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1.
Trop Biomed ; 41(1): 109-117, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38852140

RESUMO

Post-mortem microbiology (PMM) is an important tool in identifying possible causes of sudden unexpected death, as an infectious cause is highly suspected. However, contamination is a major problem in microbiology, and this has increased the difficulty determining the true pathogen that contributes to death in post-mortem cases. Skin commensals are common contaminants in blood cultures. This study was conducted to investigate the skin flora on early deceased bodies and observe the bacteria detected at different post-mortem intervals (PMIs). As blood is usually drawn from the neck and femoral sites for PMM examination, the two body sites were chosen as the sampling sites. Skin swab samples from the neck and femoral (n=80) of each early deceased body were collected by sterile cotton swabs. DNA was extracted from the swabs and then subjected to high-throughput 16S rRNA sequencing by using the Illumina MiSeq platform. Staphylococcus was found to be the most dominant genus in both neck and femoral sites. LEfSe results showed that Cutibacterium is significantly different at the neck site while Corynebacterium is more abundant at femoral site. There are significant differences at genus level between PMI<5H and PMI>5H at both neck and femoral sites. The findings of the present study may act as a reference for microbiologists and forensic pathologists when mixed growth or contamination occurs in post-mortem blood cultures.


Assuntos
Bactérias , Mudanças Depois da Morte , RNA Ribossômico 16S , Pele , Humanos , Pele/microbiologia , Bactérias/isolamento & purificação , Bactérias/classificação , Bactérias/genética , Masculino , RNA Ribossômico 16S/genética , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Idoso , Adolescente , DNA Bacteriano/genética , Criança , Pré-Escolar , Lactente , Autopsia , Idoso de 80 Anos ou mais
2.
Artigo em Inglês | MEDLINE | ID: mdl-38482085

RESUMO

Crawfurd Hospital (CFH) set up a Transitional Care Facility (TCF) in November 2022 as an interim holding facility for medically stable patients awaiting a long-term discharge disposition. The team invented the SAFE score, to monitor 4 main domains commonly impacted in long-term stays - namely Skin, Action (Behaviour), Function and Emotion. A sample size of 50 patients met the inclusion criteria and were scored by the nurses on day 7, day 14, and monthly thereafter during their TCF stay, and once more within 72 h prior to their discharge. There was no significant improvement or worsening noted across all 4 domains in this pilot study, suggesting that the TCF has achieved its goal of maintaining its patients in all these domains. The scores at the various time points were also useful for the team to immediately identify changes in individual patient scores and act on these findings to ensure optimal patient care. Through this pilot study, we identified further minor improvements which can be made to the and the score, and such a scoring system may further be applicable to various intermediate to long-term care homes to oversee these domains of care.

3.
NPJ Biofilms Microbiomes ; 9(1): 55, 2023 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-37573460

RESUMO

The prevalence of antibiotic-resistant bacteria in Southeast Asia is a significant concern, yet there is limited research on the gut resistome and its correlation with lifestyle and environmental factors in the region. This study aimed to profile the gut resistome of 200 individuals in Malaysia using shotgun metagenomic sequencing and investigate its association with questionnaire data comprising demographic and lifestyle variables. A total of 1038 antibiotic resistance genes from 26 classes were detected with a mean carriage rate of 1.74 ± 1.18 gene copies per cell per person. Correlation analysis identified 14 environmental factors, including hygiene habits, health parameters, and intestinal colonization, that were significantly associated with the resistome (adjusted multivariate PERMANOVA, p < 0.05). Notably, individuals with positive yeast cultures exhibited a reduced copy number of 15 antibiotic resistance genes. Network analysis highlighted Escherichia coli as a major resistome network hub, with a positive correlation to 36 antibiotic-resistance genes. Our findings suggest that E. coli may play a pivotal role in shaping the resistome dynamics in Segamat, Malaysia, and its abundance is strongly associated with the community's health and lifestyle habits. Furthermore, the presence of yeast appears to be associated with the suppression of antibiotic-resistance genes.


