Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 611
Filtrar
2.
Dev Cogn Neurosci ; 66: 101368, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38547783

RESUMO

Parenting behaviors and neighborhood environment influence the development of adolescents' brains and behaviors. Simultaneous trajectories of brain and behavior, however, are understudied, especially in these environmental contexts. In this four-wave study spanning 9-18 years of age (N=224 at baseline, N=138 at final assessment) we used longitudinal k-means clustering to identify clusters of participants with distinct trajectories of uncinate fasciculus (UF) fractional anisotropy (FA) and anxiety symptoms; we examined behavioral outcomes and identified environmental factors that predicted cluster membership. We identified three clusters of participants: 1) high UF FA and low symptoms ("low-risk"); 2) low UF FA and high symptoms ("high-risk"); and 3) low UF FA and low symptoms ("resilient"). Adolescents in disadvantaged neighborhoods were more likely to be in the resilient than high-risk cluster if they also experienced maternal warmth. Thus, neighborhood disadvantage may confer neural risk for psychopathology that can be buffered by maternal warmth, highlighting the importance of considering multiple environmental influences in understanding emotional and neural development in youth.

4.
Eur Rev Med Pharmacol Sci ; 27(16): 7720-7727, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37667950

RESUMO

OBJECTIVE: This study aimed to determine the rate of salvage chemotherapy and review associated factors in invasive mole patients treated by primary or delayed hysterectomy. PATIENTS AND METHODS: This study was carried out at the Tu Du Hospital, where a total of 189 patients were diagnosed with invasive mole based on histologic examination by hysterectomy between 01/2016 to 12/2020. We used the life table method to estimate the cumulative rate. We applied the Cox proportional hazard model to determine the factors associated with the need for salvage chemotherapy. RESULTS: At 12-month follow-up, 47 patients had required salvage chemotherapy. The incidence was 24.87% (95% CI: 18.88-31.66). Applying the multivariate model, prophylactic chemotherapy (HR = 2.75, 95% Cl: 1.20-6.30) and two weeks postoperative hCG value greater than 1,900 mIU/mL (HR = 4.30, 95% Cl: 2.08-8.87) increased the risk of requiring salvage chemotherapy. Postoperative chemotherapy decreased the risk of requiring salvage chemotherapy (HR = 0.43, 95% Cl: 0.22-0.83). CONCLUSIONS: Hysterectomy can be considered safe and effective in treating invasive mole patients. Although patients were treated by hysterectomy, 24.87% of patients needed salvage chemotherapy to achieve remission. This study affirms the malignant nature of invasive mole, a subtype of gestational trophoblastic neoplasia (GTN). It is not purely a local invasion of molar villi. Postoperative chemotherapy plays an essential role in reducing the risk of requiring salvage chemotherapy.


Assuntos
Mola Hidatiforme Invasiva , Neoplasias Uterinas , Feminino , Gravidez , Humanos , Vietnã , Duodeno , Histerectomia , Neoplasias Uterinas/cirurgia
5.
Beilstein J Nanotechnol ; 14: 781-792, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37441001

RESUMO

We present the in situ synthesis of silver nanoparticles (AgNPs) through ionotropic gelation utilizing the biodegradable saccharides lactose (Lac) and alginate (Alg). The lactose reduced silver ions to form AgNPs. The crystallite structure of the nanocomposite AgNPs@Lac/Alg, with a mean size of 4-6 nm, was confirmed by analytical techniques. The nanocomposite exhibited high catalytic performance in degrading the pollutants methyl orange and rhodamine B. The antibacterial activity of the nanocomposite is pH-dependent, related to the alterations in surface properties of the nanocomposite at different pH values. At pH 6, the nanocomposite demonstrated the highest antibacterial activity. These findings suggest that this nanocomposite has the potential to be tailored for specific applications in environmental and medicinal treatments, making it a highly promising material.

6.
Eur Rev Med Pharmacol Sci ; 27(8): 3670-3680, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-37140317

RESUMO

OBJECTIVE: Our study aimed to evaluate the effect of soft tissue regeneration in nude mice using grafts made from the combination of adipocytes from fat tissue mesenchymal stem cells and fibrin gel from peripheral blood. MATERIALS AND METHODS: Mesenchymal stem cells were isolated from adipose tissue and identified according to ISCT criteria. The scaffold used was fibrin obtained from peripheral blood. The grafts in this study were generated by transferring mesenchymal stem cells onto a fibrin scaffold. Two types of grafts, the research sample (fibrin scaffold containing adipocytes differentiated from mesenchymal stem cells) and the control sample (fibrin scaffold only), were grafted under the dorsal skin of the same mouse. After each research period, samples were collected and evaluated by histological methods to observe the existence and growth of cells inside the grafts. RESULTS: The results showed that the study group's graft integrated better within the tissue when compared with the control group. In addition, the grafts in the study group showed the presence of cells with characteristic morphology of adipocytes one week after transplantation. In contrast, control samples showed dimorphous shapes and features mainly composed of non-homogenous fragments. CONCLUSIONS: These initial conclusions might be considered a first step in generating safe bio-compatible engineered grafts specifically usable in post-traumatic tissue regeneration procedures.


Assuntos
Células-Tronco Mesenquimais , Camundongos , Animais , Camundongos Nus , Tecido Adiposo , Fibrina/farmacologia , Modelos Animais
7.
Vaccines (Basel) ; 10(9)2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36146637

RESUMO

Background: Influenza is a respiratory infection that continues to present a major threat to human health, with ~500,000 deaths/year. Continued circulation of epidemic subtypes in humans and animals potentially increases the risk of future pandemics. Vaccination has failed to halt the evolution of this virus and next-generation prophylactic approaches are under development. Naked, "heat inactivated", or inert bacterial spores have been shown to protect against influenza in murine models. Methods: Ferrets were administered intranasal doses of inert bacterial spores (DSM 32444K) every 7 days for 4 weeks. Seven days after the last dose, the animals were challenged with avian H7N9 influenza A virus. Clinical signs of infection and viral shedding were monitored. Results: Clinical symptoms of infection were significantly reduced in animals dosed with DSM 32444K. The temporal kinetics of viral shedding was reduced but not prevented. Conclusion: Taken together, nasal dosing using heat-stable spores could provide a useful approach for influenza prophylaxis in both humans and animals.

8.
J Dent Res ; 101(11): 1289-1298, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35912790

RESUMO

The FaceBase Consortium, funded by the National Institute of Dental and Craniofacial Research of the National Institutes of Health, was established in 2009 with the recognition that dental and craniofacial research are increasingly data-intensive disciplines. Data sharing is critical for the validation and reproducibility of results as well as to enable reuse of data. In service of these goals, data ought to be FAIR: Findable, Accessible, Interoperable, and Reusable. The FaceBase data repository and educational resources exemplify the FAIR principles and support a broad user community including researchers in craniofacial development, molecular genetics, and genomics. FaceBase demonstrates that a model in which researchers "self-curate" their data can be successful and scalable. We present the results of the first 2.5 y of FaceBase's operations as an open community and summarize the data sets published during this period. We then describe a research highlight from work on the identification of regulatory networks and noncoding RNAs involved in cleft lip with/without cleft palate that both used and in turn contributed new findings to publicly available FaceBase resources. Collectively, FaceBase serves as a dynamic and continuously evolving resource to facilitate data-intensive research, enhance data reproducibility, and perform deep phenotyping across multiple species in dental and craniofacial research.


Assuntos
Fissura Palatina , Genômica , Fissura Palatina/genética , Humanos , National Institutes of Health (U.S.) , Publicações , Reprodutibilidade dos Testes , Estados Unidos
9.
J Dent Res ; 101(6): 664-674, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35045740

RESUMO

The increased prevalence of temporomandibular joint osteoarthritis (TMJOA) in children and adolescents has drawn considerable attention as it may interfere with mandibular condyle growth, resulting in dento-maxillofacial deformities. However, treatments for osteoarthritis have been ineffective at restoring the damaged bone and cartilage structures due to poor understanding of the underlying degenerative mechanism. In this study, we demonstrate that Gli1+ cells residing in the subchondral bone contribute to bone formation and homeostasis in the mandibular condyle, identifying them as osteogenic progenitors in vivo. Furthermore, we show that, in a TMJOA mouse model, derivatives of Gli1+ cells undergo excessive expansion along with increased but uneven distribution of osteogenic differentiation in the subchondral bone, which leads to abnormal subchondral bone remodeling via Hedgehog (Hh) signaling activation and to the development of TMJOA. The selective pharmacological inhibition and specific genetic inhibition of Hh signaling in Gli1+ osteogenic progenitors result in improved subchondral bone microstructure, attenuated local immune inflammatory response in the subchondral bone, and reduced degeneration of the articular cartilage, providing in vivo functional evidence that targeting Hh signaling in Gli1+ osteogenic progenitors can modulate bone homeostasis in osteoarthritis and provide a potential approach for treating TMJOA.


