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1.
Arch. Soc. Esp. Oftalmol ; 95(12): 586-590, dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194908

RESUMO

OBJETIVO: Reportar una experiencia piloto de atención por telemedicina en la especialidad de oftalmología, en el periodo de confinamiento por la pandemia por COVID-19. MÉTODOS: Estudio descriptivo. Se describen características demográficas y clínicas de pacientes atendidos en periodo de confinamiento de 10 semanas. Se evalúa la satisfacción de los pacientes y médicos participantes mediante una encuesta en línea. RESULTADOS: En las primeras 10 semanas, se realizaron 291 atenciones de telemedicina oftalmológica. Los principales motivos de consulta fueron afecciones inflamatorias de la superficie ocular y párpados (79,4%), seguido de requerimientos administrativos (6,5%), afecciones no inflamatorias de la superficie ocular (5,2%), sospecha de estrabismo (3,4%) y síntomas vitreorretinales (3,1%); 22 pacientes (7,5%) fueron derivados a atención presencial inmediata. El nivel de satisfacción con la prestación fue alto, tanto en médicos (100%), como en pacientes (93,4%). CONCLUSIONES: La atención oftalmológica por telemedicina en periodo de pandemia es un instrumento de utilidad para realizar un filtro de potenciales consultas presenciales, ya sea electivas o de urgencia, y para reducir potencialmente el riesgo de contagio por COVID-1


BACKGROUND: To report a pilot experience of telemedicine in ophthalmology in open-care modality (i.e. direct video call), in a confinement period due to the COVID-19 pandemic. METHODS: Descriptive study of the demographic and clinical characteristics of patients attended in a 10-week confinement period. Reported satisfaction of the participating patients and doctors was evaluated through an online survey. RESULTS: In the 10-week period, 291 ophthalmologic telemedicine consultations were performed. The main reasons for consultation were inflammatory conditions of the ocular surface and eyelids (79.4%), followed by administrative requirements (6.5%), non-inflammatory conditions of the ocular surface (5.2%), strabismus suspicion (3.4%) and vitreo-retinal symptoms (3.1%). According to previously defined criteria, 22 patients (7.5%) were referred to immediate face-to-face consultation. The level of satisfaction was high, both in doctors (100%) and in patients (93.4%). CONCLUSIONS: Open-care modality of telemedicine in ophthalmology during the pandemic period is a useful instrument to filter potential face-to-face consultations, either elective or emergency, and potentially reduce the risk of COVID-19 infection


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Oftalmopatias/diagnóstico , Oftalmopatias/terapia , Telemedicina/instrumentação , Projetos Piloto , Pandemias/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Teleoftalmologia , Betacoronavirus , Satisfação do Paciente , Garantia da Qualidade dos Cuidados de Saúde/métodos , Garantia da Qualidade dos Cuidados de Saúde/estatística & dados numéricos
2.
Arch Soc Esp Oftalmol ; 95(12): 586-590, 2020 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33160746

RESUMO

BACKGROUND: To report a pilot experience of telemedicine in ophthalmology in open-care modality (i.e. direct video call), in a confinement period due to the COVID-19 pandemic. METHODS: Descriptive study of the demographic and clinical characteristics of patients attended in a 10-week confinement period. Reported satisfaction of the participating patients and doctors was evaluated through an online survey. RESULTS: In the 10-week period, 291 ophthalmologic telemedicine consultations were performed. The main reasons for consultation were inflammatory conditions of the ocular surface and eyelids (79.4%), followed by administrative requirements (6.5%), non-inflammatory conditions of the ocular surface (5.2%), strabismus suspicion (3.4%) and vitreo-retinal symptoms (3.1%). According to previously defined criteria, 22 patients (7.5%) were referred to immediate face-to-face consultation. The level of satisfaction was high, both in doctors (100%) and in patients (93.4%). CONCLUSIONS: Open-care modality of telemedicine in ophthalmology during the pandemic period is a useful instrument to filter potential face-to-face consultations, either elective or emergency, and potentially reduce the risk of COVID-19 infection.

