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1.
Phys Rev Lett ; 131(4): 041002, 2023 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-37566836

RESUMO

The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9 GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36 GeV/c^{2}, rejecting cross sections above 9.2×10^{-48} cm at the 90% confidence level.

2.
J Hosp Infect ; 135: 171-178, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36934790

RESUMO

BACKGROUND: Disinfection of gloves might reduce the workload of healthcare workers, protect the environment, and bring economic benefits. Thus, the safety of hand hygiene of gloved hands is an important issue. AIM: We aimed to evaluate the risk of microbial transmission by comparing residual micro-organisms after multiple patient contacts, with or without gloves, in clinical practice. METHODS: Researchers, two with gloved hands (single or double gloves) and one with bare hands, made rounds of patients, followed by alcohol-based hand rub. Hand imprints were obtained before and after the rounds and cultured. The number of colony-forming units (cfu) of gloved and bare hands was compared, and the colony distribution was evaluated semi-quantitatively by hand region. FINDINGS AND CONCLUSION: A total of 108 imprints were obtained after 10 rounds. The median cfu counts were significantly higher in the gloved hands (single and double) than in the bare hands (9.00 vs 3.50, P=0.028). The cfu counts of single- and double-gloved hands were higher after than before contact (P=0.044 and P=0.001, respectively). Carbapenem-resistant Acinetobacter baumannii was identified in a pair of double gloves after a round, which included patients with the same organism with identical antibiotic susceptibility results. The mean percentage of colony-growing compartments from gloved hands was significantly higher than that of bare hands in the finger and wrist regions (P=0.019 and P=0.049, respectively). Compared with bare hands, reuse of gloves increased residual microbial colonies and potential for transmission of multi-drug-resistant organisms, even after using alcohol-based hand rub.


Assuntos
Higiene das Mãos , Humanos , Higiene das Mãos/métodos , Mãos , Desinfecção/métodos , Etanol , 2-Propanol , Desinfecção das Mãos/métodos , Luvas Protetoras , Contagem de Colônia Microbiana
3.
Res Rep Health Eff Inst ; (207): 1-73, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36314577

