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2.
J Matern Fetal Neonatal Med ; 37(1): 2337720, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38616183

RESUMO

OBJECTIVE: Infants who meet the screening guidelines for retinopathy of prematurity (ROP) based on birth weight and gestational age undergo serial ophthalmological examinations for its detection and treatment. However, <10% of patients require treatment, and less than half develop ROP. Poor postnatal weight gain has been reported to be a strong indicator of ROP development; however, the information regarding this is unclear. Therefore, this study aimed to determine the relationship between postnatal weight gain and ROP development in preterm infants. METHODS: The data of 675 preterm infants with gestational age ≤32 weeks, who were hospitalized in our neonatal intensive care unit, were obtained retrospectively from file records. The infants' demographic characteristics, clinical findings, and weekly weight gain (g/kg/day) during the first 8 weeks were recorded. The univariate was used to examine the risk factors for ROP followed by multivariate regression. RESULTS: The incidence of ROP in the infants included in the study was 41% (n = 278) and 13.3% (n = 37) of them required treatment. In the infants of the group that developed ROP, the mean birth weight and gestational age were significantly lower than those in the group that did not develop ROP (973 ± 288 and 1301 ± 349 g, p = 0.001 and 28.48 ± 1.95 and 30.08 ± 1.60 weeks, p = 0.001, respectively). As the gestational week and birth weight decreased, ROP development and the risk of ROP-requiring treatment increased. In the infants of the group that developed ROP, the mean weight gain in the postnatal third week was detected as significantly lower compared to those in the group that did not develop ROP (13.9 ± 8.2 and 15.4 ± 6.8 g, p = 0.034). On multiple logistic regression analysis, birth weight (<750 g) (odds ratio [OR], 8.67; 95% confidence interval [CI], 3.99-18.82, p = 0.001), blood transfusion (OR, 2.39; 95% CI, 1.34-4.24, p = 0.003), necrotizing enterocolitis (OR, 4.79; 95% CI, 1.05-26.85, p = 0.045), bronchopulmonary dysplasia (OR, 2.03; 95% CI, 1.22-3.36, p = 0.006), antenatal steroid therapy (OR, 1.60; 95% CI, 1.05-2.43, p = 0.028), surfactant administration (OR, 2.06; 95% CI, 1.32-3.2, p = 0.001) were independent risk factors for ROP development. CONCLUSION: Postnatal weight gain may not be an accurate predictor of ROP development after adjusting for confounding factors. However, the analysis of independent risk factors that influenced the development of ROP revealed a statistically significant effect in cases of low birth weight, blood transfusion, necrotizing enterocolitis, bronchopulmonary dysplasia, and antenatal steroid and surfactant therapies. These findings may help ophthalmologists and neonatologists to pay special attention to this patient group during ROP scanning.


Assuntos
Displasia Broncopulmonar , Enterocolite Necrosante , Retinopatia da Prematuridade , Gravidez , Lactente , Recém-Nascido , Humanos , Feminino , Recém-Nascido Prematuro , Peso ao Nascer , Estudos Retrospectivos , Retinopatia da Prematuridade/epidemiologia , Retinopatia da Prematuridade/etiologia , Esteroides , Tensoativos
3.
J Am Heart Assoc ; : e033396, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38639359

RESUMO

BACKGROUND: For the majority of patients with atrial fibrillation (AF), disease management has improved in recent years. However, there are still populations underrepresented or excluded in current registries and randomized controlled trials. HERA-FIB (Heidelberg Registry of Atrial Fibrillation) was planned to assess real-world evidence for the prevalence, demographic characteristics and management of patients with the diagnosis of AF presenting consecutively to a chest pain unit. METHODS AND RESULTS: HERA-FIB is a retrospective, observational, single-center study on patients with a diagnosis of AF presenting to a chest pain unit from June 2009 until March 2020. This article describes the structure, governance, outcome assessment, quality and data collection processes of the registry. Additionally, characteristics of populations of special interest are described. The study consecutively enrolled 10 222 patients presenting with AF to the chest pain unit of the University Hospital of Heidelberg. Clinical parameters and patient characteristics were assessed retrospectively. Outcome parameters included rates for all-cause death, stroke, myocardial infarction and major bleedings. We were able to investigate patient cohorts of special interest such as advanced chronic kidney disease, octogenarians, and those with acute coronary syndrome who are often underrepresented in current studies and randomized controlled trials. CONCLUSIONS: HERA-FIB is one of the largest real-world single-center retrospective registries on patients with AF, which captures the era of transition from vitamin K antagonists to non-vitamin K oral anticoagulation regimens in clinical practice and offers the possibility to investigate patient populations usually underrepresented or excluded in current available randomized controlled trials and registries. REGISTRATION: URL: https://www.clinicaltrials.gov; unique identifier: NCT05995561.

