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1.
Opt Lett ; 48(9): 2245-2248, 2023 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-37126245

RESUMO

A Nd:YVO4/Cr4+:YAG laser with a symmetric concave-convex cavity ensuring strong intracavity beam focusing on the absorber is designed for stable pulsed operation of Lissajous structured modes with transverse patterns as Lissajous figures. Setting the cavity length to fulfill the criterion for efficient passive Q switching (PQS), as well as to meet the accidental degenerate conditions, Lissajous pulsed beams with well-defined structures and good temporal stability are created under two-dimensional off-axis pumping. Although the multi-transverse-mode oscillation inevitably induces asynchronous pulsation and leads the short-term pulse profiles to reveal parasitic effects, the overall long-term behavior of Lissajous pulses can be kept regular with amplitude fluctuations ≤15% and pulse-to-pulse timing jitter ≤5%. With the maximum peak power exceeding 500 W at a pump power of 4.5 W, the PQS Lissajous modes are further transformed into trochoidal pulsed beams to realize high-order and high-peak power structured vortex fields.

2.
Opt Lett ; 46(21): 5481-5484, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34724506

RESUMO

An Nd:YAG/Cr4+:YAG passively Q-switched (PQS) laser in a near-hemispherical cavity is exploited to generate high-order structured pulsed fields. Under tightly focused on-axis pumping, radial-order Laguerre-Gaussian (LG) modes with controllable mode orders by the input pump power are realized to exhibit quite stable temporal behavior. The pulse repetition rates of radial-LG modes can reach up to 78 kHz with an average output power of 0.57 W and peak power beyond 300 W under a 5-W pump level. Furthermore, by introducing 1D off-axis pumping into the PQS laser, various structured pulsed fields with transverse morphologies as high-order Ince-Gaussian (IG) modes are further created. With clean and well-defined beam structures, the IG pulsed fields can be nicely reconstructed by the resonant modes of the inhomogeneous Helmholtz equation for spherical cavities. More importantly, these high-order PQS IG modes reveal highly regular pulse trains with the maximum pulse repetition rate beyond 20 kHz and overall peak power higher than 1.5 kW.

3.
Osteoporos Int ; 31(8): 1555-1563, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32221674

RESUMO

Alendronate is effective in preventing second hip fracture in osteoporotic patients. However, no consensus exists on the duration that is effective in preventing a second hip fracture. Our study demonstrated that risk can be reduced when the prescription is ≥ 6 months for the year following the index hip fracture. INTRODUCTION: Alendronate is effective in preventing second hip fracture in osteoporotic patients. However, no consensus exists on the accurate medication possession ratio (MPR) that is effective in preventing a second hip fracture. Our objective was to compare the risk of second hip fracture in patients treated with different MPR of alendronate. METHODS: In this population-based cohort study, data from National Health Insurance Research Database of Taiwan were analyzed. Patients 50 years and older who had an index hip fracture and were not receiving any osteoporotic medications before their fracture during 2000-2010 were included. The cohort consisted of 88,320 patients who were new alendronate users (n = 9278) and non-users (n = 79,042). Those without alendronate were matched 4:1 as the control group. Patients were subdivided into those with no medication, MPR < 25%, MPR 25-50%, MPR 50-75%, and MPR 75-100%. Cox proportional hazard models were used to calculate the adjusted hazard ratios for different MPRs of alendronate. RESULTS: After matching, 38,675 patients were included in this study; 20,363 (52.7%) were women, and 30,940 (80%) patients were without medication of alendronate. During follow-up on December 31, 2012, 2392 patients had a second hip fracture, for an incidence of 1449/100,000 person-years. Patients with alendronate MPR 50-75% had a lower risk of a second hip fracture compared to non-users (hazard ratio 0.66). When the MPR increased to 75-100%, the hazard ratio decreased to 0.61. CONCLUSIONS: In this population-based cohort study, risk of a second hip fracture can be reduced when the alendronate MPR is ≥ 50% for the year following the index hip fracture. As the MPR increases, the risk of a second hip fracture decreases.


Assuntos
Alendronato , Conservadores da Densidade Óssea , Fraturas do Quadril , Osteoporose , Alendronato/uso terapêutico , Conservadores da Densidade Óssea/uso terapêutico , Estudos de Coortes , Feminino , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/etiologia , Fraturas do Quadril/prevenção & controle , Humanos , Estudos Retrospectivos , Taiwan/epidemiologia
4.
QJM ; 112(12): 891-899, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31350560

RESUMO

BACKGROUND: Acute stroke is the third leading cause of death in Taiwan. Although statin therapy is widely recommended for stroke prevention, little is known about the epidemiology of statin therapy after acute ischemic stroke (AIS) in Taiwan. To investigate the effects of statin therapy on recurrent stroke, intracranial hemorrhage (ICH), coronary artery disease (CAD), cost of hospitalization and mortality, we conducted a nationwide population-based epidemiologic study. METHODS: Cases of AIS were identified from the annual hospitalization discharge diagnoses of the National Health Insurance Research Database with the corresponding International Classification of Diseases, ninth revision codes from January 2001 to December 2010. We divided the AIS patients into three groups: non-statin, pre-stroke statin and post-stroke statin. RESULTS: A total of 422 671 patients with AIS (including 365 419 cases in the non-statin group, 22 716 cases in the pre-stroke statin group and 34 536 cases in the post-stroke statin group) were identified. When compared to the non-statin group, both statin groups had a lower recurrent stroke risk [pre-stroke statin: odds ratio (OR) = 0.84; 95% confidence interval (CI) = 0.82-0.87; P < 0.0001; post-stroke statin: OR = 0.89; 95% CI = 0.86-0.91; P < 0.0001], lower ICH risk (pre-statin: OR = 0.75; 95% CI = 0.69-0.82; P < 0.0001; post-stroke statin: OR = 0.75; 95% CI = 0.71-0.81; P < 0.0001), and a lower mortality rate (pre-stroke statin: OR = 0.56; 95% CI = 0.53-0.59; P < 0.0001; post-stroke statin: OR = 0.51; 95% CI = 0.48-0.53; P < 0.0001). In terms of CAD, only the post-statin group had a lower risk (OR = 0.81; 95% CI = 0.79-0.84; P < 0.0001) than the non-statin group. The post-statin group had the lowest 1-year medical costs after index discharge among the three groups. CONCLUSIONS: Statin therapy reduced the risks of recurrent stroke, CAD, ICH and the first year mortality in patients after AIS. Treatment with statin therapy after AIS is a cost-effective strategy in Taiwan.


Assuntos
Isquemia Encefálica/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Idoso , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/etiologia , Bases de Dados Factuais , Estudos Epidemiológicos , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Hemorragias Intracranianas/induzido quimicamente , Hemorragias Intracranianas/epidemiologia , Masculino , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Recidiva , Fatores de Risco , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/prevenção & controle , Taiwan/epidemiologia , Fatores de Tempo , Resultado do Tratamento
5.
J Appl Microbiol ; 121(4): 952-65, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27280957

RESUMO

AIMS: To evaluate the antibacterial efficacy of novel antimicrobial peptides (AMPs) against multidrug-resistant (MDR) Salmonella enterica serovar Choleraesuis (Salm. Choleraesuis) and to delineate the AMP-responsive mechanisms of wild-type (WT) and MDR strains. METHODS AND RESULTS: Proteomic approaches were performed based on two-dimensional gel electrophoresis and liquid chromatography-electrospray ionization-quadrupole- time-of-flight tandem mass spectrometry to analyse the protein profiles of these two strains upon exposure to AMP GW-Q6. Quantitative real-time PCR was conducted to determine the mRNA expression level of the target genes. Furthermore, lipopolysaccharide (LPS) competition analysis was used to verify whether LPS may serve as the potential binding target when AMP approach and adhere to the bacterial surface. CONCLUSIONS: The minimal inhibitory concentration assay revealed that our AMPs were even more effective against the MDR strains (4-32 µg ml(-1) ), compared with those for the WT (8-64 µg ml(-1) ). LPS dose-dependently suppressed the GW-Q6 antimicrobial activity. Clusters of orthologous groups analysis showed that the majority of the AMP-responsive proteins were involved in cell envelope biogenesis and outer membrane, translation and chaperones. SIGNIFICANCE AND IMPACT OF THE STUDY: These results indicated that the novel AMP GW-Q6 serves as a potential candidate for antimicrobial drug development against MDR strains. These findings will also be helpful for expanding our knowledge on the molecular mechanisms of AMP-microbe interaction and the pathogenicity of salmonellosis caused by MDR strains of Salm. Choleraesuis.


Assuntos
Antibacterianos/farmacologia , Peptídeos Catiônicos Antimicrobianos/farmacologia , Salmonella enterica/fisiologia , Animais , Proteínas de Bactérias/análise , Farmacorresistência Bacteriana Múltipla , Eletroforese em Gel Bidimensional , Testes de Sensibilidade Microbiana , Proteômica , Reação em Cadeia da Polimerase em Tempo Real , Infecções por Salmonella/microbiologia , Salmonella enterica/classificação , Salmonella enterica/efeitos dos fármacos , Sorogrupo
6.
Eur Heart J Cardiovasc Imaging ; 17(suppl_2): ii270-ii276, 2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-28415128

RESUMO

BACKGROUND: Our previous study showed sub-epicardial longitudinal strain (EpiLS) was an independent prognostic factor for worse outcome in regular treated hypertension but not global longitudinal strain (GLS) and sub-endocardial longitudinal strain (EndLS). Increased blood pressure variability (BPV) has been found associated with target organ damage in hypertension. However, effects of BPV on layer-specific longitudinal strain have not been well studied. PURPOSE: The aim of this study was to investigate the effects of different blood pressure parameters on layer-specific longitudinal strain in hypertension. METHODS: This study included 95 patients (57 men, age 65 ± 12 years) with uncomplicated hypertension who have been regularly treated for more than 1 year. Speckle tracking echocardiography was used for measurement of longitudinal deformation from 3 apical views of left ventricle. GLS was measured by automated function imaging (AFI). We further divided into sub-endocardial and sub-epicardial myocardium and measured their longitudinal strain by manual click-and-draw method and averaged from 3 apical views. Blood pressure parameters included office systolic blood pressure (SBP), office diastolic blood pressure (DBP), central SBP and DBP by tonometry, average 24-hour SBP and DBP, and BPV parameters by ambulatory blood pressure monitor. BPV parameters included standard deviation of daytime SBP (DSSD), standard deviation of nighttime SBP (NSSD), standard deviation of daytime DBP (DDSD), and standard deviation of nighttime DBP (NDSD). RESULTS: We divided subjects into low and high group according to median level of each strain. No blood pressure parameters were different between low and high EndLS group except week difference in NDSD (9.0 ± 3.4 vs. 7.8 ± 2.0 mmHg, p = 0.051). NSSD (11.2 ± 4.6 vs. 9.3 ± 2.9 mmHg, p = 0.027) and NDSD (9.1 ± 3.4 vs. 7.7 ± 2.0 mmHg, p = 0.031) were significant increased in low GLS group but not other parameters. DDSD (10.3 ± 3.0 vs. 9.0 ± 2.5 mmHg, p = 0.034), NSSD (11.4 ± 4.4 vs. 9.1 ± 3.1 mmHg, p = 0.006), and NDSD (9.2 ± 3.2 vs. 7.6 ± 2.2 mmHg, p = 0.012) were significantly increased in low EpiLS group. CONCLUSIONS: Only BPV parameters were associated with decreased longitudinal strain in hypertension. Effects of BPV were majorly noted in EpiLS.


Assuntos
Ecocardiografia/métodos , Hipertensão/complicações , Hipertensão/diagnóstico , Processamento de Imagem Assistida por Computador , Disfunção Ventricular Esquerda/diagnóstico por imagem , Idoso , Determinação da Pressão Arterial , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Pericárdio/diagnóstico por imagem , Pericárdio/fisiopatologia , Medição de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/fisiopatologia
8.
Cell Prolif ; 48(4): 413-20, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26009842

