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1.
Braz. j. biol ; 83: e249229, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1339374

RESUMO

Abstract Birds are very valuable indicators of species richness and endemic patterns in a specified ecosystem, which eventually help the scientist to measure the environmental degradation. The aim of present study was to know human knowledge and attitude toward urban birds in Faisalabad city, Pakistan. The study conducted in four consecutive months: November 2019 to February 2020. Population of birds was noted from eight residential towns of Faisalabad city, data were collected through questionnaire. Faisalabad has a reasonably large population of birds and present data show that, there is a significant difference between favorite bird of residential areas and institutions. The pigeon received the most likeness in bird population among residential area residents, while the myna received the least. The most popular bird in Faisalabad institutions was the sparrow, while the least popular bird was the common myna. Bird adaptation percentage of residential areas and institutional areas of Faisalabad was the highest for parrot and sparrow respectively. People in residential areas and institutions, on the other hand, adapted least to common myna. It is concluded that people of the study area like birds and offered food and high population of birds are present in study area.


Resumo Os pássaros são indicadores muito valiosos da riqueza de espécies e padrões endêmicos em um determinado ecossistema, o que acaba ajudando o cientista a medir a degradação ambiental. O objetivo do presente estudo foi conhecer o conhecimento humano e a atitude em relação às aves urbanas na cidade de Faisalabad, Paquistão. O estudo foi conduzido em quatro meses consecutivos: novembro de 2019 a fevereiro de 2020. A população de pássaros foi observada em oito cidades residenciais da cidade de Faisalabad, os dados foram coletados por meio de questionário. Faisalabad tem uma população razoavelmente grande de pássaros, e os dados atuais mostram que há uma diferença significativa entre as aves favoritas de áreas residenciais e instituições. O pombo recebeu mais semelhanças na população de pássaros entre os residentes de áreas residenciais, enquanto o myna recebeu menos. A ave mais popular nas instituições de Faisalabad era o pardal, enquanto a ave menos popular era o myna comum. A porcentagem de adaptação de pássaros em áreas residenciais e institucionais de Faisalabad foi a mais alta para papagaios e pardais, respectivamente. As pessoas em áreas residenciais e instituições, por outro lado, se adaptaram menos ao myna comum. Conclui-se que pessoas da área de estudo como pássaros e alimentos oferecidos e alta população de pássaros estão presentes na área de estudo.


Assuntos
Humanos , Animais , Aves , Ecossistema , Paquistão , Cidades , Biodiversidade
2.
Sci Total Environ ; 856(Pt 2): 159166, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36202364

RESUMO

Monkeypox disease (MPXD), a viral disease caused by the monkeypox virus (MPXV), is an emerging zoonotic disease endemic in some countries of Central and Western Africa but seldom reported outside the affected region. Since May 2022, MPXD has been reported at least in 74 countries globally, prompting the World Health Organization to declare the MPXD outbreak a Public Health Emergency of International Concern. As of July 24, 2022; 92 % (68/74) of the countries with reported MPXD cases had no historical MPXD case reports. From the One Health perspective, the spread of MPXV in the environment poses a risk not only to humans but also to small mammals and may, ultimately, spread to potent novel host populations. Wastewater-based surveillance (WBS) has been extensively utilized to monitor communicable diseases, particularly during the ongoing COVID-19 pandemic. It helped in monitoring infectious disease caseloads as well as specific viral variants circulating in communities. The detection of MPXV DNA in lesion materials (e.g. skin, vesicle fluid, crusts), skin rashes, and various body fluids, including respiratory and nasal secretions, saliva, urine, feces, and semen of infected individuals, supports the possibility of using WBS as an early proxy for the detection of MPXV infections. WBS of MPXV DNA can be used to monitor MPXV activity/trends in sewerage network areas even before detecting laboratory-confirmed clinical cases within a community. However, several factors affect the detection of MPXV in wastewater including, but not limited to, routes and duration time of virus shedding by infected individuals, infection rates in the relevant affected population, environmental persistence, the processes and analytical sensitivity of the used methods. Further research is needed to identify the key factors that impact the detection of MPXV biomarkers in wastewater and improve the utility of WBS of MPXV as an early warning and monitoring tool for safeguarding human health. In this review, we shortly summarize aspects of the MPXV outbreak relevant to wastewater monitoring and discuss the challenges associated with WBS.


