Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 64
Filtrar
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2019: 2127-2131, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31946321

RESUMO

Bony impingement (BI) may contribute to restricted hip joint motion, and recurrent dislocation after total hip arthroplasty (THA), and therefore, should be avoided where possible. However, BI risk assessment is generally performed intra-operatively by surgeons, which is partially subjective and qualitative. Therefore, the aim of the study was to develop a method for identifying subject-specific BI, and subsequently, visualising BI area on native bone anatomy to highlight the amount of bone should be resected. Activity definitions and subject-specific bone geometries, constructed from CT scans, with planned implants were used as inputs for the method. For each activity, a conical clearance angle (CCA) was checked between femur and pelvis through simulation. Simultaneously, BI boundary and area were automatically calculated using ray intersection and region growing algorithm respectively. The potential use of the developed method was explained through a case study using an anonymised pre-THA patient data. Two pure (flexion, and extension) and two combined hip joint motions (internal and external rotation at flexion and extension respectively) were considered as activities. BI area were represented in two ways: (a) CCA specific where BI area for each activity with different CCAs was highlighted, (b) activity specific where BI area for all activities with a particular CCA was presented. Result showed that BI area between the femoral and pelvic parts was clearly identified so that the pre-operative surgical plan could be adjusted to minimise impingement. Therefore, this method could potentially be used to examine the effect of different preoperative plans and hip motion on BI, and to guide bony resection during THA surgery.


Assuntos
Artroplastia de Quadril , Impacto Femoroacetabular/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Prótese de Quadril , Fêmur , Humanos , Amplitude de Movimento Articular , Medição de Risco , Tomografia Computadorizada por Raios X
3.
Dis Esophagus ; 28(5): 405-11, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24641690

RESUMO

An association between gastroesophageal reflux disease (GERD) and diabetes mellitus (DM) has been reported. Studies have not been population-based and have failed to include a representative sample of African American subjects. The aim of the study was to determine if DM is independently associated with GERD among urban African Americans. Single-center, population-based survey utilizing a complex, stratified sampling design. To obtain a simple random sample of the entire African American community, targeted survey zones and hand-delivered invitations were identified. Participating subjects had to be self-described African American, age ≥18. Surveys were completed at a computer terminal assisted by a research coordinator. Four hundred nineteen subjects (weighted sample size of 21 264 [20 888-23 930]). GERD prevalence was 23.7% (95% confidence interval [CI] 23.2-23.9). GERD prevalence was 41.5 % in those with DM versus 20.6 % for those without (P < 0.001). Those with GERD had DM longer but had lower glycohemoglobin levels. The prevalence of ≥2 DM comorbidities was higher in those with GERD (odds ratio [OR] = 2.06; 95% CI 1.71-2.48). In the final model, age >40, DM, increasing body mass index, harmful drinking, and increasing smoking dependence were independently associated with GERD. For DM, there was significant effect modification by gender. In males, the risk was (OR = 4.63; 95% CI 3.96-5.40), while in females, the risk was markedly attenuated (OR = 1.79; 95% CI 1.61-2.00). Among urban African Americans, there is an independent association between DM and GERD that appears to be stronger in men. More information is needed to understand this association.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Refluxo Gastroesofágico/epidemiologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Estudos de Coortes , Comorbidade , Complicações do Diabetes/sangue , Diabetes Mellitus/sangue , Feminino , Refluxo Gastroesofágico/sangue , Refluxo Gastroesofágico/etiologia , Hemoglobinas Glicadas/análise , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Fatores Sexuais , Fumar , Inquéritos e Questionários , População Urbana
4.
Eur Rev Med Pharmacol Sci ; 18(12): 1694-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24992608

