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1.
Curr Issues Mol Biol ; 46(2): 1437-1450, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38392211

RESUMO

Obesity is one of the major risk factors for metabolic diseases worldwide. This study examined the effects of YC-1102, an extract derived from the roots of Rosa multiflora, on 3T3-L1 preadipocytes and high-fat diet (HFD)-induced obese mice. In vivo experiments involved the oral administration of YC-1102 (100, 150, and 200 mg/kg body weight) daily to mice for eight weeks. YC-1102 was found to downregulate the expressions of PPARγ and C/EBPα during adipogenesis, inhibiting adipocyte differentiation and upregulating the expression of PGC-1α for energy metabolism to enhance mitochondrial biogenesis and fatty acid oxidation. It has been shown that daily administration of YC-1102 to mice receiving a HFD prevented an increase in body weight and the accumulation of body fat. YC-1102 administration also reduced TG, TC, and LDL cholesterol levels, as well as glucose and leptin levels, and increased adiponectin levels, thus effectively inhibiting the metabolism of lipids. YC-1102-treated mice showed significant reductions in the mRNA expression of PPARγ and C/EBPα. The levels of PGC-1α involved in energy metabolism increased significantly in the YC-1102-treated mice when compared to the HFD-treated mice. According to the findings of this study, YC-1102 has a dual mechanism that reduces transcription factors that promote the differentiation of adipocytes and increases transcription factors that promote energy consumption.

3.
J Radiat Res ; 65(1): 100-108, 2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-38037473

RESUMO

The Pencil Beam Scanning (PBS) technique in modern particle therapy offers a highly conformal dose distribution but poses challenges due to the interplay effect, an interaction between respiration-induced organ movement and PBS. This study evaluates the effectiveness of different volumetric rescanning strategies in mitigating this effect in liver cancer proton therapy. We used a Geant4-based Monte Carlo simulation toolkit, 'TOPAS,' and an image registration toolbox, 'Elastix,' to calculate 4D dose distributions from 5 patients' four-dimensional computed tomography (4DCT). We analyzed the homogeneity index (HI) value of the Clinical Tumor Volume (CTV) at different rescan numbers and treatment times. Our results indicate that dose homogeneity stabilizes at a low point after a week of treatment, implying that both rescanning and fractionation treatments help mitigate the interplay effect. Notably, an increase in the number of rescans doesn't significantly reduce the mean dose to normal tissue but effectively prevents high localized doses to tissue adjacent to the CTV. Rescanning techniques, based on statistical averaging, require no extra equipment or patient cooperation, making them widely accessible. However, the number of rescans, tumor location, diaphragm movement, and treatment fractionation significantly influence their effectiveness. Therefore, deciding the number of rescans should involve considering the number of beams, treatment fraction size, and total delivery time to avoid unnecessary treatment extension without significant clinical benefits. The results showed that 2-3 rescans are more clinically suitable for liver cancer patients undergoing proton therapy.


Assuntos
Neoplasias Hepáticas , Terapia com Prótons , Humanos , Terapia com Prótons/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Fracionamento da Dose de Radiação , Movimento , Dosagem Radioterapêutica , Tomografia Computadorizada Quadridimensional/métodos , Neoplasias Hepáticas/radioterapia
4.
Acta Cardiol Sin ; 39(6): 783-806, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38022422

RESUMO

Cardiac rehabilitation is a comprehensive intervention recommended in international and Taiwanese guidelines for patients with acute myocardial infarction. Evidence supports that cardiac rehabilitation improves the health-related quality of life, enhances exercise capacity, reduces readmission rates, and promotes survival in patients with cardiovascular disease. The cardiac rehabilitation team is comprehensive and multidisciplinary. The inpatient, outpatient, and maintenance phases are included in cardiac rehabilitation. All patients admitted with acute myocardial infarction should be referred to the rehabilitation department as soon as clinically feasible. Pre-exercise evaluation, including exercise testing, helps physicians identify the risks of cardiac rehabilitation and organize appropriate exercise prescriptions. Therefore, the Taiwan Myocardial Infarction Society (TAMIS), Taiwan Society of Cardiology (TSOC), and Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation (TACVPR) address this consensus statement to assist healthcare practitioners in performing cardiac rehabilitation in patients with acute myocardial infarction.