RESUMO

OBJECTIVES: To investigate effects of platelet-rich plasma on tendon cell proliferation and the underlying molecular mechanisms. MATERIALS AND METHODS: Platelet-rich plasma was prepared manually by two-step centrifugation. Proliferation was evaluated in cultured rat tendon cells by the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay. Cell cycle progression was assessed by flow cytometry. Messenger RNA expression of proliferating cell nuclear antigen (PCNA), cyclin E1, A2 and B1, and cyclin-dependent kinases (Cdks) 1 and 2 was assessed by real-time polymerase chain reaction. Protein expression of the above cyclins and Cdks and of signal transducer and activator of transcription (Stat) 3 and p27 was evaluated by western blotting. RESULTS: Platelet-rich plasma used in the present study had concentrations of platelets, TGF-ß1 and PDGF over 3-fold higher than normal whole blood. Platelet-rich plasma enhanced tendon cell proliferation (P = 0.008) by promoting G1 /S phase transition in the cell cycle, and increased expression of PCNA, cyclin E1, A2 and B1, Cdks1 and 2, and phosphorylated Stat3, while inhibiting p27 expression. CONCLUSIONS: Platelet-rich plasma contains high concentrations of TGF-ß1 and PDGF that increase tendon cell proliferation by modulating Stat3/p27(Kip1), which enhances expression of cyclin-Cdk complexes that promote cell cycle progression. These results provide molecular evidence for positive effects of platelet-rich plasma on tendon cell proliferation, which can be useful in clinical applications of tendon injury.


Assuntos
Proliferação de Células , Inibidor de Quinase Dependente de Ciclina p27/metabolismo , Quinases Ciclina-Dependentes/genética , Ciclinas/genética , Plasma Rico em Plaquetas/metabolismo , Fator de Transcrição STAT3/metabolismo , Tendões/citologia , Animais , Proteína Quinase CDC2 , Quinase 2 Dependente de Ciclina/genética , Fator de Crescimento Derivado de Plaquetas/metabolismo , RNA Mensageiro/genética , Ratos , Fator de Crescimento Transformador beta/metabolismo , Regulação para Cima
9.
Psychol Med ; 45(11): 2263-73, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25902960

RESUMO

BACKGROUND: An uneven neurocognitive profile is a hallmark of autism spectrum disorder (ASD). Studies focusing on the visual memory performance in ASD have shown controversial results. We investigated visual memory and sustained attention in youths with ASD and typically developing (TD) youths. METHOD: We recruited 143 pairs of youths with ASD (males 93.7%; mean age 13.1, s.d. 3.5 years) and age- and sex-matched TD youths. The ASD group consisted of 67 youths with autistic disorder (autism) and 76 with Asperger's disorder (AS) based on the DSM-IV criteria. They were assessed using the Cambridge Neuropsychological Test Automated Battery involving the visual memory [spatial recognition memory (SRM), delayed matching to sample (DMS), paired associates learning (PAL)] and sustained attention (rapid visual information processing; RVP). RESULTS: Youths with ASD performed significantly worse than TD youths on most of the tasks; the significance disappeared in the superior intelligence quotient (IQ) subgroup. The response latency on the tasks did not differ between the ASD and TD groups. Age had significant main effects on SRM, DMS, RVP and part of PAL tasks and had an interaction with diagnosis in DMS and RVP performance. There was no significant difference between autism and AS on visual tasks. CONCLUSIONS: Our findings implied that youths with ASD had a wide range of visual memory and sustained attention impairment that was moderated by age and IQ, which supports temporal and frontal lobe dysfunction in ASD. The lack of difference between autism and AS implies that visual memory and sustained attention cannot distinguish these two ASD subtypes, which supports DSM-5 ASD criteria.


Assuntos
Síndrome de Asperger/fisiopatologia , Atenção , Transtorno do Espectro Autista/fisiopatologia , Memória , Percepção Visual , Adolescente , Adulto , Transtorno do Espectro Autista/classificação , Estudos de Casos e Controles , Criança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Adulto Jovem
10.
QJM ; 108(8): 633-40, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25614611

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease and allied conditions (COPD) is frequently associated with various comorbidities. This study examined the association between osteoporosis and pathologic fractures in a sample of patients with COPD. METHODS: In this cohort study, claims data from the National Health Insurance Research Database of Taiwan were used to evaluate the risk between COPD and osteoporosis. Using data from the Longitudinal Health Insurance Database 2000, we conducted a retrospective cohort study by investigating patients aged 20 years and older who were newly diagnosed with COPD and comparing them with controls without COPD during 2000-2010. In addition, we used univariable and multivariable Cox proportional hazards regression models to measure the association between COPD and the risk of osteoporosis. RESULTS: Our results revealed that COPD was significantly associated with a high risk of osteoporosis, regardless of whether the patients with COPD were corticosteroid users and irrespective of age and sex. After adjustment for covariates, the COPD patients exhibited a 1.54-fold higher risk of developing osteoporosis (hazard ratio 1.54, 95% confidence interval 1.44-1.64). COPD was a stronger risk factor for osteoporosis in men. Moreover, patients with severe COPD had a higher risk of osteoporosis or pathologic fractures. CONCLUSION: This study revealed that COPD, which shares the characteristics of inflammatory diseases, is associated with a higher risk of osteoporosis after adjustment for comorbidities.


Assuntos
Osteoporose/etiologia , Fraturas por Osteoporose/etiologia , Doença Pulmonar Obstrutiva Crônica/complicações , Adulto , Distribuição por Idade , Idoso , Estudos de Coortes , Comorbidade , Bases de Dados Factuais , Feminino , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Fraturas por Osteoporose/epidemiologia , Prednisolona/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Taiwan/epidemiologia , Adulto Jovem
11.
Infection ; 43(1): 117-20, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25156885

RESUMO

Little is known about the virulence and clinical impact on humans from infection with Anaeroglobus geminates, an anaerobic gram-negative coccus belonging to the family Veillonellaceae. We report the first case of an Anaeroglobus geminates invasive infection in humans characterized by pneumonia complicated with empyema. The pathogen was initially identified as Veillonella spp. by an automatic identification system (Becton-Dickinson and Company, Franklin Lakes, NJ, USA) and definitively identified following 16S ribosomal RNA gene sequence analysis. The patient was cured by surgical decortication and antimicrobial therapy. In this case, the combination of effective antibiotics, surgical intervention, and adequate drainage successfully cured the patient.


Assuntos
Empiema , Infecções por Bactérias Gram-Negativas , Pneumonia Bacteriana , Veillonellaceae , Idoso , DNA Bacteriano/análise , DNA Bacteriano/genética , Feminino , Humanos , Radiografia Torácica , Veillonellaceae/classificação , Veillonellaceae/genética
12.
J Appl Microbiol ; 118(1): 27-38, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25346320

RESUMO

AIMS: To investigate whether Photobacterium damselae subsp. piscicida (Phdp) can sense and directly respond to the presence of cationic antimicrobial peptides (AMPs). METHODS AND RESULTS: We performed proteomic methodologies to investigate the responsive proteins of Phdp on exposure to AMP Q6. Proteins significantly altered were analysed by two-dimensional gel electrophoresis (2-DE) and LC-ESI-Q-TOF MS/MS, thus resulting in five outer membrane proteins (OMPs), seven inner membrane proteins (IMPs) and 17 cytoplasmic proteins (CPs) identified. Quantitative real-time PCR was also applied to monitor the mRNA expression level of these target proteins. CONCLUSIONS: COG analysis revealed that upon exposure to AMP Q6, the majority of the upregulated proteins were involved in signal transduction mechanism, carbohydrate transport and metabolism, post-translational modification, protein turnover and chaperones, while the downregulated proteins were mainly related to energy production and conversion. Among them, phage-shock-protein A (PspA)-related stress response system was considered to play a crucial role. SIGNIFICANCE AND IMPACT OF THE STUDY: To the best of our knowledge, this is the first report elucidating Phdp AMP-response mechanism using proteomics approach. AMP-responsive proteins identified in this study could serve as attractive targets for developing more effective antimicrobial agents against Phdp and other marine bacterial pathogens.


Assuntos
Antibacterianos/farmacologia , Peptídeos Catiônicos Antimicrobianos/farmacologia , Proteínas de Bactérias/metabolismo , Proteínas de Choque Térmico/metabolismo , Photobacterium/efeitos dos fármacos , Proteínas de Membrana/metabolismo , Photobacterium/metabolismo , Photobacterium/ultraestrutura , Proteômica , Estresse Fisiológico
13.
Osteoporos Int ; 25(5): 1513-8, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24557014

RESUMO

UNLABELLED: Several differences may have existed between patients treated with peritoneal dialysis and hemodialysis because of the difference in dialysis modality. This nationwide population-based cohort study demonstrated that patients on hemodialysis had an increased risk of hip fracture compared to patients on peritoneal dialysis; the hazard ratio was 1.52. INTRODUCTION: Numerous debates on which dialysis modality is "superior" have taken place in recent decades. However, no large-scale study has ever mentioned about the relationship between dialysis modality and risk of hip fracture. METHODS: We identified 64,124 incident end-stage renal disease patients from the National Health Insurance Research Database in Taiwan between 1998 and 2008, including 59,457 (92.72%) hemodialysis (HD) and 4,667 (7.28%) peritoneal dialysis (PD) patients. After 8:1 propensity score matching, 31,554 patients, of whom 28,048 were HD and 3,506 were PD patients, were included in the study. We conducted the Cox proportional hazards model to examine the effects of dialysis modality and other variables on hip fracture risk. RESULTS: A total of 2,587 hip fractures were identified in 64,124 dialysis patients. The incidence rate of hip fracture was 13.60 per 1000 patient-years in the HD group and 6.25 in the PD group. Dialysis modality, sex, age, presence of cardiovascular disease, diabetes, medication with antiepileptic drugs, diuretics, steroids, and vitamin D had statistically significant associations with hip fracture. Patients on HD had an increased risk of hip fracture compared to patients on PD; the hazard ratio (HR) was 1.52 (95% CI: 1.09-2.12, P = 0.02). CONCLUSIONS: In this population-based cohort study, HD had a greater hip fracture risk compared to PD; the HR was 1.52. We should focus more on reducing the risk of hip fractures in hemodialysis patients.


Assuntos
Fraturas do Quadril/etiologia , Falência Renal Crônica/terapia , Fraturas por Osteoporose/etiologia , Diálise Renal/efeitos adversos , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Fraturas do Quadril/epidemiologia , Humanos , Incidência , Falência Renal Crônica/complicações , Falência Renal Crônica/epidemiologia , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/epidemiologia , Diálise Peritoneal/efeitos adversos , Diálise Renal/métodos , Distribuição por Sexo , Taiwan/epidemiologia
14.
QJM ; 107(7): 557-64, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24570479

RESUMO

BACKGROUND: We explore whether cardiologist service volume, hospital level and percutaneous coronary intervention (PCI) are associated with medical costs and acute myocardial infarction (AMI) mortality. METHODS: From the 1997-2010 Taiwan National Health Insurance Research Database of the National Health Research Institute, we identified AMI patients and performed multiple regression analyses to explore the relationships among the different hospital levels and treatment factors. RESULTS: We identified 2942 patients with AMI in medical centers and 4325 patients with AMI in regional hospitals. Cardiologist service volume, performing PCI and medical costs per patient were higher in medical centers than in regional hospitals (P < 0.0001). However, the two hospital levels did not differ significantly in in-hospital mortality (P = 0.1557). Post hoc analysis showed significant differences in in-hospital mortality rate and in medical costs among the eight groups subdivided on the basis of hospital level, cardiologist service volume, and whether PCI was performed (P < 0.001 and P = 0.001, respectively). CONCLUSIONS: These results highlight the importance of encouraging hospitals to develop PCI capability and increase their cardiologist service volume after taking medical costs into account. Transferring AMI patients to hospitals with higher cardiologist service volume and PCI performed can also be very important.


Assuntos
Serviço Hospitalar de Cardiologia/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Infarto do Miocárdio/terapia , Intervenção Coronária Percutânea/estatística & dados numéricos , Centros Médicos Acadêmicos/economia , Centros Médicos Acadêmicos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Serviço Hospitalar de Cardiologia/economia , Serviço Hospitalar de Cardiologia/organização & administração , Comorbidade , Bases de Dados Factuais , Feminino , Pesquisa sobre Serviços de Saúde/métodos , Mortalidade Hospitalar , Hospitais Comunitários/economia , Hospitais Comunitários/estatística & dados numéricos , Hospitais Urbanos/economia , Hospitais Urbanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/economia , Infarto do Miocárdio/mortalidade , Intervenção Coronária Percutânea/economia , Taiwan/epidemiologia , Carga de Trabalho/estatística & dados numéricos
15.
Singapore Med J ; 55(6): e93-5, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24442188

RESUMO

Hepatocellular carcinoma with colonic metastasis is rare. It mainly occurs by direct invasion and presents with bloody stools. We describe a patient with haematogenous metastasis to the rectum who presented with tenesmus. To our knowledge, such an association has not been reported previously. Colonic metastasis should be considered when patients with hepatocellular carcinoma present with bloody stools or tenesmus.


Assuntos
Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/patologia , Neoplasias Retais/secundário , Carcinoma Hepatocelular/complicações , Evolução Fatal , Hepatite B/complicações , Humanos , Neoplasias Hepáticas/complicações , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Pneumonia Aspirativa/complicações
16.
Int J Tuberc Lung Dis ; 17(9): 1229-34, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23928171

RESUMO

OBJECTIVE: To determine whether there were any defects in the presentation of the Mycobacterium tuberculosis antigen by monocytes from patients with tuberculosis (TB) and the role of vitamin D in the defence against M. tuberculosis. DESIGN: A prospective study aimed at analysing the presentation of the M. tuberculosis antigen by monocytes and the response to vitamin D treatment in three groups of participants: 1) those with active TB, 2) those with healed TB and 3) those with frequent TB contact. RESULTS: The antigen presentation ability of monocytes of persons in the frequent contact group was significantly higher than that of the active TB and healed TB groups. There was no difference between patients with active and healed TB. In addition, 1,25(OH)2D3 increased the presentation of mycobacterial antigens by monocytes from participants with frequent TB contact, but not those with active or healed TB. CONCLUSION: Patients with active and healed TB exhibit defective M. tuberculosis presentation in monocytes. The administration of vitamin D did not correct this defect in monocytes from participants with active or healed TB, but could increase antigen presentation by monocytes in participants with frequent TB contact.


Assuntos
Apresentação de Antígeno , Antígenos de Bactérias/imunologia , Monócitos/imunologia , Mycobacterium tuberculosis/imunologia , Linfócitos T/imunologia , Tuberculose Pulmonar/imunologia , Adulto , Apresentação de Antígeno/efeitos dos fármacos , Antituberculosos/farmacologia , Calcitriol/farmacologia , Células Cultivadas , Técnicas de Cocultura , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monócitos/efeitos dos fármacos , Monócitos/microbiologia , Mycobacterium tuberculosis/isolamento & purificação , Estudos Prospectivos , Escarro/microbiologia , Linfócitos T/efeitos dos fármacos , Linfócitos T/microbiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/microbiologia
17.
Int Nurs Rev ; 59(3): 353-61, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22897186

RESUMO

AIM: The purpose of this study is to investigate the impact of breast cancer awareness on the attendance for screening among women with breast cancer prior to diagnoses of breast cancer. BACKGROUND: Breast cancer is the most commonly diagnosed cancer for women in Taiwan and its incidence rate continues to increase. However, screening for breast cancer is still not common even if the incidence rate has topped the list from 2003 to 2010. METHODS: A cross-sectional study was conducted among women diagnosed with breast cancer. Subjects (535 women) were recruited from two medical centres in central Taiwan. Information on attendance for breast cancer screening was collected by self-report. Chi-square test and logistic regression were utilized to analyse the relationships between awareness of breast cancer and attendance at screening. FINDINGS: The results indicated that pre-diagnostic awareness of 'the concept of early treatment relating to higher cure rate'[odds ratio (OR): 4.09; 95% confidence interval (CI): 1.12-14.9], 'various breast cancer screening methods' (OR:3.00; 95% CI: 1.23-7.30), 'the coverage of breast cancer screening programme in the National Health Insurance' (OR:1.76; 95% CI: 1.03-3.02) and 'breast self-examination after each menstrual cycle' (OR:3.42; 95% CI: 1.99-5.87) were all significantly associated with the screening procedures performed. CONCLUSIONS: Findings of this study indicated that particular attention should be paid towards enhancement of women's knowledge for prevention and early detection of breast cancer through educational efforts by nurse professionals, medical institutions and/or civil organizations.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mamografia/estatística & dados numéricos , Educação de Pacientes como Assunto , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem
18.
J Chem Phys ; 135(16): 164704, 2011 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-22047260

RESUMO

Continuous-time core-level photon-stimulated desorption (PSD) spectroscopy was used to study the soft x-ray-induced reactions of CF(3)Br molecules adsorbed on Si(111)-7×7 near the Si(2p) edge (98-110 eV). The monochromatic synchrotron radiation was employed as a soft x-ray light source in the photon-induced reactions and also as a probe for investigating the produced fluorination states of the bonding surface Si atom in the positive-ion PSD spectroscopy. Several different surface coverages were investigated. The PSD spectra from the low-CF(3)Br-covered surfaces show the production of surface SiF species, while those from the high-CF(3)Br-covered surfaces depict the formation of surface SiF, SiF(2), and SiF(3) species. The photolysis cross section of the submonolayer CF(3)Br-covered surface is determined as ∼4.3×10(-18) cm(2). A comparison with the results on CF(3)Cl/Si(111)-7×7 surface is discussed.

19.
J Phys Condens Matter ; 23(43): 435011, 2011 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-21996577

RESUMO

Continuous-time core-level photon-stimulated desorption (PSD) spectroscopy was used to investigate the monochromatic soft x-ray photoreactions of CF(2)Cl(2) adsorbed on Si(111)-7 × 7 near the F(1s) edge (681-704 eV). Sequential F(+) PSD spectra were observed as a function of photon exposure at the CF(2)Cl(2)-covered surface (dose = 2.0 × 10(14) molecules cm(-2), ∼0.75 monolayer). The F(+) PSD and total electron yield (TEY) spectra of solid CF(2)Cl(2) near the F(1s) edge were also measured. Both F(+) PSD and TEY spectra depict three features in the energy range of 687-695 eV, and are assigned to the excitations of F(1s) to (13a(1) + 9b(2))[(C-Cl)(∗)], (7b(1) + 14a(1))[(C-F)∗] antibonding and 5p Rydberg orbitals, respectively. Following the Auger decay process, two holes are created in the C-F bonding orbitals producing the 2h1e final state which results in the F(+) desorption. This PSD mechanism, responsible for the F(+) PSD of solid CF(2)Cl(2), is used to explain the first F(+) PSD spectrum in the sequential F(+) PSD spectra. The variation of spectral shapes in the sequential F(+) PSD spectra shows the consumption of adsorbed CF(2)Cl(2) molecules and the production of surface SiF species as a function of photon exposure. The photolysis cross section of the adsorbed CF(2)Cl(2) molecules by photons with varying energy (681-704 eV) is deduced from the sequential F(+) PSD spectra and found to be ∼6.0 × 10(-18) cm(2).


Assuntos
Clorofluorcarbonetos de Metano/química , Silício/química , Espectrofotometria/métodos , Adsorção , Carbono/química , Físico-Química/métodos , Cloro/química , Elétrons , Flúor/química , Íons , Modelos Químicos , Fótons , Propriedades de Superfície , Raios X
20.
Appl Radiat Isot ; 69(12): 1850-3, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21530281

RESUMO

This paper aims to evaluate the effective dose as well as equivalent doses of several organs of an adult hermaphrodite mathematical phantom according to the definition of ICRP Publication 60 for BNCT treatments of brain tumors in the epithermal neutron beam at THOR. The MCNP5 Monte Carlo code was used for the calculation of the average absorbed dose of each organ. The effective doses for a typical brain tumor treatment with a tumor treatment dose of 20 Gy-eq were evaluated to be 0.59 and 0.35 Sv for the LLAT and TOP irradiation geometries, respectively. In addition to the stochastic effect, it was found that it is also likely to produce deterministic effects, such as cataracts and depression of haematopoiesis.


Assuntos
Terapia por Captura de Nêutron de Boro , Neoplasias Encefálicas/radioterapia , Humanos , Método de Monte Carlo
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