RESUMO

BACKGROUND: Although the Chilaiditi sign correctly underestimates the radiological presence of air-under-the-diaphragm, in few cases it has lead to delays in the diagnosis of underlying pneumoperitoneum. In this article we report the case of a young lady presenting with acute pancreatitis and radiographic findings of "left-sided" Chilaiditi sign with underlying a large gastric perforation. CASE REPORT: A 35 year old Caucasian female presented to the Emergency Department with a twenty-four hour history of severe epigastric pain radiating into her back. Stable observations, mildly raised white cell count, increased amylase and subdiaphragmatic radiolucency were interpreted as acute pancreatitis with Chilaiditi sign and treated accordingly. Twenty-four hours later the deterioration of the clinical conditions required a CT scan and an emergency laparotomy that lead to the diagnosis of a large gastric perforation. However, after several days she died of a disseminated intravascular coagulation in the Intensive Care Unit. CONCLUSIONS: In our case the young age of the patient and lack of underlying comorbidities initially compensated the severity of the perforation until it became evident from the absent resolution of the pancreatitis. Bearing this in mind, radiological appearances similar to Chilaiditi sign with significant symptoms or signs should be investigated with a CT scan in order to reach promptly a correct diagnosis.


Assuntos
Pancreatite/diagnóstico por imagem , Ruptura Gástrica/diagnóstico por imagem , Dor Abdominal/diagnóstico por imagem , Adulto , Feminino , Humanos , Radiografia
5.
Dis Esophagus ; 26(6): 561-9, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23237330

RESUMO

Prevalence data for heartburn in the urban Black American community is lacking. In order to estimate prevalence for this community, we analyzed data from an ongoing cohort study in progress at our hospital. Comprehensive interviews allowed for exploration of factors associated with heartburn. Complex, stratified sampling design was the method used. Survey invitations are hand-delivered to random blocks in a single zip code tabulation area. One member per eligible household is invited to complete a computer-based survey. Heartburn was defined as ≥ 3 days/week of symptoms as defined by the Montreal Definition and Classification of gastroesophageal reflux disease. Scaling and weighting factors were utilized to estimate population level prevalence. Multivariate logistic regression was used to identify independent predictor variables for heartburn. Enrolled 379 participants corresponding to a weighted sample size of 22,409 (20,888-23,930) citizens. Demographic characteristics of the sample closely matched those of the entire targeted population. Overall, the weighted prevalence of heartburn ≥ 3 times per week was 17.6% (16.4-18.8%). Variables independently associated with heartburn were body mass index, daily caloric and fat intake, diabetes mellitus (odds ratio = 2.95; 2.59-3.36), cigarette smoking, and alcohol consumption (odds ratio = 2.55; 2.25-2.89). Factors inversely associated included illicit drug use and increased physical activity. Waist : hip ratio showed no relationship. The prevalence of heartburn ≥ 3 times per week is high in the Black American community. Adverse lifestyle behaviors showed particularly important associations. Our study needs to be replicated in other communities with similar demographics.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Azia/epidemiologia , Saúde da População Urbana/estatística & dados numéricos , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Anti-Inflamatórios não Esteroides/uso terapêutico , Índice de Massa Corporal , Bloqueadores dos Canais de Cálcio/uso terapêutico , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Gorduras na Dieta/administração & dosagem , Ingestão de Energia , Feminino , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/psicologia , Azia/psicologia , Humanos , Drogas Ilícitas , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Atividade Motora , Philadelphia/epidemiologia , Vigilância da População , Prevalência , Qualidade de Vida , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
6.
Epidemiol Infect ; 139(6): 919-26, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20670468

RESUMO

Acute diarrhoea remains a major public health challenge in developing countries. We examined the role of a probiotic in the prevention of acute diarrhoea to discover if there was an effect directed towards a specific aetiology. A double-blind, randomized, controlled field trial involving 3758 children aged 1-5 years was conducted in an urban slum community in Kolkata, India. Participants were given either a probiotic drink containing Lactobacillus casei strain Shirota or a nutrient drink daily for 12 weeks. They were followed up for another 12 weeks. The primary outcome of this study was the occurrence of first episodes of diarrhoea. We assessed this during 12 weeks of intake of study agent and also for 12 weeks of follow-up. There were 608 subjects with diarrhoea in the probiotic group and 674 subjects in the nutrient group during the study period of 24 weeks. The level of protective efficacy for the probiotic was 14% (95% confidence interval 4-23, P<0·01 in adjusted model). The reduced occurrence of acute diarrhoea in the probiotic group compared to nutrient group was not associated with any specific aetiology. No adverse event was observed in children of either probiotic or nutrient groups. The study suggests that daily intake of a probiotic drink can play a role in prevention of acute diarrhoea in young children in a community setting of a developing country.


Assuntos
Diarreia/prevenção & controle , Áreas de Pobreza , Probióticos/uso terapêutico , Pré-Escolar , Diarreia/epidemiologia , Diarreia/microbiologia , Diarreia/parasitologia , Método Duplo-Cego , Feminino , Humanos , Índia , Lactente , Masculino , Estado Nutricional , População Urbana/estatística & dados numéricos
7.
Lett Appl Microbiol ; 51(2): 241-3, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20536711

RESUMO

AIMS: West Bengal experienced a devastating storm named 'AILA' in its coastal and southern districts. We attempted to understand the transmission dynamics emphasizing on potable water to detect the presence of toxigenic strains of Vibrio cholerae, followed by the natural devastation. METHODS AND RESULTS: A total of 33 water samples (from tap, tube well and ponds) were analysed. From them, 11 (33.3%) samples were found to be contaminated with V. cholerae, among which 5 (45%) isolates were V. cholerae O1 biotype Ogawa. Antibiogram profile reveals that most of the V. cholerae O1 isolates were highly sensitive against fluroquinolone group of antibiotics, but less sensitive against cefuroxime (50%), cefotaxime (40.9%), ceftriaxone (38.63%), trimethoprim (37.3%), streptomycin (29.2%) and furazolidon (4.54%). Three (36%) V. cholerae isolates were found to be ctxB positive (2 ctxB classical). CONCLUSIONS: Potable water plays a crucial role in cholera transmission. Natural disasters like the reported one aided with feacal-oral contamination enhance the possibilities of drinking water contamination. SIGNIFICANCE AND IMPACT OF THE STUDY: The application of the modified technique, making use of the enrichment subsequently followed by culture and PCR, will help us to detect the presence of toxigenic V. cholerae contamination in different aquatic environment. Moreover, natural extremes have a direct role in increase of salinity level, followed by higher predominance of V. cholerae along with their toxicity development in terms of genetic modification.


Assuntos
Cólera/epidemiologia , Cólera/microbiologia , Surtos de Doenças , Água Doce/microbiologia , Vibrio cholerae/isolamento & purificação , Antibacterianos/farmacologia , Toxina da Cólera/genética , Tempestades Ciclônicas , Humanos , Índia/epidemiologia , Testes de Sensibilidade Microbiana , Vibrio cholerae/classificação , Vibrio cholerae/efeitos dos fármacos
9.
Br J Dermatol ; 157(6): 1252-6, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17854379

RESUMO

Kindler syndrome (KS) is a rare inherited skin disorder with blistering and poikiloderma as its main clinical features. It is caused by loss-of-function mutations in the C20orf42 (KIND1) gene which encodes kindlin-1, an actin cytoskeleton-focal contact-associated protein which is predominantly expressed in keratinocytes. We investigated the molecular basis of KS in a 16-year-old Indian boy who had additional clinical findings, including scleroatrophic changes of the hands and feet, pseudoainhum and early onset of squamous cell carcinoma on his foot. Immunostaining for kindlin-1 in the patient's skin was completely absent and sequencing of C20orf42 (KIND1) genomic DNA showed a homozygous splice-site mutation at the -6 position, IVS9-6T-->A. Amplification and sequencing of cDNA from the skin revealed aberrant splicing with either deletion of exon 10 or deletion of exons 9, 10 and 11, both of which involve loss of the pleckstrin homology domain of kindlin-1 that is thought to play a role in cytoskeletal attachment and integrin-mediated cell signalling. Pathogenic splice-site mutations at the -6 position are unusual and have rarely been reported for any genetic disorder. Collectively, these findings extend the spectrum of clinical and molecular abnormalities in this rare genodermatosis.