5.
Sci Rep ; 13(1): 17331, 2023 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-37833444

RESUMO

Psoriasis is a skin disease that causes lesions of various sizes across the body and can persist for years with cyclic deterioration and improvement. During treatment, and a multiple-severity disease, with irregular severity within the observation area may be found. The current psoriasis evaluation is based on the subjective evaluation criteria of the clinician using the psoriasis area and severity index (PASI). We proposed a novel psoriasis evaluation method that detects representative regions as evaluation criteria, and extracts severity features to improve the evaluation performance of various types of psoriasis, including multiple-severity diseases. We generated multiple-severity disease images using CutMix and proposed a hierarchical multi-scale deformable attention module (MS-DAM) that can adaptively detect representative regions of irregular and complex patterns in multiple-severity disease analyses. EfficientNet B1 with MS-DAM exhibited the best classification performance with an F1-score of 0.93. Compared with the performance of the six existing self-attention methods, the proposed MS-DAM showed more than 5% higher accuracy than that of multiscale channel attention module (MS-CAM). Using the gradient-weighted activation mapping method, we confirmed that the proposed method works at par with human visual perception. We performed a more objective, effective, and accurate analysis of psoriasis severity using the proposed method.


Assuntos
Psoríase , Humanos , Índice de Gravidade de Doença , Psoríase/patologia
6.
J Dairy Sci ; 106(12): 9576-9586, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37678766

RESUMO

We investigated the effects of road transportation and administration of the vitamin E and selenium (ESe) on circulating cortisol, haptoglobin, blood metabolites, oxidative biomarkers, white blood cell profiles, and behaviors in pregnant dairy heifers. Forty pregnant Holstein heifers were randomly assigned to one of 4 treatments: no transportation and no ESe administration, no transportation and ESe administration, transportation and no administration, and transportation and ESe administration. The ESe (70 IU/kg dry matter feed of dl-α-tocopheryl acetate and 0.3 mg/kg dry matter feed of sodium selenite) was orally delivered once a day from 7 d before transportation to 3 d after transportation. The heifers were transported in trucks designed for cattle transportation. Blood was collected 1 h before transportation, immediately after transportation (IAT), and at 6, 24, and 48 h after transportation. Behaviors were recorded using a video camera for 2 consecutive days after transportation. Transported/non-ESe-administered heifers had greater cortisol at IAT, haptoglobin at 6 and 24 h after transportation, total oxidative status at 6 h after transportation, and nonesterified fatty acid levels, white blood cell numbers, and neutrophil percentages at IAT and 6 h after transportation in the blood than nontransported heifers. Transported/non-ESe-administered heifers had lower total antioxidative status levels at 48 h after transportation and lymphocyte percentages at IAT and 6 h after transportation than nontransported heifers. Lying time was shorter in transported heifers than nontransported/non-ESe-administered heifers. Transported/ESe-administered heifers had lower cortisol, total oxidative status, nonesterified fatty acid levels at IAT, and haptoglobin concentrations at 6 and 24 h after transportation than transported/non-ESe-administered heifers. Transported/ESe-administered heifers had greater total antioxidative status levels at 48 h after transportation than transported/non-ESe-administered heifers. No ESe administration effects were observed for white blood cell number and neutrophil and lymphocyte percentages and lying time. In conclusion, road transportation caused temporary oxidative stress. Administrating ESe partially alleviated the stress, suggesting that ESe administration could be a viable strategy to reduce stress in transported pregnant heifers, providing a novel role of vitamin E and selenium for improving animal welfare.


Assuntos
Selênio , Gravidez , Animais , Bovinos , Feminino , Selênio/farmacologia , Hidrocortisona , Haptoglobinas , Vitamina E/farmacologia , Antioxidantes/farmacologia , Meios de Transporte , Ácidos Graxos
7.
Food Sci Biotechnol ; 32(10): 1435-1444, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37457410

RESUMO

Deer velvet (DV) is an oriental traditional medicine used to treat various diseases. The present study examined the effect of flavourzyme-derived DV extract (YC-1101) on macrophages and an immunosuppressed mouse model. YC-1101 induced activation of macrophages as measured by nitric oxide production, cell proliferation, and cytokine release via concentration-dependent phosphorylation of c-Jun N-terminal kinase, extracellular signal-regulated kinase, and AKT, and nuclear translocation of p65 in macrophages. In addition, oral YC-1101 administration significantly increased splenocyte proliferation and natural killer cell activity in the immunosuppressed mouse model. Moreover, the levels of immune-related cytokines such as tumor necrotic factor-α, interferon-γ, and interleukin-2 were significantly increased by YC-1101 treatment comparable to the control group. Thus, these results suggest that YC-1101 is an efficient natural ingredient that has an immune-enhancing effect, and it might be a potential functional food for improving immunity.

8.
Front Immunol ; 14: 1062365, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36793716

RESUMO

Introduction: Although the engineering of T cells to co-express immunostimulatory cytokines has been shown to enhance the therapeutic efficacy of adoptive T cell therapy, the uncontrolled systemic release of potent cytokines can lead to severe adverse effects. To address this, we site-specifically inserted the interleukin-12 (IL-12) gene into the PDCD1 locus in T cells using clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9)-based genome editing to achieve T-cell activation-dependent expression of IL-12 while ablating the expression of inhibitory PD-1. Methods: New York esophageal squamous cell carcinoma 1(NY-ESO-1)-specific TCR-T cells was investigated as a model system. We generated ΔPD-1-IL-12 -edited NY-ESO-1 TCR-T cells by sequential lentiviral transduction and CRISPR knock-in into activated human primary T cells. Results: We showed that the endogenous PDCD1 regulatory elements can tightly control the secretion of recombinant IL-12 in a target cell-dependent manner, at an expression level that is more moderate than that obtained using a synthetic NFAT-responsive promoter. The inducible expression of IL-12 from the PDCD1 locus was sufficient to enhance the effector function of NY-ESO-1 TCR-T cells, as determined by upregulation of effector molecules, increased cytotoxic activity, and enhanced expansion upon repeated antigen stimulation in vitro. Mouse xenograft studies also revealed that PD-1-edited IL-12-secreting NY-ESO-1 TCR-T cells could eliminate established tumors and showed significantly greater in vivo expansion capacity than control TCR-T cells. Discussion: Our approach may provide a way to safely harness the therapeutic potential of potent immunostimulatory cytokines for the development of effective adoptive T cell therapies against solid tumors.


Assuntos
Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Humanos , Camundongos , Animais , Receptor de Morte Celular Programada 1/genética , Receptor de Morte Celular Programada 1/metabolismo , Neoplasias Esofágicas/metabolismo , Linfócitos T , Citocinas/metabolismo , Receptores de Antígenos de Linfócitos T/genética , Receptores de Antígenos de Linfócitos T/metabolismo , Interleucina-12/genética , Interleucina-12/metabolismo
9.
Front Immunol ; 13: 1012078, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36225935

RESUMO

The water environment plays an important role in animal physiology. In this study, we sought to evaluate the effect of the acid environment on the Oreochromis niloticus (Nile tilapia) internal microenvironment immune response compare to the mouse macrophage model (J77A.1). The acid environment treated mouse macrophage J774A.1 model have shown that acidic treatment is able to polarize macrophages into M2-like macrophages via an increase in Ym1, Tgm2, Arg1, Fizz1, and IL-10 expression. Metabolic analysis of mouse macrophages (J774A.1) at pH 2 vs. pH 7 and pH 4 vs. pH 7 have been shown to promote the expression of intracellular acetylcholine, choline, prochlorperazine, L-leucine, and bisphenol A,2-amino-3-methylimidazo[4,5-f] quinolone metabolites in the M2-like macrophage. Immune gene expression of the O. niloticus spleen and liver treated at pH 2, 4, and 7 was shown to reduce TNF-α, IL-1 ß, IL-8, and IL-12 expression compared to pH 7 treatment. Immune gene was induced in O. niloticus following culture at pH 5, 6, and 7 fresh water environment. Taken together, we found that the acid internal environment polarizes tissues into an M2 macrophage developmental microenvironment. However, if the external environment is acid, tissues are exposed to an M1 macrophage developmental microenvironment.