3.
Nervenarzt ; 91(10): 920-925, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32914296

RESUMO

BACKGROUND: Besides the treatment of cardiovascular risk factors, the prevention and treatment of secondary complications is the main focus of outpatient poststroke care. The spectrum of noteworthy complications after a stroke changes during the course of the treatment and constitutes a specific challenge of outpatient poststroke care. OBJECTIVE AND METHODS: This article provides references to the importance, management, diagnosis and treatment of the wide spectrum of nonvascular complications after stroke in the context of outpatient stroke aftercare. RESULTS: Poststroke depression (PSD), anxiety disorders and post-stroke fatigue are common complications after stroke, which require a timely diagnosis and treatment. Furthermore, the incidence of newly diagnosed dementia is 20% within the first 6 months after a stroke. Here too, therapeutic and preventive strategies especially in the early stage can delay the subsequent burden of the disease and the dependency on care. About half of every newly diagnosed epilepsy in patients older than 60 years is the result of a stroke. Falls and subsequent injuries are another important complication and a common reason for rehospitalization after a stroke. Although nearly 50% of patients suffer from chronic pain after a stroke this is often not sufficiently recognized. CONCLUSION: The wide spectrum of secondary complications after a stroke constitutes a complex, sustained and multidisciplinary challenge, which requires a cross-sectoral interaction of various and numerous actors in outpatient poststroke care.


Assuntos
Assistência ao Convalescente , Acidente Vascular Cerebral , Assistência Ambulatorial , Depressão , Humanos , Incidência , Pacientes Ambulatoriais , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia
4.
Palliat Support Care ; : 1-11, 2020 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-32838825

RESUMO

OBJECTIVE: Cancer is one of the biggest health challenges of our times, affecting all the personal areas of a patient. The interrelationships between these areas and the need for multidisciplinary care require the assessment of psychosocial complexity in cancer patients. The main aim of this study was to reach a consensus on the general definition of psychosocial complexity in cancer and its main elements according to the experts in the field. METHOD: A Delphi study was performed, which first involved a comprehensive review of the literature to create a questionnaire that was validated by two expert panels. The first panel consisted of intra-institutional experts, while the second included extra-institutional experts in the field. The study included three more rounds: (1) validation of the questionnaire by the internal panel, (2) discussion of the results and resolving discrepancies, and (3) validation of the questionnaire by the external panel. RESULTS: After the four-round Delphi process, we obtained a consensus definition of psychosocial complexity in cancer patients, as well as of its main factors: medical-physical, social-family, psychological, and spiritual. A 21-indicators list and its 8-indicators brief version were also proposed as indicators of psychosocial complexity. SIGNIFICANCE OF RESULTS: We present a definition of psychosocial complexity in cancer patients that has been agreed by experts, also establishing its four factors: medical-physical, social-family, psychological, and spiritual. This has led to the development of a list of indicators (and its brief version) that, after a validation process, could help health professionals to identify patients with high psychosocial complexity to provide them an optimal care.

5.
Eur J Neurol ; 27(11): 2185-2190, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32596976

RESUMO

BACKGROUND AND PURPOSE: Most recurrent cervical artery dissection (CeAD) events occur shortly after the acute first CeAD. This study compared the characteristics of recurrent and first CeAD events and searched for associations between subsequent events of an individual person. METHODS: Cervical artery dissection patients with a new CeAD event occurring during a 3-6 month follow-up were retrospectively selected in seven specialized stroke centers. Clinical and vascular characteristics of the initial and the recurrent CeADs were compared. RESULTS: The study sample included 76 patients. Recurrent CeADs were occlusive in one (1.3%) patient, caused cerebral ischaemia in 13 (17.1%) and were asymptomatic in 39 (51.3%) patients, compared to 29 (38.2%) occlusive, 42 (55.3%) ischaemic and no asymptomatic first CeAD events. In 52 (68.4%) patients, recurrent dissections affected both internal carotid arteries or both vertebral arteries, whilst 24 (31.6%) patients had subsequent dissections in both types of artery. Twelve (28.6%) of 42 patients with an ischaemic first dissection had ischaemic symptoms due to the recurrent CeADs, too. However, only one (1.3%) of 34 patients with a non-ischaemic first CeAD suffered ischaemia upon recurrence. CONCLUSION: Recurrent CeAD typically affects the same site of artery. It causes ischaemic events less often than the first CeAD. The risk that patients who presented with solely non-ischaemic symptoms of a first CeAD will have ischaemic symptoms in the case of a recurrent CeAD seems very small.