Assuntos
Microbioma Gastrointestinal , Microbiota , Humanos , Malásia , Escherichia coli/genética , Saccharomyces cerevisiae , Microbioma Gastrointestinal/genética , Fezes/microbiologia , Antibacterianos/farmacologia , Demografia
4.
Phys Rev E ; 107(5-1): 054208, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37328995

RESUMO

This work focuses on the study of time-periodic solutions, including breathers, in a nonlinear lattice consisting of elements whose contacts alternate between strain hardening and strain softening. The existence, stability, and bifurcation structure of such solutions, as well as the system dynamics in the presence of damping and driving, are studied systematically. It is found that the linear resonant peaks in the system bend toward the frequency gap in the presence of nonlinearity. The time-periodic solutions that lie within the frequency gap compare well to Hamiltonian breathers if the damping and driving are small. In the Hamiltonian limit of the problem, we use a multiple scale analysis to derive a nonlinear Schrödinger equation to construct both acoustic and optical breathers. The latter compare very well with the numerically obtained breathers in the Hamiltonian limit.

5.
Phys Rev E ; 107(3-1): 034211, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37072982

RESUMO

The propagation of acoustic and elastic waves in time-varying, spatially homogeneous media can exhibit different phenomena when compared to traditional spatially varying, temporally homogeneous media. In the present work, the response of a one-dimensional phononic lattice with time-periodic elastic properties is studied with experimental, numerical and theoretical approaches in both linear and nonlinear regimes. The system consists of repelling magnetic masses with grounding stiffness controlled by electrical coils driven with electrical signals that vary periodically in time. For small-amplitude excitation, in agreement with linear theoretical predictions, wave-number band gaps emerge. The underlying instabilities associated to the wave-number band gaps are investigated with Floquet theory and the resulting parametric amplification is observed in both theory and experiments. In contrast to genuinely linear systems, large-amplitude responses are stabilized via the nonlinear nature of the magnetic interactions of the system, and results in a family of nonlinear time-periodic states. The bifurcation structure of the periodic states is studied. It is found the linear theory correctly predicts parameter values from which the time-periodic states bifurcate from the zero state. In the presence of an external drive, the parametric amplification induced by the wave-number band gap can lead to bounded and stable responses that are temporally quasiperiodic. Controlling the propagation of acoustic and elastic waves by balancing nonlinearity and external modulation offers a new dimension in the realization of advanced signal processing and telecommunication devices. For example, it could enable time-varying, cross-frequency operation, mode- and frequency-conversion, and signal-to-noise ratio enhancements.

6.
Cureus ; 15(12): e49868, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38169912

RESUMO

Sepsis is a life-threatening emergency that arises owing to a dysregulated host response to infection, leading to existence organ dysfunction. Vitamin C administration has led to a lower mortality rate in sepsis. N-acetylcysteine (NAC) treatment during sepsis improves hepatic function and enhances tissue oxygenation. The objective of this case report is to investigate the synergistic effect of the combination of vitamin C, thiamine, and NAC in delaying sepsis cascade and prolongation of survival time. In this case report, an oral dose of vitamin C 500 mg three times daily in combination with IV thiamine 100 mg three times daily, IV NAC, and hydrocortisone stress dose resulted in 12 days of survival of an immunocompromised patient with ventilator-associated pneumonia on single anti-pseudomonas beta-lactam antibiotic. The patient was a 60-year-old Malay female with previous bone marrow transplantation surgery and a medical history of ischemic stroke on phenytoin and valproate therapy. The patient was transferred to a medical ward in Penang General Hospital, Malaysia, due to community-acquired pneumonia. She was on ceftriaxone for five days, then sedated and ventilated in the ICU, with a shift to cefepime for three days, which was then changed to meropenem for nine days until the last day of life. Total anti-pseudomonas coverage was 12 days. The patient had multiple comorbidities from phenytoin-induced hepatic encephalopathy, acute kidney injury, and three sessions of hemodialysis. IV vitamin C was not available, so an oral dose was administered with potential efficacy in delaying the sepsis inflammatory cascade, leading to the use of a single (not double) anti-pseudomonas antibiotic for 12 days. Prolonged survival duration may be expected in the case of normal bone marrow patients with ventilator-associated pneumonia sepsis. In conclusion, Vitamin C, thiamine, and NAC combination resulted in delayed sepsis progression for 12 days and the survival of the immunocompromised patient on a single anti-pseudomonas beta-lactam antibiotic.