RESUMO

INTRODUCTION: Near-road ambient air pollution concentrations that are affected by vehicle emissions are typically characterized by substantial spatial variability with respect to distance from the roadway and temporal variability based on the time of day, day of week, and season. The goal of this work is to identify variables that explain either temporal or spatial variability based on case studies for a freeway site and an urban intersection site. The key hypothesis is that dispersion modeling of near-road pollutant concentrations could be improved by adding estimates or indices for site-specific explanatory variables, particularly related to traffic. Based on case studies for a freeway site and an urban intersection site, the specific aims of this project are to (1) develop and test regression models that explain variability in traffic-related air pollutant (TRAP) ambient concentration at two near-roadway locations; (2) develop and test refined proxies for land use, traffic, emissions and dispersion; and (3) prioritize inputs according to their ability to explain variability in ambient concentrations to help focus efforts for future data collection and model development.The key pollutants that are the key focus of this work include nitrogen oxides (NOx), carbon monoxide (CO), black carbon (BC), fine particulate matter (PM2.5; PM ≤ 2.5 µm in aerodynamic diameter), ultrafine particles (UFPs; PM ≤ 0.1 µm in aerodynamic diameter), and ozone (O3). NOx, CO, and BC are tracers of vehicle emissions and dispersion. PM2.5 is influenced by vehicle table emissions and regional sources. UFPs are sensitive to primary vehicle emissions. Secondary particles can form near roadways and on regional scales, influencing both PM2.5 and UFP concentrations. O3 concentrations are influenced by interaction with NOx near the roadway. Nitrogen dioxide (NO2), CO, PM2.5, and O3 are regulated under the National Ambient Air Quality Standards (NAAQS) because of demonstrated health effects. BC and UFPs are of concern for their potential health effects. Therefore, these pollutants are the focus of this work. METHODS: The methodological approach includes case studies for which variables are identified and assesses their ability to explain either temporal or spatial variability in pollutant ambient concentrations. The case studies include one freeway location and one urban intersection. The case studies address (1) temporal variability at a fixed monitor 10 meters from a freeway; (2) downwind concentrations perpendicular to the same location; (3) variability in 24-hour average pollutant concentrations at five sites near an urban intersection; and (4) spatiotemporal variability along a walking path near that same intersection.The study boundary encompasses key factors in the continuum from vehicle emissions to near-road exposure concentrations. These factors include land use, transportation infrastructure and traffic control, vehicle mix, vehicle (traffic) flow, on-road emissions, meteorology, transport and evolution (transformation) of primary emissions, and production of secondary pollutants, and their resulting impact on measured concentrations in the near-road environment. We conducted field measurements of land use, traffic, vehicle emissions, and near-road ambient concentrations in the vicinity of two newly installed fixed-site monitors. One is a monitoring station jointly operated by the U.S. Environmental Protection Agency (U.S. EPA) and the North Carolina Department of Environmental Quality (NC DEQ) on I-40 between Airport Boulevard and I-540 in Wake County, North Carolina. The other is a fixed-site monitor for measuring PM2.5 at the North Carolina Central University (NCCU) campus on E. Lawson Street in Durham, North Carolina. We refer to these two locations as the freeway site and the urban site, respectively. We developed statistical models for the freeway and urban sites. RESULTS: We quantified land use metrics at each site, such as distances to the nearest bus stop. For the freeway site, we quantified lane-by-lane total vehicle count, heavy vehicle (HV) count, and several vehicle-activity indices that account for distance from each lane to the roadside monitor. For the urban site, we quantified vehicle counts for all 12 turning movements through the intersection. At each site, we measured microscale vehicle tailpipe emissions using a portable emission measurement system.At the freeway site, we measured the spatial gradient of NOx, BC, UFPs, and PM, quantified particle size distributions at selected distances from the roadway and assessed partitioning of particles as a function of evolving volatility. We also quantified fleet-average emission factors for several pollutants.At the urban site, we measured daily average concentrations of nitric oxide (NO), NOx, O3, and PM2.5 at five sites surrounding the intersection of interest; we also measured high resolution (1-second to 10-second averages) concentrations of O3, PM2.5, and UFPs along a pedestrian transect. At both sites, the Research LINE-source (R-LINE) dispersion model was applied to predict concentration gradients based on the physical dispersion of pollution.Statistical models were developed for each site for selected pollutants. With variables for local wind direction, heavy-vehicle index, temperature, and day type, the multiple coefficient of determination (R2) was 0.61 for hourly NOx concentrations at the freeway site. An interaction effect of the dispersion model and a real-time traffic index contributed only 24% of the response variance for NOx at the freeway site. Local wind direction, measured near the road, was typically more important than wind direction measured some distance away, and vehicle-activity metrics directly related to actual real-time traffic were important. At the urban site, variability in pollutant concentrations measured for a pedestrian walk-along route was explained primarily by real-time traffic metrics, meteorology, time of day, season, and real-world vehicle tailpipe emissions, depending on the pollutant. The regression models explained most of the variance in measured concentrations for BC, PM, UFPs, NO, and NOx at the freeway site and for UFPs and O3 at the urban site pedestrian transect. CONCLUSIONS: Among the set of candidate explanatory variables, typically only a few were needed to explain most of the variability in observed ambient concentrations. At the freeway site, the concentration gradients perpendicular to the road were influenced by dilution, season, time of day, and whether the pollutant underwent chemical or physical transformations. The explanatory variables that were useful in explaining temporal variability in measured ambient concentrations, as well as spatial variability at the urban site, were typically localized real-time traffic-volume indices and local wind direction. However, the specific set of useful explanatory variables was site, context (e.g., next to road, quadrants around an intersection, pedestrian transects), and pollutant specific. Among the most novel of the indicators, variability in real-time measured tailpipe exhaust emissions was found to help explain variability in pedestrian transect UFP concentrations. UFP particle counts were very sensitive to real-time traffic indicators at both the freeway and urban sites. Localized site-specific data on traffic and meteorology contributed to explaining variability in ambient concentrations. HV traffic influenced near-road air quality at the freeway site more so than at the urban site. The statistical models typically explained most of the observed variability but were relatively simple. The results here are site-specific and not generalizable, but they are illustrative that near-road air quality can be highly sensitive to localized real-time indicators of traffic and meteorology.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Humanos , Emissões de Veículos/análise , Monitoramento Ambiental/métodos , Poluição do Ar/análise , Poluentes Atmosféricos/análise , Material Particulado/análise , Fuligem
4.
J Laryngol Otol ; 133(12): 1103-1106, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31791435

RESUMO

OBJECTIVE: To analyse how the auditory brainstem response changes in patients with sudden sensorineural hearing loss. METHOD: Data were collected via retrospective medical chart review. RESULTS: Forty-three patients were included in this study. The mean latency of auditory brainstem response wave 1 was significantly longer for the affected side than for the unaffected side (p = 0.003). The mean latency of auditory brainstem response wave 1 was significantly shorter, and the mean amplitude of auditory brainstem response wave 1 was significantly larger, in the good response group compared to the poor response group. In forward conditional logistic regression analysis, auditory brainstem response wave 1 latency was an independent predictor of a good response (odds ratio = 34.37, 95 per cent confidence interval = 1.56-757.15, p = 0.025). CONCLUSION: In patients with sudden sensorineural hearing loss, the latency of wave 1 of the auditory brainstem response was significantly increased and was related to prognosis.