Assuntos
COVID-19 , Varíola dos Macacos , Animais , Humanos , Varíola dos Macacos/epidemiologia , Varíola dos Macacos/diagnóstico , Varíola dos Macacos/patologia , Águas Residuárias , Pandemias , COVID-19/epidemiologia , Vírus da Varíola dos Macacos/genética , DNA Viral , Monitoramento Ambiental , Mamíferos
3.
Anaesthesia ; 77(12): 1321-1325, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36330952
4.
Mymensingh Med J ; 31(4): 1142-1147, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36189564

RESUMO

Anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee. It can be repaired and reconstructed by open and endoscopic method, the gold standard is, however, endoscopic reconstruction. It is usually reconstructed using bone patellar tendon bone (BPTB) or Hamstring autograft. The graft is supported using endobutton at the femoral end while bioabsorbable interference screw at the tibial end. This study aimed to determine how a certain fixation procedure for quadrupled hamstring autografts worked out. This prospective observational study duration period was 1 year in which 40 patients with ACL injury were treated with arthroscopic reconstruction using hamstring autograft from January 2020 to December 2020 with 6 months follow up after surgery. On the femoral side, an endobutton was used to secure the graft, while the tibial end was secured using a bioabsorbable screw. The International Knee Documentation Committee (IKDC) scoring system was used for prospective evaluation. According to subjective IKDC scoring, 20(50.0%) results were very good, 14(35.0%) were good, 4(10.0%) were satisfactory and 2(5.0%) were bad. In 95.0% patients the state of knee joint is very good compared to preoperative state. Of all the 40 patients underwent ACL reconstruction, 38(95.0%) patients are satisfied with the results of the operation.


Assuntos
Implantes Absorvíveis , Reconstrução do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior/métodos , Autoenxertos/cirurgia , Parafusos Ósseos , Humanos , Articulação do Joelho/cirurgia , Tendões/transplante , Resultado do Tratamento
5.
Saudi Med J ; 43(10): 1168-1172, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36261198

RESUMO

OBJECTIVES: To study reduction in pain score after treatment with intravenous regional anesthesia (IVRA) and Stellate ganglion block (SGB) combination on complex regional pain syndrome (CPRS) patients and to quantify patients' satisfaction with treatment and occurrence of complications. METHODS: This is a record-based retrospective review carried out in 2020, targeting patients treated in the University of Jordan Hospital, Amman, Jordan, over the years 2002-2020. RESULTS: Among 99 patients, a significant drop in pain scores occurred in 88% of the patients' sample. Gender, age, type of CRPS, and duration of symptoms didn't affect statistical results. An average of 8.6 sessions needed to achieve 50% drop in pain score, and 2-3 sessions for first clinical improvement. Patients with previous application of plaster of Paris had increased success rates. CONCLUSION: We find it practical, inexpensive, safe, and straightforward to combine SGB with IVRA for CRPS patients.


Assuntos
Anestesia por Condução , Síndromes da Dor Regional Complexa , Distrofia Simpática Reflexa , Humanos , Sulfato de Cálcio/uso terapêutico , Síndromes da Dor Regional Complexa/terapia , Dor , Distrofia Simpática Reflexa/diagnóstico , Distrofia Simpática Reflexa/tratamento farmacológico , Gânglio Estrelado , Centros de Atenção Terciária
6.
Anaesthesia ; 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36070622