7.
Med J Malaysia ; 77(6): 661-668, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36448382

RESUMO

INTRODUCTION: Diaphragmatic dysfunction is often underdiagnosed as clinical presentation is non-specific and reference values for normal diaphragmatic excursion are inadequate. The rationale of this study is to provide a normal reference value of diaphragmatic excursion and thickness in Malaysia's paediatric population using M-mode sonography, as no previous local data are available to our knowledge. MATERIALS AND METHODS: A total of 119 healthy infants and children fulfilling our inclusion and exclusion criteria were recruited. They were divided into three groups according to age - 0-2 years old in group 1; 2-6 years old in group 2; 6- 12 years old in group 3. Sonography B-mode was used to assess bilateral diaphragmatic thickness and M-mode to assess diaphragmatic excursion during quiet spontaneous respiration. RESULTS: In our paediatric population, the normal right and left diaphragmatic thickness were 2.0 mm ± 0.5 and 2.0 mm ± 0.5 for group 1; 2.5 mm ± 0.8 and 2.4 mm ± 0.6 for group 2; 2.7 mm ± 0.7 and 2.5 mm ± 0.5 for group 3, respectively. The normal right and left diaphragmatic excursion were 7.7 mm ± 2.5 and 7.3 mm ± 2.6 for group 1; 11.5 mm ± 3.8 and 10.6 mm ± 3.8 for group 2; 13.8 mm ± 3.9 and 12.9 mm ± 3.3 for group 3, respectively (data presented in mean ± standard deviation). There were no significant differences between two genders for each group. Significant positive correlation between age, weight, height, and body surface area with bilateral diaphragmatic thickness and excursion were detected in all studied population. The percentage difference between excursions of both hemidiaphragm was below 40%. CONCLUSIONS: M-mode sonography is the modality of choice for diaphragmatic kinetics especially in paediatric population. This study provides normal sonographic reference value of diaphragmatic excursion and thickness in the Malaysian paediatric population as well as percentile curves for right diaphragmatic excursion plotted against body weight. The availability of this data will aid in the diagnosis of diaphragmatic dysfunction and hence immediate intervention for better recovery.


Assuntos
Povo Asiático , Criança , Lactente , Humanos , Feminino , Masculino , Pré-Escolar , Estudos Transversais , Malásia , Ultrassonografia , Valores de Referência
8.
Clin Radiol ; 77(10): 743-748, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35810024

RESUMO

AIM: To assess the prevalence of publication bias in the radiology literature, data-mining techniques were used to extract p-values in abstracts published in key radiology journals over the past 20 years. MATERIALS AND METHODS: A total of 34,699 abstracts published in Radiology, Investigative Radiology, European Radiology, American Journal of Roentgenology, and American Journal of Neuroradiology published between January 2000 and December 2019 were included in the analysis. Automated text mining using regular expressions was used to mine abstracts for p-values. RESULTS: The text mining algorithm detected 43,489 p-values, the majority (82.4%) of which were reported as "significant", i.e., p<0.05. There has also been an increased propensity to report more p-values over time. The distribution of p-values showed a step change at the conventional significance threshold of 0.05. The odds ratio of a "significant" p-value being reported in the abstract compared to the full text was calculated to be 2.52 (95% confidence interval 1.78-3.58; p<0.001). Taken together, these results provide strong evidence for selective reporting of significant p-values in abstracts. CONCLUSION: Statistically significant p-values are preferentially reported in radiology journal abstracts.


Assuntos
Radiologia , Humanos , Viés de Publicação , Estados Unidos
9.
Phys Rev E ; 105(3-1): 034202, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35428101

RESUMO

In this work we present an analytical and numerical study of rogue and solitary waves in a coupled one-dimensional nonlinear lattice that involves both axial and rotational degrees of freedom. Using a multiple-scale analysis, we derive a system of coupled nonlinear Schrödinger-type equations in order to approximate solitary waves and rogue waves of the coupled lattice model. Numerical simulations are found to agree with the analytical approximations. We also consider generic initialization data in the form of a Gaussian profile and observe that they can result in the spontaneous formation of rogue-wave-like patterns in the lattice. The solitary and rogue waves in the lattice demonstrate both energy isolation and exchange between the axial and rotational degrees of freedom of the system. This suggests that the studied coupled lattice has the potential to be an efficient energy isolation, transfer, and focusing medium.