Assuntos
Ciclídeos , Quinolonas , Acetilcolina/metabolismo , Animais , Colina/metabolismo , Expressão Gênica , Interleucina-10/metabolismo , Interleucina-12/metabolismo , Interleucina-1beta/metabolismo , Interleucina-8/metabolismo , Leucina/metabolismo , Macrófagos , Camundongos , Proclorperazina/metabolismo , Fator de Necrose Tumoral alfa/metabolismo
10.
Skin Res Technol ; 28(6): 815-826, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36168928

RESUMO

BACKGROUND: The skin surface becomes wrinkled and rough due to various internal and external factors. A three-dimensional (3D) analysis of the skin is required to improve skin conditions. Stereophotogrammetry, a noninvasive 3D analysis method, is easy to install and use, but most stereo systems have a fixed baseline and scale. Previous stereo systems are not suitable for observing micro-range skin features. Therefore, we suggest the optimal conditions and methods for the 3D analysis of skin microrelief using a multi-conditioned stereo system. METHODS: We constructed a nonconvergence model using a mobile device and acquired stereo images under multiscale and multi-baseline conditions. We extracted 3D information of the skin through our process: preprocessing, skin feature extraction, feature matching, and actual depth mapping. We improved the accuracy of the 3D analysis of the skin by using disparity values instead of disparity maps. We compared and analyzed the performances of six local feature detector and descriptor algorithms. In addition, we suggested depth-mapping formulas to estimate the actual depth of the skin microrelief. RESULTS: We confirmed that stereo images with a working distance of 70-75 mm and a baseline of 4-8 mm are effective for the 3D analysis of skin microrelief. In addition, accelerated KAZE exhibited the best performance for features extraction and stereo matching. Finally, the extracted 3D information was converted to the actual depth, and the performance of the 3D analysis was verified. CONCLUSION: The proposed system and method that provide texture information are effective for 3D skin disease analysis and evaluation.


Assuntos
Imageamento Tridimensional , Dermatopatias , Humanos , Imageamento Tridimensional/métodos , Algoritmos , Pele/diagnóstico por imagem
11.
Microsc Res Tech ; 85(11): 3623-3632, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35916360

RESUMO

The type and ratio of abnormal red blood cells (RBCs) in blood can be identified through peripheral blood smear test. Accurate classification is important because the accompanying diseases indicated by abnormal RBCs vary. In clinical practice, this task is time-consuming because the RBCs are manually classified. In addition, because the classification depends on the subjective criteria of pathologists, objective classification is difficult to achieve. In this paper, an automatic classification method that is solely based on images of RBCs captured under a microscope and processed using machine learning (ML) is proposed. The size and hemoglobin abnormalities of RBCs were classified by optimizing the criteria used in clinical practice. For morphologically abnormal RBCs classification, used seven geometric features information (major axis, minor axis, ratio of major and minor axis, perimeter, circularity, number of convex hulls, difference between area and convex area) and five types of multiple classifiers (Support Vector Machine, Decision Tree, K-Nearest Neighbor, Random Forest, and Adaboost models). Among was categorized using SVM, highly accurate results (99.9%) were obtained. The classification is performed simultaneously, and results are provided to the user through a graphical user interface (GUI).


Assuntos
Aprendizado de Máquina , Máquina de Vetores de Suporte , Algoritmos , Eritrócitos , Microscopia
13.
Sci Rep ; 11(1): 18130, 2021 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-34518578

RESUMO

Psoriasis is a chronic inflammatory skin disease that occurs in various forms throughout the body and is associated with certain conditions such as heart disease, diabetes, and depression. The psoriasis area severity index (PASI) score, a tool used to evaluate the severity of psoriasis, is currently used in clinical trials and clinical research. The determination of severity is based on the subjective judgment of the clinician. Thus, the disease evaluation deviations are induced. Therefore, we propose optimal algorithms that can effectively segment the lesion area and classify the severity. In addition, a new dataset on psoriasis was built, including patch images of erythema and scaling. We performed psoriasis lesion segmentation and classified the disease severity. In addition, we evaluated the best-performing segmentation method and classifier and analyzed features that are highly related to the severity of psoriasis. In conclusion, we presented the optimal techniques for evaluating the severity of psoriasis. Our newly constructed dataset improved the generalization performance of psoriasis diagnosis and evaluation. It proposed an optimal system for specific evaluation indicators of the disease and a quantitative PASI scoring method. The proposed system can help to evaluate the severity of localized psoriasis more accurately.


Assuntos
Interpretação de Imagem Assistida por Computador/métodos , Psoríase/diagnóstico , Pele/diagnóstico por imagem , Pele/patologia , Área Sob a Curva , Tomada de Decisão Clínica , Gerenciamento Clínico , Eritema/patologia , Humanos , Interpretação de Imagem Assistida por Computador/normas , Processamento de Imagem Assistida por Computador , Psoríase/etiologia , Índice de Gravidade de Doença
15.
Int J Mol Sci ; 22(4)2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33670808

RESUMO

Hepatic fibrosis occurs when liver tissue becomes scarred from repetitive liver injury and inflammatory responses; it can progress to cirrhosis and eventually to hepatocellular carcinoma. Previously, we reported that neoagarooligosaccharides (NAOs), produced by the hydrolysis of agar by ß-agarases, have hepatoprotective effects against acetaminophen overdose-induced acute liver injury. However, the effect of NAOs on chronic liver injury, including hepatic fibrosis, has not yet been elucidated. Therefore, we examined whether NAOs protect against fibrogenesis in vitro and in vivo. NAOs ameliorated PAI-1, α-SMA, CTGF and fibronectin protein expression and decreased mRNA levels of fibrogenic genes in TGF-ß-treated LX-2 cells. Furthermore, downstream of TGF-ß, the Smad signaling pathway was inhibited by NAOs in LX-2 cells. Treatment with NAOs diminished the severity of hepatic injury, as evidenced by reduction in serum alanine aminotransferase and aspartate aminotransferase levels, in carbon tetrachloride (CCl4)-induced liver fibrosis mouse models. Moreover, NAOs markedly blocked histopathological changes and collagen accumulation, as shown by H&E and Sirius red staining, respectively. Finally, NAOs antagonized the CCl4-induced upregulation of the protein and mRNA levels of fibrogenic genes in the liver. In conclusion, our findings suggest that NAOs may be a promising candidate for the prevention and treatment of chronic liver injury via inhibition of the TGF-ß/Smad signaling pathway.


Assuntos
Cirrose Hepática/metabolismo , Cirrose Hepática/prevenção & controle , Oligossacarídeos/farmacologia , Substâncias Protetoras/farmacologia , Transdução de Sinais , Proteínas Smad/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Animais , Tetracloreto de Carbono , Linhagem Celular , Regulação da Expressão Gênica/efeitos dos fármacos , Células Estreladas do Fígado/efeitos dos fármacos , Células Estreladas do Fígado/metabolismo , Humanos , Cirrose Hepática/patologia , Masculino , Camundongos Endogâmicos ICR
16.
J Cardiothorac Vasc Anesth ; 35(7): 1989-1996, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33593649

RESUMO

OBJECTIVE: Acute brain injury (ABI) is common in venoarterial extracorporeal membrane oxygenation (VA-ECMO). One of the most common indications for use of VA-ECMO is postcardiotomy shock (PCS). The authors aimed to characterize the prevalence of ABI and its association with outcomes in this population. DESIGN: prospective observational. SETTING: Single-center tertiary care university hospital. PARTICIPANTS: Fifty-two consecutive patients treated for PCS with VA-ECMO from November 2017 to March 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The median age of patients was 64 (interquartile range 44-84), 62% were male. Of 52 PCS patients treated with extracorporeal membrane oxygenation, 38% (n = 20) experienced acute brain injury. Ischemic stroke was the most common (n = 13, 25%). Patients with central versus peripheral cannulation experienced more ischemic and hemorrhagic strokes (8% v 38%, p = 0.04). Patients with intracardiac thrombus experienced more brain injury (n = 4, 8% p = 0.02). The in-hospital mortality in patients with brain injury was 90% (n = 18/20) compared to 78% (n = 25/32) in patients without brain injury. CONCLUSIONS: ABI is common in postcardiotomy VA-ECMO and associated with worse outcome. Patients with central recanalization experienced the majority of acute strokes. Intracardiac thrombus was significantly associated with acute brain injury.


Assuntos
Lesões Encefálicas , Oxigenação por Membrana Extracorpórea , Choque , Lesões Encefálicas/diagnóstico por imagem , Lesões Encefálicas/epidemiologia , Lesões Encefálicas/etiologia , Oxigenação por Membrana Extracorpórea/efeitos adversos , Mortalidade Hospitalar , Humanos , Masculino , Estudos Prospectivos , Choque Cardiogênico/epidemiologia , Choque Cardiogênico/etiologia , Choque Cardiogênico/terapia
17.
ACS Omega ; 5(46): 29746-29754, 2020 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-33251410

RESUMO

A detailed understanding of the catalytic upgrading of light cycle oil (LCO) is important to achieve effective deep hydrodesulfurization (HDS) when LCO is mixed with straight run gas oil in the diesel pool. Herein, HDS of polyaromatic-rich LCO was studied at the molecular level over three NiMo catalysts on silica-alumina supports, which were synthesized on the pilot scale using different silica/alumina mixing procedures. Gas chromatography with atomic emission detection and two-dimensional gas chromatography with time-of-flight mass spectrometry were used to evaluate the HDS performance through determining the feed and product compositions, respectively, at the molecular level. Furthermore, the textural properties of the catalysts were evaluated using Raman spectroscopy, transmission electron microscopy, and the temperature-programmed desorption of NH3. The performance of the best catalyst was attributed to its higher content of octahedrally coordinated Mo oxide species, a lower number of layered stacks, and the more acidic sites on the surface. In addition, the hydrotreating reactivity of various family groups in LCO over the catalyst was investigated.

18.
Sensors (Basel) ; 20(16)2020 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-32796654

RESUMO

With the development of the mobile phone, we can acquire high-resolution images of the skin to observe its detailed features using a mobile camera. We acquire stereo images using a mobile camera to enable a three-dimensional (3D) analysis of the skin surface. However, geometric changes in the observed skin structure caused by the lens distortion of the mobile phone result in a low accuracy of the 3D information extracted through stereo matching. Therefore, our study proposes a Distortion Correction Matrix (DCM) to correct the fine distortion of close-up mobile images, pixel by pixel. We verified the correction performance by analyzing the results of correspondence point matching in the stereo image corrected using the DCM. We also confirmed the correction results of the image taken at the five different working distances and derived a linear regression model for the relationship between the angle of the image and the distortion ratio. The proposed DCM considers the distortion degree, which appears to be different in the left and right regions of the image. Finally, we performed a fine distortion correction, which is difficult to check with the naked eye. The results of this study can enable the accurate and precise 3D analysis of the skin surface using corrected mobile images.


Assuntos
Telefone Celular , Lentes , Pele
19.
BJOG ; 127(13): 1646-1654, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32536019

RESUMO

OBJECTIVE: To compare the efficacy of two types of progestogen therapy for preventing preterm birth (PTB) and to review the relevant literature. DESIGN: A multicentre, randomised, open-label, equivalence trial and a meta-analysis. SETTING: Tertiary referral hospitals in South Korea. POPULATION: Pregnant women with a history of spontaneous PTB or short cervical length (<25 mm). METHODS: Eligible women were screened and randomised at 16-22 weeks of gestation to receive either 200 mg of vaginal micronised progesterone daily (vaginal group) or an intramuscular injection of 250 mg 17α-hydroxyprogesterone caproate weekly (IM group). Stratified randomisation was carried out according to participating centres and indications for progestogen therapy. This trial was registered at ClinicalTrials.gov (NCT02304237). MAIN OUTCOME MEASURE: Preterm birth (PTB) before 37 weeks of gestation. RESULTS: A total of 266 women were randomly assigned and a total of 247 women (119 and 128 women in the vaginal and IM groups, respectively) were available for the intention-to-treat analysis. Risks of PTB before 37 weeks of gestation did not significantly differ between the two groups (22.7 versus 25.8%, P = 0.571). The difference in PTB risk between the two groups was 3.1% (95% CI -7.6 to 13.8%), which was within the equivalence margin of 15%. The meta-analysis results showed no significant differences in the risk of PTB between the vaginal and IM progestogen treatments. CONCLUSION: Compared with vaginal progesterone, treatment with intramuscular progestin might increase the risk of PTB before 37 weeks of gestation by as much as 13.8%, or reduce the risk by as much as 7.6%, in women with a history of spontaneous PTB or with short cervical length. TWEETABLE ABSTRACT: Vaginal and intramuscular progestogen showed equivalent efficacy for preventing preterm birth before 37 weeks of gestation.


Assuntos
Nascimento Prematuro/prevenção & controle , Progestinas/administração & dosagem , Administração Intravaginal , Adulto , Feminino , Humanos , Injeções Intramusculares , Metanálise como Assunto , Gravidez , Gravidez de Alto Risco
20.
Int Nurs Rev ; 67(2): 239-248, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31762026

RESUMO

OBJECTIVES: The International Council of Nurses supports the development of International Classification for Nursing Practice® (ICNP®) catalogues to support the construction of electronic health records and evidence-based practice. Such a catalogue is needed for inpatient falls. METHODS: The ICNP®-Based Inpatient Fall-Prevention Catalogue ('The Catalogue') was developed following the six steps recommended by the International Council of Nurses: (1) identifying inpatient falls as a priority, (2) gathering relevant concepts from 10 international guidelines and comparing locally defined sets of fall-prevention terms, (3) mapping the concepts to the ICNP® terminology, (4) identifying new concepts, (5) conducting a clinical face validation with a 12-member panel and finalizing The Catalogue and (6) setting a strategy for dissemination. The high-level structure of the International Classification for Patient Safety was used as a theoretical framework. RESULTS: Eighteen nursing care elements and 141 terms were identified. A local vocabulary set had 89 terms (63.1%) that all corresponded to the identified terms. The exact and post-coordination mapping rates to the ICNP® were 75% and 40.6% for assessment/diagnosis/outcomes and interventions, respectively. The 54 new terms corresponded to 52 primitive concepts. An external review of The Catalogue showed that it had adequate understandability and validity. However, one-third of assessments/diagnoses/outcomes and one-fourth of interventions were not found in a tertiary hospital practice. CONCLUSION: A fall-prevention catalogue has been developed based on evidence and a theoretical framework and also clinically validated. IMPLICATION FOR NURSING AND HEALTH POLICY: The Catalogue is a standardized interface terminology and content subset in any electronic health records system that can directly deliver evidence on fall prevention. It can also be used as an informatics tool to aggregate, analyse, interpret and compare nursing data worldwide.


Assuntos
Acidentes por Quedas/prevenção & controle , Registros Eletrônicos de Saúde/normas , Cuidados de Enfermagem/classificação , Cuidados de Enfermagem/normas , Segurança do Paciente/normas , Terminologia Padronizada em Enfermagem , Adulto , Feminino , Humanos , Conselho Internacional de Enfermagem , Masculino , Pessoa de Meia-Idade
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