RESUMO

The perceived risk of transmission of aerosolised viral particles from patients to airway practitioners during the COVID-19 pandemic led to the widespread use of aerosol precautions, including personal protective equipment and modifications to anaesthetic technique. The risk of these aerosol precautions on peri-operative airway complications has not been assessed outside of simulation studies. This prospective, national, multicentre cohort study aimed to quantify this risk. Adult patients undergoing general anaesthesia for elective or emergency procedures over a 96-hour period were included. Data collected included use of aerosol precautions by the airway practitioner, airway complications and potential confounding variables. Mixed-effects logistic regression was used to assess the risk of individual aerosol precautions on overall and specific airway complications. Data from 5905 patients from 70 hospital sites were included. The rate of airway complications was 10.0% (95%CI 9.2-10.8%). Use of filtering facepiece class 2 or class 3 respirators was associated with an increased risk of airway complications (odds ratio 1.38, 95%CI 1.04-1.83), predominantly due to an association with difficult facemask ventilation (odds ratio 1.68, 95%CI 1.09-2.61) and desaturation on pulse oximetry (odds ratio 2.39, 95%CI 1.26-4.54). Use of goggles, powered air-purifying respirators, long-sleeved gowns, double gloves and videolaryngoscopy were not associated with any alteration in the risk of airway complications. Overall, the use of filtering facepiece class 2 or class 3 respirators was associated with an increased risk of airway complications, but most aerosol precautions used during the COVID-19 pandemic were not.

7.
J Surg Res ; 280: 421-428, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36041342

RESUMO

INTRODUCTION: Repeat abdominal surgery in the bariatric surgery patient population may be challenging for non-bariatric-accredited institutions. The impact of regionalized bariatric care on clinical outcomes for bariatric surgery patients requiring repeat abdominal surgery is currently unknown. This study aims to investigate the association between bariatric center designation and clinical outcomes following hepatobiliary, hernia, and upper and lower gastrointestinal operations among patients with prior bariatric surgery. METHODS: This is a cohort study of a large sample of Ontario residents who underwent primary bariatric surgery between 2010 and 2017. A comprehensive list of eligible abdominal operations was captured using administrative data. The primary outcome was 30-d complications. Secondary outcomes included 30-d mortality, readmission, and length of stay. RESULTS: Among the 3301 study patients, 1305 (40%) received their first abdominal reoperation following bariatric surgery at a designated bariatric center. Nonbariatric center designation was not associated with significantly higher rates of 30-d complications (5.73% versus 5.72%), mortality (0.80% versus 0.77%), readmissions (1.11% versus 1.85%), or median postoperative length of stay (4 versus 4 d). After grouping the category of reoperations, upper gastrointestinal (odds ratio [OR] 0.66, confidence interval [CI] 0.39-1.11) and abdominal wall hernia surgery (OR 0.52, CI 0.27-0.99) showed a lower adjusted OR for complications among bariatric centers. CONCLUSIONS: Our study demonstrates that after adjustment for case-mix and patient characteristics, bariatric surgery patients undergoing repeat abdominal surgery at nonbariatric centers is not associated with higher proportion of complications or mortality. Complex hernia surgery may be considered the most appropriate for referral.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Humanos , Obesidade Mórbida/cirurgia , Obesidade Mórbida/complicações , Estudos de Coortes , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Cirurgia Bariátrica/efeitos adversos , Hérnia/complicações , Estudos Retrospectivos
8.
Anaesthesia ; 77(10): 1081-1088, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35933725

RESUMO

Difficult airway management continues to adversely affect patient care and clinical outcomes and is poorly predicted. Previous difficult airway management is the most accurate predictor of future difficulty. The Difficult Airway Society initiated a national airway database to allow clinicians to access details of previous difficult airway episodes in patients issued with a difficult airway alert card. We aimed to analyse this database, reporting patient characteristics, airway management and patient outcomes. We included all living adult patients reported in the first 5 years of the database (n = 675). Clinical airway assessment was reported in 634 (94%) patients, with three or more parameters assessed in 488 (72%). A history of difficult airway was known in 136 (20%) patients and difficult airway management was anticipated in 391 (58%). In all, 75 (11%) patients had an airway-related critical incident, with 1 in 29 being awoken from anaesthesia, 1 in 34 requiring unplanned or prolonged stay in the intensive care unit and 1 in 225 needing an emergency front-of-neck airway or had a cardiac arrest/peri-arrest episode. Airway-related critical incidents were associated with out-of-hours airway management, but no other associations were apparent. Our data report the first analysis of a national difficult airway database, finding that unanticipated difficult airway management continues to occur despite airway assessment, and the rate of critical incidents in this cohort of patients is high. This database has the potential to improve airway management for patients in the future.


Assuntos
Anestesia , Anestesiologia , Adulto , Manuseio das Vias Aéreas/efeitos adversos , Bases de Dados Factuais , Humanos , Intubação Intratraqueal/efeitos adversos
9.
Nanomaterials (Basel) ; 12(15)2022 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-35957069

RESUMO

Biomolecular detection methods have evolved from simple chemical processes to laboratory sensors capable of acquiring accurate measurements of various biological components. Recently, silicon nanowire field-effect transistors (SiNW-FETs) have been drawing enormous interest due to their potential in the biomolecular sensing field. SiNW-FETs exhibit capabilities such as providing real-time, label-free, highly selective, and sensitive detection. It is highly critical to diagnose infectious diseases accurately to reduce the illness and death spread rate. In this work, a novel SiNW-FET sensor is designed using a semiempirical approach, and the electronic transport properties are studied to detect the COVID-19 spike protein. Various electronic transport properties such as transmission spectrum, conductance, and electronic current are investigated by a semiempirical modeling that is combined with a nonequilibrium Green's function. Moreover, the developed sensor selectivity is tested by studying the electronic transport properties for other viruses including influenza, rotavirus, and HIV. The results indicate that SiNW-FET can be utilized for accurate COVID-19 identification with high sensitivity and selectivity.

10.
Cancer Radiother ; 2022 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-35973914

RESUMO

PURPOSE: To analyze the treatment strategies, outcomes and factors impacting these outcomes in extraosseous ewings sarcoma (EOES). MATERIAL AND METHODS: A search of the hospital database yielded a total of 109 EOES patients registered in last 10 years out of which 25 patients were excluded from analysis due to incomplete medical records. Demographic and clinical characteristics were reported using descriptive statistics. Overall survival (OS) was taken from the time of diagnosis to death. Patients who were alive or lost to follow up were censored from the survival analysis. A total of 12 clinical and treatment related variables were taken into univariate analysis and those showing significance or a trend towards significance were taken up for multivariate analysis. Further a cluster analysis was done in a quest to find a subgroup which would have a better survival outcome as compared to other clusters. SPSS version 23 was used for statistical analysis. RESULTS: Chest wall (n=26), lower extremity (n=22) and paraspinal area (n=14) were the common sites involved. Localised swelling (n=43) was the most common presenting symptom and the median time to presentation was 2 months. Overall survival of the entire cohort at 5 years was 52 percent. Stage at presentation had a significant impact (P value<0.001) on estimated median OS (localised 70 months versus 36 months in metastatic stage). Cluster analysis showed that, patients with localised stage at presentation, good response to chemotherapy, negative resection margin and no adjuvant RT had a median survival of 69 months. CONCLUSION: Judicious use of trimodality treatment in EOES yields optimal results and it also adds significantly onto the scarce literature on this subtype of sarcoma.

11.
Appl Radiat Isot ; 188: 110379, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35930952

RESUMO

Evaluation of the 63Cu(α,n)66Ga, 65Cu(α,2n) 67Ga and 65Cu(α,n)68Ga reactions was done to study the production of medical radionuclides 66Ga, 67Ga and 68Ga respectively. 63Cu(α,2n)65Ga and 65Cu(α,3n)66Ga reactions were also evaluated for the estimation of radioisotopic impurities. Cross section data of each reaction were compiled and normalized to the standard values of decay data and monitor reaction. To check the consistency of the literature data, three nuclear model calculations were performed, using nuclear model codes; TAYLS 1.9, ALICE-IPPE, and EMPIRE 3.2. A well-developed evaluation methodology based on the normalized experimental data and nuclear model calculations was used to generate the statistically fitted cross sections. From the fitted cross sections, thick target yields for each reaction were calculated for the estimation of radioisotopic impurities. Finally, a suitable energy region for the production of 66Ga, 67Ga and 68Ga was suggested with a minimum level of radioisotopic impurities.


Assuntos
Radioisótopos de Gálio , Radioisótopos
12.
Anaesth Rep ; 10(2): e12174, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35813406
13.
Cureus ; 14(6): e25580, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35800194

RESUMO

BACKGROUND: Abdominal ultrasound is a non-invasive, relatively inexpensive, and widely available diagnostic modality in family medicine settings. OBJECTIVES: Our study aimed to identify the most common indications for requesting abdominal ultrasounds by family physicians, determine the frequency of abdominal ultrasound with abnormal findings, identify the most common findings, and determine patients' characteristics associated with abnormal findings. METHODS: This retrospective chart-based study was conducted from January 2020 to June 2020 to analyze patients' abdominal ultrasounds reports requested by family physicians in 2019 at King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia. RESULTS: We assessed abdominal ultrasound reports of 1,113 patients. There were 620 (55.7%) female patients. The mean age and body mass index (BMI) were 46.35 years ± 15.04 and 29.33 kg/m2 ± 7.06, respectively. The most common indications were abdominal pain (43.2%), suspicion of gallbladder and biliary system diseases (18.5%), and abnormal liver function tests (14.6%). The frequency of abnormal findings was 793 (71.2%), and the most common findings were fatty liver infiltration (49.7%), liver enlargement (20.1%), and gallstones (13.3%). Females had a lower likelihood to have abnormal findings compared to males (odds ratio (OR)=0.688, p=0.009). Lastly, the likelihood of abnormal findings increased with age and was highest among patients aged 71 years or more (OR=25.9, p< 0.001). CONCLUSION: Abnormal findings were more prevalent in our study compared with other studies. Abnormal findings were more common among males and older age groups. We recommend future studies on patients from community-based family medicine settings, and to examine the association of abnormal findings with patient-centered endpoints. Finally, disseminating the results of this study will inform family physicians with the most common abnormal abdominal ultrasound findings, and will enhance the discussion with patients undergoing an abdominal ultrasound examination.

14.
Saudi J Biol Sci ; 29(5): 3806-3814, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35844417

RESUMO

Fruit drop is a key issue with date palm cultivars that can be addressed with a variety of methods and strategies. Foliar application of macronutrients can be more effective in inhibiting fruit drop and improving the quality of date fruits. The current study was carried out to investigate the possible role of potassium (K) and urea to reduce fruit drop and improve the fruit quality of "Dhakki" date palm. It was conducted in a complete randomised block design with seven treatments and three replications at Pakistan's Agricultural Research Institute, Dera Ismail Khan. The treatments used were: (i) Control (distilled water spray); (ii) Potassium sulphate (K2SO4) at 1 %; (iii) K2SO4 at 1 % + Urea at 2 %; (iv) K2SO4 at 2 %; (v) K2SO4 at 2 % + Urea at 2 %; (vi) K2SO4 at 3 % and; (vii) K2SO4 at 3 % + Urea at 2 %. All the concentrations were sprayed at Kimri stage of fruit development during two consecutive growing seasons. Twenty-one date palms of equal size and age were chosen for the assessments to measure percent fruit drop and other physicochemical variables, including fruit length, fruit diameter, fruit weight, pulp percentage, yield/bundle, pH, total soluble solids (TSS), K content in fruit, and all sugars (percent) of harvested date fruit. The results revealed that bunch spray of K significantly affected all the parameters during both seasons. Application of K2SO4 alone and in combination with urea not only effectively reduced the fruit drop but also improved fruit quality in date where, K2SO4 applied at 2 % combined with urea was the best concentration in reducing fruit drop, enhancing other physicochemical attributes, and improving fruit quality of "Dhakki" date palm. This study may effectively contribute to reduce the fruit drop and enhance the fruit quality by using K and urea, enabling farmers to improve the date yield and increase economic growth.

16.
Materials (Basel) ; 15(12)2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35744204

RESUMO

BACKGROUND: We aim to evaluate the effect of surface conditioning, bonding agents and composite types on surface roughness (SR) and shear bond strength (SBS) of clear aligner composite attachments bonded to ceramics. METHODS: One hundred and eighty IPS e.max CAD specimens were prepared. For SR, 60 specimens were divided according to surface conditioning (n = 15) into four groups: control, 9.6% hydrofluoric acid (HFA), 37% phosphoric acid (PhA), air abrasion (AA). SR was measured using a Profilometer and Atomic Force Microscopy. For SBS, 120 specimens were divided according to conditioning methods (n = 40) (9.6% HFA and 37% PhA or AA), then according to bonding agents (n = 20) (Assure universal bond (AUB) or Single bond universal (SBU)) and then according to composite type (n = 10): Filtek™ Z350 and Filtek™ Z350 XT flowable composite. SBS was measured using Instron testing machine. Descriptive and group comparison were calculated (p < 0.05). RESULTS: AA had the highest SR, while the control had the lowest SR (p < 0.05). HFA had the highest, but insignificant SBS, followed by AA (p > 0.05). AUB had higher SBS than SBU (p < 0.001). Filtek™ Z350 produced higher SBS than Filtek™ Z350 XT flowable composite (p < 0.01). CONCLUSION: The combination of AA, AUB, and Filtek Z350 produced the highest SBS, followed by HFA, AUB, and Filtek Z350.

17.
Crit Rev Microbiol ; : 1-21, 2022 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-35574602

RESUMO

Clostridioides difficile infection (CDI) is a life-threatening disease caused by the Gram-positive, opportunistic intestinal pathogen C. difficile. Despite the availability of antimicrobial drugs to treat CDI, such as vancomycin, metronidazole, and fidaxomicin, recurrence of infection remains a significant clinical challenge. The use of live commensal microorganisms, or probiotics, is one of the most investigated non-antibiotic therapeutic options to balance gastrointestinal (GI) microbiota and subsequently tackle dysbiosis. In this review, we will discuss major commensal probiotic strains that have the potential to prevent and/or treat CDI and its recurrence, reassess the efficacy of probiotics supplementation as a CDI intervention, delve into lessons learned from probiotic modulation of the immune system, explore avenues like genome-scale metabolic network reconstructions, genome sequencing, and multi-omics to identify novel strains and understand their functionality, and discuss the current regulatory framework, challenges, and future directions.

18.
J Comput Assist Tomogr ; 46(3): 333-343, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35575649

RESUMO

BACKGROUND: Routine computed tomography (CT) scans are thought to have poor performance for detection of gastrointestinal (GI) neuroendocrine neoplasms (NENs), which leads to delayed workup. Detection of even 1 bowel tumor can guide diagnostic workup and management. The purposes of this study were to assess the accuracy of multidetector computed tomography (MDCT) and to compare negative versus positive enteric contrast in detecting at least 1 GI tumor per patient with suspected or confirmed diagnosis of a NEN. METHODS: This retrospective study included 107 patients with intravenous and oral contrast (65 positive, 40 negative, and 2 no oral contrast) abdominopelvic MDCT. Two abdominal radiologists independently analyzed the CTs for detection and localization of bowel NENs. Surgical pathology was considered the reference standard. Analyses included κ and summary statistics, McNemar test, Pearson χ2 test, and Fisher exact test. RESULTS: Among the 107 CT scans, there were 30 pathology negative studies and 77 studies with positive pathology for GI NEN. Interreader agreement for CT evaluation was substantial (κ = 0.61). At least 1 GI NEN per patient was detected with 51% to 53% sensitivity, 87% to 93% specificity, 91% to 95% positive predictive value (PPV), 42% negative predictive value, and 63% accuracy for each reader, and 57% accuracy when only the concordant (ie, matching) results of the 2 readers were considered. Computed tomography scans with negative enteric contrast had significantly higher sensitivity for concordant results than CTs with positive enteric contrast (58% vs 30%, P = 0.01). Specificity (100% vs 95%, P = 0.5), PPV (100% vs 93%, P = 0.49), negative predictive value (39% vs 39%, P = 0.99), and accuracy (67% vs 51%, P = 0.10) were not significantly different for negative versus positive enteric contrast for the concordant results. There was no significant difference in GI NEN localization between the readers. CONCLUSIONS: Routine MDCT with either positive or negative enteric contrast can detect at least 1 GI tumor per patient with more than 90% PPV and more than 50% accuracy in patients suspected of GI NEN. Using negative enteric contrast improves sensitivity for GI NEN versus positive enteric contrast. In addition, there is high accuracy in localizing the bowel tumor with positive or negative enteric contrast, which may guide surgery. Radiologists should have heightened awareness that evaluating such scans closely may lead to detection of primary bowel NENs at a higher rate than previously reported.


Assuntos
Tomografia Computadorizada Multidetectores , Tumores Neuroendócrinos , Meios de Contraste , Humanos , Intestino Delgado/patologia , Tomografia Computadorizada Multidetectores/métodos , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/patologia , Estudos Retrospectivos , Sensibilidade e Especificidade
19.
BMC Nephrol ; 23(1): 132, 2022 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-35382766

RESUMO

BACKGROUND: In the light of recent years, an increase in the number of life-threatening infections due to various fungi has been observed, especially in tertiary care centres. With Amphotericin B labelled as the first choice in treating these infections, one of its common side effects, nephrotoxicity, along with hypokalemia, were studied to determine the epidemiology, risk factors, and protective measures. METHODOLOGY: The study was a retrospective observational chart review study in which patients were receiving conventional Amphotericin B in two tertiary hospitals in Palestine from January 2018 to December 2020 were evaluated for the development of hypokalemia and nephrotoxicity; according to the KDIGO criteria. A total of 117 patients were included in the study. Patients who have received the drug intermittently, in fewer than two doses, through non-IV routes and patients under the age of 12 were excluded. The data collected included, but were not limited to, age, gender, comorbidities, Amphotericin B treatment details, medications, COVID-19 status, risk factors, and hypothesized protective measures. RESULTS: The incidence of conventional Amphotericin B nephrotoxicity and hypokalemia was 46% and 33%, respectively. With a roughly equal representation of both genders and a median age of 52 years in a range of 13-89. No association between the variables and the development of nephrotoxicity was found. However, a 3.4 increased risk (p-value = 0.01) of developing hypokalemia in females compared to males was observed. CONCLUSION: Our research has shown a relatively lower yet consistent, incidence of conventional amphotericin B nephrotoxicity and hypokalemia compared to literature with gender being a risk factor for developing hypokalemia.


Assuntos
Anfotericina B , COVID-19 , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anfotericina B/efeitos adversos , Antifúngicos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária , Adulto Jovem
20.
Am J Surg Pathol ; 46(7): 963-976, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35385405

RESUMO

Kaposiform lymphangiomatosis is an uncommon generalized lymphatic anomaly with distinctive clinical, radiologic, histopathologic, and molecular findings. Herein, we document the pathology in 43 patients evaluated by the Boston Children's Hospital Vascular Anomalies Center from 1999 to 2020. The most frequent presentations were respiratory difficulty, hemostatic abnormalities, and a soft tissue mass. Imaging commonly revealed involvement of some combination of mediastinal, pulmonary, pleural, and pericardial compartments and most often included spleen and skeleton. Histopathology was characterized by dilated, redundant, and abnormally configured lymphatic channels typically accompanied by dispersed clusters of variably canalized, and often hemosiderotic, spindled lymphatic endothelial cells that were immunopositive for D2-40, PROX1, and CD31. An activating lesional NRAS variant was documented in 9 of 10 patients. The clinical course was typically aggressive, marked by hemorrhage, thrombocytopenia, diminished fibrinogen levels, and a mortality rate of 21%.


Assuntos
Células Endoteliais , Pulmão , Boston , Criança , Humanos
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