is that the TCD is useful and easily applicated on carotid endarterectomy.


Assuntos
Artérias Cerebrais/fisiologia , Endarterectomia das Carótidas , Ultrassonografia Doppler Transcraniana , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo/fisiologia , Isquemia Encefálica , Artérias Cerebrais/diagnóstico por imagem , Feminino , Humanos , Embolia Intracraniana , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
17.
Arq Bras Cardiol ; 68(1): 35-7, 1997 Jan.
Artigo em Português | MEDLINE | ID: mdl-9334458

RESUMO

The case of a 56 year-old male with acute lymphoid leukemia and no signs of activity for the last four months is reported. He presented with superior vena cava thrombosis caused by a Hickman catheter, and had positive blood cultures for Candida albicans and Staphylococcus epidermidis. Despite adequate antimicrobial therapy, the fever persisted, and the patient was submitted to surgical thrombectomy. One week following the procedure, the fever returned, and thrombosis of the superior vena cava extending to the right atrium was identified by transesophageal echocardiography (TEE). The patient underwent thrombolytic therapy with streptokinase, and no thrombus could be identified in the control TEE. No hemorrhagic or thromboembolic complication occurred. The patient was discharged with oral anticoagulation.


Assuntos
Fibrinolíticos/uso terapêutico , Estreptoquinase/uso terapêutico , Síndrome da Veia Cava Superior/tratamento farmacológico , Cateteres de Demora/efeitos adversos , Cateteres de Demora/microbiologia , Ecocardiografia Transesofagiana , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Síndrome da Veia Cava Superior/diagnóstico por imagem , Síndrome da Veia Cava Superior/etiologia , Síndrome da Veia Cava Superior/cirurgia , Trombectomia
18.
Rev Hosp Clin Fac Med Sao Paulo ; 52(6): 291-4, 1997.
Artigo em Português | MEDLINE | ID: mdl-9629737

RESUMO

In order to find risk factors of carotid endarterectomy related stroke (CERS), 102 consecutive carotid endarterectomies, performed within two years on 95 patients were analyzed. Age, sex, diabetes, smoking, hypertension, degree of the operated and non operated carotid stenosis, previous neurological symptoms, anesthesia, protamine, cerebral monitoring, shunt, patch, post op. hypertensive crisis and clamping time were compared with the incidence of CERS. Four patients had major neurological deficits, two of which were fatal (3.92%). Six patients had minor transitory neurological deficit (5.8%). The use of patch and a long clamping time were the only identifiable statistically significant factors (p = 0.016 and p = 0.0053 respectively) that increase the odds of a CERS.


Assuntos
Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/etiologia , Endarterectomia das Carótidas/efeitos adversos , Idoso , Feminino , Humanos , Masculino , Análise Multivariada , Fatores de Risco
19.
Pharm Res ; 14(11): 1563-7, 1997 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9434275

RESUMO

PURPOSE: A permeability-index approach was developed and used to study the transport of D-glucose in the jejunum and ileum of rats. METHODS: The effective permeability coefficient (Pe) of [3H]D-glucose and [14C]antipyrine (an internal standard) in jejunum and ileum of four rats was determined using an in situ rat intestinal perfusion technique. The permeability ratio of the test compound (D-glucose) to the internal standard was defined as the permeability-index (P(i)), which was mathematically independent of the length and surface area of the intestinal segment perfused. Using this approach, the transport of [3H]D-glucose in jejunum and ileum of eight animals was investigated at concentrations ranging from 1 to 300 mM. The tissue/perfusate distribution of [3H]D-glucose and [14C]antipyrine at steady state was also determined. RESULTS: The variability (%CV) in P(i) of D-glucose was only approximately 5%, compared with 23-36% in Pe values of D-glucose or antipyrine alone. The permeability and tissue distribution of [14C]antipyrine were unaffected by the presence of D-glucose. In contrast, the permeability and tissue distribution of [3H]D-glucose were concentration-dependent in both jejunum and ileum. The transport of D-glucose was studied assuming that the transport was mediated by a carrier (with maximum flux, Vmax and dissociation constant, Km) as well as by non-saturable transport (Pd). The maximum transport capacity for D-glucose in jejunum (0.522 mumole/min/cm2) was twice that in ileum (0.199 mumole/min/cm2), but the affinity (1/Km) was less than half of that in ileum (1/(48.2 mumole/mL) vs. 1/(21.4 mumole/mL)), rendering a similar active transport efficiency (Vmax/Km) in these two regions. The non-saturable permeability (Pd) in jejunum (44.6 x 10(-4) cm/min) was approximately twice that in ileum (20.4 x 10(-4) cm/min). CONCLUSIONS: The permeability-index approach yielded parameters with reduced variability by eliminating potential imprecisions in length and surface area measurements of the intestinal segments perfused. D-glucose was transported via carrier-mediated systems in both jejunum and ileum, with different transport capacity and affinity in these two regions.


Assuntos
Antipirina/farmacocinética , Permeabilidade da Membrana Celular , Glucose/farmacocinética , Absorção Intestinal , Perfusão/métodos , Animais , Radioisótopos de Carbono/metabolismo , Íleo/metabolismo , Jejuno/metabolismo , Ratos , Distribuição Tecidual , Trítio/metabolismo
20.
Cir. vasc. angiol ; 12(3): 120-4, set. 1996.
Artigo em Português | LILACS | ID: lil-248229

RESUMO

As embolias arteriais dos membros superiores correspondem a 16 a 32 'por cento' dos casos de obstrução arterial embólica periférica. Os autores analisaram 34 casos de embolia arterial em membros superiores, atendidos de janeiro de 1991 a dezembro de 1993. A idade variou entre 38 a 84 anos (mediana = 62 anos). Quinze pacientes eram do sexo masculino e 17 do feminino. A etiologia da embolia foi na grande maioria dos casos bem definida, sendo que a principal causa foi a fibriliação atrial (81 'por cento'). A oclusão da artéria braquial foi a mais frequente (62 'por cento'). Todos os pacientes desta série apresentavam isquemia de membro, sendo leve em 16 casos (47 'por cento') e grave nos outros 18 (53 'por cento'). Nenhum paciente estava com gangrena à admissão. A maioria dos pacientes apresentavam tempo de isquemia entre o início do quadro e da liberação do fluxo arterial entre 6 a 12 horas (40 'por cento'). Uma paciente foi tratada clinicamente. Todos os outros foram submetidos a embolectomia braquial com catéter de Fogarty. Empregou-se a fasciotomia em um paciente devido a presença de síndrome compartimental. Dois pacientes faleceram, no pós-operatório imediato, um por embolia mesentérica e o outro por infarto miocárdico. A recuperação dos batimentos arteriais foi obtida em todos os pacientes. Em três casos houve oclusão pós-operatória, reoperados com sucesso. Em nenhum caso observou-se alteraçöes metabólicas que comprometessem o estado geral do paciente e que pudessem ser relacionadas à reperfusão do membro superioe isquêmico. A preservação do membro foi obtida em todos os doentes. Concluímos que em casos de embolia de membro superioe, apresentando-se o paciente em boas condiçöes clínicas e com o membro superior sem necrose instalada, vale a pena a realização da embolectomia com catéter de Fogarty, devido aos bons resultados quanto à manutenção do membro e batimentos arteriais, além de baixos índices de complicaçöes derivadas do procedimento cirúrgico.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Embolia/diagnóstico , Embolia/etiologia , Doença Aguda , Idoso de 80 Anos ou mais , Cateterismo , Embolectomia , Gangrena , Estudos Retrospectivos , Resultado do Tratamento
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