Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 202
Filtrar
1.
Heliyon ; 10(9): e26674, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38707392

RESUMO

Little is known about the simultaneous effects of non-pharmacological interventions (NPI) on healthy older adults' behavior and brain plasticity, as measured by psychometric instruments and magnetic resonance imaging (MRI). The purpose of this scoping review was to compile an extensive list of randomized controlled trials published from January 1, 2000, to August 31, 2023, of NPI for mitigating and countervailing age-related physical and cognitive decline and associated cerebral degeneration in healthy elderly populations with a mean age of 55 and over. After inventorying the NPI that met our criteria, we divided them into six classes: single-domain cognitive, multi-domain cognitive, physical aerobic, physical non-aerobic, combined cognitive and physical aerobic, and combined cognitive and physical non-aerobic. The ultimate purpose of these NPI was to enhance individual autonomy and well-being by bolstering functional capacity that might transfer to activities of daily living. The insights from this study can be a starting point for new research and inform social, public health, and economic policies. The PRISMA extension for scoping reviews (PRISMA-ScR) checklist served as the framework for this scoping review, which includes 70 studies. Results indicate that medium- and long-term interventions combining non-aerobic physical exercise and multi-domain cognitive interventions best stimulate neuroplasticity and protect against age-related decline and that outcomes may transfer to activities of daily living.

2.
Braz. j. biol ; 81(3): 650-656, July-Sept. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1153376

RESUMO

Abstract Light is considered a factor that influences the seed germination of many weed species, and it can signal whether the environmental conditions are favorable or are not favorable for germination. We aimed to study if there is an influence of light quality and dormancy overcoming in seed germination of Echium plantagineum L. We carried out a 2 x 6 factorial experiment, with and without dormancy overcoming with potassium nitrate followed by immersion in gibberellic acid; six light qualities, obtained through the light filters: blue, green, red, far-red, white light and absence of light. The evaluations performed were germination speed index (GSI), average germination time (AGT), germination at the four and 14 days after seeding (DAS), accumulated germination and relative frequency of germination. We observed significant interaction among the light qualities and seed dormancy overcoming or not for the studied variables. There was no significant effect of light qualities, in the evaluated variables, when performing dormancy overcoming, presenting germination above 90% in all the light qualities. However, without dormancy overcoming, we observed greater GSI, germination at four and 14 DAS for the red light filter with 5, 4, 29 and 45%, respectively. When the seeds were submitted to the absence of light, and without dormancy overcoming, there was only 7% of germination at 14 DAS. The seeds of E. plantagineum presented greater germination under incidence of red light, without dormancy overcoming, being classified as preferably positively photoblastics, provided that the dormancy is not overcome.


Resumo A luz é considerada um fator que influencia a germinação das sementes de muitas espécies de plantas daninhas, podendo sinalizar se as condições ambientais são favoráveis ou não para a germinação. Objetivou-se estudar se há influência da qualidade da luz e superação de dormência na germinação de sementes de Echium plantagineum L. Realizou-se um experimento fatorial 2 x 6, com e sem superação de dormência com nitrato de potássio seguido pela imersão em ácido giberélico; seis qualidades de luz, obtidas através de filtros de luz: azul, verde, vermelho, vermelho-distante, luz branca e ausência de luz. As avaliações realizadas foram índice de velocidade de germinação (IVG), tempo médio de germinação (TMG), germinação aos quatro e 14 dias após a semeadura (DAS), germinação acumulada e frequência relativa de germinação. Observou-se interação significativa entre as qualidades de luz e a superação ou não de dormência das sementes para as variáveis estudadas. Não houve efeito significativo das qualidades de luz, nas variáveis avaliadas, ao realizar superação de dormência, apresentando germinação acima de 90% em todas as qualidades de luz. Todavia, sem superação de dormência, observou-se maior IVG, germinação aos quatro e 14 DAS para o filtro de luz vermelha com 5,4, 29 e 45%, respectivamente. Quando as sementes foram submetidas à ausência de luz, e sem superação de dormência, houve apenas 7% de germinação aos 14 DAS. As sementes de E. plantagineum apresentam maior germinação sob incidência de luz vermelha, sem superação de dormência, sendo classificadas como fotoblásticas positivas preferenciais, desde que não seja superada a dormência.