10.
BJS Open ; 5(5)2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34601569

RESUMO

BACKGROUND: Acute kidney injury (AKI) is increasingly being recognized after hepatectomy. This study aimed to identify factors predicting its occurrence and its impact on long-term outcome among patients with hepatocellular carcinoma (HCC). METHODS: This was a retrospective analysis of the incidence of AKI, factors predicting its occurrence, and its impact on patients undergoing hepatectomy between September 2007 and December 2018. A subgroup analysis included patients with histologically proven HCC. RESULTS: The incidence of AKI was 9.2 per cent in 930 patients. AKI was associated with increased mortality, morbidity, posthepatectomy liver failure (PHLF), and a longer hospital stay. On multivariable analysis, study period December 2013 to December 2018, diabetes mellitus, mean intraoperative BP below 72.1 mmHg, operative blood loss exceeding 377ml, high Model for End-Stage Liver Disease (MELD) score, and PHLF were predictive factors for AKI. Among 560 patients with HCC, hypertension, BP below 76.9 mmHg, blood loss greater than 378ml, MELD score, and PHLF were predictive factors. The 1-, 3-, and 5-year overall survival rates were 74.1, 59.2, and 51.6 per cent respectively for patients with AKI, and 91.8, 77.9, and 67.3 per cent for those without AKI. Corresponding 1-, 3-, and 5-year disease-free survival rates were 56.9, 42.3, and 35.4 per cent respectively in the AKI group, and 71.7, 54.5, and 46.2 per cent in the no-AKI group. AKI was an independent predictor of survival in multivariable analysis. CONCLUSION: AKI is associated with longer hospital stay, and higher morbidity and mortality rates. It is also associated with shorter long-term survival among patients with HCC. To avoid AKI, control of blood loss and maintaining a reasonable BP (72-77 mmHg) during hepatectomy is important.


Assuntos
Injúria Renal Aguda , Carcinoma Hepatocelular , Doença Hepática Terminal , Neoplasias Hepáticas , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Carcinoma Hepatocelular/cirurgia , Hepatectomia/efeitos adversos , Humanos , Neoplasias Hepáticas/cirurgia , Estudos Retrospectivos , Índice de Gravidade de Doença
11.
Br J Surg ; 109(1): 71-78, 2021 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-34643677

RESUMO

BACKGROUND: The therapeutic value of repeat hepatic resection (rHR) or radiofrequency ablation (RFA) for recurrent hepatocellular carcinoma (HCC) is unknown. This study aimed to investigate the safety and efficacy of rHR or RFA. METHODS: This was a retrospective multicentre study of patients with recurrent HCC within the Milan criteria who underwent rHR or RFA at nine university hospitals in China and Italy between January 2003 and January 2018. Survival after rHR or RFA was examined in unadjusted analyses and after propensity score matching (1 : 1). RESULTS: Of 847 patients included, 307 and 540 underwent rHR and RFA respectively. Median overall survival was 73.5 and 67.0 months after rHR and RFA respectively (hazard ratio 1.01 (95 per cent c.i. 0.81 to 1.26)). Median recurrence-free survival was longer after rHR versus RFA (23.6 versus 15.2 months; hazard ratio 0.76 (95 per cent c.i. 0.65 to 0.89)). These results were confirmed after propensity score matching. RFA was associated with lower morbidity of grade 3 and above (0.6 versus 6.2 per cent; P < 0.001) and shorter hospital stay (8.0 versus 3.0 days, P < 0.001) than rHR. CONCLUSION: rHR was associated with longer recurrence-free survival but not overall survival compared with RFA.


Assuntos
Carcinoma Hepatocelular/cirurgia , Hepatectomia , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/cirurgia , Ablação por Radiofrequência , Intervalo Livre de Doença , Feminino , Hepatectomia/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Ablação por Radiofrequência/efeitos adversos , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
12.
BJS Open ; 5(5)2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34642737