4.
Infect Dis Clin Microbiol ; 6(1): 22-31, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38633437

RESUMO

Objective: This study aimed to determine the predictors for significant hepatic abnormality (SHA), a treatment indication, by assessing demographic, laboratory, and radiological results of chronic hepatitis B (CHB) patients who underwent liver biopsy. Materials and Methods: In this retrospective study, individuals with untreated hepatitis B e-antigen (HBeAg)-negative CHB infection were enrolled. Multivariate analysis modeling was conducted with parameters identified as predictors for SHA in univariate analysis. Optimal threshold levels for variables to predict SHA in patients with chronic hepatitis B were determined based on receiver operating characteristic (ROC) curve analysis. Results: A total of 566 patients with untreated chronic hepatitis B were included in the cohort; 61% (345/566) were male, and the median age was 41 years (interquartile range [IQR]=34-50). Notably, 36.9% (209/566) had SHA. In the multivariate analysis, utilizing different models, age, gender, HBV-DNA, LDL, ALT, and platelet count were identified as the most reliable predictors for SHA in CHB patients. For predicting SHA, the area under the ROC curve values of HBV-DNA, AST, and ALT were 0.704 (sensitivity=62.8%, specificity=76.2%; p<0.0001), 0.747 (sensitivity=51.9%, specificity=88.9%; p<0.0001), and 0.737 (sensitivity=68.6%, specificity=68.4%; p<0.0001), respectively. Conclusion: In our study, age, male gender, ALT, AST, HBV-DNA, LDL cholesterol, platelet count, and FIB-4 score were independent predictors of SHA in HBeAg-negative chronic hepatitis B. The most sensitive parameters for SHA were LDL and ALT. The most specific parameters were age, AST, and APRI score. SHA may occur in patients with high HBV-DNA levels, even if ALT values are normal in HBeAg-negative patients.

5.
Rev Assoc Med Bras (1992) ; 70(4): e20231036, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38537007

RESUMO

OBJECTIVE: There are limited data on non-alcoholic fatty liver disease in chronic hepatitis B virus infection. We aimed to determine the predictors for non-alcoholic fatty liver disease in patients with treatment-naïve chronic hepatitis B virus infection. METHODS: All consecutive treatment-naïve patients with chronic hepatitis B virus infection at the Haseki Training and Research Hospital between October 1, 2021, and September 31, 2022, were retrospectively enrolled. Chronic hepatitis B virus infection is defined by positive serum hepatitis B surface antigen for 6 months or more. Patients with significant alcohol consumption, prolonged steatogenic drug use, malignancy, monogenic hereditary disorders, patients co-infected with hepatitis D virus, hepatitis C virus infection, or human immunodeficiency virus were excluded. Demographic characteristics, anthropometric determinants, laboratory findings, and virological parameters were retrospectively collected from patients' charts and electronic medical records. RESULTS: A total of 457 patients with treatment-naïve chronic hepatitis B virus infection were included in the study. The three multivariate regression models revealed that age (p<0.028), body mass index (p=0.046), diabetes mellitus (p=0.030), hemoglobin (p=0.008), platelet (p=0.012), and triglyceride (p=0.002) in Model 1; body mass index (p=0.033), diabetes mellitus (p<0.001), hemoglobin (p=0.008), platelet (p=0.004), LDL (p=0.023), and HDL (p=0.020) in Model 2; and age (p<0.001), body mass index (p=0.033), hemoglobin (p=0.004), platelet (p=0.004), and HDL (p=0.007) in Model 3 were independent predictors. CONCLUSION: Non-alcoholic fatty liver disease was observed in about one-third of patients with chronic hepatitis B virus infection and was positively associated with older age, higher body mass index, presence of comorbid conditions including diabetes mellitus, increased levels of metabolic laboratory parameters, especially serum triglyceride and LDL, and decreased HDL.


Assuntos
Diabetes Mellitus , Hepatite B Crônica , Hepatite B , Hepatopatia Gordurosa não Alcoólica , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatite B Crônica/complicações , Estudos Retrospectivos , Triglicerídeos , Hemoglobinas , Hepatite B/complicações , Fígado
6.
Cureus ; 16(1): e53089, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38414686

RESUMO

BACKGROUND: The current study aimed to compare the posterior cruciate ligament (PCL) index values of patients who underwent hamstring tendon (HT) autograft reconstruction due to an anterior cruciate ligament (ACL) tear. The comparison involved assessing these values in a similar cohort and evaluating the association between the alteration in the PCL index and functional results. METHODS: Patients who were clinically diagnosed with a complete, unilateral ACL tear and underwent ACL reconstruction (ACLR) using HT autograft between January 2018 and January 2021 constituted the operated group (Group 1) of the study. The control group (Group 2) consisted of patients selected from a convenience sample without ACL rupture, meniscal lesion, or cartilage damage who underwent an MRI during an outpatient orthopaedic consultation for knee pain. The operated group was submitted for an MRI of the knee one year after the operation for any reason such as pain, graft healing, the presence of tunnel widening, or suspicion of re-rupture. The International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form and the Lysholm Scoring System were applied to the patients in the operated group in the preoperative and postoperative periods to evaluate their complaints, function, and participation in sports and to assess functional ability and functional capacity. A radiologist with five years of experience measured the PCL index in the sagittal section of an MRI. In the operated group, changes in PCL index, IKDC, and Lysholm values during the postoperative period were assessed, along with their correlation. Additionally, a comparison was made between the values of the operated group and the non-operated group. RESULTS: No statistically significant correlation was found between the PCL index alteration and the functional score alteration (IKDC and Lysholm) in the operated group (p>0.05). In comparison to the non-operated group, the preoperative PCL index measures of the operated group were significantly lower (p: 0.000; p<0.05). The increase in the postoperative PCL index measurements of the operated group was similarly statistically significant (p: 0.000; p<0.05). CONCLUSION: Although the PCL index appears to be a strong anatomical structural parameter in ACLR patients performing HT autograft in the postoperative period, its correlation with functional results is weak.

7.
J Orofac Orthop ; 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38378857

RESUMO

PURPOSE: The aim of this respectively cohort study was to evaluate the lower second and third molars and canine angulations, retromolar space and occlusal relationships after functional orthodontic treatments with the monoblock or Herbst appliance using panoramic radiographs. METHODS: Pre- and posttreatment cephalometric and panoramic radiographs of 133 patients (mean age 13.89 ± 1.14 years) treated non-extraction with monoblock (n: 44), Herbst (n: 45) and fixed orthodontic appliances (control group; n: 44) were included to the study. Dental and skeletal measurements were performed on cephalometric radiographs. The angle between the third and second molars, and canines with the lower border of the mandible and the occlusal plane, gonial angle, the angle between the third and second molars and the retromolar space width were assessed on pre- and posttreatment panoramic radiographs. Paired and independent t tests were used for the statistical analysis of the data for intragroup and intergroup comparisons. RESULTS: Functional treatment with both the monoblock and the Herbst appliances resulted in improvement of skeletal class II relationships. Retromolar space significantly increased in the functional appliance groups compared to the control group (p ≤ 0.001), but improvement of the angulations of posterior teeth was significant only in the monoblock group (p ≤ 0.001). CONCLUSION: While both the Herbst and monoblock appliances led to an increase in retromolar space, monoblock treatment resulted in more favorable angulation of the third molars compared to the Herbst treatment.

8.
Int J Cardiol ; 400: 131815, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38278492

RESUMO

BACKGROUND: The clinical chemistry score (CCS) comprising high-sensitivity cardiac troponins (hs-cTn), glucose and estimated glomerular filtration rate has been previously validated with superior accuracy for detection and risk stratification of acute myocardial infarction (AMI) compared to hs-cTn alone. METHODS: The CCS was compared to other biomarker-based algorithms for rapid rule-out and prognostication of AMI including the hs-cTnT limit-of-blank (LOB, <3 ng/L) or limit-of-detection (LOD, <5 ng/L) and a dual marker strategy (DMS) (copeptin <10 pmol/L and hs-cTnT ≤14 ng/L) in 1506 emergency department (ED) patients with symptoms suggestive of acute coronary syndrome. Negative predictive values (NPV) and sensitivities for AMI rule-out, and 12-month combined endpoint rates encompassing mortality, myocardial re-infarction, as well as stroke were assessed. RESULTS: NPVs of 100% (95% CI: 98.3-100%) were observed for CCS = 0, hs-cTnT LoB and hs-cTnT LoD with rule-out efficacies of 11.1%, 7.6% and 18.3% as well as specificities of 13.0% (95% CI: 9.9-16.6%), 8.8% (95% CI: 7.3-10.5%) and 21.4% (95% CI: 19.2-23.8%), respectively. A CCS ≤ 1 achieved a rule-out in 32.2% of all patients with a NPV of 99.6% (95% CI: 98.4-99.9%) and specificity of 37.4% (95% CI: 34.2-40.5%) compared to a rule-out efficacy of 51.2%, NPV of 99.0 (95% CI: 98.0-99.5) and specificity of 59.7% (95% CI: 57.0-62.4%) for the DMS. Rates of the combined end-point of death/AMI within 30 days ranged between 0.0% and 0.7% for all fast-rule-out protocols. CONCLUSIONS: The CCS ensures reliable AMI rule-out with low short and long-term outcome rates for a specific ED patient subset. However, compared to a single or dual biomarker strategy, the CCS displays reduced efficacy and specificity, limiting its clinical utility.


Assuntos
Síndrome Coronariana Aguda , Infarto do Miocárdio , Humanos , Síndrome Coronariana Aguda/diagnóstico , Algoritmos , Biomarcadores , Química Clínica , Serviço Hospitalar de Emergência , Infarto do Miocárdio/diagnóstico , Estudos Prospectivos , Medição de Risco , Troponina T
9.
Artigo em Inglês | MEDLINE | ID: mdl-38160332

RESUMO

BACKGROUND: Many formulations and dosing regimens are available for hyaluronic acid (HA). OBJECTIVE: To compare different doses of linear, high-molecular weight (HMW) HA injections among patients with knee osteoarthritis (OA). METHODS: Hundred patients were included in this randomized, single-blinded trial and randomly divided into three HA injection groups. The first group received five weekly 20 mg HA injections, the second group received three weekly 32 mg HA injections, and the third group received a single 48 mg HA injection. Patients were evaluated at baseline, 1, 3, and 6 months after the last injection for pain, stiffness, and function using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Quality of life, patient's global assessment, and Timed Up and Go (TUG) test scores were also evaluated. RESULTS: There was significant improvement in the WOMAC, VAS-pain, quality of life, patient's global assessment, and TUG test mean scores at all follow-up time points (p< 0.001). However, the groups showed no significant differences in WOMAC, VAS-activity pain, and patient global scores at any follow-up point. CONCLUSION: Intra-articular injections of different doses of linear HMW HA can improve pain, stiffness, function, and quality of life in patients suffering from knee OA over a six-month period.