Assuntos
Proteínas de Membrana/genética , Proteínas de Neoplasias/genética , Dermatopatias Genéticas/patologia , Adolescente , Evolução Fatal , Humanos , Masculino , Sítios de Splice de RNA/genética , Dermatopatias Genéticas/genética , Síndrome
11.
J Vector Borne Dis ; 43(3): 115-22, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17024860

RESUMO

BACKGROUND & OBJECTIVES: The kala-azar fever (Visceral leishmaniasis) is continuing unabated in India for over a century, now being largely confined to the eastern part of India mainly in Bihar state and to some extent in its bordering states like West Bengal and Uttar Pradesh. Two study sites namely Patepur block in Vaishali district with high endemicity in northern part and Lohardagga block in Lohardagga district with absolute non-endemicity in southern part of Bihar were selected for the study with the following objectives : (i) to study the macro-ecosystem in relation to distribution of vector -Phlebotomus argentipes; (ii) to identify/map the risk prone areas or villages in a block for quick remedial measures; and (iii) to make use of satellite remote sensing and GIS to demonstrate the utility for rapid assessment of landuse/landcover and their relation with the incidence of kalaazar leading to the mapping of risk prone areas. METHODS: Indian Remote Sensing (IRS)-1D LISS III satellite data for the periods of March and November 2000 were analysed in Silicon graphic image processing system using ERDAS software. False color composites (FCC) were generated and landuse/landcover was assessed using Maximum likelihood supervised classification techniques based on ground truth training sets. During the study the GIS functions are used to quantify the remotely sensed landscape proportions of 5 km2 buffer surrounding each known group of villages of high occurrence of sandflies in endemic and nonendemic study sites. Instead of traditional ground based survey methods to vector surveillance, the present study used a combination of remote sensing (RS) and geographical information system (GIS) approach to develop landscape predictors of sandfly abundance-an indicator of human vector contact and as a measure of risk prone areas. RESULTS: Statistical analysis using the remotely sensed landscape variables showed that rural villages surrounded by higher proportion of transitional swamps with soft stemmed edible plants and banana, sugarcane plantations had higher sandfly abundance and would, therefore, be at higher risk prone areas for man-vector contact. INTERPRETATION & CONCLUSION: The present study clearly brought out the usefulness of satellite remote sensing technology in generating the crucial information on spatial distribution of landuse/landcover classes with special emphasis on indicator landcover classes thereby helping in prioritising the area to identify risk prone areas of kala-azar through GIS application tools.


Assuntos
Ecossistema , Sistemas de Informação Geográfica , Leishmaniose Visceral/prevenção & controle , Fatores de Risco , Robótica , Comunicações Via Satélite , Animais , Processamento de Imagem Assistida por Computador , Índia/epidemiologia , Insetos Vetores , Phlebotomus , Dinâmica Populacional , População Rural , Estações do Ano
12.
Indian J Med Res ; 123(1): 31-6, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16567865

