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1.
Opt Quantum Electron ; 54(8): 497, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35815228

RESUMO

In this work, the performance of wavelength division multiplexing based radio over free space optics (WDM-RoFSO) communication system is investigated utilizing OptiSystem 0.7 software. Four weather conditions are adopted in this paper, namely, clear, haze, rain and fog with attenuation losses of 0.2 dB/km, 2.3 dB/km, 4.3 dB/km and 8 dB/km, respectively In addition, a high radio frequency of 30 GHz with high bit rate of 160 Gbps is modulated and carried on optical signal for fifth generation (5G) applications. The dual channel technique is employed in order to enhance the performance parameters of proposed WDM-RoFSO communication system. The enhancement in the link range is about; 46.1%, 35%, 29.4% and 25.9% for clear, haze, rain and fog, respectively.

2.
Appl Opt ; 60(34): 10680-10683, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-35200932

RESUMO

In this work, a new, to the best of our knowledge, full double-pass serial hybrid fiber amplifier is simulated on OptiSystem 7.0 software. A wideband flat gain spectrum covered both conventional and long communication bandwidth (C+L) from 1530 to 1590 nm, which is approximately 60 nm with high average gain of 23.6 dB; acceptable noise figure of 7 dB is achieved via the L-shape configuration. The main innovative step in the proposed design is decreasing the cascading amplification effect between the combined amplifiers, by making the individual full double-pass for the input signal in each amplifier stage.

3.
Mymensingh Med J ; 29(4): 800-806, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33116080

RESUMO

Hepatic encephalopathy (HE) is a neuro-psychiatric manifestation of chronic liver disease causing significant morbidity and mortality worldwide. Though the exact mechanism is unknown but it is well accepted that various precipitating factors are involved in hepatic encephalopathy. Aim of the study was explore the precipitating factors of chronic hepatic encephalopathy. This cross sectional descriptive study was conducted in the Department of Medicine and Department of Hepatology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period from April 2016 to October 2016. One hundred patients with hepatic encephalopathy fulfilling the inclusion and exclusion criteria were enrolled. Inclusion criteria were designed for all diagnosed cases of hepatic encephalopathy associated with cirrhosis of liver aged 18 years or above irrespective of sex. Patients with acute fulminant hepatitis and non-cirrhotic hepatic encephalopathy were excluded. The result of the study was mean age of hepatic encephalopathy was 52.81±8.15 years and 94.0% patients were above 40 years. Male (66.0%) were predominant over female (34.0%). HBsAg and Anti HCV were positive in 49.0% and 11.0% patients respectively. Stage of hepatic encephalopathy was stage-I in 8.0%, stage-II in 37.0%, stage-III in 39.0% and stage-IV in 16.0% patients. Changes of biochemical parameters were low haemoglobin level (70.0%), raised total count of leukocyte (25.0%), low platelet count (68.0%), low serum albumin (98.0%) raised prothrombin time (60.0%), low serum sodium (34.0%) and low serum potassium (63.0%). The recoded precipitating factors were gastrointestinal bleeding (14.0%), constipation (37.0%), hyponatremia (34.0%), hypokalemia (28.0%) infections (20.0%), use of diruretics (8.0%), use of sedatives (4.0%) and excess intake of protein (6.0%). While precipitating factor was absent in 11.0% of cases. In conclusion there are different factors which play a key role in precipitating hepatic encephalopathy but electrolytes imbalance, constipation, infections, Upper GI bleed, diuretics are the most common precipitating factors.


Assuntos
Encefalopatia Hepática , Adolescente , Adulto , Bangladesh , Estudos Transversais , Feminino , Encefalopatia Hepática/epidemiologia , Encefalopatia Hepática/etiologia , Humanos , Cirrose Hepática , Masculino , Pessoa de Meia-Idade , Fatores Desencadeantes
4.
Mymensingh Med J ; 29(1): 202-208, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915359

RESUMO

Giant cell tumors (GCT) are usually benign bone tumors with aggressive characteristics. Giant cell tumors have a benign indolent course in most patients, but tumors may recur locally in as many as 50% of cases depending on the type of treatment and initial presentation of the tumor. The aim in the management of long bone GCT is to eradicate the tumor and prevent local recurrences. In this study, we retrospectively assessed the functional outcomes in 5 patients having recurrent GCTs of the distal femur treated with custom made modular endoprosthesis following wide resection of the tumor from January 2017 to December 2018 in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Tumor Society functional score (MSTS) was used to assess the results of our patients. The mean follow-up period was 13.2 months. We achieved good to excellent results with our mean functional score of 80.66%. To the best of our knowledge, probably first started by us using customized modularendoprosthetic massive replacements for recurrent GCTs in our country. The use of custom made modular mega prosthesis is a simple and technically superior method of feeling the bone defects after wide resection in aggressive recurrent GCTs. In our opinion endoprosthesis replacement for recurrent GCTs had early good to excellent functional results 5.


Assuntos
Neoplasias Femorais/cirurgia , Fêmur/cirurgia , Tumor de Células Gigantes do Osso/cirurgia , Recidiva Local de Neoplasia/cirurgia , Implantação de Prótese , Bangladesh , Fêmur/fisiopatologia , Humanos , Recidiva Local de Neoplasia/patologia , Próteses e Implantes , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Resultado do Tratamento
5.
Mymensingh Med J ; 28(1): 126-136, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30755561

RESUMO

Anterior cruciate ligament injury is one of the commonest sports injuries, which often markedly reduces activity and the quality of life. The autologous hamstring double bundle graft and single bundle graft are commonly used for anterior cruciate ligament reconstruction. The choice of graft material for ACL reconstruction is believed to play a major role in the outcome but still there are controversies about the graft selection for primary ACL reconstruction. The aim of this study was to compare the clinical and functional outcome of autologous double bundle (DB) hamstring graft and single bundle (SB) hamstring graft reconstruction for the ACL injury. This prospective observational study was conducted in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2015 to September 2017. Total 42 cases of ACL injury that required reconstruction surgery was selected as per inclusion criteria. Total patients were allocated into two groups. One group was treated by single bundle graft and other group was treated by double bundle graft for the ACL reconstruction. In this study, the mean age of double bundle and single bundle groups were 28±6.63 and 30.14±7.55 years respectively and majority of the subjects were male. The post-operative symptoms and signs were more improved in double bundle group than single bundle group during last follow-up period of 6th months. The Lachman test, Anterior drawer test and pivot sift test were more negative in double bundle group than that of single bundle groups. The Lysholm and Tegner activity were better in double bundle group than single bundle group. Again rotational and anterior stability of the knee was better in the double bundle group. However, the differences were not statistically significant and all patients in our study were able to return their activity. Double bundle group showed better rotational stability than the single bundle groups and all knees were improved by anterior cruciate ligament reconstruction compared with their pre-operative status.


Assuntos
Reconstrução do Ligamento Cruzado Anterior/métodos , Ligamento Cruzado Anterior/cirurgia , Tendões/transplante , Adulto , Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior/instrumentação , Bangladesh , Feminino , Humanos , Masculino , Complicações Pós-Operatórias , Estudos Prospectivos , Qualidade de Vida , Amplitude de Movimento Articular/fisiologia , Resultado do Tratamento , Adulto Jovem
6.
Br J Oral Maxillofac Surg ; 55(6): 580-583, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28400075

RESUMO

Dually-registered specialists in oral and maxillofacial surgery (OMFS) may be subject to disciplinary hearings by the General Medical Council (GMC) and the General Dental Council (GDC) for the same allegations, a phenomenon referred to as "double jeopardy" within the specialty. Previous efforts by both councils to simplify regulatory arrangements have made little progress. We have therefore reviewed the range and scope of fitness to practise (FTP) proceedings relevant to OMFS. We searched the online GMC register to find registered OMFS specialists and obtained FTP proceedings from 2004-2016 through a Freedom of Information request from the GDC. We then searched for cases relevant to OMFS, and cross-checked GMC and GDC registers for dual registration before reviewing relevant cases and identifying and discussing themes. Seven OMFS specialists are currently subject to GMC sanctions. A total of 22 GDC hearings related to OMFS, all of which began after 2011. Six involved the practice of OMFS, work within an OMFS department, or work by a dually-registered doctor. While "double jeopardy" is uncommon, it does happen. The cases reviewed raise issues about the remit of the GDC and their understanding of clinical practice in OMFS. We found no evidence of progress in attempts to simplify FTP proceedings. The number of GDC hearings relevant to OMFS is increasing.


Assuntos
Competência Clínica , Disciplina no Trabalho/estatística & dados numéricos , Cirurgia Bucal , Comitês Consultivos , Humanos , Reino Unido
7.
Mymensingh Med J ; 25(2): 226-31, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27277352

RESUMO

Troponins are regarded as markers of choice for the diagnosis of acute myocardial infarction (AMI). But B-type natriuretic peptide (BNP) level is also elevated in AMI and is a quantitative biochemical marker related to the extent of infarction and the left ventricle systolic dysfunction. Thus, BNP has prognostic value. In this study, we investigate the correlation of Troponin-I with BNP levels in patients presenting with AMI with or without Acute Heart Failure. Rationale of this study is to see, whether quantitative Troponin alone can serve for both diagnosis and prognosis of AMI Patients with heart failure or not. This cross-sectional analytical study was conducted in the Department of Cardiology in Mymensingh Medical College Hospital from January 2014 to December 2014. Total 100 patients were studied and divided into two groups - 50 patients in each group. Group I: Patients with first attack of acute myocardial infarction (without heart failure) & Group II: Patients with first attack of acute myocardial infarction with acute heart failure. Mean Troponin-I of Group I and Group II were 3.10±2.68 and 62.93±32.75ng/ml respectively & mean BNP value of Group I and Group II were 20.96±14.18 and 615.65±249.27pg/ml respectively. In this study, it was shown that the levels of BNP had positive correlation with Troponin-I levels, with medium strength of association (r=0.734, p<0.05). Echocardiography shows that patients with high BNP level has low ejection fraction (LVEF) and patients with low BNP level has preserved ejection fraction (LVEF). Thus, the present study shows that the higher the Troponin-I levels, the higher the BNP levels in first attack of AMI patients and the more severe the heart failure (more severe left ventricle dysfunction). There is positive correlation between Troponin-I and BNP levels in first attack of AMI patients with acute heart failure.


Assuntos
Insuficiência Cardíaca/diagnóstico , Infarto do Miocárdio/diagnóstico , Peptídeo Natriurético Encefálico/sangue , Troponina I/sangue , Idoso , Bangladesh , Biomarcadores/sangue , Estudos Transversais , Ecocardiografia , Feminino , Insuficiência Cardíaca/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/metabolismo , Prognóstico
8.
Eye (Lond) ; 29(10): 1321-8, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26113498

RESUMO

PURPOSE: To determine the sensitivity and specificity of various methods of detecting a relative afferent pupillary defect (RAPD) in patients with glaucoma-related diagnoses. PATIENTS AND METHODS: Patients underwent RAPD evaluation using the swinging flashlight method (SFM), the magnifier-assisted SFM, and pupillography using the Konan RAPDx. Main outcome measures were sensitivity and specificity of three methods of RAPD evaluation in detecting visual field mean deviation (MD), cup to disc ratio (CDR), disc damage likelihood scale (DDLS), and retinal nerve fiber layer (RNFL) asymmetry. RESULTS: Eighty-one consecutive patients from the Wills Eye Hospital glaucoma service were enrolled, 60 with glaucoma and 21 with ocular hypertension or glaucoma suspect. Thirty-one percent of subjects had MD asymmetry>5 dB, 19.7% had CDR asymmetry≥0.20, 26.7% had DDLS asymmetry≥2, and 38.2% had RNFL asymmetry>10 microns. Sensitivity values for pupillography were 93.3% (95% CI, 68.1-99.8) for detecting MD asymmetry, 80.0% (95% CI, 51.9-95.7) for CDR asymmetry, 100.0% (95% CI, 73.5-100.0) for DDLS asymmetry, and 69.2% (95% CI, 38.6-90.9) for RNFL asymmetry. Specificity values were 41.2% (95% CI, 24.7-59.3) for detecting MD asymmetry, 32.8% (95% CI, 21.3-46.0) for CDR asymmetry, 33.3% (95% CI, 18.0-51.8) for DDLS asymmetry, and 42.9% (95% CI, 21.8-66.0) for RNFL asymmetry. Pupillography amplitude score was correlated with MD asymmetry (r2=0.41, P<0.001) and area under the curve was 0.84. CONCLUSION: Automated pupillography had higher sensitivity and lower specificity in detecting MD, CDR, DDLS, and RNFL asymmetry. Within the bounds of the cohort tested, this method had limited case-finding ability.


Assuntos
Técnicas de Diagnóstico Oftalmológico , Glaucoma/diagnóstico , Distúrbios Pupilares/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Hipertensão Ocular/diagnóstico , Estudos Prospectivos , Células Ganglionares da Retina/patologia , Sensibilidade e Especificidade , Tomografia de Coerência Óptica , Transtornos da Visão/diagnóstico , Testes de Campo Visual , Campos Visuais , Adulto Jovem
9.
Osteoarthritis Cartilage ; 23(12): 2242-2251, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26117175

RESUMO

OBJECTIVE: Lumbar facet joint degeneration (FJD) may be an important cause of low back pain (LBP) and sciatica. The goal of this study was to characterize cellular alterations of inflammatory factor expression and neovascularization in human degenerative facet joint capsular (FJC) tissue. These alterations in FJC tissues in pain stimulation were also assessed. DESIGN: FJs were obtained from consented patients undergoing spinal reconstruction surgery and cadaveric donors with no history of back pain. Histological analyses of the FJs were performed. Cytokine antibody array and quantitative real-time polymerase chain reaction (qPCR) were used to determine the production of inflammatory cytokines, and western blotting analyses (WB) were used to assay for cartilage-degrading enzymes and pain mediators. Ex vivo rat dorsal root ganglion (DRG) co-culture with human FJC tissues was also performed. RESULTS: Increased neovascularization, inflammatory cell infiltration, and pain-related axonal-promoting factors were observed in degenerative FJCs surgically obtained from symptomatic subjects. Increased VEGF, (NGF/TrkA), and sensory neuronal distribution were also detected in degenerative FJC tissues from subjects with LBP. qPCR and WB results demonstrated highly upregulated inflammatory cytokines, pain mediators, and cartilage-degrading enzymes in degenerative FJCs. Results from ex vivo co-culture of the DRG and FJC tissue demonstrated that degenerative FJCs increased the expression of inflammatory pain molecules in the sensory neurons. CONCLUSION: Degenerative FJCs possess greatly increased inflammatory and angiogenic features, suggesting that these factors play an important role in the progression of FJD and serve as a link between joint degeneration and neurological stimulation of afferent pain fibers.


Assuntos
Degeneração do Disco Intervertebral/genética , Cápsula Articular/metabolismo , Dor Lombar/genética , Vértebras Lombares , Osteoartrite da Coluna Vertebral/genética , RNA Mensageiro/metabolismo , Escoliose/genética , Espondilolistese/genética , Articulação Zigapofisária/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Western Blotting , Cadáver , Técnicas de Cocultura , Citocinas/genética , Citocinas/imunologia , Citocinas/metabolismo , Feminino , Gânglios Espinais , Humanos , Imuno-Histoquímica , Degeneração do Disco Intervertebral/imunologia , Degeneração do Disco Intervertebral/metabolismo , Cápsula Articular/imunologia , Dor Lombar/imunologia , Dor Lombar/metabolismo , Masculino , Pessoa de Meia-Idade , Fator de Crescimento Neural/metabolismo , Osteoartrite da Coluna Vertebral/imunologia , Osteoartrite da Coluna Vertebral/metabolismo , Ratos , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase em Tempo Real , Receptor trkA/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Escoliose/imunologia , Escoliose/metabolismo , Espondilolistese/imunologia , Espondilolistese/metabolismo , Regulação para Cima , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adulto Jovem , Articulação Zigapofisária/imunologia
10.
Transplant Proc ; 47(4): 1152-7, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26036542

RESUMO

OBJECTIVES: Kidney donors, similar to the general population, are at risk for developing type 2 diabetes mellitus (T2DM). The course of donors who develop T2DM has not been well studied. This work estimates the incidence of diabetes after kidney donation, and some risk factors and complications of diabetes mellitus postdonation. MATERIALS AND METHODS: This study examined the records of 2267 donors who donated one of their kidneys between 1976 and 2014 at the Urology and Nephrology Center, Mansoura University, Egypt, and who were regularly followed up at its outpatient clinic. A total of 388 donors were included in the study, and their medical records were revised. RESULTS: Postdonation weight gain and family history of diabetes mellitus were statistically significant for the development of diabetes mellitus, high or very high albuminuria, and/or decreased creatinine clearance. Metformin and insulin use seemed to significantly reduce the protein excretion and creatinine clearance decline in the studied group. CONCLUSIONS: There is a significant impact of a family history of diabetes mellitus on the development of high or very high albuminuria and/or decreased creatinine clearance.


Assuntos
Complicações do Diabetes/epidemiologia , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Medição de Risco , Adulto , Complicações do Diabetes/etiologia , Egito/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
11.
Appl Opt ; 53(23): 5187-92, 2014 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-25320928

RESUMO

We demonstrate a simple design to enhance the performance of a multiwavelength Brillouin-Raman fiber laser by capturing the residual Raman pump power (RPP) from the laser cavity using a wavelength-selective coupler. The performance parameters of the laser system are investigated and compared with the conventional design under the same input design parameters. Both laser systems at a RPP of 375 mW can generate up to 33 Stokes lines with an equal channel spacing of 0.08 nm; however, the tunability of the laser without injection of residual RPP is 25% higher than the conventional laser structure. In addition, for a laser system without residual RPP injection, increasing the RPP improves the laser performance and generates up to 42 Stokes lines with a tunability of 24.5 nm, from 1570 to 1594.5 nm, at 475 mW. In contrast, the laser system with a residual RPP has the worst performance as the pump power is increased, and generates only nine Stokes lines with a tuning range of 5 nm at the same RPP of 475 mW.

12.
Mymensingh Med J ; 20(3): 441-5, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21804509

RESUMO

This intervention study was conducted to determine the efficacy of Levofloxacin in the treatment of uncomplicated enteric fever. Among 100 patients, who were purposively selected for the study had presented sign and symptoms of enteric fever with blood culture positive salmonella in laboratory findings during the admission in the department of Medicine, Uttara Adhunik Medical College & Hospital, Dhaka. Patients who fulfilled the diagnostic criteria were enrolled in the study and divided into two groups. One group was treated with oral levofloxacin 750mg once daily (OD) and another was injected with Levofloxacin 500mg once daily for 7 days. All the patients were examined twice daily to observe the clinical cure or failure of levofloxacin. Study was conducted from January 2008 to December 2008. Statistical analysis was performed by using statistical software SPSS version 12. Among the 100 patients in the study, majority of them 46(92%) were aged between 15 to 25 years, the next group was between 25 to 35 years 26(52%) and only three patients were aged above 65 years. Significant number of the patients were male (67), and the rest of them were female. The patients were clinically examined specially for anaemia, jaundice, caecal gurgling, hepatosplenomegaly in both the groups and the relevant investigations were performed. It was found that 46 patients in group A, who took oral levofloxacin, were cured after seven days, whereas 48 patients in group B were fully cured by taking injectable levofloxacin by seven days. In this study, levofloxacin was found to be the most effective drug in both oral and injectable form in one-week treatment of uncomplicated typhoid.


Assuntos
Antibacterianos/uso terapêutico , Levofloxacino , Ofloxacino/uso terapêutico , Febre Tifoide/tratamento farmacológico , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Resultado do Tratamento , Adulto Jovem
13.
Mymensingh Med J ; 20(3): 463-71, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21804513

RESUMO

The present survey was conducted to find out the prevalence of Gastro-Esophageal Reflux Disease (GERD) among rural population in Bangladesh. The survey was carried out between the periods of June and October 2005 in a defined population at Jangalia village of Gazipur district. All respondents were interviewed face-to-face at their home by using a structured questionnaire. Total 3948 respondents were interviewed and 3924 were included in the final analysis. Response rate was 87.73%. Among the respondents male and female were 2089(53.2%) and 1835(46.8%) respectively. Male: female ratio was 1:0.87. The mean±SD age was 33.74±15.52 years. The prevalence of heartburn for at least monthly, weekly and daily episodes was 17.8%, 12.1% and 2.7% respectively. The corresponding figures for acid regurgitation were 19.2%, 10.9% and 1.6% respectively. The prevalence of GERD, as defined by the presence of heartburn and/or acid regurgitation at least once weekly was 19.4%. Prevalence of GERD by scoring system using the questionnaire was 22.1%. The multivariate analysis revealed that the increasing prevalence of GERD in older age group (p>0.05; OR, 1.04; 95% CI 0.31-3.67), men (p>0.05; OR, 1.44; 95% CI, 0.89-2.36), with smoking habit (p<0.001; OR, 2.49; 95% CI, 1.94-3.20). Prevalence of GERD was significantly more in housewives (p<0.05; OR, 2.56; 95% CI, 1.80-3.63). This can be concluded from the present study that GERD is highly prevalent in the community.


Assuntos
Refluxo Gastroesofágico/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bangladesh/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Adulto Jovem
14.
East Mediterr Health J ; 16(4): 434-7, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20795430

RESUMO

Dentistry is a profession demanding physical and mental efforts as well as people contact, which can result in burnout. The level of burnout among 307 clinical dental students in 2 Jordanian universities was evaluated using the Maslach Burnout Inventory survey. Scores for the inventory's 3 subscales were calculated and the mean values for the students' groups were computed separately. Dental students in both universities suffered high levels of emotional exhaustion and depersonalization. The dental students at the University of Jordan demonstrated a significantly higher level of emotional exhaustion than their counterparts at the Jordan University of Science and Technology.


Assuntos
Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Estudantes de Odontologia , Análise de Variância , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Esgotamento Profissional/diagnóstico , Esgotamento Profissional/etiologia , Esgotamento Profissional/prevenção & controle , Feminino , Humanos , Jordânia/epidemiologia , Masculino , Vigilância da População , Fatores de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Estatísticas não Paramétricas , Estudantes de Odontologia/psicologia , Estudantes de Odontologia/estatística & dados numéricos , Fatores de Tempo , Universidades , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
15.
J Antimicrob Chemother ; 57(5): 959-62, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16531431

RESUMO

BACKGROUND: Rational antimicrobial therapy should provide maximum benefit to patients while minimizing the development of resistant microorganisms. OBJECTIVES: The aim of this study was to investigate (i) which antimicrobial drugs were chosen by hospital doctors faced with two common infections [community-acquired pneumonia (CAP) and urinary tract infection (UTI)], (ii) whether these choices were compliant with local guidance and (iii) the factors that influenced antimicrobial choice. METHODS: A questionnaire based on two hypothetical clinical scenarios was distributed to 316 hospital doctors across four UK NHS hospitals in two cities (Newcastle and Edinburgh). RESULTS: Doctors in Newcastle were significantly more aggressive in their management: more patients were admitted (CAP: 78.9% versus 48.4%, P < 0.05) and given antimicrobials intravenously (CAP: 53.4% versus 21.2%, P < 0.05). Adherence to the local hospital guideline for CAP was significantly higher in Newcastle (83.3% versus 38.0%; P < 0.05). Fewer than half of the doctors surveyed used the local hospital guideline when choosing an antimicrobial, and the British National Formulary was the most frequently used resource (>90%). Junior doctors also identified medical school teaching and opinions of senior doctors as important influences. CONCLUSIONS: This study highlights inadequacies in the implementation and promotion of local guidelines, and demonstrates the potential for widely varying antimicrobial practices in two comparable UK cities.


Assuntos
Antibacterianos/uso terapêutico , Atitude do Pessoal de Saúde , Prescrições de Medicamentos , Fidelidade a Diretrizes , Padrões de Prática Médica , Antibacterianos/administração & dosagem , Infecções Comunitárias Adquiridas/tratamento farmacológico , Hospitais Gerais , Humanos , Pneumonia Bacteriana/tratamento farmacológico , Inquéritos e Questionários , Reino Unido , Infecções Urinárias/tratamento farmacológico
16.
J Org Chem ; 66(8): 2560-5, 2001 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-11304171

RESUMO

Aryl iodides are coupled with amines to give the corresponding arylamines in high yield in the presence of palladium, a suitable ligand, and NaOt-Bu. Functionalized aryl iodides give good yields of the corresponding arylamines when Cs(2)CO(3) is substituted as the base.


Assuntos
Aminas/síntese química , Hidrocarbonetos Aromáticos/química , Catálise , Iodetos/química , Ligantes , Paládio
17.
Eur J Biochem ; 267(14): 4556-60, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10880980

RESUMO

Six forms of helospectin (a vasoactive intestinal peptide analogue) were purified from the venom of the Heloderma horridum lizard. Their identification was performed by combining sequencing by automated Edman degradation and electrospray mass spectrometry analysis on the complete peptides and their tryptic fragments. The products resulting from the action of an O-glycosidase were also analysed. Two forms were identified as the previously named Hs1 and Hs2 of 38 and 37 amino-acid residues, respectively. Two forms corresponded to Hs1 and Hs2 O-glycosylated by a N-acetylhexosamine-hexose motif attached to the Ser32 residue. Two other forms were not completely characterized but might correspond to the O-glycosylated forms bearing a phosphate or a sulfate group. The glycosylation did not affect the capacity of the helospectins to recognize and to activate the human and the rat VPAC1 and VPAC2 receptors.


Assuntos
Venenos de Anfíbios/química , Venenos de Anfíbios/metabolismo , Peptídeos/química , Adenilil Ciclases/metabolismo , Sequência de Aminoácidos , Animais , Células CHO , Membrana Celular/efeitos dos fármacos , Cricetinae , Relação Dose-Resposta a Droga , Ativação Enzimática , Glicosilação , Humanos , Concentração Inibidora 50 , Peptídeos e Proteínas de Sinalização Intercelular , Lagartos/metabolismo , Espectrometria de Massas , Dados de Sequência Molecular , Peptídeos/isolamento & purificação , Ratos , Receptores de Peptídeo Intestinal Vasoativo/metabolismo , Receptores Tipo II de Peptídeo Intestinal Vasoativo , Receptores Tipo I de Polipeptídeo Intestinal Vasoativo , Proteínas Recombinantes/metabolismo , Homologia de Sequência de Aminoácidos , Tripsina/farmacologia , Peptídeo Intestinal Vasoativo/química , Peptídeo Intestinal Vasoativo/farmacologia
18.
Am J Physiol ; 277(5): L1057-65, 1999 11.
Artigo em Inglês | MEDLINE | ID: mdl-10564193

RESUMO

Prolonged hypoxia produces reversible changes in endothelial permeability, but the mechanisms involved are not fully known. Previous studies have implicated reactive oxygen species (ROS) and cytokines in the regulation of permeability. We tested whether prolonged hypoxia alters permeability to increasing ROS generation, which amplifies cytokine production. Human umbilical vein endothelial cell (HUVEC) monolayers were exposed to hypoxia while secretion of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1alpha, IL-6, and IL-8 was measured. IL-6 and IL-8 secretion increased fourfold over 24 h in a pattern corresponding to changes in HUVEC permeability measured by transendothelial electrical resistance (TEER). Addition of exogenous IL-6 to normoxic HUVEC monolayers caused time-dependent changes in TEER that mimicked the hypoxic response. An antibody to IL-6 significantly attenuated the hypoxia-induced changes in TEER (86 +/- 4 vs. 63 +/- 3% with hypoxia alone at 18 h), whereas treatment with anti-IL-8 had no effect. To determine the role of hypoxia-induced ROS on this response, HUVEC monolayers were incubated with the antioxidants ebselen (50 microM) and N-acetyl-L-cysteine (NAC, 1 mM) before hypoxia. Antioxidants attenuated hypoxia-induced IL-6 secretion (13 +/- 2 pg/ml with ebselen and 19 +/- 3 pg/ml with NAC vs. 140 +/- 15 pg/ml with hypoxia). Ebselen and NAC prevented changes in TEER during hypoxia (94 +/- 2% with ebselen and 90 +/- 6% with NAC vs. 63 +/- 3% with hypoxia at 18 h). N-nitro-L-arginine (500 microM) did not decrease hypoxia-induced changes in dichlorofluorescin fluorescence, IL-6 secretion, or TEER. Thus ROS generated during hypoxia act as signaling elements, regulating secretion of the proinflammatory cytokines that lead to alterations of endothelial permeability.


Assuntos
Endotélio Vascular/metabolismo , Hipóxia/metabolismo , Interleucina-6/biossíntese , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/imunologia , Anticorpos/farmacologia , Antioxidantes/farmacologia , Azóis/farmacologia , Permeabilidade da Membrana Celular/efeitos dos fármacos , Permeabilidade da Membrana Celular/imunologia , Células Cultivadas , Impedância Elétrica , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/imunologia , Humanos , Peróxido de Hidrogênio/farmacologia , Hipóxia/imunologia , Interleucina-6/imunologia , Isoindóis , Compostos Organosselênicos/farmacologia , Oxidantes/farmacologia , Oxigênio/farmacologia , Veias Umbilicais/citologia
19.
Eur J Gastroenterol Hepatol ; 11(12): 1355-8, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10654794

RESUMO

BACKGROUND: The pattern of oesophageal carcinoma type has been changing for some time in a number of countries, with adenocarcinoma becoming more frequent OBJECTIVE: To investigate the prevalence of columnar-lined (Barrett's) oesophagus and oesophageal adenocarcinoma in Barrett's oesophagus during a 20-year period in a single centre. METHODS: All upper gastrointestinal endoscopy and histology reports for the period January 1977 to December 1996 inclusive were reviewed. Data were analysed from patients who had histologically proven Barrett's oesophagus. The data were analysed as a single cohort and in five-year bands according to the date of diagnosis. RESULTS: Of 44,721 endoscopies, 636 Barrett's oesophagus cases were diagnosed; 508 (323 males 185 females; M:F ratio 1.7) were histologically proven. The frequency of Barrett's oesophagus detection increased steadily from 0.2% to 1.6% of all endoscopies per five-year band. The M:F ratio and the mean ages at diagnosis (61 years, range 60-63 for males and 69 years, range 68-79 for females) remained constant throughout. Barrett's oesophagus was diagnosed at a younger age in males (peak 60-69 years) compared to females (peak 70-79 years). The male oesophageal adenocarcinoma incidence (11.1%) was almost twice that in females (6.5%). In the majority (81%), the initial diagnosis of oesophageal adenocarcinoma and Barrett's oesophagus was made concurrently. CONCLUSIONS: The increasing Barrett's oesophagus frequency may reflect an increasing incidence or recognition of this condition or both. Barrett's oesophagus males are more likely to develop oesophageal adenocarcinoma than females.


Assuntos
Adenocarcinoma/epidemiologia , Esôfago de Barrett/epidemiologia , Neoplasias Esofágicas/epidemiologia , Adenocarcinoma/complicações , Distribuição por Idade , Idoso , Esôfago de Barrett/complicações , Estudos de Coortes , Endoscopia Gastrointestinal , Neoplasias Esofágicas/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Reino Unido/epidemiologia
20.
Surgery ; 124(3): 491-7, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9736900

RESUMO

BACKGROUND: It is well recognized that hypoxia/reoxygenation and exposure to inflammatory mediators such as cytokines and neutrophils alter the barrier function of the vascular endothelium. The experiments we conducted tested whether hypoxia alone could produce changes in permeability and whether a prolonged period of hypoxia alters the surface expression of cell adhesion molecules. METHODS: Endothelial cells were cultured from human umbilical vein endothelial cells (HUVECs). Hypoxia was created by isolating the cells in a chamber through which 1% 02, 5% CO2, and 94% N2 were insufflated (30 min at 1/min). Oxygen tension was measured through oxygen-quenching phosphorescence. Hypoxia was maintained for 24 hours. Changes in endothelial permeability were measured by transendothelial electrical resistance (TEER). Endothelial leukocyte adhesion molecule 1 (ELAM-1) and intercellular adhesion molecule 1 (ICAM-1) expression were assessed by flow cytometry (mean +/ standard error of the mean [SEM]. RESULTS: Exposure of endothelial cells to hypoxia resulted in increased permeability between 6 and 24 hours, with the greatest decrease in TEER at 18 hours (63% +/ 3%; P < .05). Prolonged hypoxia produced no change in the surface expression of ELAM-1 or ICAM-1. CONCLUSIONS: Hypoxia alone produced a significant reversible alteration in endothelial permeability. However, this change was observed only under severe hypoxic conditions (eg, below 20 mm Hg); higher oxygen tensions (25 and 35 mm Hg) had no significant effect. Unlike observations made after cytokine exposure, hypoxic breakdown of endothelial barrier function was unassociated with up-regulation of either ELAM-1 or ICAM-1.


Assuntos
Hipóxia Celular/imunologia , Endotélio Vascular/imunologia , Células Cultivadas , Selectina E/imunologia , Endotélio Vascular/efeitos dos fármacos , Citometria de Fluxo , Humanos , Molécula 1 de Adesão Intercelular/imunologia , Oxigênio/farmacologia , Fatores de Tempo , Fator de Necrose Tumoral alfa/imunologia , Veias Umbilicais/imunologia
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