Assuntos
Boraginaceae , Echium , Sementes , Germinação , Dormência de Plantas
3.
Braz J Biol ; 81(3): 650-656, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32876169

RESUMO

Light is considered a factor that influences the seed germination of many weed species, and it can signal whether the environmental conditions are favorable or are not favorable for germination. We aimed to study if there is an influence of light quality and dormancy overcoming in seed germination of Echium plantagineum L. We carried out a 2 x 6 factorial experiment, with and without dormancy overcoming with potassium nitrate followed by immersion in gibberellic acid; six light qualities, obtained through the light filters: blue, green, red, far-red, white light and absence of light. The evaluations performed were germination speed index (GSI), average germination time (AGT), germination at the four and 14 days after seeding (DAS), accumulated germination and relative frequency of germination. We observed significant interaction among the light qualities and seed dormancy overcoming or not for the studied variables. There was no significant effect of light qualities, in the evaluated variables, when performing dormancy overcoming, presenting germination above 90% in all the light qualities. However, without dormancy overcoming, we observed greater GSI, germination at four and 14 DAS for the red light filter with 5, 4, 29 and 45%, respectively. When the seeds were submitted to the absence of light, and without dormancy overcoming, there was only 7% of germination at 14 DAS. The seeds of E. plantagineum presented greater germination under incidence of red light, without dormancy overcoming, being classified as preferably positively photoblastics, provided that the dormancy is not overcome.


Assuntos
Boraginaceae , Echium , Germinação , Dormência de Plantas , Sementes
4.
Unfallchirurg ; 122(9): 736-743, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31115603

RESUMO

Transposition of the proximal radioulnar joint, so-called convergent elbow dislocation, is an extremely rare injury whereby the proximal radius crosses over the proximal ulnar and converges medially. This injury can occur in isolation or even less frequently in association with a posterior humeroulnar dislocation. Open reduction is almost always necessary. The diagnosis is frequently delayed as the injury is easily overlooked. In the literature, 13 cases in children and 2 in adults have so far been described. This is the first report of a combined elbow dislocation (posterior and convergent) with an initially diagnosed and definitively treated comminuted radial head fracture in adults.


Assuntos
Articulação do Cotovelo , Fraturas Cominutivas , Luxações Articulares , Fraturas do Rádio , Adulto , Criança , Cotovelo , Humanos
5.
HNO ; 67(4): 274-281, 2019 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-30725125

RESUMO

BACKGROUND: Dysosmia is one of the most common disorders in otorhinolaryngology. However, epidemiological data are lacking and treatment strategies are insufficiently standardized. OBJECTIVE: The aim of this study was to evaluate the frequency of causes of olfactory disorders and the different therapeutic approaches used in ENT departments in German-speaking countries. The results were also compared to findings of the survey in 2000. Furthermore, a systematic review of treatment strategies was conducted. MATERIALS AND METHODS: In 2010, a two-page survey addressing olfactory dysfunction was sent to all ENT departments in German-speaking countries. The literature review included sources such as PubMed, the Cochrane Library, and relevant guidelines. RESULTS: The diagnosis of dysosmia was made less frequently in ENT departments (decrease of 52%). The three most widely used therapeutic approaches were corticosteroids (topical and systemic) and systemic antibiotics. There is evidence in the literature showing a small to medium effect of topical steroids in sinonasal smell disorders. CONCLUSION: Since a 50% decrease in the prevalence of olfactory disturbances is unlikely, the lower patient numbers may relate to a more critical diagnosis. The use of olfactory training in clinics has increased significantly (from <6% to up to 23%). The use of topical steroids for sinonasal dysosmia is evidence based. Smell training is a safe and effective treatment strategy, especially in post-infectious and post-traumatic olfactory disorders.


Assuntos
Transtornos do Olfato/diagnóstico , Transtornos do Olfato/terapia , Olfato , Humanos , Esteroides/uso terapêutico , Resultado do Tratamento
6.
J Helminthol ; 93(6): 775-777, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30205852

RESUMO

Many molluscs may be infected with angiostrongylid larvae. Following the histopathological diagnosis of abdominal angiostrongyliasis in a grape farmer from southern Brazil, molluscs in the area were investigated. During a nocturnal search, 245 specimens of slugs were collected and identified as the invasive Chinese slug Meghimatium pictum. Angiostrongylus costaricensis worms were recovered from mice that were experimentally infected with larvae obtained from 11 (4.5%) of the molluscs. This study presents the first report of M. pictum being identified as an intermediate host for A. costaricensis. Most of the slugs were collected from grape plants, which suggests that transmission may be associated with grape consumption.