RESUMO

BACKGROUND & OBJECTIVE: Epidemics of cholera caused by Vibrio cholerae O1 or O139 have been reported from different parts of India. Factors such as unsafe water supply, poor environmental sanitation, indiscriminate defaecation and lack of personal hygiene are mainly responsible for continued transmission of this disease. We report here epidemiological and microbiological findings of a localized outbreak of cholera, which occurred during March and April 2004 in the eastern part of Kolkata city. METHODS: The affected slum area has a population of 4409, predominantly muslims. Patients suffering from acute watery diarrhoea attended the health outposts organized by National Institute of Cholera and Enteric Diseases, Kolkata and International Vaccine Institute, South Korea as part of a routine surveillance programme at the locality as well as the emergency medical camp organized by the Kolkata Municipal Corporation. Stool and water samples were collected and tested for diarrhoeagenic pathogens in the laboratory. Bacteriophages specific for V. cholerae were isolates and studied electron microscopically for morphology. RESULTS: A total of 89 diarrhoea cases were reported giving an attack rate of 2 per cent. V. cholerae O1 biotype ElTor, serotype Ogawa was isolated as a sole pathogen from 15 (15.8%) of 89 stool samples screened. Water samples (2 from tube wells, 3 from municipal taps and 1 from well) showed presence of coliform bacilli with high MPN (Most Probable Number) count. Bacteriophages specific to V. cholerae were isolated from 2 of 6 water samples examined. A leakage was detected in the main pipeline supplying drinking water to that area. INTERPRETATION & CONCLUSION: The outbreak was caused by V. cholerae O1 (Ogawa) biotype ElTor. The presence of phages in the water samples was an additional indicator for V. cholerae contamination in this community. Occurrences of such outbreaks support vaccination against cholera as an alternative strategy.


Assuntos
Cólera , Áreas de Pobreza , Vibrio cholerae , Tipagem de Bacteriófagos , Bacteriófagos/ultraestrutura , Cólera/epidemiologia , Cólera/microbiologia , Fezes/microbiologia , Humanos , Índia/epidemiologia , Microbiologia da Água
14.
Int J Environ Health Res ; 15(6): 449-54, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16506438

RESUMO

Host preference Phlebotomus argentipes and Phlebotomus papatasi in different biotopes was investigated in two highly endemic Kala-azar districts of West Bengal, India for a better understanding of the transmission dynamics. Blood meals of 304 P. argentipes and 206 P. papatasi, collected from different biotopes from two Kala-azar affected districts in West Bengal, were tested against seven different antisera by modified Ouchterlony gel diffusion techniques. It appeared that host preference of P. argentipes varied widely in different biotopes, which is mainly zoophilic (62.80%), preferring to feed on man as the second choice (24.92%); however it is also a "chance feeder" according to biotopes. Multiple blood meals are also prevalent in P. argentipes at a much higher rate than that of P. papatasi. The implication in relation to epidemiological significance has been discussed.


Assuntos
Comportamento Alimentar , Leishmaniose Visceral/transmissão , Phlebotomus/patogenicidade , Animais , Sangue , Meio Ambiente , Humanos , Índia , Phlebotomus/fisiologia
17.
Indian J Med Res ; 117: 201-4, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-14609047

RESUMO

BACKGROUND & OBJECTIVES: Kolkata and its suburbs in eastern India faced an epidemic of typhoid fever in 1990. A prospective, hospital and laboratory based study over a period of 12 yr (1990-2001), on the phage typing and biotyping pattern of Salmonella enterica serotype Typhi was carried out, to see if there has been a change. METHODS: A total of 338 S. enterica serotype Typhi isolates from 1491 blood samples were phage typed and biotyped. The mean age of isolation was calculated. RESULTS: The age distribution of subjects (neonates to 12 yr) has been analysed. Of the 338 (22.7%) isolates obtained, eight different S. enterica serotype Typhi phage types were detected. Biotype I (95.8%) was more prevalent as compared to biotype II (4.1%). Phage type E1 was the commonest phage type in Kolkata and its suburbs. INTERPRETATION & CONCLUSION: The mean age at isolation was found to be 6.7 +/- 3.3 yr. Biotype I was predominant and it was of interest that all strains of phage type E1 belonged to biotype I.


Assuntos
Bacteriófagos/genética , Criança Hospitalizada , Salmonella typhi/genética , Tipagem de Bacteriófagos , Criança , Pré-Escolar , Humanos , Índia/epidemiologia , Lactente , Estudos Prospectivos , Febre Tifoide/epidemiologia , Febre Tifoide/microbiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA