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1.
PLoS One ; 15(4): e0232624, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32353069

RESUMO

BACKGROUND: A global epidemic of obesity has been documented, particularly among African countries. While central obesity and overweight have been reported for many countries, very limited information exists about the prevalence of these health problems in Sudan, and these data are nonexistent for Eastern Sudan. The present study aimed to determine the prevalence of obesity and central obesity, as well as the factors associated with both, among adults in Gadarif, Eastern Sudan. METHODS: A cross-sectional study was conducted in Gadarif, Eastern Sudan, during the period of January through May 2018. Sociodemographic and health characteristics data were collected through a questionnaire. Body mass index (BMI) and waist circumference (WC) were measured using the standard methods. Both descriptive and inferential statics were applied to analyze the data. RESULTS: A total of 594 adults participated in the study; 70.4% of them were female. The mean (standard deviation) age was 44.98 (16.64) years. Of the 594 enrolled participants, 33.7%, 7.4%, 26.8%, and 32.2% were normal weight, underweight, overweight, and obese, respectively. The prevalence of central obesity was (67.8%). Approximately, one-third of the participants (29.29%) were obese and had central obesity. In the multinomial regression, being married was the main risk factor associated with overweight, and older age, female sex, being married and hypertension were significantly associated with obesity. In the binary regression, the main risk factors associated with central obesity were female sex and being married. CONCLUSION: The prevalence rates of both obesity and central obesity among the study participants were high. Older age and hypertension were only associated with obesity. Obesity and central obesity were significantly associated with female sex and being married. This study provided valuable baseline information to develop appropriate strategies for the prevention and control of obesity in Eastern Sudan.

2.
Neurology ; 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32444492

RESUMO

An asymptomatic 27-year-old physician is diagnosed SARS-CoV-2 by occupational medicine after contagion (RT-PCR).

3.
Sci Total Environ ; 729: 139022, 2020 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-32353722

RESUMO

An outbreak of respiratory illness which is proven to be infected by a 2019 novel coronavirus (2019-nCoV) officially named as Coronavirus Disease 2019 (COVID-19) was first detected in Wuhan, China and has spread rapidly in other parts of China as well as other countries around the world, including Malaysia. The first case in Malaysia was identified on 25 January 2020 and the number of cases continue to rise since March 2020. Therefore, 2020 Malaysia Movement Control Order (MCO) was implemented with the aim to isolate the source of the COVID-19 outbreak. As a result, there were fewer number of motor vehicles on the road and the operation of industries was suspended, ergo reducing emissions of hazardous air pollutants in the atmosphere. We had acquired the Air Pollutant Index (API) data from the Department of Environment Malaysia on hourly basis before and during the MCO with the aim to track the changes of fine particulate matter (PM2.5) at 68 air quality monitoring stations. It was found that the PM2.5 concentrations showed a high reduction of up to 58.4% during the MCO. Several red zone areas (>41 confirmed COVID-19 cases) had also reduced of up to 28.3% in the PM2.5 concentrations variation. The reduction did not solely depend on MCO, thus the researchers suggest a further study considering the influencing factors that need to be adhered to in the future.

4.
Am J Med ; 2020 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-32272101

RESUMO

BACKGROUND: Digoxin reduces the risk of heart failure hospitalization in patients with heart failure with reduced ejection fraction. Less is known about this association in patients with heart failure with preserved ejection fraction (HFpEF), the examination of which was the objective of the current study. METHODS: In the Medicare-linked OPTIMIZE-HF registry, 7374 patients hospitalized for HF had ejection fraction ≥50% and were not receiving digoxin prior to admission. Of these, 5675 had a heart rate ≥50 beats per minute, an estimated glomerular filtration rate ≥30 mL/min/1.73 m2 or did not receive inpatient dialysis, and digoxin was initiated in 524 of these patients. Using propensity scores for digoxin initiation, calculated for each of the 5675 patients, we assembled a matched cohort of 513 pairs of patients initiated and not initiated on digoxin, balanced on 58 baseline characteristics (mean age, 80 years; 66% women; 8% African American). Hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes associated with digoxin initiation were estimated in the matched cohort. RESULTS: Among the 1026 matched patients with HFpEF, 30-day heart failure readmission occurred in 6% and 9% of patients initiated and not initiated on digoxin, respectively (HR 0.70; 95% CI, 0.45-1.10; P = .124). HRs (95% CIs) for 30-day all-cause readmission and all-cause mortality associated with digoxin initiation were 0.95 (0.73-1.23; P = .689) and 0.93 (0.55-1.56; P = .773), respectively. Digoxin initiation had no association with 6-year outcomes. CONCLUSION: Digoxin initiation prior to hospital discharge was not associated with 30-day or 6-year outcomes in older hospitalized patients with HFpEF.

5.
J Alzheimers Dis ; 75(1): 311-320, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32280090

RESUMO

BACKGROUND: Racial disparity in the epidemiology of Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) has been reported. However, less is known about this disparity among Veterans. OBJECTIVE: To estimate the racial disparity in AD/ADRD among the Veterans. METHODS: Of the 5,413,418 Veterans≥65 years receiving care at the Veterans Health Administration (1999-2016), 4,045,269 were free of prevalent AD/ADRD, schizophrenia, or bipolar disorder at baseline. Of these, 432,469 were African American. Race was self-identified and incident AD/ADRD during 20 (median 6.7) years of follow-up was ascertained using International Classification of Diseases codes. RESULTS: Patients had a mean age of 70.4 (±6.6) years and 97.8% were men. Age-sex-adjusted incidence of AD/ADRD per 1,000 person-year was 19.3 and 10.8 for African American and white Veterans, respectively (age-sex-adjusted hazard ratio associated with African American race, 1.77; 95% confidence interval, 1.75-1.79; p < 0.0001). This association remained essentially unchanged after multivariable adjustment (hazard ratio, 1.67; 95% confidence interval, 1.65-1.69; p < 0.0001). Among the key baseline characteristics that were significant predictors of AD/ADRD in both races, stroke was a significantly stronger predictor among African Americans, and Hispanic ethnicity and depression among whites (p-value for all interaction,<0.0001). CONCLUSION: The findings of a higher incidence of AD/ADRD among African American Veterans is consistent with the findings in the general population reported in the literature, although the overall incidence appears to be lower than that in the general population. Future studies need to examine this disparity in incidence as well as the between-race heterogeneity in AD/ADRD risk.

6.
Molecules ; 25(7)2020 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-32225061

RESUMO

In the recent decade, deep eutectic solvents (DESs) have occupied a strategic place in green chemistry research. This paper discusses the application of DESs as functionalization agents for multi-walled carbon nanotubes (CNTs) to produce novel adsorbents for the removal of 2,4-dichlorophenol (2,4-DCP) from aqueous solution. Also, it focuses on the application of the feedforward backpropagation neural network (FBPNN) technique to predict the adsorption capacity of DES-functionalized CNTs. The optimum adsorption conditions that are required for the maximum removal of 2,4-DCP were determined by studying the impact of the operational parameters (i.e., the solution pH, adsorbent dosage, and contact time) on the adsorption capacity of the produced adsorbents. Two kinetic models were applied to describe the adsorption rate and mechanism. Based on the correlation coefficient (R2) value, the adsorption kinetic data were well defined by the pseudo second-order model. The precision and efficiency of the FBPNN model was approved by calculating four statistical indicators, with the smallest value of the mean square error being 5.01 × 10-5. Moreover, further accuracy checking was implemented through the sensitivity study of the experimental parameters. The competence of the model for prediction of 2,4-DCP removal was confirmed with an R2 of 0.99.

7.
ESC Heart Fail ; 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32319205

RESUMO

AIMS: Hypokalaemia is a risk factor for ventricular arrhythmias and sudden death in ambulatory patients with chronic heart failure (HF). The objective of this study was to examine the association between hypokalaemia and outcomes in hospitalized patients with decompensated HF in whom sudden death is less common. METHODS AND RESULTS: Of the 5881 hospitalized patients with HF, 1052 had consistent hypokalaemia (both admission and discharge serum potassium <4.0 mmol/L), and 2538 had consistent normokalaemia (both admission and discharge serum potassium 4.0-5.0 mmol/L). Propensity scores for consistent hypokalaemia, estimated for each of 3590 (1052 + 2538) patients, were used to assemble a matched cohort of 971 pairs of patients with consistent hypokalaemia vs. consistent normokalaemia, balanced on 54 baseline characteristics (mean age, 75 years; 60% women; 28% African American). We repeated the above process to assemble 2327 pairs of patients with discharge potassium <4.0 vs. 4.0-5.0 mmol/L and 449 pairs of patients with discharge serum potassium <3.5 vs. 4.0-5.0 mmol/L. Hazard ratios (HR) and 95% confidence intervals (CIs) associated with hypokalaemia were estimated in matched cohorts. 30 day all-cause mortality occurred in 5% and 4% of patients with consistent normokalaemia vs. consistent hypokalaemia, respectively (HR, 0.78; 95% CI, 0.52-1.18; P = 0.241). HRs (95% CI) for 30 day mortality associated with discharge serum potassium <4.0 and <3.5 mmol/L were 0.90 (0.70-1.16; P = 0.419) and 1.69 (0.94-3.04; P = 0.078), respectively. Hypokalaemia (<4.0 or <3.5 mmol/L) had no association with long-term mortality or other outcomes. CONCLUSIONS: In hospitalized older patients with HF, compared with normokalaemia (serum potassium 4.0-5.0 mmol/L), hypokalaemia (<4.0 or <3.5 mmol/L) had no significant associations with outcomes.

8.
PLoS One ; 15(4): e0231055, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32287272

RESUMO

Soil temperature has a vital importance in biological, physical and chemical processes of terrestrial ecosystem and its modeling at different depths is very important for land-atmosphere interactions. The study compares four machine learning techniques, extreme learning machine (ELM), artificial neural networks (ANN), classification and regression trees (CART) and group method of data handling (GMDH) in estimating monthly soil temperatures at four different depths. Various combinations of climatic variables are utilized as input to the developed models. The models' outcomes are also compared with multi-linear regression based on Nash-Sutcliffe efficiency, root mean square error, and coefficient of determination statistics. ELM is found to be generally performs better than the other four alternatives in estimating soil temperatures. A decrease in performance of the models is observed by an increase in soil depth. It is found that soil temperatures at three depths (5, 10 and 50 cm) could be mapped utilizing only air temperature data as input while solar radiation and wind speed information are also required for estimating soil temperature at the depth of 100 cm.

9.
J Voice ; 2020 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-32273209

RESUMO

The aim of this study is to compare the relatively new CO2 laser microlaryngeal surgery and conventional cold dissection method in treatment of minimal associated pathological lesions of vocal folds. Eighty patients aged 20-70 years old were randomly divided into two groups, group A (40 patients) was treated by the conventional method and group B (40 patients) was treated with CO2 laser microlaryngeal surgery. Assessment procedures included GRBAS scale, stroboscopic examination, and Arabic version of voice handicap index. Results stated that improvement of quality of voice after surgery in both techniques had no significant difference. The significant difference was in operative time and bleeding because laser had less time and bleeding. Both techniques had no recurrence within 3-months follow-up.

10.
Malar J ; 19(1): 108, 2020 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-32131841

RESUMO

BACKGROUND: Ethiopia has set a goal for malaria elimination by 2030. Low parasite density infections may go undetected by conventional diagnostic methods (microscopy and rapid diagnostic tests) and their contribution to malaria transmission varies by transmission settings. This study quantified the burden of subpatent infections from samples collected from three regions of northwest Ethiopia. METHODS: Sub-samples of dried blood spots from the Ethiopian Malaria Indicator Survey 2015 (EMIS-2015) were tested and compared using microscopy, rapid diagnostic tests (RDTs), and nested polymerase chain reaction (nPCR) to determine the prevalence of subpatent infection. Paired seroprevalence results previously reported along with gender, age, and elevation of residence were explored as risk factors for Plasmodium infection. RESULTS: Of the 2608 samples collected, the highest positive rate for Plasmodium infection was found with nPCR 3.3% (95% CI 2.7-4.1) compared with RDT 2.8% (95% CI 2.2-3.5) and microscopy 1.2% (95% CI 0.8-1.7). Of the nPCR positive cases, Plasmodium falciparum accounted for 3.1% (95% CI 2.5-3.8), Plasmodium vivax 0.4% (95% CI 0.2-0.7), mixed P. falciparum and P. vivax 0.1% (95% CI 0.0-0.4), and mixed P. falciparum and Plasmodium malariae 0.1% (95% CI 0.0-0.3). nPCR detected an additional 30 samples that had not been detected by conventional methods. The majority of the nPCR positive cases (61% (53/87)) were from the Benishangul-Gumuz Region. Malaria seropositivity had significant association with nPCR positivity [adjusted OR 10.0 (95% CI 3.2-29.4), P < 0.001]. CONCLUSION: Using nPCR the detection rate of malaria parasites increased by nearly threefold over rates based on microscopy in samples collected during a national cross-sectional survey in 2015 in Ethiopia. Such subpatent infections might contribute to malaria transmission. In addition to strengthening routine surveillance systems, malaria programmes may need to consider low-density, subpatent infections in order to accelerate malaria elimination efforts.

11.
Chem Asian J ; 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32207232

RESUMO

Searching new light-absorbing materials to replace toxic lead halide in solar cells is very important and highly desirable. In this research, we firstly demonstrated that tellurium iodide (TeI4 ) could be used as a light-absorbing material in solar cells due to its suitable optical band gap and the active lone-pair electron orbital in Te4+ . The best power conversion efficiency (PCE=3.56%) was achieved with a concentration of 0.9 M TeI4 in DMF:DMSO (4 : 1, v,v) without any heat treatment or antisolvent dripping. Our study indicates the promising potential of TeI4 for photovoltaic and optoelectronic applications.

12.
Sci Rep ; 10(1): 4684, 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32170078

RESUMO

In nature, streamflow pattern is characterized with high non-linearity and non-stationarity. Developing an accurate forecasting model for a streamflow is highly essential for several applications in the field of water resources engineering. One of the main contributors for the modeling reliability is the optimization of the input variables to achieve an accurate forecasting model. The main step of modeling is the selection of the proper input combinations. Hence, developing an algorithm that can determine the optimal input combinations is crucial. This study introduces the Genetic algorithm (GA) for better input combination selection. Radial basis function neural network (RBFNN) is used for monthly streamflow time series forecasting due to its simplicity and effectiveness of integration with the selection algorithm. In this paper, the RBFNN was integrated with the Genetic algorithm (GA) for streamflow forecasting. The RBFNN-GA was applied to forecast streamflow at the High Aswan Dam on the Nile River. The results showed that the proposed model provided high accuracy. The GA algorithm can successfully determine effective input parameters in streamflow time series forecasting.

15.
Eur Heart J ; 41(13): 1357-1364, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32125360

RESUMO

AIMS: Recent data from national registries suggest that acute heart failure (AHF) outcomes might vary in men and women, however, it is not known whether this observation is universal. The aim of this study was to evaluate the association of biological sex and 1-year all-cause mortality in patients with AHF in various regions of the world. METHODS AND RESULTS: We analysed several AHF cohorts including GREAT registry (22 523 patients, mostly from Europe and Asia) and OPTIMIZE-HF (26 376 patients from the USA). Clinical characteristics and medication use at discharge were collected. Hazard ratios (HRs) for 1-year mortality according to biological sex were calculated using a Cox proportional hazards regression model with adjustment for baseline characteristics (e.g. age, comorbidities, clinical and laboratory parameters at admission, left ventricular ejection fraction). In the GREAT registry, women had a lower risk of death in the year following AHF [HR 0.86 (0.79-0.94), P < 0.001 after adjustment]. This was mostly driven by northeast Asia [n = 9135, HR 0.76 (0.67-0.87), P < 0.001], while no significant differences were seen in other countries. In the OPTIMIZE-HF registry, women also had a lower risk of 1-year death [HR 0.93 (0.89-0.97), P < 0.001]. In the GREAT registry, women were less often prescribed with a combination of angiotensin-converting enzyme inhibitors and beta-blockers at discharge (50% vs. 57%, P = 0.001). CONCLUSION: Globally women with AHF have a lower 1-year mortality and less evidenced-based treatment than men. Differences among countries need further investigation. Our findings merit consideration when designing future global clinical trials in AHF.

16.
Sensors (Basel) ; 20(6)2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32183041

RESUMO

Clinical treatment of skin lesion is primarily dependent on timely detection and delimitation of lesion boundaries for accurate cancerous region localization. Prevalence of skin cancer is on the higher side, especially that of melanoma, which is aggressive in nature due to its high metastasis rate. Therefore, timely diagnosis is critical for its treatment before the onset of malignancy. To address this problem, medical imaging is used for the analysis and segmentation of lesion boundaries from dermoscopic images. Various methods have been used, ranging from visual inspection to the textural analysis of the images. However, accuracy of these methods is low for proper clinical treatment because of the sensitivity involved in surgical procedures or drug application. This presents an opportunity to develop an automated model with good accuracy so that it may be used in a clinical setting. This paper proposes an automated method for segmenting lesion boundaries that combines two architectures, the U-Net and the ResNet, collectively called Res-Unet. Moreover, we also used image inpainting for hair removal, which improved the segmentation results significantly. We trained our model on the ISIC 2017 dataset and validated it on the ISIC 2017 test set as well as the PH2 dataset. Our proposed model attained a Jaccard Index of 0.772 on the ISIC 2017 test set and 0.854 on the PH2 dataset, which are comparable results to the current available state-of-the-art techniques.

17.
Pancreas ; 49(2): 242-248, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32011528

RESUMO

OBJECTIVES: Pancreatic exocrine insufficiency (PEI) is a common complication of chronic pancreatitis. However, little is known about the natural course of PEI and the effect of pancreatic enzyme replacement therapy on symptoms. The aim of this study was to evaluate the natural course and treatment of PEI in a nationwide cohort of patients with chronic pancreatitis. METHODS: Patients with chronic pancreatitis were selected from the multicenter Dutch Chronic Pancreatitis Registry. Patients were classified in 3 groups: definite PEI, potential PEI, and no PEI. Definite PEI and no PEI were compared regarding the course of disease, symptoms, treatment, and quality of life. RESULTS: Nine hundred eighty-seven patients were included from 29 centers, of which 304 patients (31%) had definite PEI; 451 (46%), potentially PEI; and 232 (24%), no PEI. Patients with definite PEI had significantly more malabsorption symptoms, a lower body mass index, and aberrant defecation. Lowered quality of life was not independently associated with PEI. Of the PEI patients using pancreatic enzyme replacement therapy, 47% still reported steatorrhea. CONCLUSIONS: Pancreatic exocrine insufficiency is associated with malabsorption symptoms and a lower body mass index. Some form of pancreatic enzyme replacement therapy is reasonably effective in alleviating malabsorption symptoms, but improvement of treatment is needed.

18.
Oxid Med Cell Longev ; 2020: 9316751, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32104544

RESUMO

The current study was carried out to evaluate the ameliorative effect of fucoidan against aflatoxicosis-induced hepatorenal toxicity in streptozotocin-induced diabetic rats. Sixty-four Wister albino male rats were randomly assigned into eight groups (8 rats each) that received normal saline, fucoidan (FUC) at 100 mg/kg/day orally for 4 weeks, streptozotocin (STZ) at 50 mg/kg/i.p. single dose, STZ plus FUC, aflatoxin B1 (AFB1) at 50 µg/kg/i.p. after one month of the beginning of the experiment for 2 weeks, AFB1 plus FUC, STZ plus AFB1, or STZ plus AFB1 and FUC. Injection of rats with STZ induced hyperglycemia. Rats with STZ-induced diabetes, with or without AFB1 intoxication, had significantly elevated activities of serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase, and levels of serum urea, creatinine, cholesterol, 8-oxo-2'-deoxyguanosine, interleukin-1ß, interleukin-6, and tumor necrosis factor-α. In addition, these rats exhibited increased lipid peroxidation and reduced glutathione concentration and activities of superoxide dismutase, catalase, and glutathione peroxidase enzymes in the hepatic and renal tissues. In contrast, administration of FUC to diabetic rats, with or without AFB1 intoxication, ameliorated the altered serum parameters, reduced oxidative stress, DNA damage, and inflammatory biomarkers, and enhanced the antioxidant defense system in the hepatic and renal tissues. These results indicated that FUC ameliorated diabetes and AFB1-induced hepatorenal injuries through alleviating oxidative stress, DNA damage, and inflammation.

19.
Chemistry ; 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32017260

RESUMO

A series of imide-fused diazatetracenes were synthesized via Buchwald-Hartwig C-N coupling with a highly active palladium source. The introduction of an imide segment effectively lowers the LUMO levels compared with that of unsubstituted diazatetracene. By adjusting the alkyl chains of the diazatetracenes, different solid-state packings were achieved, resulting in distinct photoluminescent behaviors. Their electron-transporting properties were demonstrated in the proof-of-concept Perovskite solar cells as electron transporting layers.

20.
JAMA ; 323(3): 237-247, 2020 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-31961419

RESUMO

Importance: For patients with painful chronic pancreatitis, surgical treatment is postponed until medical and endoscopic treatment have failed. Observational studies have suggested that earlier surgery could mitigate disease progression, providing better pain control and preserving pancreatic function. Objective: To determine whether early surgery is more effective than the endoscopy-first approach in terms of clinical outcomes. Design, Setting, and Participants: The ESCAPE trial was an unblinded, multicenter, randomized clinical superiority trial involving 30 Dutch hospitals participating in the Dutch Pancreatitis Study Group. From April 2011 until September 2016, a total of 88 patients with chronic pancreatitis, a dilated main pancreatic duct, and who only recently started using prescribed opioids for severe pain (strong opioids for ≤2 months or weak opioids for ≤6 months) were included. The 18-month follow-up period ended in March 2018. Interventions: There were 44 patients randomized to the early surgery group who underwent pancreatic drainage surgery within 6 weeks after randomization and 44 patients randomized to the endoscopy-first approach group who underwent medical treatment, endoscopy including lithotripsy if needed, and surgery if needed. Main Outcomes and Measures: The primary outcome was pain, measured on the Izbicki pain score and integrated over 18 months (range, 0-100 [increasing score indicates more pain severity]). Secondary outcomes were pain relief at the end of follow-up; number of interventions, complications, hospital admissions; pancreatic function; quality of life (measured on the 36-Item Short Form Health Survey [SF-36]); and mortality. Results: Among 88 patients who were randomized (mean age, 52 years; 21 (24%) women), 85 (97%) completed the trial. During 18 months of follow-up, patients in the early surgery group had a lower Izbicki pain score than patients in the group randomized to receive the endoscopy-first approach group (37 vs 49; between-group difference, -12 points [95% CI, -22 to -2]; P = .02). Complete or partial pain relief at end of follow-up was achieved in 23 of 40 patients (58%) in the early surgery vs 16 of 41 (39%)in the endoscopy-first approach group (P = .10). The total number of interventions was lower in the early surgery group (median, 1 vs 3; P < .001). Treatment complications (27% vs 25%), mortality (0% vs 0%), hospital admissions, pancreatic function, and quality of life were not significantly different between early surgery and the endoscopy-first approach. Conclusions and Relevance: Among patients with chronic pancreatitis, early surgery compared with an endoscopy-first approach resulted in lower pain scores when integrated over 18 months. However, further research is needed to assess persistence of differences over time and to replicate the study findings. Trial Registration: ISRCTN Identifier: ISRCTN45877994.


Assuntos
Cálculos/terapia , Drenagem , Endoscopia , Litotripsia , Manejo da Dor/métodos , Ductos Pancreáticos/cirurgia , Pancreatite Crônica/terapia , Adulto , Analgésicos Opioides/uso terapêutico , Área Sob a Curva , Cálculos/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Medição da Dor , Pancreatite Crônica/complicações , Pancreatite Crônica/cirurgia
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