6.
Nervenarzt ; 91(6): 475-476, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32533230
7.
Nervenarzt ; 91(6): 477-483, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32361775

RESUMO

BACKGROUND: Registry data demonstrate a high risk of recurrent stroke and rehospitalization rates after first-time stroke in Germany compared to the international level. Meanwhile, a report of the Institute for Applied Quality Assurance in the Healthcare System (aQua institute) pointed out the potential for improvement of post-stroke care in Germany. OBJECTIVE: To establish perspectives for improvement of outpatient post-stroke care in Germany. METHODS: Critical discussion of important aspects of post-stroke care, presentation of the current structures of healthcare provision and possibilities for improvement of post-stroke care. RESULTS: Post-stroke care in Germany is predominantly carried out by general practitioners. Currently, standard healthcare procedures do not provide a comprehensive supportive system of structured and cross-sectoral aftercare after ischemic stroke. Special attention must be paid to the treatment of cardiovascular risk factors according to the guidelines, a specific and rapid provision of assist devices and physiotherapy as well as prevention and treatment of stroke-associated complications. Previous investigations have revealed sometimes clear deficits in the provision of treatment. The reasons include but are not limited to sectoral barriers that are difficult to overcome. New concepts of post-stroke care for improvement of these deficits are currently undergoing clinical testing. CONCLUSION: Ischemic stroke should be considered as a complex chronic disease and should be treated accordingly after discharge from acute inpatient treatment. Emphasis should be placed on the optimization of interdisciplinary and cross-sectoral cooperation and support for general practitioners in the outpatient post-stroke care. New concepts of post-stroke care have the potential for improvement of the current healthcare structures.


Assuntos
Assistência ao Convalescente , Acidente Vascular Cerebral , Assistência Ambulatorial , Alemanha , Hospitalização , Humanos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral
8.
Nervenarzt ; 91(6): 484-492, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32350547

RESUMO

In this overview the current quality of acute in-hospital care of stroke patients in Germany in 2018 is described based on standardized and evidence-based quality indicators. For this purpose the reports of the regional quality assurance projects for stroke care, which collaborated within the German-speaking Stroke Registers Study Group (ADSR) were analyzed. Overall, more than 280,000 acute admissions of stroke patients were documented in the included quality assurance projects. The results regarding the defined 16 quality indicators comprising diagnostics, acute treatment, rehabilitation and secondary prevention showed a high level of acute inpatient treatment of stroke in Germany. Only a few quality indicators, such as early transfer for thrombectomy indicated a great necessity for process optimization.


Assuntos
Isquemia Encefálica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/terapia , Alemanha , Humanos , Qualidade da Assistência à Saúde , Sistema de Registros , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia
9.
Arts Health ; : 1-15, 2020 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-32223531

RESUMO

Background: The therapeutic role of humor and hospital clowns has become a focus of interest in recent decades. Most of the research in the area has focused on children; here, we explore the influence of clown performances on adult cancer patients, their companions, and health-care staff.Methods: Ninety-nine cancer patients and 113 companions were assessed pre- and post-interventions performed by professional clowns; 31 health professionals were asked about the possible influence of the presence of clowns in hospital on their work.Results: Patients felt that clowning performances helped to reduce their level of psychological symptoms, but not their physical symptoms. Companions reported improvements in all the psychological symptoms explored. Health professionals reported that the presence of clowns in the workplace improved their well-being.Conclusions: Clowning performances helped to improve psychological functioning in all the populations studied, especially in companions. Adult hospitals should consider promoting clowning interventions to improve general well-being.