Assuntos
Angiostrongylus/isolamento & purificação , Gastrópodes/parasitologia , Infecções por Strongylida/parasitologia , Vitis/parasitologia , Angiostrongylus/classificação , Angiostrongylus/genética , Animais , Brasil , Gastrópodes/classificação , Humanos , Espécies Introduzidas , Camundongos , Infecções por Strongylida/transmissão
7.
Clin Exp Immunol ; 191(1): 74-83, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28940439

RESUMO

ATP binding cassette subfamily B member 5 (ABCB5) has been identified as a tumour-initiating cell marker and is expressed in various malignancies, including melanoma. Moreover, treatment with anti-ABCB5 monoclonal antibodies has been shown to inhibit tumour growth in xenotransplantation models. Therefore, ABCB5 represents a potential target for cancer immunotherapy. However, cellular immune responses against ABCB5 in humans have not been described so far. Here, we investigated whether ABCB5-reactive T cells are present in human melanoma patients and tested the applicability of ABCB5-derived peptides for experimental induction of human T cell responses. Peripheral blood mononuclear cells (PBMNC) isolated from blood samples of melanoma patients (n = 40) were stimulated with ABCB5 peptides, followed by intracellular cytokine staining (ICS) for interferon (IFN)-γ and tumour necrosis factor (TNF)-α. To evaluate immunogenicity of ABCB5 peptides in naive healthy donors, CD8 T cells were co-cultured with ABCB5 antigen-loaded autologous dendritic cells (DC). ABCB5 reactivity in expanded T cells was assessed similarly by ICS. ABCB5-reactive CD8+ T cells were detected ex vivo in 19 of 29 patients, melanoma antigen recognised by T cells (MART-1)-reactive CD8+ T cells in six of 21 patients. In this small, heterogeneous cohort, reactivity against ABCB5 was significantly higher than against MART-1. It occurred significantly more often and independently of clinical characteristics. Reactivity against ABCB5 could be induced in 14 of 16 healthy donors in vitro by repeated stimulation with peptide-loaded autologous DC. As ABCB5-reactive CD8 T cells can be found in the peripheral blood of melanoma patients and an ABCB5-specific response can be induced in vitro in naive donors, ABCB5 could be a new target for immunotherapies in melanoma.


Assuntos
Membro 1 da Subfamília B de Cassetes de Ligação de ATP/imunologia , Antígenos de Neoplasias/imunologia , Linfócitos T CD8-Positivos/imunologia , Melanoma/imunologia , Subfamília B de Transportador de Cassetes de Ligação de ATP , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/química , Sequência de Aminoácidos , Linfócitos T CD8-Positivos/metabolismo , Citocinas/metabolismo , Citotoxicidade Imunológica , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Epitopos de Linfócito T/química , Epitopos de Linfócito T/imunologia , Feminino , Humanos , Imunoterapia , Ativação Linfocitária , Masculino , Melanoma/diagnóstico , Melanoma/metabolismo , Melanoma/terapia , Estadiamento de Neoplasias , Peptídeos/química , Peptídeos/imunologia
8.
Artigo em Inglês | LILACS-Express | LILACS, VETINDEX | ID: biblio-1467456

RESUMO

Abstract Light is considered a factor that influences the seed germination of many weed species, and it can signal whether the environmental conditions are favorable or are not favorable for germination. We aimed to study if there is an influence of light quality and dormancy overcoming in seed germination of Echium plantagineum L. We carried out a 2 x 6 factorial experiment, with and without dormancy overcoming with potassium nitrate followed by immersion in gibberellic acid; six light qualities, obtained through the light filters: blue, green, red, far-red, white light and absence of light. The evaluations performed were germination speed index (GSI), average germination time (AGT), germination at the four and 14 days after seeding (DAS), accumulated germination and relative frequency of germination. We observed significant interaction among the light qualities and seed dormancy overcoming or not for the studied variables. There was no significant effect of light qualities, in the evaluated variables, when performing dormancy overcoming, presenting germination above 90% in all the light qualities. However, without dormancy overcoming, we observed greater GSI, germination at four and 14 DAS for the red light filter with 5, 4, 29 and 45%, respectively. When the seeds were submitted to the absence of light, and without dormancy overcoming, there was only 7% of germination at 14 DAS. The seeds of E. plantagineum presented greater germination under incidence of red light, without dormancy overcoming, being classified as preferably positively photoblastics, provided that the dormancy is not overcome.