10.
Eurasian J Med ; 55(3): 249-253, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37909199

RESUMO

OBJECTIVE: Based on several studies, atrial remodeling results in an increase in left atrial (LA) stiffness, which is indicative of a worsened reservoir function. A typical microvascular consequence of diabetes mellitus (DM) is diabetic retinopathy. Therefore, the objective of this study was to assess the factors that might be related to LA stiffness in DM patients. MATERIALS AND METHODS: There were 200 DM patients in the study population. The LA stiffness value of 0.33 led to the division of the patients into 2 groups. According to these groups, the parameters to predict the development of the LA stiffness were investigated. RESULTS: The patient population's median age was 54.7 ± 9.4 years, and of them, 105 (52.5% of the population) were men. Retinopathy was substantially linked with LA stiffness. Interventricular septum thickness (B coefficient: 0.261, 95% CI 0.128; 0.394; P < .001), mitral annular plane systolic excursion (B coefficient: -0.350, 95% CI -0.489; -0.2212; P < 0.001), and retinopathy (B coefficient: 0.644, 95% CI 0.307; 0.983; P < .001) were identified as independent predictors of the progression of LA stiffness by the linear regression model. CONCLUSION: The results of the current investigation demonstrated a correlation between higher LA stiffness values and the presence of diabetic retinopathy in diabetic patients.

11.
Comput Biol Chem ; 107: 107961, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37788543

RESUMO

COVID-19, caused by infection with the SARS-CoV-2 has become a global health problem due to significant mortality rates; the exact pathophysiological mechanism remains uncertain. Articles reporting patient data are quite heterogeneous and have several limitations. Surviving patients develop a CD4 and CD8 T-cell response to the virus SARS-CoV-2 during COVID-19. Interestingly, pre-existing virus-reactive T-cells have been found in patients that were not infected before, suggesting some form of cross-reactivity or immunological mimicry. To better understand this phenomenon, we performed a bioinformatic study, which was aimed to identify antigenic structures that may explain the presence of such "reactive" T-cells, which may support or modulate the immune response to SARS-CoV-2 infections. Seven different common environmental allergen epitopes identical to the SARS-CoV-2 S-protein were identified that share affinity to 8 MHCI-specific epitope regions. Pollen showed the greatest similarity with the S protein epitope. In the epitope similarity analysis between the S protein and MHC-II / T helper epitopes, the highest similarity was determined for mites. When S-protein that stimulates B cells and identical epitope antigens are examined, the most common allergens were hornbeam and wheat. The high epitope similarity observed for the allergens examined and S protein epitopes suggest that these allergens may be a reason for pre-existing SARS-CoV-2 - reactive T-cells in previously non-infected subjects and such a previous exposure may affect the course of the disease in COVID-19 infection. It remains to be determined whether such a previous existence of SARS-CoV-2 reactive cells can support the clearance of the virus or if they, in contrast, may even aggravate the disease course. (Table 4, Ref 54).


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Epitopos de Linfócito T , Imunidade , Alérgenos , Biologia Computacional
12.
Opt Lett ; 48(20): 5249-5252, 2023 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-37831839

RESUMO

Neural networks (NNs) have demonstrated remarkable capabilities in various tasks, but their computation-intensive nature demands faster and more energy-efficient hardware implementations. Optics-based platforms, using technologies such as silicon photonics and spatial light modulators, offer promising avenues for achieving this goal. However, training multiple programmable layers together with these physical systems poses challenges, as they are difficult to fully characterize and describe with differentiable functions, hindering the use of error backpropagation algorithm. The recently introduced forward-forward algorithm (FFA) eliminates the need for perfect characterization of the physical learning system and shows promise for efficient training with large numbers of programmable parameters. The FFA does not require backpropagating an error signal to update the weights, rather the weights are updated by only sending information in one direction. The local loss function for each set of trainable weights enables low-power analog hardware implementations without resorting to metaheuristic algorithms or reinforcement learning. In this paper, we present an experiment utilizing multimode nonlinear wave propagation in an optical fiber demonstrating the feasibility of the FFA approach using an optical system. The results show that incorporating optical transforms in multilayer NN architectures trained with the FFA can lead to performance improvements, even with a relatively small number of trainable weights. The proposed method offers a new path to the challenge of training optical NNs and provides insights into leveraging physical transformations for enhancing the NN performance.