10.
Herz ; 45(7): 689-695, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-30643922

RESUMO

Atrial fibrillation (AF) is the most common form of cardiac tachyarrhythmia. It is estimated that in the Rhein-Neckar region approximately 40,000-50,000 out of 2 million people are affected. Due to demographic changes in the near future there will be a significant increase in the prevalence of AF within the next decades. The ARENA project was initiated by the Foundation Institute for Cardiac Infarction Research (IHF) Ludwigshafen in cooperation with cardiological and neurological departments of neighboring hospitals, resident doctors and pharmacies to improve the awareness and care of patients with AF. The particular aim is the prevention of stroke as one of the most dreaded complications. The project focusses on the following three subtopics: interventions, medication, migration. The aim of the intervention project is to raise awareness of AF as a risk factor for stroke and to improve the diagnostic work-up and care for patients with diagnosed or unknown AF. The subproject medication focusses on the adherence of patients with AF to the prescribed antithrombotic medication. To evaluate differences concerning patients with and without a migration background the subproject migration was initiated.


Assuntos
Fibrilação Atrial , Acidente Vascular Cerebral , Antraquinonas , Anticoagulantes , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/epidemiologia , Humanos , Sistema de Registros , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/prevenção & controle
11.
Food Chem ; 283: 155-163, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-30722855

RESUMO

This work aims to study the effect of the addition of saffron extract on fresh pasta in-vitro digestibility. Fresh pasta was formulated with different concentrations of saffron extracts (0.2 and 0.4 %w/w), cooked at two different times (1.5 and 3 min), and in vitro digested (oral, gastric and intestinal stages). Oil was added to pasta before digestion to evaluate the presence of lipids on starch and crocin bioaccessibility. Saffron enrichment and oil addition slowed down the digestion of starch, thus, decreasing the glycemic index of pasta. Concentration of saffron and oil addition contributed to crocin release in the digestion fluids, with the opposite effect of cooking time. Isomerization from trans to cis was enhanced by both, cooking and oil addition. Bioaccessibility of total crocins varied from 2.9 ±â€¯1.1, to 97 ±â€¯3%. Finally, the trans:cis isomers distribution was only close to 50:50 in enriched-pasta cooked during 3 min or with oil addition.


Assuntos
Carotenoides/metabolismo , Crocus/metabolismo , Extratos Vegetais/metabolismo , Amido/metabolismo , Carotenoides/análise , Cromatografia Líquida de Alta Pressão , Culinária , Farinha/análise , Isomerismo , Extratos Vegetais/química , Fatores de Tempo , Triticum/metabolismo
13.
Mar Environ Res ; 142: 21-31, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30253919

RESUMO

Describing the spatial patterns of benthic coastal habitats and investigating how those patterns affect the ecology of inhabiting species is a main objective of seascape ecology. Within this emerging discipline spatial scale is a principal topic. Different spatial scales inform on different characteristics of the habitat and therefore the relation between species and their habitats would be better defined when observed at multiple levels of spatial scale. Here we apply a multiscale seascape approach to investigate the habitat preferences of juvenile and adult individuals of dusky grouper (Epinephelus marginatus) in a Mediterranean marine protected area. Results show that the information obtained at different spatial scales is complementary, improving our capability to identify the preferred habitats and how it changes throughout ontogeny. These results show the relevance of implementing multiscale seascape ecology approaches to investigate the species-habitat relationships and to improve management and conservation of necto-benthic endangered top predators.


Assuntos
Bass , Biodiversidade , Ecossistema , Animais , Conservação dos Recursos Naturais , Mar Mediterrâneo
14.
Psychooncology ; 27(8): 1971-1978, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29740909

RESUMO

OBJECTIVE: Changes perceived as both positive (eg, posttraumatic growth [PTG]) and negative (eg, posttraumatic stress symptoms [PTSS]) have been associated with intensive Internet use among breast cancer survivors. In this multicenter study, we analyzed the role of PTG and PTSS on the amount of time spent looking for online cancer information, its content, and its psychological impact. METHODS: Posttraumatic stress symptoms and PTG were assessed in 182 breast cancer survivors by using the Post-traumatic Stress Disorder Checklist and Post-traumatic Growth Inventory questionnaires. Subjects also completed a questionnaire about their behavior when looking for online illness-related information (ie, time spent, type of contents, and psychological impact). RESULTS: Posttraumatic stress symptoms positively correlated with the amount of time spent looking for cancer-related information, including both medical and psychosocial content. By contrast, PTG showed no relationships with the amount of time, but with a predominant search for cancer-related psychosocial information. The psychological impact of online information was associated with participants' levels of PTG and/or PTSS. Whereas PTG was related to a decrease of women's hope, PTSS was linked to the perception of being less conscious or inadequately informed about the illness, thereby increasing feelings of distress. CONCLUSIONS: Posttraumatic stress symptoms and PTG show relationships with the amount of time spent online, the type of information accessed online, and the psychological impact of Internet use. Health professionals should prescribe online information according to the psychological response to cancer. There is a need for professional-led online resources to provide patients with timely information as well as support sites to facilitate psychological adjustment.


Assuntos
Acesso à Informação/psicologia , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Comportamento de Busca de Informação , Transtornos de Estresse Pós-Traumáticos/psicologia , Adaptação Psicológica , Adulto , Atitude Frente a Saúde , Neoplasias da Mama/terapia , Ajustamento Emocional , Feminino , Esperança , Humanos , Internet , Pessoa de Meia-Idade , Crescimento Psicológico Pós-Traumático , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Inquéritos e Questionários
15.
Scand J Med Sci Sports ; 28(2): 585-595, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28321925

RESUMO

Aerobic interval training (AIT) improves the health of metabolic syndrome patients (MetS) more than moderate intensity continuous training. However, AIT has not been shown to reverse all metabolic syndrome risk factors, possibly due to the limited duration of the training programs. Thus, we assessed the effects of 6 months of AIT on cardio-metabolic health and muscle metabolism in middle-aged MetS. Eleven MetS (54.5±0.7 years old) underwent 6 months of 3 days a week supervised AIT program on a cycle ergometer. Cardio-metabolic health was assessed, and muscle biopsies were collected from the vastus lateralis prior and at the end of the program. Body fat mass (-3.8%), waist circumference (-1.8%), systolic (-10.1%), and diastolic (-9.3%) blood pressure were reduced, whereas maximal fat oxidation rate and VO2peak were significantly increased (38.9% and 8.0%, respectively; all P<.05). The remaining components of cardio-metabolic health measured (body weight, blood cholesterol, triglycerides, and glucose) were not changed after the intervention, and likewise, insulin sensitivity (CSi) remained unchanged. Total AMPK (23.4%), GLUT4 (20.5%), endothelial lipase (33.3%) protein expression, and citrate synthase activity (26.0%) increased with training (P<.05). Six months of AIT in MetS raises capacity for fat oxidation during exercise and increases VO2peak in combination with skeletal muscle improvements in mitochondrial enzyme activity. Muscle proteins involved in glucose, fat metabolism, and energy cell balance improved, although this was not reflected by parallel improvements in insulin sensitivity or blood lipid profile.


Assuntos
Exercício Físico , Síndrome Metabólica/metabolismo , Músculo Esquelético/metabolismo , Adiposidade , Glicemia/análise , Pressão Sanguínea , Peso Corporal , Colesterol/sangue , Feminino , Humanos , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio , Triglicerídeos/sangue , Circunferência da Cintura
16.
Sci Rep ; 7(1): 13548, 2017 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-29051521