Resumo A luz é considerada um fator que influencia a germinação das sementes de muitas espécies de plantas daninhas, podendo sinalizar se as condições ambientais são favoráveis ou não para a germinação. Objetivou-se estudar se há influência da qualidade da luz e superação de dormência na germinação de sementes de Echium plantagineum L. Realizou-se um experimento fatorial 2 x 6, com e sem superação de dormência com nitrato de potássio seguido pela imersão em ácido giberélico; seis qualidades de luz, obtidas através de filtros de luz: azul, verde, vermelho, vermelho-distante, luz branca e ausência de luz. As avaliações realizadas foram índice de velocidade de germinação (IVG), tempo médio de germinação (TMG), germinação aos quatro e 14 dias após a semeadura (DAS), germinação acumulada e frequência relativa de germinação. Observou-se interação significativa entre as qualidades de luz e a superação ou não de dormência das sementes para as variáveis estudadas. Não houve efeito significativo das qualidades de luz, nas variáveis avaliadas, ao realizar superação de dormência, apresentando germinação acima de 90% em todas as qualidades de luz. Todavia, sem superação de dormência, observou-se maior IVG, germinação aos quatro e 14 DAS para o filtro de luz vermelha com 5,4, 29 e 45%, respectivamente. Quando as sementes foram submetidas à ausência de luz, e sem superação de dormência, houve apenas 7% de germinação aos 14 DAS. As sementes de E. plantagineum apresentam maior germinação sob incidência de luz vermelha, sem superação de dormência, sendo classificadas como fotoblásticas positivas preferenciais, desde que não seja superada a dormência.

9.
J Ind Microbiol Biotechnol ; 43(12): 1641-1646, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27771781

RESUMO

A novel whole cell cascade for double oxidation of cyclooctane to cyclooctanone was developed. The one-pot oxidation cascade requires only a minimum of reaction components: resting E. coli cells in aqueous buffered medium (=catalyst), the target substrate and oxygen as environmental friendly oxidant. Conversion of cyclooctane was catalysed with high efficiency (50% yield) and excellent selectivity (>94%) to cyclooctanone. The reported oxidation cascade represents a novel whole cell system for double oxidation of non-activated alkanes including an integrated cofactor regeneration. Notably, two alcohol dehydrogenases from Lactobacillus brevis and from Rhodococcus erythropolis with opposite cofactor selectivities and one monooxygenase P450 BM3 were produced in a coexpression system in one single host. The system represents the most efficient route with a TTN of up to 24363 being a promising process in terms of sustainability as well.


Assuntos
Álcool Desidrogenase/química , Proteínas de Bactérias/química , Ciclo-Octanos/química , Oxigenases de Função Mista/química , Álcool Desidrogenase/biossíntese , Proteínas de Bactérias/metabolismo , Biocatálise , Reatores Biológicos , Evolução Molecular Direcionada , Escherichia coli/genética , Escherichia coli/metabolismo , Levilactobacillus brevis/enzimologia , Oxigenases de Função Mista/biossíntese , Oxirredução , Rhodococcus/enzimologia
10.
Arq. bras. med. vet. zootec ; 67(3): 689-697, May-Jun/2015. tab
Artigo em Português | LILACS | ID: lil-753918

RESUMO

O objetivo do presente estudo foi verificar a influência da contaminação ambiental na microbiota dos animais utilizados em experimentação, usando-se videocâmera como ferramenta de controle, a partir da comparação de dois biotérios de experimentação, sendo um protegido com presença de videocâmeras (A) e o outro não (B), quanto ao padrão microbiológico dos camundongos. Para os testes bacteriológicos, foram utilizadas amostras de 222 animais do biotério A e 236 do biotério B; para os testes virológicos, 119 do biotério A e 236 do biotério B; já para os exames parasitológicos, 158 do biotério A e 316 do biotério B. Os dados foram submetidos à análise descritiva e ao teste do Qui-quadrado. Verificou-se uma maior ocorrência de microrganismos e de parasitas no biotério não protegido pelas videocâmeras. Klebsiella pneumoniae, Pasteurella sp. e Pseudomonas sp. foram encontradas nos animais de ambos os biotérios, ao passo que vírus e parasitos só foram detectados nos animais no biotério não protegido. Dentre os vírus, nos animais infectados, o de maior ocorrência foi o Vírus da Hepatite de Camundongos (MHV) e, dentre os parasitos, o de maior ocorrência foi Syphacia sp. Concluiu-se que o biotério protegido foi capaz de garantir padrões microbiológicos mais adequados para a experimentação animal, que as videocâmeras são importantes ferramentas de controle e que a prática da biossegurança deve ser constante nas instituições de pesquisa.