13.
J Infect Dev Ctries ; 17(8): 1055-1062, 2023 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-37699088

RESUMO

INTRODUCTION: Ischemia-modified albumin (IMA) level increases in inflammatory conditions. We aimed to investigate the association between IMA levels and the severity of coronavirus disease 2019 (COVID-19) infection in adult patients. METHODOLOGY: We grouped adult patients with COVID-19 infection: Group A - mild symptoms, but normal computed tomography (CT), Group B - mild/moderate illness, and Group C - severe or critical illness. We measured IMA levels at the time of diagnosis of COVID-19 infection. RESULTS: Mean age of the total number of patients (n = 90) was 54.43 (± 8.11) year, and 46.7% (n = 42) were female. IMA levels were highest in Group C and lowest in A (p < 0.001). The most important factor predicting COVID-19 disease severity was IMA. Type 2 diabetes was more frequent in Group C (n = 31) than in Group B (n = 30) (p = 0.042). Asthma was less frequent, and coronary artery disease was more frequent in Group C than in Group A (n = 29) and B (p = 0.009). Duration of hospitalization was highest in Group C (p < 0.001). CONCLUSIONS: We analyzed a sample of patients with COVID-19 infection and found that IMA predicted severe COVID-19 disease. Disease severity grouping was based on patients' clinical and radiological features. IMA level measured when SARS-CoV-2 infection is diagnosed may be a useful marker in predicting likely disease severity or intensive care need.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 2 , Adulto , Humanos , Feminino , Masculino , Biomarcadores , COVID-19/diagnóstico , SARS-CoV-2 , Albumina Sérica , Índice de Gravidade de Doença
14.
J Am Heart Assoc ; 12(16): e030879, 2023 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-37581388

RESUMO

Background Management of patients with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) is based on 2020 European Society of Cardiology guidelines, which recommend the preferential use of prasugrel over ticagrelor. Because the selection of the respective P2Y12 inhibitor has to consider label restrictions, we sought to evaluate the proportion of patients qualifying for either ticagrelor or prasugrel and reasons for noneligibility in an unselected cohort of patients with acute coronary syndrome. Methods and Results In this retrospective observational study, patients with ST-segment-elevation myocardial infarction (STEMI) or NSTE-ACS presenting consecutively during a 24-month period were enrolled. The eligibility of patients for a dual antiplatelet therapy option was assessed retrospectively. A total of 1502 patients had confirmed acute coronary syndrome (287 STEMI and 1215 NSTE-ACS). Eligibility for ticagrelor and full-dose prasugrel differed significantly for STEMI and NSTE-ACS (93% versus 51%, P<0.0001 versus 80% versus 31%, P<0.0001). Eligibility remained significantly lower (STEMI 78% versus NSTE-ACS 52%) if low-dose prasugrel was considered. Patients eligible for full-dose prasugrel had lower ischemic risk per GRACE (Global Registry of Acute Coronary Events) score (109 points [90-129 points] versus 121 points [98-146 points], P<0.0001) and lower bleeding risk (14 points [13-15 points] versus 20 points [12-29 points], P<0.0001) per PRECISE-DAPT (Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy) score. Conclusions In real life, eligibility for prasugrel in patients requiring dual antiplatelet therapy is considerably lower than for ticagrelor, even in a cohort with high rates of coronary angiography and percutaneous coronary interventions. The recommended use of prasugrel over ticagrelor in current acute coronary syndrome guidelines contrasts with our observations of a substantial disparity on the eligibility. This important aspect has not received appropriate attention yet. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT05774431.