RESUMO

Breast conserving surgery is the preferred treatment for women diagnosed with early stage invasive breast cancer. To ensure successful breast conserving surgeries, efficient tumour margin resection is required for minimizing tumour recurrence. Currently surgeons rely on touch preparation cytology or frozen section analysis to assess tumour margin status intraoperatively. These techniques have suboptimal accuracy and are time-consuming. Tumour margin status is eventually confirmed using postoperative histopathology that takes several days. Thus, there is a need for a real-time, accurate, automated guidance tool that can be used during tumour resection intraoperatively to assure complete tumour removal in a single procedure. In this paper, we evaluate feasibility of a 3-dimensional scanner that relies on Raman Spectroscopy to assess the entire margins of a resected specimen within clinically feasible time. We initially tested this device on a phantom sample that simulated positive tumour margins. This device first scans the margins of the sample and then depicts the margin status in relation to an automatically reconstructed image of the phantom sample. The device was further investigated on breast tissues excised from prophylactic mastectomy specimens. Our findings demonstrate immense potential of this device for automated breast tumour margin assessment to minimise repeat invasive surgeries.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Imageamento Tridimensional/métodos , Análise Espectral Raman , Área Sob a Curva , Automação , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Desenho de Equipamento , Estudos de Viabilidade , Feminino , Humanos , Imageamento Tridimensional/instrumentação , Mastectomia , Curva ROC
17.
Nervenarzt ; 88(8): 911-918, 2017 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-28184974

RESUMO

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is associated with an increased mortality. Knowledge of possible causes of death could lead to an individualization of the palliative treatment concept and result in a differentiated palliative treatment pathway. Currently, only few systematic data are available on the heterogeneity of causes of death associated with ALS. OBJECTIVE: Analysis of the various causes of death in a prospective population-based German cohort of ALS patients. MATERIAL AND METHODS: Analysis of data of the Rhineland-Palatinate ALS registry in which newly diagnosed patients who had been identified between October 2009 and September 2012 were prospectively enrolled and followed up at regular intervals. From this prospective cohort study the causes of death were elicited based on information provided by the attending physicians, family members and by means of death certificates registered by the regional health authorities in Rhineland-Palatinate. RESULTS: Out of 200 ALS patients registered 148 died between register initiation on 1 October 2009 and the end of follow-up on 30 September 2015 (78 males and 70 females, death rate 74%). The most frequent cause of death was respiratory failure as a consequence of weakness of respiratory muscles (n = 91, 61%). Less frequent causes of death were pneumonia (n = 13, 9%), terminal cachexia (n = 9, 6%) and death from cardiovascular causes including sudden death (n = 9, 6%). Cases of suicide were rare (n = 3, 2%) as were deaths due to concurrent diseases (n = 2). In 21 cases (14%) the exact cause of death could not be clarified. Differences in the causes of death only showed a tendency towards the ALS phenotype. Respiratory failure was the cause of death in all patients with a respiratory phenotype and in 78% of patients with flail arm syndrome. Despite the low number of patients (8%) with additional frontotemporal dementia (FTD) a distinct difference in causes of death between those with and without FTD could be observed. Death due to respiratory failure was less frequent in ALS patients with FTD (33% vs. 65%) while pneumonia was more frequent (27% vs. 7%). CONCLUSION: Respiratory failure was the most frequent cause of death in our cohort of ALS patients. In contrast, pneumonia and nutritional disorders played a less important role as the cause of death. The phenotypic expression of ALS might in part allow the cause of the prospective death to be predicted. Differentiation of ALS phenotypes is an important foundation for patient counseling on the process of dying to be expected and for the determination of an individual palliative concept.


Assuntos
Esclerose Amiotrófica Lateral/mortalidade , Causas de Morte , Sistema de Registros/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
18.
J Plant Res ; 130(2): 327-337, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28083783

RESUMO

Yacon (Smallanthus sonchifolius, Asteraceae) is an ancient andean crop that has numerous dietary and medicinal properties. Morphological and anatomical features and developmental changes of the capitulum were studied. A ray floret is a pistillate, female flower, while a disc floret is a staminate male flower, and the former opens before the latter, being pseudanthium protogynous. The capitulum presents interesting attributes for pollinators such as flower structure, nectaries and pollenkitt. Gynoecial nectaries were found on undeveloped ovary in the disc floret, but not in the ray floret. Glandular trichomes were observed on the abaxial epidermis of corolla in the ray floret, but not in the disc floret. Capitulum development was divided into eight stages. Stigma receptivity varied with these stages. Pollen viability was low (15%). In accordance with low viability, pollen grains exhibit diverse sizes and shapes, reduction in length of spines, and abnormal protoplasm. Examination of ovary development in the ray floret showed that a mature ovule was formed, but fertilization did not occur. In advanced developmental stages, the capitulum showed proliferation of the endothelium, degeneration of the embryo sac, and all harvested cypselae had aborted seeds. Problems found in pollen viability and aborted cypselae could be the result of a history of vegetative propagation in the domestication process.


Assuntos
Asteraceae/crescimento & desenvolvimento , Flores/crescimento & desenvolvimento , Argentina , Asteraceae/anatomia & histologia , Asteraceae/fisiologia , Flores/anatomia & histologia , Reprodução
19.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 42(6): 388-394, sept. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-155030

RESUMO

La ecografía es una técnica que permite una exploración bastante completa del aparato urinario, alcanzando una alta sensibilidad para la detección de enfermedades relevantes, sobre todo a nivel renal, vesical y prostático. La detección temprana de afecciones como los tumores o la obstrucción de la vía urinaria, en ocasiones incluso antes de presentar expresión clínica, ha mejorado su manejo y pronóstico en muchas ocasiones. Esto, junto con su bajo coste e inocuidad, convierte a la ecografía en la técnica idónea para el abordaje inicial y el seguimiento de un número amplio de enfermedades del aparato urinario. En el presente artículo se revisan las características ecográficas de las principales afecciones que se pueden diagnosticar con esta técnica en el aparato urinario (AU)


Ultrasound techniques are able to provide a fairly complete examination of the urinary system, achieving a high sensitivity in relevant-pathology detection, especially in the kidney, bladder and prostate. Early detection of pathologies such as tumors or urinary tract obstructions, sometimes even before their clinical manifestation, has improved their management and prognosis in many cases. This, added to its low cost and harmlessness, makes ultrasound ideal for early approaches and follow-up of a wide number of urinary system pathologies. In this article, the ultrasound characteristics of the main urinary system pathologies that can be diagnosed by this technique, are reviewed (AU)


Assuntos
Humanos , Masculino , Feminino , Sistema Urinário , Rim/patologia , Rim , Ureter , Bexiga Urinária , Próstata , Neoplasias , Cálculos Ureterais , Cálculos Urinários , Anormalidades Congênitas , Urolitíase , Hidronefrose
20.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 42(6): 395-401, sept. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-155031

RESUMO

La ecografía aporta datos de extraordinario valor a la hora de estudiar la enfermedad esplénica, resultando diagnóstica en la esplenomegalia y traumatismos esplénicos, y muy orientadora en enfermedad focal tanto benigna como maligna, con especial mención del linfoma. En la evaluación de la enfermedad suprarrenal y retroperitoneal, sin embargo, la ecografía se ve superada por otras técnicas como la TAC o la RMN, si bien sigue constituyendo un excelente método de screening y de seguimiento, y resulta también en ocasiones útil a la hora de un abordaje terapéutico no invasivo (AU)


Ultrasound provides data of extremely great value when studying spleen pathology, being diagnostic in splenomegaly and splenic trauma, as well as offering a good approach to the diagnosis of both benign and malignant focal pathology, particularly lymphoma. However, for the evaluation of adrenal and retroperitoneal diseases, other techniques such as CT or MRI are more suitable, even though ultrasound is still an excellent screening and monitoring method, as well as being useful in non-invasive therapeutic approaches (AU)


Assuntos
Humanos , Masculino , Feminino , Baço/anormalidades , Baço/patologia , Baço , Esplenopatias/complicações , Esplenopatias , Neoplasias Retroperitoneais , Ultrassonografia/instrumentação , Esplenomegalia , Doenças do Córtex Suprarrenal , Doenças das Glândulas Suprarrenais , Glândulas Suprarrenais/lesões , Glândulas Suprarrenais/patologia , Glândulas Suprarrenais
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