The aim of this study was to investigate the influence of environmental contamination in the microbiota of animals used in experimentation, from the comparison of two experimental animal facilities, one protected with video cameras (A) and one not protected with video cameras (B). Bacteria, viruses and endoparasites have been investigated in both facilities, according to the methodology proposed for each agent. For the bacteriological tests, a sample of 222 animals in facility A and 236 from facility B was used; for the virological tests, 119 from facility A and 236 from facility B; and for parasitological examination, 158 from facility A and 316 from facility B. The data were submitted to descriptive analysis and to the Chi-square test. The results indicated a higher occurrence of microrganisms and parasites in animals from the unprotected facility. Klebsiella pneumoniae, Pasteurella sp. and Pseudomonas sp. could be detected in the animals from both facilities, whereas viruses and parasites were found only in the unprotected housed mice. Among the viruses in infected animals the most common was the occurrence of Mice Hepatitis Virus (MHV) and among the parasites, the predominant was Syphacia sp. It was concluded that the protected facility was able to ensure microbiological standards more suitable for animal testing, video cameras are important control tools, and the practice of biosecurity must be constant in research institutions.


Assuntos
Animais , Camundongos , Animais de Laboratório , /análise , /prevenção & controle , Gravação em Vídeo , Microbiota , Ensaio de Imunoadsorção Enzimática/veterinária , Parasitologia
11.
Tissue Antigens ; 84(6): 587-8, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25346417

RESUMO

The sequence of a novel allele, HLA-B*57:71, differs from HLA-B*57:01:01 by three-nucleotide exchanges in exon 2.


Assuntos
Alelos , Éxons , Antígenos HLA-B/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos
12.
Phys Rev Lett ; 113(9): 099601, 2014 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-25216015
13.
Phys Rev Lett ; 112(11): 110602, 2014 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-24702342

RESUMO

Signatures of Anderson localization in the momentum distribution of a cold atom cloud after a quantum quench are studied. We consider a quasi-one-dimensional cloud initially prepared in a well-defined momentum state, and expanding for some time in a disorder speckle potential. Quantum interference generates a peak in the forward scattering amplitude which, unlike the common weak localization backscattering peak, is a signature of strong Anderson localization. We present a nonperturbative, and fully time resolved description of the phenomenon, covering the entire diffusion-to-localization crossover. Our results should be observable by present day experiments.

14.
Scand J Surg ; 102(3): 164-70, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23963030

RESUMO

BACKGROUND AND AIMS: Octreotide is suggested to harden the pancreas, thus facilitating the construction of a pancreatic anastomosis and lowering the risk of postoperative fistula. We tested the hypothesis that intra-arterial application of octreotide in the gastroduodenal artery during pancreatectomy may increase pancreatic hardness. MATERIAL AND METHODS: A single-center, prospective, double-blinded, randomized controlled trial with parallel assignment was conducted. Patients planned for a pancreatoduodenectomy or a total pancreatectomy, who had a palpatory and durometer proven (<40 Shore units) soft pancreas, were assigned to receive intraoperatively either 5 mL 500µg octreotide or 5 mL 0.9% saline solution as a bolus injection in the gastroduodenal artery. Pancreatic hardness was measured before, early, and late after intervention. The investigator performing the durometer measurements and pathologist were masked to group assignment. The primary outcome was increased pancreatic hardness. Analysis was by intention to treat. This trial is registered at http://www.clinicaltrials.gov (ID NCT01400100). RESULTS: A total of 12 patients received octreotide and 13 received saline solution. Pancreatic hardness marginally increased in the octreotide group: 0.67 ± 2.3 Shore units, whereas it decreased in the control group: -2.15 ± 2.7 Shore units. The difference was statistically significant, p = 0.029 (95% confidence interval = -4.87 to -0.77). Histology did not find any correlate for this clinically irrelevant hardening effect. CONCLUSIONS: A single bolus application of octreotide did not deliver a clinically relevant increase in pancreatic hardness. Future studies on the hardening effect of octreotide should employ repeated or continuous preoperative administration of this drug.