Assuntos
Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Perda Auditiva Súbita/fisiopatologia , Tempo de Reação/fisiologia , Adulto , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prognóstico , Estudos Retrospectivos
5.
Osteoarthritis Cartilage ; 27(11): 1692-1701, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31323297

RESUMO

OBJECTIVE: Extracorporeal shockwave therapy (ESWT) has been shown to have chondroprotective effects on arthritic diseases. We investigated the effects of ESWT on temporomandibular joint osteoarthritis (TMJOA) using rat chondrocytes and TMJOA rat models. DESIGN: Cell viability and expression of pro-inflammatory cytokines, cartilage degradation, and apoptosis markers were measured in control, monosodium iodoacetate (MIA)-treated and ESWT plus MIA-treated chondrocytes in vitro, and intra-articular MIA injection (TMJOA) and ESWT on TMJOA rats in vivo. In vivo99mTc-hydroxymethylene diphosphonate (HDP) single-photon emission computerized tomography/computerized tomography (SPECT/CT) and ex-vivo micro-CT and histologic examinations were performed in rat models. RESULTS: ESWT plus MIA-treated chondrocytes showed increased cell viability significantly (P = 0.007), while decreased genetic expression of pro-inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), and interleukin-6 (IL-6); P < 0.001 for each] and cartilage degradation markers [matrix metalloproteinase-3 (MMP3), matrix metalloproteinase-13 (MMP13), and bone morphogenetic protein 7 (BMP7); P < 0.001 for each], and number of apoptotic cells (P < 0.001) compared to MIA-treated chondrocytes. Changes in cytochrome c and cleaved caspase-3 levels relative to procaspase-3 were decreased over MIA-treated chondrocytes. ESWT on TMJOA rat models was associated with a significant decrease in pro-inflammatory and cartilage degradation markers, as demonstrated by real-time PCR and immunohistochemistry stains (P < 0.001 for each). On 99mTc-HDP SPECT/CT, the ESWT group showed a significantly lower uptake ratio compared to the TMJOA group (P = 0.008). Micro-CT analysis revealed that the ESWT group showed improved structure and bone quality compared to the TMJOA control group. CONCLUSIONS: ESWT was associated with a protective effect on cartilage and subchondral bone structures of TMJOA by reducing inflammation, cartilage degradation, and chondrocyte apoptosis.


Assuntos
Cartilagem Articular/diagnóstico por imagem , Difosfonatos/farmacologia , Tratamento por Ondas de Choque Extracorpóreas/métodos , Compostos de Organotecnécio/farmacologia , Osteoartrite/terapia , Articulação Temporomandibular/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Microtomografia por Raio-X/métodos , Animais , Proliferação de Células , Células Cultivadas , Modelos Animais de Doenças , Citometria de Fluxo , Masculino , Osteoartrite/diagnóstico , Ratos , Ratos Sprague-Dawley
6.
Anaesthesia ; 74(8): 1033-1040, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31106853

RESUMO

Phase lag entropy, an electro-encephalography-based hypnotic depth indicator, calculates diversity in temporal patterns of phase relationship. We compared the performance of phase lag entropy with the bispectral index™ in 30 patients scheduled for elective surgery. We initiated a target-controlled infusion of propofol using the Schnider model, and assessed sedation levels using the Modified Observer's Assessment of Alertness/Sedation scale every 30 s with each stepwise increase in the effect-site propofol concentration. Phase lag entropy and bispectral index values were recorded. The correlation coefficient and prediction probability between phase lag entropy or bispectral index and the sedation level or effect-site propofol concentration were analysed. We calculated baseline variabilities of phase lag entropy and bispectral index. In addition, we applied a non-linear mixed-effects model to obtain the pharmacodynamic relationships among the effect-site propofol concentration, phase lag entropy or bispectral index and sedation level. As sedation increased, phase lag entropy and bispectral index both decreased. The prediction probability values of phase lag entropy and bispectral index for sedation levels were 0.697 and 0.700 (p = 0.261) and for the effect-site concentration of propofol were 0.646 and 0.630 (p = 0.091), respectively. Baseline variability in phase lag entropy and bispectral index was 3.3 and 5.7, respectively. The predicted propofol concentrations, using the Schnider pharmacokinetic model, producing a 50% probability of moderate and deep sedation were 1.96 and 3.01 µg.ml-1 , respectively. Phase lag entropy was found to be useful as a hypnotic depth indicator in patients receiving propofol sedation.


Assuntos
Sedação Consciente , Entropia , Hipnóticos e Sedativos/farmacologia , Propofol/farmacologia , Adulto , Idoso , Eletroencefalografia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade
7.
Int J Biometeorol ; 63(7): 927-938, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30895382

RESUMO

Thermal comfort could indicate human thermal sensation when exposed to a local meteorological condition. Because humans can suffer illness when exposed to heat or even die, it is essential to assess human comfort levels to increased temperature and to provide this information to the public. This study aims to estimate thermal comfort using the human heat balance model combined with a numerical meteorological model in Seoul mega city during the heat wave periods experienced during 2016. The gridded thermal comfort index of physiological subjective temperature (PST) was calculated based on the Man-Environment Heat Exchange (MENEX) model, which used as inputs the meteorological parameters, clothing insulations, and metabolic rates. High-resolution meteorological parameters were obtained by coupling Weather Research and Forecasting (WRF) model with Building Effect Parameterization (BEP) + Building Energy Model (BEM) using detailed urban classification. The modeling results showed that the PST distribution has a clearly heterogeneous spatial distribution during the heat wave period. The high PST values were largely found in the residential area during the day, due to the high temperature and low wind speed associated with high-density buildings, and the daily maximum PST reached a very hot level (44.1-54.0 °C). Our study suggested that the human heat balance model combined with the numerical meteorological model could be used to provide more reliable information about thermal comfort to groups that may be vulnerable to the effects of heat waves in complex urban environments.


Assuntos
Calor Extremo , Cidades , Humanos , Seul , Sensação Térmica , Tempo (Meteorologia)
8.
Front Mol Neurosci ; 11: 335, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30294259

RESUMO

In the past 4 years, many publications described a concentration-dependent deposition of gadolinium in the brain both in adults and children, seen as high signal intensities in the globus pallidus and dentate nucleus on unenhanced T1-weighted images. Postmortem human or animal studies have validated gadolinium deposition in these T1-hyperintensity areas, raising new concerns on the safety of gadolinium-based contrast agents (GBCAs). Residual gadolinium is deposited not only in brain, but also in extracranial tissues such as liver, skin, and bone. This review summarizes the current evidence on gadolinium deposition in the human and animal bodies, evaluates the effects of different types of GBCAs on the gadolinium deposition, introduces the possible entrance or clearance mechanism of the gadolinium and potential side effects that may be related to the gadolinium deposition on human or animals, and puts forward some suggestions for further research.

9.
AJNR Am J Neuroradiol ; 39(5): 864-868, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29519788

RESUMO

BACKGROUND AND PURPOSE: During stent-assisted coiling of ICA aneurysms, stent tips are sometimes unintentionally embedded into ICA branches. Stent tips can be visualized because they have radiopaque markers. Concerns regarding stent tip misplacement include risks of artery perforation and occlusion. The aim of this study was to evaluate the long-term outcomes of ICA branches with embedded stent tips. MATERIALS AND METHODS: ICA branches with embedded stent tips were identified among 35 patients with unruptured ICA aneurysms treated with stent-assisted coiling between November 2003 and November 2014. Patient clinical and angiographic outcomes associated with the embedded stent tip were analyzed. RESULTS: Most of the 35 studied aneurysms were paraclinoid ICA aneurysms (n = 30). The most commonly involved ICA branch was the posterior communicating artery (26 patients, 74.3%), followed by the anterior choroidal artery (8 patients, 22.9%) and ophthalmic artery (1 patient, 2.9%). During the follow-up period (38.6 ± 17.9 months), no new neurologic deficits developed. Neither hemorrhagic nor thromboembolic events occurred. Angiography was performed during the final follow-up evaluation at a mean of 32.7 ± 18.0 months, and all ICA branches with embedded stent tips showed patent blood flow without severe luminal narrowing. CONCLUSIONS: In our experience, placement of a stent tip into ICA branches during stent-assisted coiling was not associated with any major adverse events.


Assuntos
Artéria Carótida Interna/patologia , Embolização Terapêutica/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Aneurisma Intracraniano/terapia , Stents/efeitos adversos , Adulto , Idoso , Embolização Terapêutica/instrumentação , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
10.
J Hosp Infect ; 99(4): 487-491, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29476883

RESUMO

A 10-month active surveillance study was conducted to assess carriage of carbapenemase-producing Enterobacteriaceae (CPE), vancomycin-resistant enterococci (VRE) and toxigenic Clostridium difficile colonization among patients transferred to hospital from long-term care facilities (LTCFs). Four (1.4%) patients with carbapenem-resistant Enterobacteriaceae (none of which were CPE), 59 (21%) patients with VRE and 20 (7.1%) patients colonized with toxigenic C. difficile were identified from 282 rectal specimens. There was no outbreak of VRE infection during the study period. The low prevalence of CPE carriage suggests that screening all admissions from LTCFs for CPE would not be cost-effective, and that screening and use of contact precautions for VRE should be reconsidered.


Assuntos
Enterobacteriáceas Resistentes a Carbapenêmicos/isolamento & purificação , Portador Sadio/microbiologia , Clostridioides difficile/isolamento & purificação , Infecções por Clostridium/microbiologia , Infecções por Enterobacteriaceae/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Enterococos Resistentes à Vancomicina/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Portador Sadio/epidemiologia , Infecções por Clostridium/epidemiologia , Infecções por Enterobacteriaceae/epidemiologia , Monitoramento Epidemiológico , Fezes/microbiologia , Feminino , Infecções por Bactérias Gram-Positivas/epidemiologia , Humanos , Coreia (Geográfico)/epidemiologia , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Prevalência
11.
Br J Anaesth ; 118(6): 883-891, 2017 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-28541533

RESUMO

BACKGROUND: : In our preliminary study, the modified Marsh (M-Marsh) model caused an inadvertent underdosing of propofol in underweight patients. However, the predictive performance of the M-Marsh and Schnider models incorporated in commercially available target-controlled infusion (TCI) pumps was not evaluated in underweight patients. METHODS: : Thirty underweight patients undergoing elective surgery were randomly allocated to receive propofol via TCI using the M-Marsh or Schnider models. The target effect-site concentrations (Ces) of propofol were, in order, 2.5, 3, 4, 5, 6 and 2 µg ml -1 . Arterial blood samples were obtained at least 7 min after achieving each pseudo-steady-state. RESULTS: A total of 172 plasma samples were used to determine the predictive performance of both models. The pooled median (95% confidence interval) biases and inaccuracies at a target Ce ≤ 3 µg ml -1 were -22.6 (-28.8 to -12.6) and 31.9 (24.8-36.8) for the M-Marsh model and 9.0 (1.7-16.4) and 28.5 (21.7-32.8) for the Schnider model, respectively. These values at Ce ≥ 4 µg ml -1 were -9.6 (-16.0 to -6.0) and 24.7 (21.1-27.9) for the M-Marsh model and 19.8 (12.9-25.7) and 36.2 (31.4-39.7) for the Schnider model, respectively. CONCLUSIONS: The pooled biases and inaccuracies of both models were clinically acceptable. However, the M-Marsh and Schnider models consistently produced negatively and positively biased predictions, respectively, in underweight patients. In particular, the M-Marsh model showed greater inaccuracy at target Ce ≤ 3 µg ml -1 and the Schnider model showed greater inaccuracy at target Ce ≥ 4 µg ml -1 . Therefore, it is necessary to develop a new pharmacokinetic model for propofol in underweight patients. CLINICAL TRIAL REGISTRATION: KCT0001502.


Assuntos
Anestesia Geral/métodos , Anestesia Intravenosa/métodos , Anestésicos Intravenosos/administração & dosagem , Propofol/administração & dosagem , Magreza/complicações , Adulto , Anestésicos Intravenosos/sangue , Simulação por Computador , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Valor Preditivo dos Testes , Propofol/sangue , Estudos Prospectivos , Reprodutibilidade dos Testes , Magreza/fisiopatologia
12.
Clin Microbiol Infect ; 22(10): 880-886, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27475739

RESUMO

Given the mode of transmission of Middle East respiratory syndrome (MERS), healthcare workers (HCWs) in contact with MERS patients are expected to be at risk of MERS infections. We evaluated the prevalence of MERS coronavirus (CoV) immunoglobulin (Ig) G in HCWs exposed to MERS patients and calculated the incidence of MERS-affected cases in HCWs. We enrolled HCWs from hospitals where confirmed MERS patients had visited. Serum was collected 4 to 6 weeks after the last contact with a confirmed MERS patient. We performed an enzyme-linked immunosorbent assay (ELISA) to screen for the presence of MERS-CoV IgG and an indirect immunofluorescence test (IIFT) to confirm MERS-CoV IgG. We used a questionnaire to collect information regarding the exposure. We calculated the incidence of MERS-affected cases by dividing the sum of PCR-confirmed and serology-confirmed cases by the number of exposed HCWs in participating hospitals. In total, 1169 HCWs in 31 hospitals had contact with 114 MERS patients, and among the HCWs, 15 were PCR-confirmed MERS cases in study hospitals. Serologic analysis was performed for 737 participants. ELISA was positive in five participants and borderline for seven. IIFT was positive for two (0.3%) of these 12 participants. Among the participants who did not use appropriate personal protective equipment (PPE), seropositivity was 0.7% (2/294) compared to 0% (0/443) in cases with appropriate PPE use. The incidence of MERS infection in HCWs was 1.5% (17/1169). The seroprevalence of MERS-CoV IgG among HCWs was higher among participants who did not use appropriate PPE.


Assuntos
Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Coronavírus da Síndrome Respiratória do Oriente Médio/imunologia , Adolescente , Adulto , Idoso , Infecções por Coronavirus/imunologia , Feminino , Pessoal de Saúde , Inquéritos Epidemiológicos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância da População , Estudos Soroepidemiológicos , Adulto Jovem
13.
AJNR Am J Neuroradiol ; 37(11): 2060-2065, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27390320

RESUMO

BACKGROUND AND PURPOSE: Prophylactic antiplatelet medication is beneficial in decreasing thromboembolic complications during endovascular treatment of unruptured intracranial aneurysms. The efficacy may be limited by variability of individual response to antiplatelet medication, especially clopidogrel. We compared the efficacy of 2 antiplatelet medications, low-dose prasugrel and clopidogrel, in patients undergoing endovascular treatment of unruptured aneurysms. MATERIALS AND METHODS: From November 2014 to July 2015, 194 patients with a total of 222 unruptured aneurysms underwent endovascular treatment at a single institution. Laboratory and clinical data from the prospectively maintained registry were used in this study. Antiplatelet medication was given the day before endovascular treatment (prasugrel 20 mg or 30 mg or clopidogrel 300 mg). Response to the antiplatelet medication was measured by the VerifyNow system. Periprocedural adverse event rates between the 2 groups were compared. RESULTS: There were no significant differences in the baseline characteristics of patients and aneurysms between the 2 groups. The P2Y12 reaction unit values were lower (clopidogrel group versus prasugrel group, 242.7 ± 69.8 vs 125.7 ± 79.4; P < .0001) and percentage inhibition values were higher (22.1% ± 19.7% vs 60.2 ± 24.7%; P < .0001) in the prasugrel group. There were no thromboembolic events, but there was 1 procedural bleed in each group, without any clinical consequences. CONCLUSIONS: The prasugrel group showed more effective and consistent platelet inhibition. We may omit the antiplatelet response assay with the low-dose prasugrel premedication before the endovascular treatment of patients with unruptured aneurysms. Further study is required to determine whether there is benefit of this strategy regarding clinical outcome.

14.
J Hand Surg Eur Vol ; 41(6): 648-56, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26763269

RESUMO

Axons from the median and ulnar nerves can pass to each other through aberrant connections between them. Multiple interconnections between the nerves may provide a detour route for nerve fibres going to the hand. We investigated the incidence of variations and the associations between them in 90 cadaveric upper limbs. In 91% of upper limbs, one to five variations were found, with several statistically significant associations. The contribution of the C8 nerve to the lateral cord was positively associated with an accessory contribution of the lateral cord to the ulnar nerve. The latter variation showed positive association with the occurrence of any of the variations in the hand itself. Ulnar innervation of the superficial head of the flexor pollicis brevis was positively associated with the Riche-Cannieu communication. The co-existence of the variations and their associations may be the explanation for unusual clinical findings related to median and ulnar conduction, which appear contrary to anatomical knowledge.


Assuntos
Plexo Braquial/patologia , Mãos/inervação , Fibras Nervosas/patologia , Condução Nervosa , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
Drug Alcohol Depend ; 156: 14-20, 2015 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-26442907

RESUMO

BACKGROUND: Ketamine, an N-methyl-d-aspartate receptor antagonist, is used as a pediatric anesthetic because of its favorable safety profile. It is also being investigated as an antidepressant. Unfortunately, ketamine causes adverse reactions including hallucinations and is associated with a high prevalence of abuse among adolescents. Although chronic ketamine use has been shown to produce cognitive impairments even years following cessation, little is known about its long-term consequences on adolescents. The beta-lactam ceftriaxone has been shown to attenuate alcohol withdrawal, and alleviate early brain injury and memory impairments following subarachnoid hemorrhage. However, its ability to reverse the effects of adolescent ketamine exposure is not known. Previous data indicate that ketamine causes a reduction in the number of Excitatory Amino Acid Transporter Type 2 (EAAT2)-containing astrocytes. Additionally, the beta lactam antibiotic ceftriaxone increased expression of EAAT2. As EAAT2 is a principal mechanism of glutamate clearance from the synapse, the current study tests the hypothesis that ceftriaxone may reverse functional consequences of ketamine exposure. METHODS: We examined the effects of chronic ketamine in juvenile mice as well as reversal by ceftriaxone using electroencephalography (EEG). Subsequently, we assessed the effects of these treatments on markers of astrocyte proliferation, using Glial Fibrillary Acidic Protein (GFAP), and function, as evidenced by EAAT2. RESULTS: Juvenile mice exposed to chronic ketamine showed lasting alterations in EEG measurements as well as markers of astrocyte number and function. These alterations were reversed by ceftriaxone. CONCLUSIONS: Data suggest that ceftriaxone may be able to ameliorate ketamine-induced long-term disturbances in adolescent brains.


Assuntos
Anestésicos Dissociativos/farmacologia , Antibacterianos/farmacologia , Astrócitos/efeitos dos fármacos , Ceftriaxona/farmacologia , Eletroencefalografia/efeitos dos fármacos , Ketamina/antagonistas & inibidores , Ketamina/farmacologia , Animais , Encéfalo/citologia , Encéfalo/efeitos dos fármacos , Contagem de Células , Eletrodos Implantados , Potenciais Evocados/efeitos dos fármacos , Transportador 2 de Aminoácido Excitatório/genética , Ritmo Gama/efeitos dos fármacos , Proteína Glial Fibrilar Ácida/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL
16.
Theriogenology ; 84(4): 509-23, 2015 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-25998272

RESUMO

The production of cloned embryos using conventional methods has extremely low success rates owing to low embryo quality. To improve the quality of cloned bovine embryos expressing enhanced green fluorescent protein (EGFP), we applied an aggregation culture method. The EGFP gene was transfected into bovine fetal fibroblasts using a retroviral vector system. Somatic cell nuclear transfer was performed using these cells, and the resulting embryos were cultured in aggregates or individually. Gene expression was analyzed by a microarray, and differentially expressed genes were validated by quantitative real-time polymerase chain reaction. The total number of cells per blastocyst and the ratio of inner cell mass cells to trophectoderm cells were higher in aggregated transgenic cloned blastocysts (agBL; 368.7 ± 109.6 and 1:4.8, respectively) than in in vitro-fertilized blastocysts (ivfBL; 189.8 ± 65.8 and 1:2.6, respectively) and nonaggregated transgenic cloned blastocysts (sBL; 113.1 ± 36.3 and 1:1.5, respectively; P < 0.05 and P < 0.01, respectively). Moreover, the blastocyst perimeter was larger in the agBL group than in the ivfBL and sBL groups (1168.8 ± 200.23 vs. 887.33 ± 187.62 and 678 ± 226.1 µm; P < 0.05). In addition, mitochondrial fluorescence intensity was higher in the agBL group than in the ivfBL and sBL groups (P < 0.05). The number of apoptotic cells per blastocyst was lower in the ivfBL and agBL groups than in the sBL group (3.7 ± 2.2 and 3.4 ± 2.1 vs. 6.7 ± 6.8; P < 0.05). The genes identified in the microarray belonged to 18 categories. Expression of the Krüppel-like factor 4 gene, which is associated with cell proliferation, development, and transcription, was 7.2-fold higher in the agBL group than in the ivfBL group (P < 0.05) but did not differ between the sBL and ivfBL groups (P > 0.05). Expression of the heat shock 70-kDa protein 1A gene, which is associated with apoptosis, was 12-fold higher in the sBL group than in the ivfBL and agBL groups (P < 0.05). Expression of a stemness-related gene (octamer-binding transcription factor 4) and trophectoderm-specific genes (homeobox protein CDX2 and keratin 18) was higher in the agBL group than in the sBL group (P < 0.05). However, expression of the stemness gene homeobox protein NANOG did not differ among the groups (P > 0.05). Taken together, these data suggest that the aggregation method improves the quality of cloned embryos expressing EGFP and might be helpful in animal cloning.


Assuntos
Blastocisto/metabolismo , Bovinos/embriologia , Regulação da Expressão Gênica no Desenvolvimento/fisiologia , Proteínas de Fluorescência Verde/metabolismo , Mitocôndrias/fisiologia , Transcriptoma/fisiologia , Animais , Biomarcadores , Agregação Celular , Clonagem de Organismos , Proteínas de Fluorescência Verde/genética , Organismos Geneticamente Modificados
17.
J Vet Pharmacol Ther ; 38(6): 590-5, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25955782

RESUMO

The objective of this study was to describe the population pharmacokinetics (PK) of mosapride under fasting and fed conditions. A single 5-mg oral dose of mosapride was administered to fasted (n = 15) and fed (n = 12) beagle dogs. Plasma concentrations of mosapride were subsequently measured by liquid chromatography-tandem mass spectrometry. Data were analyzed using modeling approaches with the NONMEM 7.2 software. A one-compartment open PK model utilizing model event time (MTIME) with first-order absorption and first-order elimination was found to be more appropriate than all other PK models tested. The absorption rate constants of mosapride were significantly decreased under fed conditions, compared to fasting conditions. The observed bootstrap medians of PK parameters were generally consistent with the corresponding population mean estimates. Furthermore, with the exception of some mosapride concentrations, most of observed data fell into the range of the 5th and 95th percentiles of the simulated values. Overall, the final model was able to describe the observed mosapride concentrations reasonably well. These findings suggest that food intake affects both the rate and extent of absorption of mosapride and that the pharmacological effect of mosapride can differ significantly depending on food intake.


Assuntos
Benzamidas/farmacocinética , Ingestão de Alimentos , Morfolinas/farmacocinética , Agonistas do Receptor de Serotonina/farmacocinética , Administração Oral , Animais , Benzamidas/administração & dosagem , Benzamidas/sangue , Cromatografia Líquida , Cães , Jejum , Masculino , Modelos Biológicos , Morfolinas/administração & dosagem , Morfolinas/sangue , Agonistas do Receptor de Serotonina/administração & dosagem , Agonistas do Receptor de Serotonina/sangue , Espectrometria de Massas em Tandem
18.
Reprod Domest Anim ; 50(2): 292-298, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25605137

RESUMO

This study evaluated the effects of co-culture of immature cumulus oocyte complexes (COCs) with denuded immature oocytes (DO) during in vitro maturation on the developmental competence and quality of cloned bovine embryos. We demonstrated that developmental competence, judged by the blastocyst formation rate, was significantly higher in the co-cultured somatic cell nuclear transfer (SCNT+DO, 37.1 ± 1.1%) group than that in the non-co-cultured somatic cell nuclear transfer (SCNT-DO, 25.1 ± 0.9%) group and was very similar to that in the control IVF (IVF, 38.8 ± 2.8%) group. Moreover, the total cell number per blastocyst in the SCNT+DO group (101.7 ± 6.2) was higher than that in the SCNT-DO group (81.7 ± 4.3), while still less than that in the IVF group (133.3 ± 6.0). Furthermore, our data showed that mRNA levels of the methylation-related genes DNMT1 and DNMT3a in the SCNT+DO group were similar to that in the IVF group, while they were significantly higher in the SCNT-DO group. Similarly, while the mRNA levels of the deacetylation-related genes HDAC2 and HDAC3 were significantly higher in the SCNT-DO group, they were comparable between the IVF and SCNT+DO groups. However, the mRNA levels of HDAC1 and DNMT3B were significantly higher in the SCNT+DO group than in the other groups. In conclusion, the present study demonstrated that co-culture of COCs with DO improves the in vitro developmental competence and quality of cloned embryos, as evidenced by increased total cell number.


Assuntos
Bovinos/embriologia , Clonagem de Organismos , Células do Cúmulo/fisiologia , Embrião de Mamíferos/fisiologia , Técnicas de Maturação in Vitro de Oócitos/veterinária , Oócitos/fisiologia , Animais , Técnicas de Cocultura/métodos , Técnicas de Cocultura/veterinária , Células do Cúmulo/citologia , Embrião de Mamíferos/citologia , Desenvolvimento Embrionário/fisiologia , Regulação da Expressão Gênica no Desenvolvimento/fisiologia , Técnicas de Maturação in Vitro de Oócitos/métodos , Oócitos/citologia
19.
J Chem Ecol ; 41(1): 44-51, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25527347

RESUMO

Gas chromatography (GC) and mass spectrometry (MS) were used to determine the stereoisomeric compositions of 6,10,14-trimethylpentadecan-2-ol and 6,10,14-trimethylpentadecan-2-one in wing extracts from 17 Bicyclus butterfly species from different regions of Africa. All samples were purified using solid phase extraction (SPE). Since some species contained both alcohol and ketone, these were separated and the ketone was reduced to the alcohol before analysis as either (R)-trans-chrysanthemoyl or (S)-2-acetoxypropionyl esters. A novel asymmetric synthesis was developed for a reference mixture of (2R/S,6S,10R)-6,10,14-trimethylpentadecan-2-ol with known composition of the eight stereoisomers. The mixture then was used as the (R)-trans-chrysanthemoyl esters to correlate each of the eight gas chromatographic peaks to a specific stereoisomer of the extracted wing compounds. Seven butterfly species showed (2R,6R,10R)-configuration of the alcohol, four species contained minute amounts of alcohol too small to determine the stereochemistry, nine species showed (6R,10R)-configuration of the ketone, and one species contained minute amounts of ketone too small to determine the stereochemistry. No other stereoisomers of alcohol or ketone could be detected in the extracts, and the quantities of the compounds in the wing extracts varied from 5 to 900 ng per sample for each species.


Assuntos
Álcoois/química , Borboletas/química , Terpenos/química , Asas de Animais/química , Álcoois/síntese química , Animais , Técnicas de Química Sintética , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Masculino , Estrutura Molecular , Atrativos Sexuais/química , Extração em Fase Sólida , Estereoisomerismo , Terpenos/síntese química , Extratos de Tecidos/análise , Extratos de Tecidos/química
20.
Br J Surg ; 101(13): 1729-38, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25333872

RESUMO

BACKGROUND: The aim of the study was to compare the outcomes of patients with pancreatic or peripancreatic walled-off necrosis by endoscopy using the conventional approach versus an algorithmic approach based on the collection size, location and stepwise response to intervention. METHODS: This was an observational before-after study of consecutive patients managed over two time intervals. In the initial period (2004-2009) symptomatic patients with walled-off necrosis underwent conventional single transmural drainage with placement of two stents and a nasocystic catheter, followed by direct endoscopic necrosectomy, if required. In the later period (2010-2013) an algorithmic approach was adopted based on size and extent of the walled-off necrosis and stepwise response to intervention. The main outcome was treatment success, defined as a reduction in walled-off necrosis size to 2 cm or less on CT after 8 weeks. RESULTS: Forty-seven patients were treated in the first interval and 53 in the second. There was no difference in patient demographics, clinical or walled-off necrosis characteristics and laboratory parameters between the groups, apart from a higher proportion of women and Caucasians in the later period. The treatment success rate was higher for the algorithmic approach compared with conventional treatment (91 versus 60 per cent respectively; P < 0·001). On multivariable logistic regression, management based on the algorithm was the only predictor of treatment success (odds ratio 6·51, 95 per cent c.i. 2·19 to 19·37; P = 0·001). CONCLUSION: An algorithmic approach to pancreatic and peripancreatic walled-off necrosis, based on the collection size, location and stepwise response to intervention, resulted in an improved rate of treatment success compared with conventional endoscopic management.


Assuntos
Endoscopia do Sistema Digestório/métodos , Pancreatite Necrosante Aguda/cirurgia , Adulto , Algoritmos , Cateterismo/métodos , Drenagem/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite Necrosante Aguda/etiologia , Estudos Prospectivos , Estudos Retrospectivos , Stents , Resultado do Tratamento
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