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1.
Gerontol Geriatr Med ; 2: 2333721416649488, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28138499

RESUMO

Objectives: This study sought to assess the value of differing pre-operative measures in prediction of post-operative non-surgical site infection (NSSI) and length of hospital stay following hip fracture surgery. Methods: All patients admitted during a one year period with a hip fracture to our department were included in the study (n=207). Primary outcome measures were ten independent risk factors correlated to the development of non-surgical site infection following surgery for hip fracture. Secondary outcome measures were duration of hospital stay and inpatient mortality. Results: The patients who had severe cognitive impairment had a 71.0% risk of developing non-surgical site infection. Patients who had multiple medical co-morbidities also had increased risk of developing non-surgical site infection at 59.1%. Patients who developed NSSI on average stayed in hospital 13.1 days longer than patients who did not (31.6 vs. 18.5, p < .001). Conclusions: This study demonstrates the importance of reducing post-operative infection in hip fracture patients in view of reducing morbidity, mortality and cost. These patients can be stratified by risk factors and interventions can be employed in view of reducing inpatient post-operative infection rates in this cohort.

2.
Am J Addict ; 23(5): 459-65, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24628943

RESUMO

BACKGROUND: Varenicline carries a black box warning for neuropsychiatric adverse events. OBJECTIVE: We examined varenicline use and past history of major depressive disorder (MDD) on depressive symptoms during smoking cessation. METHOD: This is a secondary analysis of two smoking cessation studies in 152 postmenopausal women who received placebo or nicotine patch, or 78 women who received varenicline with relaxation. Lifetime history of MDD (LH-MDD) was assessed at baseline and women with current MDD were excluded. Center for Epidemiologic Study Depression scale (CESD) measured depressive symptoms at baseline, 6 and 12 weeks. RESULTS: Baseline CESD scores were 5.3 + 4.4. Those with a LH-MDD reported higher CESD scores (p > .001). Those taking varenicline reported lower scores over all time periods compared to nicotine or placebo (p < .01). The differences between varenicline and the other treatments remained when controlling for LH-MDD, indicating an independent effect. CESD scores were associated with concurrent smoking status (p < .001), and with withdrawal symptoms (p < .001). CONCLUSION: CESD score were lower in those receiving varenicline, whether this is due to an anti-depressant effect, subject selection, use of relaxation or another cause is unknown. Varenicline does not increase depressive symptoms during smoking cessation in postmenopausal women without current MDD. Subjects with a LH-MDD are susceptible to developing depressive symptoms during smoking cessation, regardless of pharmacologic aid. SCIENTIFIC SIGNIFICANCE: Pharmacologic aids did not increase depression symptoms in this select population of postmenopausal women without current depression. Smoking cessation does increase depressive symptoms in those with LH-MDD, though the degree of increase was not clinically meaningful.


Assuntos
Benzazepinas/uso terapêutico , Depressão/induzido quimicamente , Transtorno Depressivo Maior/tratamento farmacológico , Nicotina/uso terapêutico , Pós-Menopausa/psicologia , Quinoxalinas/uso terapêutico , Abandono do Hábito de Fumar/psicologia , Fumar/tratamento farmacológico , Fumar/psicologia , Benzazepinas/efeitos adversos , Terapia Combinada , Depressão/psicologia , Transtorno Depressivo Maior/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Nicotina/efeitos adversos , Agonistas Nicotínicos/uso terapêutico , Placebos , Quinoxalinas/efeitos adversos , Terapia de Relaxamento , Fumar/terapia , Síndrome de Abstinência a Substâncias/psicologia , Dispositivos para o Abandono do Uso de Tabaco/efeitos adversos , Vareniclina
3.
Clin Vaccine Immunol ; 18(11): 1996-8, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21918121

RESUMO

In order to augment responses to respiratory vaccines in swine, various adjuvants were intranasally coadministered with a foot-and-mouth disease virus (FMDV) antigen to pigs. Detoxified Escherichia coli enterotoxins LTK63 and LTR72 enhanced antigen-specific mucosal and systemic immunity, demonstrating their efficacy as adjuvants for nonreplicating antigens upon intranasal immunization in swine.


Assuntos
Adjuvantes Imunológicos/administração & dosagem , Toxinas Bacterianas/administração & dosagem , Enterotoxinas/administração & dosagem , Proteínas de Escherichia coli/administração & dosagem , Vírus da Febre Aftosa/imunologia , Febre Aftosa/prevenção & controle , Toxoides/administração & dosagem , Vacinação/métodos , Vacinas Virais/imunologia , Administração Intranasal , Animais , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Toxinas Bacterianas/genética , Sangue/imunologia , Enterotoxinas/genética , Proteínas de Escherichia coli/genética , Febre Aftosa/imunologia , Imunidade nas Mucosas , Imunoglobulina A/análise , Imunoglobulina G/sangue , Suínos , Toxoides/genética , Vacinas Virais/administração & dosagem
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