Assuntos
Síndrome Coronariana Aguda , Infarto do Miocárdio , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Humanos , Ticagrelor/efeitos adversos , Cloridrato de Prasugrel/efeitos adversos , Inibidores da Agregação Plaquetária/efeitos adversos , Síndrome Coronariana Aguda/tratamento farmacológico , Síndrome Coronariana Aguda/etiologia , Estudos Retrospectivos , Infarto do Miocárdio com Supradesnível do Segmento ST/tratamento farmacológico , Infarto do Miocárdio/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Resultado do Tratamento , Antagonistas do Receptor Purinérgico P2Y/efeitos adversos
15.
Turk J Med Sci ; 53(3): 780-790, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37476892

RESUMO

BACKGROUND: To have country-wide information about multidrug resistance (MDR) in isolates from community-acquired urinary tract infections (CAUTI) of Turkey, in terms of resistance rates and useful options. METHODS: We used a geocode standard, nomenclature of territorial units for statistics (NUTS), and a total of 1588 community-acquired isolates of 20 centres from 12 different NUTS regions between March 2019 and March 2020 were analysed. RESULTS: Of the 1588 culture growths, 1269 (79. 9%) were Escherichia coli and 152 (9.6%) were Klebsiella spp. Male sex, advancedage, and having two or more risk factors showed a statistically significant relation with MDR existence (p < 0.001, p: 0.014, p < 0.001, respectively) that increasing number of risk factors or degree of advancing in age directly affects the number of antibiotic groups detected to have resistance by pathogens. In total, MDR isolates corresponded to 36.1% of our CAUTI samples; MDR existence was 35.7% in E. coli isolates and 57.2% in Klebsiella spp. isolates. Our results did not show an association between resistance or MDR occurrence rates and NUTS regions. DISCUSSION: The necessity of urine culture in outpatient clinics should be taken into consideration, at least after evaluating risk factorsfor antibacterial resistance individually. Community-acquired UTIs should be followed up time- and region-dependently. Antibiotic stewardship programmes should be more widely and effectively administrated.


Assuntos
Infecções Comunitárias Adquiridas , Infecções por Escherichia coli , Esclerose Múltipla Recidivante-Remitente , Esclerose Múltipla , Infecções Urinárias , Humanos , Masculino , Escherichia coli , Infecções por Escherichia coli/microbiologia , Esclerose Múltipla Recidivante-Remitente/complicações , Universidades , Farmacorresistência Bacteriana Múltipla , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Klebsiella , Antibacterianos/uso terapêutico , Antibacterianos/farmacologia , Testes de Sensibilidade Microbiana
16.
Turk J Emerg Med ; 23(2): 82-87, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37169036

RESUMO

OBJECTIVE: In this study, we aimed to evaluate the performance of emergency department intubations for 1 year. METHODS: This was a retrospective analysis of prospectively collected data. The collected variables were patient demographics, indication for intubation, preintubation hemodynamics, preoxygenation methods, medications used for premedication, induction and paralysis, type of laryngoscope used, Cormack-Lehane (C-L) grades, number of intubation attempts, and peri-intubation adverse events. RESULTS: A total of 194 patients were included. The median age of the population was 66.5 years (53.75-79); 61.9% of the patients were male. The majority of the patients were intubated due to medical conditions. The main indication for endotracheal intubation was respiratory failure in 38.6% of the patients. Preoxygenation before intubation was performed in 87.2% of the patients. Fifty-eight percent of the population were hemodynamically stable before the intubation. Fentanyl was the agent used for premedication, induction agents of choice were ketamine and midazolam, and rocuronium was the neuromuscular blocking agent. The C-L grades 1 and 2 were detected in 87.6% of the patients. The first-pass success rate was 72.8%. The peri-intubation adverse events were mainly hypotension and desaturation observed in 82 (42%) patients. The patients with higher C-L grades needed more intubation attempts (P < 0.001). Peri-intubation adverse events were associated with the increased number of intubation attempts (P < 0.001). CONCLUSION: This and similar studies or an airway registry on a national level may help improve the quality of service given and delineate the deficiencies of the airway-related procedures in the emergency department.

17.
Talanta ; 261: 124660, 2023 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-37207509

RESUMO

Detection of bisulfite (HSO3-) in food and beverages has vital importance because the excessive amount leads to ill effects on the human body. Colorimetric and fluorometric chromenylium-cyanine-based chemosensor CyR was synthesized and applied for high selective and sensitive analysis of HSO3- in red wine, rose wine and, granulated sugar with high recovery ranges and very fast response time without any interference from other competitive species. The limits of detection (LOD) for the UV-Vis and fluorescence titrations were found as 11.5 µM and 3.77 µM, respectively. The on-site and very rapid methods based on paper strips and smartphone which depend on the color changes from yellow to green have been successfully developed to analyze HSO3- concentration (10-5-10-1 M for paper strip and 163-1205 µM for smartphone). CyR and the bisulfite-adduct formed in the nucleophilic addition reaction with HSO3- were verified by FT-IR, 1H NMR, and MALDI-TOF results as well as Single-Crystal X-Ray Crystallography for CyR.


Assuntos
Corantes Fluorescentes , Vinho , Humanos , Corantes Fluorescentes/química , Colorimetria/métodos , Smartphone , Espectroscopia de Infravermelho com Transformada de Fourier , Vinho/análise
18.
Spectrochim Acta A Mol Biomol Spectrosc ; 297: 122725, 2023 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-37075687

RESUMO

A new near-infrared, spectrophotometric, and colorimetric probe based on a phthalocyanine-containing mercaptoquinoline unit (MQZnPc) has been constructed and utilized for discriminative and highly selective/sensitive detection of Ag+, Cu2+, and Hg2+ ions by using proper masking agents like EDTA, KI, and NaCl. The probe only responds to Ag+, Cu2+, and Hg2+ among the tested ions without any interference. The probe performs quite well (the limit of detection: 160 ppb, 148 ppb, and 276 ppb of Ag+, Cu2+, and Hg2+ions for UV-Vis, and 15 ppb, 37 ppb, and 467 ppb of Ag+, Cu2+, and Hg2+ ions for fluorescence, respectively), and has a fast response time (150 sec, 90 sec, and 90 sec of Ag+, Cu2+, and Hg2+ions for UV-Vis, and 300 sec, 240 sec, and 90 sec Ag+, Cu2+, and Hg2+ions for fluorescence, respectively). The probe also displays a colorimetric feature for UV-Vis and smartphone applications. Based on a single probe, Ag+, Cu2+, and Hg2+ ions which are the main toxic water contaminants could be recognized very quickly and colorimetrically with high recovery values in tap water samples. This study stands out with its unique properties compared to the related studies in the literature.

20.
Talanta ; 259: 124471, 2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-37001401

RESUMO

The objective of the study is, for the first time, to construct a new near infrared (NIR) fluorophore, spectrophotometric, colorimetric, ratiometric, and turn-on probe (CSME) based on chromenylium cyanine platform decorated with methionine biomolecule to provide an efficient solution for critical shortcoming to be encountered for analysis of hazardous Hg2+ in environment and living cell. The CSME structure and its interaction with Hg2+ ion were evaluated by NMR, FTIR, MS, UV-Vis and fluorescence methods as well as Density Functional Theory (DFT) calculations. The none fluorescence CSME having spirolactam ring only interacted with Hg2+ in aqueous solution including competing ions. This interaction caused the fluorescence CSME with opened spirolactam form which exhibited spectral and colorimetric changes in the NIR region. The probe based on UV-Vis and fluorescence techniques respond in 90 s, has wide linear ranges (for UV-Vis: 6.29 × 10-8 - 1.86 × 10-4 M; for fluorescence: 9.49 × 10-9 - 1.13 × 10-5 M), and has a lower Limit of Detection (LOD) value (for fluorescence: 4.93 × 10-9 M, 0.99 ng/mL) than the value predicted by the US Environmental Protection Agency (EPA) organization. Hg2+ analysis was performed in drinking and tap water with low Relative Standard Deviation (RSD) values and high recovery. Smartphone and living cell applications were successfully performed for colorimetric sensing Hg2+ in real samples and 3T3 cells, respectively.


Assuntos
Corantes Fluorescentes , Mercúrio , Camundongos , Animais , Corantes Fluorescentes/química , Metionina , Água/química , Racemetionina , Mercúrio/análise
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