Assuntos
Cartilagem Articular , Osteoartrite , Animais , Proteínas Hedgehog , Côndilo Mandibular , Camundongos , Osteogênese , Articulação Temporomandibular , Proteína GLI1 em Dedos de Zinco
10.
Nat Commun ; 13(1): 364, 2022 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-35042881

RESUMO

The near-Earth asteroid (162173) Ryugu, the target of Hayabusa2 space mission, was observed via both orbiter and the lander instruments. The infrared radiometer on the MASCOT lander (MARA) is the only instrument providing spectrally resolved mid-infrared (MIR) data, which is crucial for establishing a link between the asteroid material and meteorites found on Earth. Earlier studies revealed that the single boulder investigated by the lander belongs to the most common type found on Ryugu. Here we show the spectral variation of Ryugu's emissivity using the complete set of in-situ MIR data and compare it to those of various carbonaceous chondritic meteorites, revealing similarities to the most aqueously altered ones, as well as to asteroid (101955) Bennu. The results show that Ryugu experienced strong aqueous alteration prior to any dehydration.

11.
Water Sci Technol ; 84(6): 1379-1388, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34559073

RESUMO

Ozone, UV/ozone, ozone/persulfate (PS) and UV/ozone/PS systems were used to mineralize sulfonamides. Sulfadiazine (SDZ), sulfamerazine (SMR) and sulfamethazine (SMZ) were the target compounds. The novel contribution of this study is its determination of the effects of PS addition, sulfonamide structure, pH and salinity on sulfonamide mineralization in ozone-based systems. The mineralization rate of sulfonamides satisfied pseudo-first-order kinetics. The SMZ mineralization rate constant in ozone, UV/ozone, ozone/PS and UV/ozone/PS systems at pH 5 were 0.0058; 0.0101; 0.0069 and 0.0802 min-1, respectively, and those at pH 7 were 0.0075; 0.0116; 0.0083 and 0.0873 min-1, respectively. The increase in the number of methyl substituents in the heterocyclic group of SMZ and the corresponding increase in the steric hindrance of radical addition, reduced mineralization rates below those of SMR and SDZ. The addition of PS promoted sulfonamide mineralization in the ozone-based systems; conversely, salinity inhibited sulfonamide mineralization.


Assuntos
Ozônio , Poluentes Químicos da Água , Sulfadiazina , Sulfonamidas , Águas Residuárias , Poluentes Químicos da Água/análise
12.
Trop Biomed ; 38(3): 371-376, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34508346

RESUMO

In Vietnam, severe malaria is currently rare but is a life-threatening disease. It may be misdiagnosed with other common diseases. This descriptive study aimed to characterize severe malaria and its clinical aspects, as well as outcomes of infected pediatric patients to improve case management. The case-series study was carried out based on medical records of children aged between one month and 15 years with malaria diagnosed by blood smear or rapid diagnostic test. Chi-squared test with the p values less than 0.05 were considered statistically significant. There were 47 cases enrolled in the study. The prevalence of severe malaria was 29.8% (57.1% in children under five). The morbidity was 71.4% in male and 28.6% in female. Common clinical signs of severe malaria were fever (100%), severe anemia (21.4%), hepatomegaly (85.7%), and splenomegaly (71.4%). Common biological abnormalities in severe malaria were anemia, thrombocytopenia, increased liver enzymes, and high CRP level. The severe malaria was mainly caused by P. falciparum (100%). The age range for those infected with P. falciparum was 6.5 ± 4.5 years (min 0.3; max 14.9). The successful rate of treatment was 92.9% with artesunate. Antimalarial treatment time was 9.0 (6 - 12) days for severe malaria, which was twice as many as that for non-severe malaria (p = 0.067). The current clinical and biological findings of severe malaria are different from those in previous times, which make it easy to be overlooked. Therefore, it's important to perform malaria diagnostic tests when there're clinical suggestions of severe malaria, including fever, hepatomegaly or splenomegaly.


Assuntos
Anemia , Malária Falciparum , Adolescente , Anemia/epidemiologia , Anemia/etiologia , Artesunato , Criança , Criança Hospitalizada , Pré-Escolar , Feminino , Febre/epidemiologia , Febre/etiologia , Hepatomegalia/epidemiologia , Hepatomegalia/etiologia , Humanos , Lactente , Malária Falciparum/diagnóstico , Malária Falciparum/tratamento farmacológico , Malária Falciparum/epidemiologia , Masculino , Esplenomegalia , Vietnã/epidemiologia
13.
Benef Microbes ; 12(3): 283-293, 2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34030609

RESUMO

Escherichia coli Nissle (EcN), a probiotic bacterium protects against several disorders. Multiple reports have studied the pathways involved in cardiac hypertrophy. However, the effects of probiotic EcN against diabetes-induced cardiac hypertrophy remain to be understood. We administered five weeks old Wistar male (271±19.4 g body weight) streptozotocin-induced diabetic rats with 109 cfu of EcN via oral gavage every day for 24 days followed by subjecting the rats to echocardiography to analyse the cardiac parameters. Overexpressed interleukin (IL)-6 induced the MEK5/ERK5, JAK2/STAT3, and MAPK signalling cascades in streptozotocin-induced diabetic rats. Further, the upregulation of calcineurin, NFATc3, and p-GATA4 led to the elevation of hypertrophy markers, such as atrial and B-type natriuretic peptides. In contrast, diabetic rats supplemented with probiotic EcN exhibited significant downregulated IL-6. Moreover, the MEK5/ERK5 and JAK2/STAT3 cascades involved during eccentric hypertrophy and MAPK signalling, including phosphorylated MEK, ERK, JNK, and p-38, were significantly attenuated in diabetic rats after supplementation of EcN. Western blotting and immunofluorescence revealed the significant downregulation of NFATc3 and downstream mediators, thereby resulting in the impairment of cardiac hypertrophy. Taken together, the findings demonstrate that supplementing probiotic EcN has the potential to show cardioprotective effects by inhibiting diabetes-induced cardiomyopathies.


Assuntos
Cardiomegalia/terapia , Diabetes Mellitus Experimental/terapia , Cardiomiopatias Diabéticas/terapia , Escherichia coli/fisiologia , Interleucina-6/antagonistas & inibidores , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Probióticos/uso terapêutico , Animais , Calcineurina/metabolismo , Cardiomegalia/metabolismo , Cardiomegalia/fisiopatologia , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/fisiopatologia , Cardiomiopatias Diabéticas/metabolismo , Cardiomiopatias Diabéticas/fisiopatologia , Ventrículos do Coração/efeitos dos fármacos , Ventrículos do Coração/metabolismo , Ventrículos do Coração/fisiopatologia , Interleucina-6/metabolismo , Janus Quinase 2/metabolismo , MAP Quinase Quinase 5/metabolismo , Masculino , Proteína Quinase 7 Ativada por Mitógeno/metabolismo , Ratos , Ratos Wistar , Fator de Transcrição STAT3/metabolismo , Estreptozocina
14.
Carbohydr Polym ; 251: 116998, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33142567

RESUMO

This work presents a simply new method for in situ synthesis of gold nanoparticles (AuNPs) using the biodegradable polysaccharides. A novel composite of lactose/alginate (Lac/Alg) could be prepared easily through ionotropic gelation mechanism which can reduce in situ gold ions into AuNPs. Lactose plays a crucial role as a reducing reagent which are demonstrated by FTIR analysis. The crystalline structure of AuNPs with a mean size of 10 nm has been confirmed by analysis techniques. The nanocomposite powder possesses highly catalytic performance for degradation of contaminants including 4-nitrophenol, methyl orange, rhodamine 6 G and rhodamine B. The dispersion solution of AuNPs@Lac/Alg was used as an effective probe for highly selective detection of Fe3+ ions. The detection mechanism replies on the aggregation of nanocomposite in the presence of Fe3+ ions. LOD value was found to be 0.8 µM in a linear range of 2.0-80.0 µM.


Assuntos
Alginatos/química , Compostos Férricos/análise , Lactose/química , Nanopartículas Metálicas/química , Nanocompostos/química , Biodegradação Ambiental , Catálise , Colorimetria/métodos , Corantes/isolamento & purificação , Ouro/química , Limite de Detecção , Nanopartículas Metálicas/ultraestrutura , Microscopia Eletrônica , Nanocompostos/ultraestrutura , Tamanho da Partícula , Espectroscopia de Infravermelho com Transformada de Fourier , Propriedades de Superfície , Poluentes Químicos da Água/isolamento & purificação
15.
Tropical Biomedicine ; : 371-376, 2021.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-906540

RESUMO

@#In Vietnam, severe malaria is currently rare but is a life-threatening disease. It may be misdiagnosed with other common diseases. This descriptive study aimed to characterize severe malaria and its clinical aspects, as well as outcomes of infected pediatric patients to improve case management. The case-series study was carried out based on medical records of children aged between one month and 15 years with malaria diagnosed by blood smear or rapid diagnostic test. Chi-squared test with the p values less than 0.05 were considered statistically significant. There were 47 cases enrolled in the study. The prevalence of severe malaria was 29.8% (57.1% in children under five). The morbidity was 71.4% in male and 28.6% in female. Common clinical signs of severe malaria were fever (100%), severe anemia (21.4%), hepatomegaly (85.7%), and splenomegaly (71.4%). Common biological abnormalities in severe malaria were anemia, thrombocytopenia, increased liver enzymes, and high CRP level. The severe malaria was mainly caused by P. falciparum (100%). The age range for those infected with P. falciparum was 6.5 ± 4.5 years (min 0.3; max 14.9). The successful rate of treatment was 92.9% with artesunate. Antimalarial treatment time was 9.0 (6 – 12) days for severe malaria, which was twice as many as that for non-severe malaria (p = 0.067). The current clinical and biological findings of severe malaria are different from those in previous times, which make it easy to be overlooked. Therefore, it’s important to perform malaria diagnostic tests when there’re clinical suggestions of severe malaria, including fever, hepatomegaly or splenomegaly.

16.
J Investig Allergol Clin Immunol ; 30(5): 307-316, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32573459

RESUMO

Anti-interleukin 5 (IL-5) and anti-IL-5 receptor α monoclonal antibodies markedly decrease airway and peripheral blood eosinophil numbers and are thus highly effective in reducing asthma exacerbations. Nonetheless, these biologics do not completely resolve exacerbations. There is very little information on the cellular nature of exacerbations during treatment with biologics. Using illustrative clinical case scenarios, we highlight the importance of carefully characterizing asthmatics at the time of exacerbation and recognizing neutrophilic causes of exacerbations to ensure optimal management. While an eosinophilic exacerbation may improve with more corticosteroids or by switching to another anti-IL-5 monoclonal antibody, a noneosinophilic exacerbation will likely not. An infective exacerbation needs to be recognized, and the pathogen must be identified and treated with the appropriate antimicrobial agent.


Assuntos
Antiasmáticos/efeitos adversos , Anticorpos Monoclonais/efeitos adversos , Asma/diagnóstico , Asma/tratamento farmacológico , Interleucina-5/antagonistas & inibidores , Receptores de Interleucina-5/antagonistas & inibidores , Idoso , Idoso de 80 Anos ou mais , Animais , Antiasmáticos/administração & dosagem , Antiasmáticos/uso terapêutico , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Asma/complicações , Gerenciamento Clínico , Progressão da Doença , Eosinófilos/efeitos dos fármacos , Eosinófilos/imunologia , Eosinófilos/metabolismo , Feminino , Humanos , Interleucina-5/metabolismo , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Receptores de Interleucina-5/metabolismo , Testes de Função Respiratória , Escarro/imunologia , Escarro/metabolismo , Escarro/microbiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
17.
J Vet Med Educ ; 47(s1): 83-91, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32530797

RESUMO

A World Organisation for Animal Health (OIE) Veterinary Education Twinning Project was established between the veterinary schools at Nong Lam University (NLU) in Ho Chi Minh City, Vietnam, and the University of Queensland, Gatton, Australia, as part of the scheme established to promote high-quality veterinary services through improved veterinary education. Included in the partnership's primary aims were building the capacity of veterinary teaching staff with respect to general teaching practice and also in response to identified deficiency areas, and to develop outcome assessment processes. One challenge facing the project was the different approaches and experiences of teaching and learning for the faculty and students between the two widely different historical and cultural contexts of Australia and Vietnam. The project enhanced the pedagogy capability in NLU faculty and introduced student-focused approaches to teaching. The NLU staff involved in the project strongly embraced a student-centered approach to learning and case-based teaching in particular, adopting these strategies in their own teaching. An analysis of students' approach to learning demonstrates that the majority preferred a deep approach to learning and that these students valued case studies, problem-solving exercises, and working in small groups during teaching sessions more than students who took a surface approach to learning. An improved recognition of the ways the Vietnamese students approach their learning in their home country will guide future teaching design, as well as give insight into the approaches to teaching for Southeast Asian students within the Australian veterinary science programs.


Assuntos
Educação em Veterinária , Condicionamento Físico Animal , Animais , Austrália , Faculdades de Medicina Veterinária , Ensino , Vietnã
19.
Gynecol Oncol Rep ; 32: 100538, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32090165

RESUMO

Introduction Dedifferentiated endometrioid adenocarcinoma (DEAC) was first described in 2007. However, it has only been recognised as a distinct subtype of endometrioid adenocarcinoma in the last 1-2 years. DEAC is a more aggressive histological subtype and carries a poorer prognosis. Patients with DEAC tend to present with advanced disease compared the other endometrioid adenocarcinomas. Methodology The study is a retrospective review of patients with DEAC diagnosed in two institutions in Singapore between January 2012 and October 2017. Results 7 patients were diagnosed with DEAC. The mean age was 56.4 years. All patients presented with either abnormal uterine bleeding or post menopausal bleeding. Out of the 7 patients, one was diagnosed with Stage 2 disease, 5 were diagnosed with Stage 3 disease and 1 was diagnosed with Stage 4 disease. One patient had neoadjuvant chemotherapy, followed by surgery, and completion chemotherapy post surgery. The other 6 patients (87.5%) underwent primary debulking surgery. Out of these 6 patients, 5 patients had adjuvant chemotherapy post surgery and one patient had both adjuvant chemotherapy and radiotherapy. Lymphovascular invasion was found in 71.4% of the cases. Conclusion DEAC is a more aggressive histological subtype of endometrioid adenocarcinomas. Better awareness of this condition can lead to proper diagnosis and treatment.

20.
Hernia ; 24(4): 771-780, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31781964

RESUMO

PURPOSE: In the past we have developed and validated the hernia-specific quality of life assessment instrument, HERQL, for groin hernias. In current study we evaluated the conceptual structure and validated HERQL for abdominal wall hernias. METHODS: Subjective quality-of-life perceptions from abdominal wall hernia patients were assessed. Clinical responsiveness was evaluated comparing treatment naïve with follow-up hernia patients. Measurement invariance between groin and abdominal wall hernias was approached with structural equation modeling (SEM). Subgroup comparisons were conducted between primary ventral and incisional hernias, as well as the presence of co-morbidity, hernia incarceration, surgical complications, and recurrent abdominal wall hernias. RESULTS: A total of 775 HERQL assessments, including 167 from abdominal wall hernias, were successfully performed. Cronbach's alpha coefficients for the summative pain, worse symptoms for treatment-naïve patients, and improving summative pain scores across the pre-operative, immediately post-operative, and post-operative 3-month assessments indicating clinical responsiveness were observed and comparable between groin and abdominal wall hernias. Configural invariance was evidenced by that the same model held true for both types of hernias with multi-group SEM, while mean structure exploration showed that abdominal wall hernia patients reported less latent summative pain (- 0.535, p < 0.0001) but worse latent quality-of-life score (0.207, p < 0.0001). Patients with peri-operative complications suffered from worse pain during mild activities (2.7 versus 1.5, p = 0.01), and patients with recurrent hernias reported compromised global health/quality of life (2 versus 1.6, p = 0.001). CONCLUSIONS: The study successfully validated and extended the clinical applicability of HERQL across distinct types of hernias. Measurement invariance was ascertained and the same HERQL construct could be administered for both abdominal wall and groin hernias in Taiwan.


Assuntos
Parede Abdominal/cirurgia , Herniorrafia , Qualidade de Vida , Adulto , Feminino , Virilha/cirurgia , Hérnia Inguinal/cirurgia , Hérnia Ventral/cirurgia , Humanos , Hérnia Incisional/cirurgia , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Período Pós-Operatório , Taiwan
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA