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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.
Orthopedics ; : 1-6, 2022 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-36098574

RESUMO

Nationwide perspectives on cannabis have changed dramatically over recent decades. Although cannabis remains illegal at the federal level, medical cannabis (MC) is now legal in most states, and research has continued to show its effectiveness in a variety of medical conditions. However, both perception and acceptance of MC by the general public are evolving and remain poorly understood. Treating patients effectively with these novel therapeutics requires an understanding of the complex interplay of social and legal factors that could affect patient use. This cross-sectional survey study of more than 2500 patients sought to assess current patient perspectives on MC and to investigate factors related to its use that may represent barriers to broader patient use. Most respondents would consider using MC for chronic pain or other medical conditions. Most respondents were aware of the legal status of MC in their state, and 9 of 10 respondents believed that MC should be legal throughout the United States. General public knowledge of the utility of MC is an area needing improvement because older patients were significantly less likely to believe that MC is safe to use or that MC is safer than prescription opioids. As has been reported in previous literature, social stigma and cost appear to remain barriers for patient use of MC. Our findings provide further insight into current patient perspectives on MC, aiding both medical providers and researchers as we continue to provide access to and research MC. [Orthopedics. 20XX;XX(X):xx-xx.].

3.
Cureus ; 14(8): e27879, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36110459

RESUMO

BACKGROUND: The opioid epidemic is a major public health crisis in the United States. Legislators have enacted various strategies to combat this crisis, including the implementation of statewide prescription drug monitoring programs (PDMP). These PDMPs are electronic databases that collect and analyze patient prescription data on controlled substances, allowing physicians to review prior prescriptions before prescribing. The objective of this study was to determine opioid prescribing patterns after the implementation of a statewide PDMP in Pennsylvania. METHODS: After IRB approval, PDMP data were obtained from the Pennsylvania Department of Health. Data obtained included: drug name, days supplied, refill count, and partially filled prescriptions. The study timeline was three years, from first quarter 2017 through first quarter 2020. RESULTS: Over the three years post-implementation of a PDMP, Pennsylvania saw a 33% decrease in the overall quantity of opioid pills prescribed (677,194 absolute reduction), a 9% decrease in partially filled prescriptions (5,821 absolute reduction), and an 18% decrease in authorized refills (525 absolute reduction). Opioid prescriptions for greater than seven days of supply decreased by a larger amount than prescriptions for less than seven days of supply (43% vs 27%). Similarly, prescriptions for more than 22 pills saw a greater decrease than prescriptions for less than 21 days (37% vs 21%). However, the rate of decrease in opioid pills prescribed lessened from 14% in the first two years post implementation, to 10% in the third year. The decrease in partially filled opioid prescriptions for the first two years averaged 14% per year, while it increased by 23% in the third year. An 8% average decrease occurred in the rate of refills for opioid prescriptions for the first two years post implementation, followed by a 3% reduction in the third year. CONCLUSION: There was a 33% decrease in the overall quantity of opioid pills prescribed in the three years after the implementation of the PDMP. The first two years after implementation saw the largest decreases in prescribing habits, which slowed in the third year. More data are needed to show the long-term effects of implementing a statewide PDMP.

4.
J Hand Surg Am ; 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-36100487

RESUMO

PURPOSE: Ligament reconstruction and tendon interposition is a common technique for thumb basal joint arthroplasty. Recently, a variation of this technique, a suture suspensionplasty, has been introduced. The goal of our study was to assess the optimal position of the bone anchor in the thumb metacarpal. We hypothesized that an anchor placed in the radial aspect of the thumb metacarpal base would provide improved stability and resist subsidence more effectively than an ulnar-based thumb anchor. METHODS: Eight fresh-frozen cadaver arms were imaged fluoroscopically in anteroposterior and lateral views centered over the thumb carpometacarpal joint before and after trapeziectomy and after the placement of radial-based and ulnar-based bone anchors. The intermetacarpal angle between the thumb and index metacarpals was measured on all images after the application of a standard force. Radial abduction, opposition, subsidence, palmar abduction, and adduction were measured. Subsidence was calculated as the percentage loss of the trapezial space. RESULTS: Both radially and ulnarly placed internal brace constructs allowed more radial abduction, opposition, and palmar abduction than the pretrapeziectomy constructs. They both also reduced subsidence by approximately 20% to 29% compared with the posttrapeziectomy constructs. Comparing radial to ulnar constructs, motion and subsidence were similar. CONCLUSIONS: There was immediate stability of the thumb with respect to axial load and subsidence after anchor placement, and this was independent of the anchor position. The position of the bone anchor in the thumb metacarpal base did not affect the range of motion. Although the device can limit subsidence, it does not appear to restrict any range of motion of the thumb, irrespective of anchor position. CLINICAL RELEVANCE: This cadaver study can help hand surgeons understand the effect of positioning of bone anchors when performing a specific suture suspensionplasty technique.

5.
Comput Struct Biotechnol J ; 20: 4446-4463, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36051872

RESUMO

Klebsiella pneumoniae is a Gram-negative pathogen of clinical relevance, which can provoke serious urinary and blood infections and pneumonia. This bacterium is a major public health threat due to its resistance to several antibiotic classes. Using a reverse vaccinology approach, 7 potential antigens were identified, of which 4 were present in most of the sequences of Italian carbapenem-resistant K. pneumoniae clinical isolates. Bioinformatics tools demonstrated the antigenic potential of these bacterial proteins and allowed for the identification of T and B cell epitopes. This led to a rational design and in silico characterization of a multiepitope vaccine against carbapenem-resistant K. pneumoniae strains. As adjuvant, the mycobacterial heparin-binding hemagglutinin adhesin (HBHA), which is a Toll-like receptor 4 (TLR-4) agonist, was included, to increase the immunogenicity of the construct. The multiepitope vaccine candidate was analyzed by bioinformatics tools to assess its antigenicity, solubility, allergenicity, toxicity, physical and chemical parameters, and secondary and tertiary structures. Molecular docking binding energies to TLR-2 and TLR-4, two important innate immunity receptors involved in the immune response against K. pneumoniae infections, and molecular dynamics simulations of such complexes supported active interactions. A codon optimized multiepitope sequence cloning strategy is proposed, for production of recombinant vaccine in classical bacterial vectors. Finally, a 3 dose-immunization simulation with the multiepitope construct induced both cellular and humoral immune responses. These results suggest that this multiepitope construct has potential as a vaccination strategy against carbapenem-resistant K. pneumoniae and deserves further validation.

6.
Cureus ; 14(8): e28111, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36134102

RESUMO

Introduction Diversion of unused prescription opioids is a common source of opioid sensitization in the community. Educating patients about safe opioid use has been shown to be effective in decreasing opioid use. However, decreasing diversion will also require educating patients on proper opioid disposal. A survey was administered to better understand patients' habits with opioid disposal for opioids prescribed after orthopedic surgery. Methods A cross-sectional survey study of 469 patients who had undergone orthopedic surgery was conducted to learn their preferences and habits regarding the disposal of unused prescription opioids received after orthopedic surgery. Results The survey respondents consisted of 48.8% female and 51.2% male patients. Ninety-four point two percent (94.2%) of those receiving opioid prescriptions reported having leftover unused opioids. In terms of voluntary disposal, 68.8% claimed to dispose of their prescription opioids while 31.2% did not. Gender, but not age, had a significant effect on plans for opioid disposal and how seriously respondents viewed issues of opioid misuse. When asked their preferred location for prescription opioid disposal, the most common preference was a local pharmacy. Discussion This survey identified that most patients do not store their prescription opioids in a locked location, claim to dispose of their unused prescription opioids, and would prefer to dispose of them at a pharmacy if possible. This information points to the need for close prescriber-to-pharmacy collaboration to promote the safe disposal of prescription opioids and mitigate drug diversion.

7.
Sensors (Basel) ; 22(14)2022 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-35891033

RESUMO

In current decades, significant advancements in robotics engineering and autonomous vehicles have improved the requirement for precise depth measurements. Depth estimation (DE) is a traditional task in computer vision that can be appropriately predicted by applying numerous procedures. This task is vital in disparate applications such as augmented reality and target tracking. Conventional monocular DE (MDE) procedures are based on depth cues for depth prediction. Various deep learning techniques have demonstrated their potential applications in managing and supporting the traditional ill-posed problem. The principal purpose of this paper is to represent a state-of-the-art review of the current developments in MDE based on deep learning techniques. For this goal, this paper tries to highlight the critical points of the state-of-the-art works on MDE from disparate aspects. These aspects include input data shapes and training manners such as supervised, semi-supervised, and unsupervised learning approaches in combination with applying different datasets and evaluation indicators. At last, limitations regarding the accuracy of the DL-based MDE models, computational time requirements, real-time inference, transferability, input images shape and domain adaptation, and generalization are discussed to open new directions for future research.


Assuntos
Realidade Aumentada , Aprendizado Profundo , Previsões
8.
Pol J Vet Sci ; 25(2): 207-212, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35861963

RESUMO

Umbilical hernia is one of the most common problems in young calves. This problem occurs in dairy sector as well as in the local farmers. Present study was conducted to compare outcomes of four different techniques of herniorrhaphy. Twenty four young calves (n=24) were divided in 4 groups (A, B, C, and D) which underwent four different surgical techniques. Group A underwent vicryl plus suture material and pants-over-west technique, Group B underwent mesh application with Dexon suture material by using simple interrupted suture pattern, Group C underwent closed method with Nylon No. 3 suture material by using vertical mattress suture pattern and Group D underwent clamp application method with Silk No. 2 suture material by using simple interrupted suture pattern. The result showed that mesh application method was comparatively better with respect to feed intake, body weight gain and healing time. There was no reoccurrence with non-significant hematological changes (p≤0.05). It is concluded that mesh application method is safer than other three techniques and there are no systemic effects of this surgical intervention on calves' health.


Assuntos
Doenças dos Bovinos , Hérnia Umbilical , Animais , Bovinos , Doenças dos Bovinos/cirurgia , Hérnia Umbilical/cirurgia , Hérnia Umbilical/veterinária , Herniorrafia/métodos , Herniorrafia/veterinária , Técnicas de Sutura/veterinária , Suturas , Cicatrização
9.
Ann Surg ; 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35797618

RESUMO

OBJECTIVE: The aim of the study was to evaluate transanal irrigation (TAI) as a treatment for low anterior resection syndrome (LARS). BACKGROUND: LARS is a bowel disorder that is common after sphincter preserving rectal cancer surgery. Despite symptomatic medical treatment of LARS many patients still experience bowel symptoms that may have a negative impact on quality of life (QoL). TAI is a treatment strategy, of which the clinical experience is promising but scientific evidence is limited. MATERIALS AND METHODS: A multicenter randomized trial comparing TAI (intervention) with conservative treatment (control) was performed. Inclusion criteria were major LARS, age above 18 years, low anterior resection with anastomosis and a defunctioning stoma as primary surgery, >6 months since stoma reversal, anastomosis without signs of leakage or stricture, and no signs of recurrence at 1-year follow-up. The primary endpoint was differences in bowel function at 12-month follow-up measured by LARS score, Cleveland Clinic Florida Fecal Incontinence Score, and 4 study-specific questions. The secondary outcome was QoL. RESULTS: A total of 45 patients were included, 22 in the TAI group and 23 in the control group. Follow-up was available for 16 and 22 patients, respectively. At 12 months, patients in the TAI group reported significantly lower LARS scores (22.9 vs 32.4; P=0.002) and Cleveland Clinic Florida Fecal Incontinence Score (6.4 vs 9.2; P=0.050). In addition, patients in the TAI group also scored significantly higher QoL [8 of 16 European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) QoL aspects] compared with the control group. CONCLUSIONS: The results confirm our clinical experience that TAI reduces symptoms included in LARS and improves QoL.

10.
J Hand Surg Glob Online ; 4(4): 208-213, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35880154

RESUMO

Purpose: We assessed the rate of periprosthetic joint infection (PJI) following hand surgery in patients with prosthetic joints, and determined the efficacy of prophylactic antibiotics for preventing PJI in this patient subset. Methods: A systematic review of PubMed (MEDLINE) and Scopus (EMBASE, MEDLINE, COMPENDEX) from 1968 to 2021 was conducted. Primary articles that studied PJIs following hand surgery in patients with prosthetic joints (hip, knee, shoulder, elbow, or ankle) and/or the use of prophylactic antibiotics prior to hand surgery in patients with prosthetic joints were included. Results: A total of 3 studies (439,080 patients) met our inclusion criteria. Of the total study population, 9,070 patients (2.1%) had a prior total joint arthroplasty treated and subsequently underwent soft-tissue hand surgery. A single study reported a 0.2% prevalence of PJI secondary to hand surgery. The remaining 2 studies found no cases of PJI following hand surgery in patients with a history of total joint arthroplasty. On average, 16% (1,214 of 7,374) of patients with prosthetic joints received antibiotics prior to hand surgery. No significant relationships were found between hand surgery, antibiotic prophylaxis, and PJI risks. Conclusions: There is a very low reported incidence of PJI following hand surgery in patients with existing prosthetic joints, with or without the use of prophylactic antibiotics. Therefore, the authors do not recommend the routine use of prophylactic antibiotics in this patient subgroup. The decision to use prophylaxis should be made on a case-by-case basis, accounting for patient-specific comorbidities and risk factors. Further research on hand surgery-associated PJI is warranted. Type of study/level of evidence: Therapeutic III.

11.
Orthopedics ; 45(5): e235-e242, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35700430

RESUMO

The scaphoid is predisposed to nonunion after fracture because of its tenuous blood supply and propensity for delayed diagnosis. Many surgical techniques exist and continue to be developed to treat scaphoid non-unions. However, with variability in patient presentation, differences in nonunion location and type, and multiple bone graft sources and fixation options, selecting a surgical strategy proves a difficult task. The goal of this article is to provide an updated review of surgical strategies used to treat scaphoid nonunions. Particular attention is paid to methods of fixation as well as the ongoing debate over indications for structural and vascularized bone grafting. [Orthopedics. 2022;45(5):e235-e242.].


Assuntos
Fraturas Ósseas , Fraturas não Consolidadas , Osso Escafoide , Transplante Ósseo/métodos , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Fraturas não Consolidadas/diagnóstico por imagem , Fraturas não Consolidadas/cirurgia , Humanos , Osso Escafoide/diagnóstico por imagem , Osso Escafoide/cirurgia
12.
Artigo em Inglês | MEDLINE | ID: mdl-35649169

RESUMO

Controlling the nanoscale light-matter interaction using superfocusing hybrid photonic-plasmonic devices has attracted significant research interest in tackling existing challenges, including converting efficiencies, working bandwidths, and manufacturing complexities. With the growth in demand for efficient photonic-plasmonic input-output interfaces to improve plasmonic device performances, sophisticated designs with multiple optimization parameters are required, which comes with an unaffordable computation cost. Machine learning methods can significantly reduce the cost of computations compared to numerical simulations, but the input-output dimension mismatch remains a challenging problem. Here, we introduce a physics-guided two-stage machine learning network that uses the improved coupled-mode theory for optical waveguides to guide the learning module and improve the accuracy of predictive engines to 98.5%. A near-unity coupling efficiency with symmetry-breaking selectivity is predicted by the inverse design. By fabricating photonic-plasmonic couplers using the predicted profiles, we demonstrate that the excitation efficiency of 83% on the radially polarized surface plasmon mode can be achieved, which paves the way for super-resolution optical imaging.

13.
J Helminthol ; 96: e41, 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35726176

RESUMO

Based on morphometric, morphological and molecular characterization using partial small subunit 18S ribosomal DNA (rDNA) and the D2/D3 domain of large subunit 28S rDNA, we described a new species Mononchoides kanzakii collected from manure, and the known species Mononchoides composticola Steel, Moens, Scholaert, Boshoff, Houthoofd and Bert, 2011, isolated from the dung beetle Oniticellus cinctus (Fabricius, 1775). Phylogenetic trees based on the evolutionary model (GTR + I + G) were inferred by Bayesian inference algorithms. Mononchoides kanzakii sp. n. is characterized by 28-32 longitudinal ridges, discontinuous at level of stoma; amphidial apertures inconspicuous; metastegostom armed with thorn-shaped dorsal tooth; a flattened, claw-like right subventral tooth, and left subventral denticulate ridge with 12-14 fine denticles delimited by a group of five denticles in females vs. triangular, flattened right subventral tooth, 5-8 prominent denticles at left subventral sector in males; cloacal lips with a distinct rim; and gubernaculum with cuticularized, proximal and distal extensions of equal length, each constituting half of the length of the wider part of gubernaculum.


Assuntos
Calcificações da Polpa Dentária , Rabditídios , Animais , Teorema de Bayes , DNA Ribossômico/genética , Feminino , Masculino , Filogenia
14.
Arch Bone Jt Surg ; 10(5): 420-425, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35755785

RESUMO

Background: With the rise in distal radius fracture (DRF) incidence and treatment through open reduction internal fixation, there are increasing concerns in the current medical cost containment climate. To help reduce costs, manufacturers are introducing sterile packed kits. The purpose of this study is to compare the costs of the single use kit (SK) against conventional reprocessed DRF surgical sets (RS). Methods: A four-year retrospective review at three surgical centers was performed to determine a company's RS average sterilization and processing costs. RS instrumentation cost was estimated by straight-line depreciation from the original purchase price. RS implant costs were calculated from the list price. SK list cost was obtained from the same company. Incidence of surgical delays was estimated by a survey of 23 hand surgeons and cost of delays was obtained from surgical center reports. Sensitivity analysis on delay frequency was performed to assess a range of overall costs. Results: OR delays were estimated at one out of 100 cases, with an average cost of $11 per case. For RS, average instruments, implants, and sterilization costs per case was $47, $2882, and $39. The total RS cost of $2,978 and the SK was $1,667 with a difference of $1,313 per case. Conclusion: RS was found to cost $1,313 more per case than the SK in an ambulatory surgical setting and potentially more cost effective. Ultimately, pricing is highly variable at each center based on negotiated and contractual pricing.

15.
Cureus ; 14(4): e24541, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35664391

RESUMO

Background Opioid prescribing practices have been an area of interest for orthopedic surgeons in the wake of the opioid epidemic. Previous studies have investigated the effects of a multitude of patient-specific risk factors on prolonged opioid use postoperatively. However, to date, there is a lack of studies examining the effects of multiple prescribers during the perioperative period and their potential contribution to prolonged opioid use postoperatively. This study aimed to investigate if multiple unique opioid prescribers perioperatively predispose patients to prolonged opioid use following upper extremity surgery. Second, we compared opioid prescribing patterns among different medical specialties. Methodology This retrospective study was conducted at three academic institutions. Between April 30, 2018, and August 30, 2019, 634 consecutive patients who underwent one of three upper extremity procedures  were included in the analysis: carpal tunnel release (CTR), basal joint arthroplasty (BJA), or distal radius fracture open reduction and  internal fixation (DRF ORIF). Prescription information was collected using the state Prescription Drug Monitoring Program (PDMP) online database  from a period of three months preoperatively to six months postoperatively. A Google search was performed to group prescriptions by medical specialty.  Dependent outcomes included whether patients filled an additional opioid prescription postoperatively and prolonged opioid use (defined as opioid use three to six months postoperatively). Results In total, 634 patients were identified, including 276 CTRs, 217 DRF ORIFs, and 141 BJAs. This consisted of 196 males (30.9%) and 438 females (69.1%) with an average age of 59.4 years (SD: 14.7 years). By six months postoperatively, 191 (30.1%) patients filled an additional opioid prescription, and 89 (14.0%) experienced prolonged opioid use. In total, 235 (37.1%) patients had more than one unique opioid prescriber during the study period (average 2.5 prescribers). Patients with more than one unique opioid prescriber were significantly more likely to have received overlapping opioid prescriptions (15.7% vs. 0.8%, p<.001), to have filled an additional opioid prescription postoperatively (63.8% vs 10.3%, p<.001), and to have experienced prolonged opioid use postoperatively (35.3% vs 1.5%, p<.001) compared to patients with only one opioid prescriber. Patients with multiple unique prescribers filled more opioid prescriptions compared to those with a single prescriber (2.8 refills vs 1.8 refills, p=.035). Within six months postoperatively, 71.4% of opioid refills were written by non-orthopedic providers. Opioid refills written by non-orthopedic prescribers were written for a significantly greater number of pills (68.4 vs. 27.9, p<.001), for a longer duration (22.2 vs. 6.2 days, p<.001), and for larger total morphine milligram equivalents per prescription (831.4 vs. 169.8, p<.001) compared to those written by orthopedic prescribers. Conclusions Patients with multiple unique opioid prescribers during the perioperative period are at a higher risk for prolonged opioid use postoperatively. Non-orthopedic providers were the highest prescribers of opioids postoperatively, and they prescribed significantly larger and longer prescriptions. Our findings highlight the value of utilizing PDMP databases to help curtail opioid overprescription and potential adverse opioid-related outcomes following upper extremity surgery.

16.
Braz J Biol ; 84: e250132, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35584455

RESUMO

The study was designed to investigate the effect of mannan-oligosaccharide (MOS) supplementation on intestinal histomorphology, immunity against Newcastle disease virus (NDV) and productive parameters of broilers. A total of 1800, day old broiler chicks of Cobb-500 strain were selected and randomly assorted into 6 treatment groups: T1 (basal diet without antibiotics as negative control); T2 (basal diet plus antibiotics as positive control group); T3 (basal diet plus 200g/ton MOS); T4 (basal diet plus 400g/ton MOS); T5 (basal diet plus 600g/ton MOS) and T6 (basal diet plus 800g/ton MOS). Each treatment was having 6 replicates and the feed intake, body weight gain and feed conversion ratio (FCR) were recorded on weekly basis. Results showed that, MOS supplemented birds have significantly higher feed intake, weight gain and FCR (P < 0.05). Similarly, supplementation of MOS showed positive effect on villus height and crypt depth both in jejunum and ilium. Goblet cell density was unaffected by MOS addition (P < 0.05). Furthermore, birds fed with diets containing MOS, exhibited better productive performance in comparison to positive and negative control groups. In conclusion, MOS can replace antibiotic growth promoters (AGPs) as non-microbial performance-enhancing feed advocates.


Assuntos
Galinhas , Mananas , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Antibacterianos , Dieta/veterinária , Suplementos Nutricionais , Mananas/farmacologia , Oligossacarídeos/farmacologia
18.
Cureus ; 14(3): e23508, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35494931

RESUMO

OBJECTIVES: The opioid epidemic is a multifactorial issue, which includes pain mismanagement. Resident physician education is essential in addressing this issue. We aimed to analyze the effects of an educational intervention on the knowledge and potential prescribing habits of emergency medicine (EM), general surgery (GS), and internal medicine residents (IM). METHODS: Resident physicians were provided with educational materials and were given pre-tests and post-tests to complete. Descriptive statistics were used to analyze pre-test and post-test responses. Chi-squared analysis was used to identify changes between the pre-tests and post-tests. A p < 0.05 value was considered statistically significant.  Results: Following the educational intervention, we observed improvement in correct prescribing habits for acute migraine management among emergency medicine residents (from 14.8% to 38.5%). Among general surgery residents, there was a significant improvement in adherence to narcotic amounts determined by recent studies for sleeve gastrectomy (p= 0.01) and laparoscopic cholecystectomy (p= 0.002). Additionally, we observed a decrease in the number of residents who would use opioids as a first-line treatment for migraines, arthritic joint pain, and nephrolithiasis. DISCUSSION: Resident physicians have an essential role in combating the opioid epidemic. There was a significant improvement in various aspects of opioid-related pain management among emergency medicine, internal medicine, and general surgery residents following the educational interventions. We recommend that medical school and residency programs consider including opioid-related pain management in their curricula.

19.
Am Surg ; : 31348221101523, 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35537489

RESUMO

Numerous guidelines have been published regarding Enhanced Recovery Programs (ERP) following colorectal surgery over the past decade. Participation in these guidelines at a national level is unclear. We hypothesize that the adaptation of ERP for patients undergoing elective colorectal surgery is limited but the use of quality improvement measures has increased and while outcomes have improved over the past several years. A total of 86 402 patients were evaluated undergoing elective colectomy between 2013-2018 using the ACS-NSQIP database. Over a 5-year period, there was a significant increase in the use of quality improvement process measures: mechanical and oral bowel preparation and minimally invasive approach. During this time, there was a significant decrease in overall perioperative morbidities (P <.001). These encouraging results from a large national database suggest that evidence-based, quality improvement guidelines are being embraced and that overall outcomes for patients undergoing elective colectomy are improving.

20.
Artigo em Inglês | MEDLINE | ID: mdl-35412506

RESUMO

BACKGROUND: Prescription opioid abuse remains an ongoing public health crisis, especially in orthopaedic surgery. The purpose of the present study is to analyze opioid-prescribing patterns and investigate risk factors for prolonged opioid use after common outpatient orthopaedic surgical procedures. METHODS: After institutional review board approval, a review of 1,384 patients undergoing common elective outpatient orthopaedic procedures from January 2018 to June 2019 was conducted. Data on controlled substance prescriptions were obtained from the prescription drug monitoring program website. Statistical analysis was done to identify predictors for a second opioid prescription and prolonged opioid use (>6 months). RESULTS: Over 10% (150/1,384) of patients were still using opioids beyond 6 months. Of the opioid exposed patients, 60.4% (174/288) filled at least 1 additional opioid prescription postoperatively, and 29.2% (84/288) filled prescriptions beyond 6 months, compared with 26.4% (289/1,096) and 6.0% (66/1,096) of opioid-naive patients, respectively. Following multivariate analysis, significant predictors for filling a second opioid prescription included preoperative opioid use, current smoker status, benzodiazepine use, psychiatric disorder, and advanced age. CONCLUSION: This study revealed risk factors for prolonged opioid use after orthopaedic surgery. Surgeons should be mindful of these risk factors and counsel patients regarding postoperative pain management.


Assuntos
Transtornos Relacionados ao Uso de Opioides , Procedimentos Ortopédicos , Analgésicos Opioides/uso terapêutico , Humanos , Transtornos Relacionados ao Uso de Opioides/complicações , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Procedimentos Ortopédicos/efeitos adversos , Pacientes Ambulatoriais , Dor Pós-Operatória/tratamento farmacológico
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