Assuntos
Fármacos Gastrointestinais/farmacologia , Dureza/efeitos dos fármacos , Octreotida/farmacologia , Pâncreas/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Artérias , Método Duplo-Cego , Duodeno/irrigação sanguínea , Feminino , Fármacos Gastrointestinais/uso terapêutico , Testes de Dureza , Humanos , Cuidados Intraoperatórios , Masculino , Pessoa de Meia-Idade , Octreotida/uso terapêutico , Pâncreas/cirurgia , Pancreatectomia , Fístula Pancreática/etiologia , Fístula Pancreática/prevenção & controle , Pancreaticoduodenectomia , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Estômago/irrigação sanguínea , Resultado do Tratamento
15.
Phys Rev Lett ; 109(19): 190601, 2012 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-23215369

RESUMO

Numerical simulations show that, at the onset of Anderson localization, the momentum distribution of a coherent wave packet launched inside a random potential exhibits, in the forward direction, a novel interference peak that complements the coherent backscattering peak. An explanation of this phenomenon in terms of maximally crossed diagrams predicts that the signal emerges around the localization time and grows on the scale of the Heisenberg time associated with the localization volume. Together, coherent back and forward scattering provide evidence for the occurrence of Anderson localization.

16.
Praxis (Bern 1994) ; 101(25): 1621-6, 2012 Dec 12.
Artigo em Alemão | MEDLINE | ID: mdl-23233100

RESUMO

The German PRISCUS study amongst others investigated in the different priority setting of patients and their doctors. General practice patients aged 72 and above were given a comprehensive geriatric assessment. On the basis of the results, patients and their physicians independently rated the importance of each problem disclosed by the assessment. Whereas patients had their focus on psychosocial aspects and health problems with impact in their daily lives, their doctors assessed importance mainly for patients' medical care. We assume open communication about patients' preferences as a key factor for a successful health care for older multimorbid patients.


Assuntos
Atitude Frente a Saúde , Comorbidade , Medicina Geral/estatística & dados numéricos , Avaliação Geriátrica/estatística & dados numéricos , Participação do Paciente , Idoso , Idoso de 80 Anos ou mais , Comportamento Cooperativo , Estudos Transversais , Feminino , Humanos , Comunicação Interdisciplinar , Masculino , Suíça
18.
Z Gerontol Geriatr ; 44 Suppl 2: 101-12, 2011 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-22270976

RESUMO

BACKGROUND: The concurrent presence or manifestation of multiple chronic conditions, i.e. multimorbidity, poses a challenge to affected patients and their relatives, physicians, and practitioners, and to the health care system in general. Aiming to improve medical care for different chronic diseases, the Chronic Care Model also appears to be suited for multimorbidity. The established research consortium PRISCUS is trying to create some of the prerequisites for a new care model for multimorbid, elderly patients oriented along the lines of the Chronic Care Model. METHODS AND RESULTS: Four out of seven subprojects of the research consortium provide an overview of some of their findings. Topics in a sports medicine subproject were the assessment of physical activity by means of a newly developed questionnaire and the development and feasibility testing of an exercise program for elderly people with chronic conditions and mobility impairment. Partners from family medicine implemented geriatric assessment in a primary care setting and evaluated its consequences. In a pharmacological subproject, potentially inappropriate medication as well as drug-drug interactions and dosing errors were addressed. The health economic subproject investigated quality of life impairment due to multiple chronic diseases and the effects of multimorbidity on costs. CONCLUSIONS: The results of the PRISCUS research consortium allow a better description of consequences of multimorbidity and illustrate at least some new approaches towards prevention, diagnosis, and treatment of patients suffering from multimorbidity. Ongoing projects will test the efficacy of a physical activity program and a new complex intervention to reduce potentially inappropriate medication in the elderly. With this, the research consortium will create some prerequisites for a new health care model for patients with multimorbidity comparable to the Chronic Care Model.


Assuntos
Doença Crônica/epidemiologia , Ensaios Clínicos como Assunto , Comorbidade , Medicina Baseada em Evidências , Pesquisa sobre Serviços de Saúde/organização & administração , Serviços de Saúde para Idosos , Modelos Organizacionais , Idoso , Idoso de 80 Anos ou mais , Alemanha , Humanos
19.
Injury ; 41(12): 1317-22, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20850117

RESUMO

BACKGROUND: To determine whether reamed or unreamed intramedullary nailing of femoral fractures results in higher incidence of pulmonary fat embolism, three different methods of intramedullary nailing were compared in sheep. To analyze the presence of bone marrow fat embolism in pulmonary arteries, histological evaluation was undertaken using a quantitative computer-assisted measurement system. METHODS: In this experimental model of 27 female Swiss alpine sheep, an osteotomy of the proximal femur was conducted in each animal. Then, the animals were divided into three groups according to the method of treatment: two different reamed intramedullary nailing techniques and an unreamed nailing technique were used. In the first group "ER" (experimental reamer; n=9), the nail was inserted after reaming with an experimental reamer; in the second group "CR" (conventional reamer; n=7), the intramedullary nail was inserted after reaming with the conventional AO-reamer. In the third group "UN" (unreamed; n=8) unreamed nailing was performed. During the operation procedure intramedullary pressure was measured in the distal fragment. After sacrificing the animals, quantitative histological analyses of bone marrow fat embolism in pulmonary arteries were done using osmium tetroxide fixation and staining of the fat. RESULTS: The measurement of intramedullary pressure showed significantly lower values for reamed nailing than for the unreamed technique. The quantitative histological evaluation of lung vessels concerning bone marrow fat embolism revealed a statistically significant difference between reamed and unreamed insertion of the nail: 7.77%±6.93 (ER) and 6.66%±5.61 (CR) vs. 16.25%±10.05 (UN) (p<0.05) of the assessed lung vessels were filled with fat emboli. However, no difference was found between the traditional and experimental reamer. CONCLUSIONS: Intramedullary nailing after reaming is a safe procedure with low systemic embolisation when compared to the unreamed insertion of the nail.


Assuntos
Embolia Gordurosa/etiologia , Fraturas do Fêmur/complicações , Fixação Intramedular de Fraturas/efeitos adversos , Embolia Pulmonar/etiologia , Animais , Pinos Ortopédicos/efeitos adversos , Embolia Gordurosa/cirurgia , Feminino , Fraturas do Fêmur/cirurgia , Fixação Intramedular de Fraturas/métodos , Incidência , Osteotomia , Embolia Pulmonar/cirurgia , Ovinos/cirurgia
20.
Pharmacopsychiatry ; 43(5): 184-9, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20503149

RESUMO

INTRODUCTION: Anticonvulsant drugs are increasingly being used for alcohol detoxification in in- and outpatient settings. The aim of this study was to examine the efficacy, medical safety and mid-term outcome of levetiracetam, a drug with no marked liver toxicity, for outpatient alcohol detoxification. METHODS: This was an open-label observational study. After screening eligibility for outpatient alcohol detoxification, patients were seen daily for 5 days and received levetiracetam in a flexible dosage regime between 500 and 4 000 mg/d for a maximum of 7 days. Diazepam was used as a rescue medication. The severity of alcohol withdrawal was evaluated daily using the ALCOHOL WITHDRAWAL SYNDROME SCALE (AWSS). Mid-term treatment outcome was assessed at a 6-month follow-up. RESULTS: A total number of 131 consecutively admitted alcohol-dependent patients received an outpatient detoxification treatment, 122 (93.1%) completed the programme successfully. The mean initial dose of levetiracetam was 1 850 mg/d. Alcohol withdrawal syndrome as indicated by the AWSS score decreased clearly over 5 days. Overall, the medication was well tolerated. There was no treatment discontinuations due to side effects of levetiracetam. No serious medical complications, especially seizures or deliria, were observed during the detoxification. At the 6-month follow-up, 57 patients (43.5%) were still abstinent. Patients with previous detoxifications had a significant higher risk for relapse (HR=1.88; p=0.016; CI 95%: 1.12-3.14) than patients without previous treatments. DISCUSSION: The findings of this study provide some evidence that levetiracetam is an efficacious and safe treatment option for outpatient alcohol detoxification. Further randomised, controlled trials including mid- and long-term follow-ups are needed to confirm these findings.


Assuntos
Alcoolismo/reabilitação , Assistência Ambulatorial/psicologia , Piracetam/análogos & derivados , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Feminino , Humanos , Levetiracetam , Masculino , Pessoa de Meia-Idade , Piracetam/efeitos adversos , Piracetam/uso terapêutico , Psicoterapia , Recidiva , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Temperança , Resultado do Tratamento , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...