RESUMO

BACKGROUND: The quality of total mesorectal excision (TME) is regarded as a fundamental key to the oncological outcome of rectal cancer. Robotic low anterior resection (RLAR) and transanal TME (TaTME) were developed to overcome the technical challenges of conventional open TME. This study aimed to compare the short- and long-term outcomes of RLAR versus TaTME for rectal cancer. METHODS: Retrospective data from patients undergoing RLAR or TaTME at a colorectal unit in Singapore were analysed. The primary outcomes were the short-term clinical and pathological results including specimen margins and quality of TME. Secondary outcomes were recurrence, disease-free survival (DFS), and overall survival rates. RESULTS: A total of 80 patients who underwent either RLAR or TaTME were analysed. The TaTME group had a shorter operating time than the RLAR group (354 versus 481 min respectively; P < 0.001) and fewer stays in the high-dependency and intensive care units (38.1 versus 73.7 per cent; P = 0.010). There was a higher rate of readmissions at 30 days in the TaTME group (19.0 versus 0 per cent; P = 0.006). Specimens from TaTME had greater proximal (14.0 versus 10.0 cm; P = 0.045) and distal (2.50 versus 1.65 cm; P = 0.021) margins. Patients undergoing TaTME had borderline longer DFS (25.9 versus 15.7 months; P = 0.049). Subgroup analysis of patients with (y)pT3-4 tumours showed fewer positive circumferential resection margins with TaTME (0 versus 18.2 per cent; P = 0.019) and improved DFS (25.9 versus 15.7 months; P = 0.017). CONCLUSION: Superior margins were obtained with TaTME, especially in locally advanced tumours, although TaTME was associated with a higher readmission rate compared with RLAR.


Assuntos
Laparoscopia , Neoplasias Retais , Procedimentos Cirúrgicos Robóticos , Cirurgia Endoscópica Transanal , Humanos , Neoplasias Retais/cirurgia , Reto/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
13.
Curr Microbiol ; 78(11): 3901-3912, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34522979

RESUMO

The emerging aquaculture industry is in need of non-antibiotic-based disease control approaches to minimize the risk of antibiotic-resistant bacteria. Bacterial infections mainly caused by Vibrio spp. have caused mass mortalities of fish especially during the larval stages. The objectives of this study were to verify the potential of symbiotic probiont strains, isolated from microalgae (Amphora, Chlorella, and Spirulina) for suppressing the growth of Vibrio spp. and at the same time ascertain their abilities to enhance microalgal biomass by mutualistic interactions through microalgae-bacteria symbiosis. In addition, in vivo studies on Artemia bioencapsulated with probiont strains (single strain and mix strains) and microalgae were evaluated. The selected potential probionts were identified as Lysinibacillus fusiformis strain A-1 (LFA-1), Bacillus sp. strain A-2 (BA-2), Lysinibacillus fusiformis strain Cl-3 (LFCl-3), and Bacillus pocheonensis strain S-2 (BPS-2) using 16s rRNA. The cell densities of Amphora culture supplemented with BA-2 and Chlorella culture supplemented with LFCl-3 were higher than those of the controls. Artemia bioencapsulated with mix strains (LFA-1 + BA-2 + LFCl-3 + BPS-2) and Amphora demonstrated the highest survival rate compared to the controls, after being challenged with V. harveyi (60 ± 4%) and V. parahaemolyticus (78 ± 2%). Our study postulated that BA-2 and LFCl-3 were found to be good promoting bacteria for microalgal growth and microalgae serve as a vector to transport probiotic into Artemia. Moreover, mixture of potential probionts is beneficial for Artemia supplementation in conferring protection to Artemia nauplii against pathogenic Vibrios.


Assuntos
Chlorella , Vibrio , Animais , Artemia , Bacillaceae , Bacillus , RNA Ribossômico 16S , Simbiose , Vibrio/genética
15.
Radiography (Lond) ; 27(3): 927-934, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33775519

RESUMO

INTRODUCTION: Continuing Professional development (CPD) is deemed essential for the Radiographers (DR) and Radiation Therapists (RT) after Singapore commenced state registration. Diagnostic imaging and radiotherapy treatment services are constantly revolutionizing and those working in this field requires sufficient knowledge of the uptrends for training and development. The purpose of this survey is to identify the current training needs of the registered DR and RT in Singapore, and to understand their views about CPD activities. METHODS: An online questionnaire was disseminated by the Singapore Society of Radiographers (SSR) to all registered DR and RT in Singapore, and all practicing in restructured and private hospitals were included. Data collection took place from January 2018 to April 2018. RESULTS: 102 responses were analysed, where 89 were DR and 13 were RT. CPD was provided in 72.5% (n = 74) of the participants' institutions, and 69.6% (n = 71) of participants were aware of CPD. Interestingly, participants were significantly more likely to be unaware of CPD when working in an institution which do not offer CPD. Training programme objective was the most important factor for selecting a programme. 93.1% (n = 95) preferred SSR to support them for CPD. There were a few constraints to CPD engagements identified such as financial factors, lack of time, and institution availability. CONCLUSION: There was significant intrinsic motivation in a quality CPD activity. CPD activities should be current, accessible and relevant for the healthcare professionals to increase participation, which directly contributes to high standards of clinical care. IMPLICATIONS FOR PRACTICE: Local healthcare institutions should be aware and address needs, gaps and aspirations of the local DR and RT community to ensure adequate preparation has been made upon initiation of mandatory CPD.


Assuntos
Pessoal Técnico de Saúde , Pessoal de Saúde , Humanos , Motivação , Singapura , Inquéritos e Questionários
16.
Br J Surg ; 108(1): 40-48, 2021 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-33640932

RESUMO

BACKGROUND: Previous studies have suggested improved efficiency and patient outcomes with 125I seed compared with hookwire localization (HWL) in breast-conserving surgery, but high-level evidence of superior surgical outcomes is lacking. The aim of this multicentre pragmatic RCT was to compare re-excision and positive margin rates after localization using 125I seed or hookwire in women with non-palpable breast cancer. METHODS: Between September 2013 and March 2018, women with non-palpable breast cancer eligible for breast-conserving surgery were assigned randomly to preoperative localization using 125I seeds or hookwires. Randomization was stratified by lesion type (pure ductal carcinoma in situ (DCIS) or other) and study site. Primary endpoints were rates of re-excision and margin positivity. Secondary endpoints were resection volumes and weights. RESULTS: A total of 690 women were randomized at eight sites; 659 women remained after withdrawal (125I seed, 327; HWL, 332). Mean age was 60.3 years in the 125I seed group and 60.7 years in the HWL group, with no difference between the groups in preoperative lesion size (mean 13.2 mm). Lesions were pure DCIS in 25.9 per cent. The most common radiological lesion types were masses (46.9 per cent) and calcifications (28.2 per cent). The localization modality was ultrasonography in 65.5 per cent and mammography in 33.7 per cent. The re-excision rate after 125I seed localization was significantly lower than for HWL (13.9 versus 18.9 per cent respectively; P = 0.019). There were no significant differences in positive margin rates, or in specimen weights and volumes. CONCLUSION: Re-excision rates after breast-conserving surgery were significantly lower after 125I seed localization compared with HWL. Registration number: ACTRN12613000655741 (http://www.ANZCTR.org.au/).


Assuntos
Neoplasias da Mama/cirurgia , Radioisótopos do Iodo , Margens de Excisão , Mastectomia Segmentar/métodos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/diagnóstico , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Intraductal não Infiltrante/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Cirurgia Assistida por Computador/métodos , Resultado do Tratamento
17.
Epidemiol Infect ; 149: e18, 2021 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-33427152

RESUMO

It is important to understand the temporal trend of the paediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load to estimate the transmission potential of children in schools and communities. We determined the differences in SARS-CoV-2 viral load dynamics between nasopharyngeal samples of infected asymptomatic and symptomatic children. Serial cycle threshold values of SARS-CoV-2 from the nasopharynx of a cohort of infected children were collected for analysis. Among 17 infected children, 10 (58.8%) were symptomatic. Symptomatic children, when compared to asymptomatic children, had higher viral loads (mean cycle threshold on day 7 of illness 28.6 vs. 36.7, P = 0.02). Peak SARS-CoV-2 viral loads occurred around day 2 of illness in infected children. Although we were unable to directly demonstrate infectivity, the detection of significant amount of virus in the upper airway of asymptomatic children suggest that they have the potential to shed and transmit SARS-CoV-2. Our study highlights the importance of contact tracing and screening for SARS-CoV-2 in children with epidemiological risk factors regardless of their symptom status, in order to improve containment of the virus in the community, including educational settings.


Assuntos
Nasofaringe/virologia , RNA Viral/análise , SARS-CoV-2/isolamento & purificação , Carga Viral , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase , SARS-CoV-2/genética
18.
Tech Coloproctol ; 25(3): 267-278, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33386511

RESUMO

BACKGROUND: Diabetes mellitus has been commonly associated with poor surgical outcomes. The aim of this meta-analysis was to assess the impact of diabetes on postoperative complications following colorectal surgery. METHODS: Medline, Embase and China National Knowledge Infrastructure electronic databases were reviewed from inception until May 9th 2020. Meta-analysis of proportions and comparative meta-analysis were conducted. Studies that involved patients with diabetes mellitus having colorectal surgery, with the inclusion of patients without a history of diabetes as a control, were selected. The outcomes measured were postoperative complications. RESULTS: Fifty-five studies with a total of 666,886 patients comprising 93,173 patients with diabetes and 573,713 patients without diabetes were included. Anastomotic leak (OR 2.407; 95% CI 1.837-3.155; p < 0.001), surgical site infections (OR 1.979; 95% CI 1.636-2.394; p < 0.001), urinary complications (OR 1.687; 95% CI 1.210-2.353; p = 0.002), and hospital readmissions (OR 1.406; 95% CI 1.349-1.466; p < 0.001) were found to be significantly higher amongst patients with diabetes following colorectal surgery. The incidence of septicemia, intra-abdominal infections, mechanical failure of wound healing comprising wound dehiscence and disruption, pulmonary complications, reoperation, and 30-day mortality were not significantly increased. CONCLUSIONS: This meta-analysis and systematic review found a higher incidence of postoperative complications including anastomotic leaks and a higher re-admission rate. Risk profiling for diabetes prior to surgery and perioperative optimization for patients with diabetes is critical to improve surgical outcomes.


Assuntos
Cirurgia Colorretal , Diabetes Mellitus , Procedimentos Cirúrgicos do Sistema Digestório , Fístula Anastomótica/epidemiologia , Fístula Anastomótica/etiologia , Diabetes Mellitus/epidemiologia , Humanos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia
19.
Sci Rep ; 11(1): 2618, 2021 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-33514807

RESUMO

No studies have investigated the influence of ethnicity in a multi-ethnic middle-income country with a long-standing history of co-habitation. Stool samples from 214 Malaysian community members (46 Malay, 65 Chinese, 49 Indian, and 54 Jakun) were collected. The gut microbiota of the participants was investigated using 16S amplicon sequencing. Ethnicity exhibited the largest effect size across participants (PERMANOVA Pseudo-F = 4.24, R2 = 0.06, p = 0.001). Notably, the influence of ethnicity on the gut microbiota was retained even after controlling for all demographic, dietary factors and other covariates which were significantly associated with the gut microbiome (PERMANOVA Pseudo-F = 1.67, R2 = 0.02, p = 0.002). Our result suggested that lifestyle, dietary, and uncharacterized differences collectively drive the gut microbiota variation across ethnicity, making ethnicity a reliable proxy for both identified and unidentified lifestyle and dietary variation across ethnic groups from the same community.


Assuntos
Bactérias , Fezes/microbiologia , Microbioma Gastrointestinal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/classificação , Bactérias/isolamento & purificação , Criança , Estudos Transversais , Dieta , Etnicidade , Feminino , Humanos , Estilo de Vida , Malásia/etnologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
J Forensic Sci ; 66(3): 947-959, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33290606

RESUMO

Under normal circumstances, insects such as blow flies will oviposit and larvae will colonize a carcass as soon as possible. However, insect colonization on a carcass may be delayed due to the effects of wrapping, shallow burial, addition of lime derivatives to mitigate scavenging and odor, or extreme weather. The impacts of delayed insect colonization on carcass decomposition and its subsequent effect on soil chemistry profiles have not been examined to date. The objectives of this study were to determine soil chemistry dynamics associated with porcine carcasses experiencing delayed insect colonization for 7-day or 14-day. Soil chemistry profiles such as ammonium-N (NH4 -N), orthophosphate-P (PO4 -P), and dissolved organic carbon (DOC) were significantly different among treatments: insect inclusion (immediate access of blow fly colonization on porcine carcasses), 7-day insect exclusion and 14-day insect exclusion (blow fly access was delayed up to 7-day and 14-day). Furthermore, significant differences of soil chemical profiles were detected between days of decomposition and soil regions. Soil moisture, NH4 -N, PO4 -P, and DOC were significantly higher when insects were excluded from the porcine carcass suggesting loss of tissue from larval feeding reduced the mass of nutrients entering the soil. This study provides useful information for forensic science in cases where insect colonization is delayed for a period of time postmortem and soil chemistry in the cadaver decomposition island is considered for estimating postmortem interval.


Assuntos
Dípteros , Mudanças Depois da Morte , Solo/química , Compostos de Amônio/análise , Animais , Carbono/análise , Comportamento Alimentar , Entomologia Forense , Fosfatos/análise , Sus scrofa
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