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1.
Braz. j. biol ; 82: e238673, 2022. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1153461

RESUMO

Abstract Coccidiosis remains one of the major problems in poultry all over the world. Very limited data on anticoccidial drugs in wild pigeons is available. The current study was aimed to understand the comparative efficacy of sulfadimidine, amprolium and triquen in wild pigeons of Dir district, Pakistan suffering from coccidiosis. The faecal matter of wild pigeons were purchased from the local market for coccidian infection. Results revealed that 88.8% (16/18) were found infected with Eimeria spp. Three positive groups were treated with sulfadimidine (0.2mg/L), amprolium (25mg/L) and triquen. Sulfadimidine was most effective (45%) followed by amprolium (44.6%) while triquen (24.0%) showed less effectiveness against coccidiosis in pigeons. Number of oocysts were 79, 81 and 80 before treatment and 60, 44 and 44 after treatment with sulfadimidine, amprolium and triquen respectively. This study showed that sulphadimidine, amprolium and triquen could not significantly reduce the coccidiosis in pigeons. Further studies are required to clear the mechanism of anti-coccidial drugs in wild pigeons.


Resumo A coccidiose continua sendo um dos maiores problemas em aves de todo o mundo. Dados muito limitados sobre drogas anticoccidiais em pombos selvagens estão disponíveis. O presente estudo teve como objetivo compreender a eficácia comparativa da sulfadimidina, amprólio e triquenho em pombos selvagens do distrito de Dir, no Paquistão, que sofrem de coccidiose. A matéria fecal dos pombos selvagens foi comprada no mercado local para infecção por coccídios. Os resultados revelaram que 88,8% (16/18) foram encontrados infectados com Eimeria spp. Três grupos positivos foram tratados com sulfadimidina (0,2mg / L), amprólio (25mg / L) e triquenho. A sulfadimidina foi mais eficaz (45%), seguida pelo amprólio (44,6%), enquanto o triquenho (24,0%) apresentou menor efetividade contra a coccidiose em pombos. O número de oocistos foram 79, 81 e 80 antes do tratamento e 60, 44 e 44 após o tratamento com sulfadimidina, amprólio e triquenho, respectivamente. Este estudo mostrou que sulphadimidine, amprolium e triquen não poderiam reduzir significativamente a coccidiose em pombos. Mais estudos são necessários para limpar o mecanismo de drogas anticoccidiais em pombos selvagens.

2.
Braz J Biol ; 82: e238673, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33729384

RESUMO

Coccidiosis remains one of the major problems in poultry all over the world. Very limited data on anticoccidial drugs in wild pigeons is available. The current study was aimed to understand the comparative efficacy of sulfadimidine, amprolium and triquen in wild pigeons of Dir district, Pakistan suffering from coccidiosis. The faecal matter of wild pigeons were purchased from the local market for coccidian infection. Results revealed that 88.8% (16/18) were found infected with Eimeria spp. Three positive groups were treated with sulfadimidine (0.2mg/L), amprolium (25mg/L) and triquen. Sulfadimidine was most effective (45%) followed by amprolium (44.6%) while triquen (24.0%) showed less effectiveness against coccidiosis in pigeons. Number of oocysts were 79, 81 and 80 before treatment and 60, 44 and 44 after treatment with sulfadimidine, amprolium and triquen respectively. This study showed that sulphadimidine, amprolium and triquen could not significantly reduce the coccidiosis in pigeons. Further studies are required to clear the mechanism of anti-coccidial drugs in wild pigeons.


Assuntos
Amprólio , Coccidiose , Animais , Galinhas , Coccidiose/tratamento farmacológico , Coccidiose/veterinária , Columbidae , Paquistão , Sulfametazina
3.
J Burn Care Res ; 2021 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-33608722

RESUMO

Nucleated red blood cells have been studied in critically ill and injured patients as a predictor of increased in-hospital mortality and poor clinical outcomes. While prior studies have demonstrated the prognostic power of nucleated red blood cells in the critical patient, there has been a paucity of literature available describing their value as a prognostic indicator in the severely burned patient.In this retrospective observational study conducted from 2012 to 2017. Inclusion criteria for the purpose of this study included all burn patients with total body surface area > 10% that were age ≥ 15 years. Demographic and clinical data collected from the electronic medical record. Data analysis consisted of descriptive and comparative analysis using SPSS.Two hundred and nineteen patients (17.5%) met inclusion criteria with 51 (23.3%) patients positive for nucleated red blood cells. The presence of nucleated red blood cells had an increased mortality rate with an odds ratio of 6.0 (p = 0.001; 2.5, 14.5), were more likely to appear in older patients (p<0.001), and were associated with increased hospital length of stay (p<0.001), injury severity scores (p<0.001), and complications.The presence of NRBCs even at the low concentrations reported in our study showed a 6-fold increase in the rate of mortality. With the current improvements in burn care leading to higher survival rates, the need to improve upon the numerous models that have been developed to predict mortality in severe burn patients is clear given the significantly increased risk of death the presence of NRBCs portend.

4.
Surg Innov ; : 1553350620967246, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33135574

RESUMO

Since the SARS-CoV-2 (COVID-19) outbreak, health-care workers (HCWs) have had to create personal protective equipment (PPE) due to the worldwide demand and thus ensuing shortage. To address the dearth of available PPE, HCWs have quickly explored options to repurpose in-hospital equipment to provide alternative PPE to caregivers. We report the modification of a Stryker T5TM and Stryker Flyte® personal protection surgical helmets as a powered air-purifying respirator.

5.
J Vet Med Educ ; 47(6): 720-727, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32053055

RESUMO

The importance of communication skills in veterinary medicine has been increasing for a long time. The aim of this article is to investigate how theoretical training, role-playing, and standardized/simulated client (SC) methods improve senior (fifth-year) veterinary students' skills in breaking bad news. The study was carried out with 67 volunteer senior students. The research was designed from a pre-test and post-test control group pattern. All students encountered the SC. After pre-tests, theoretical training was given to Experimental Group A (EGA) and Experimental Group B (EGB). Then, only the students in EGA role-played together. Each student completed a checklist consisting of 10 basic items after pre-tests and post-tests. After post-tests, focus group interviews with open-ended questions were conducted. In the pairwise comparisons, EGA's and EGB's adjusted post-test mean scores were significantly higher than the control group's (p < .001). EGA's and EGB's post-test scores were found to be significantly higher than their pre-test scores. Women's empathy and eye contact scores were found to be statistically higher than men's scores. This study is the first of its kind in Turkey to use SCs and peer-to-peer learning with role-play simulations in training students about breaking bad news in veterinary medicine. These findings show that theoretical training and role-playing has an impact on senior veterinary students' skills in breaking bad news.

6.
Liver Int ; 40(1): 47-50, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31612570

RESUMO

There is an ongoing global hepatitis C virus (HCV) epidemic mainly related to high-risk behaviour in persons who inject drugs (PWID) and in HIV-infected men who have sex with men (MSM) which continues to fuel the HCV epidemic. Treatment of HCV infection with direct antiviral therapy (DAA) has been very successful in the last decade. Main obstacles for HCV elimination are HCV reinfections observed in PWID and HIV-infected MSM. We present here an HIV-infected MSM patient who has been reinfected thrice with HCV. The virus which was investigated from his last reinfection episode reveals transmission of a newly acquired HCV protease inhibitor (PI) resistance, despite not having been exposed to HCV-PIs during his last DAA therapy.

7.
Sci Rep ; 9(1): 1620, 2019 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-30733586

RESUMO

Because of its ideal band gap, high density and high electron mobility-lifetime product, cadmium zinc telluride (CdZnTe or CZT) is currently the best room-temperature compound-semiconductor X- and gamma-ray detector material. However, because of its innate poor thermo-physical properties and above unity segregation coefficient for Zn, the wide spread deployment of this material in large-volume CZT detectors is still limited by the high production cost. The underlying reason for the low yield of high-quality material is that CZT suffers from three major detrimental defects: compositional inhomogeneity, high concentrations of dislocation walls/sub-grain boundary networks and high concentrations of Te inclusions/precipitates. To mitigate all these disadvantages, we report for the first time the effects of the addition of selenium to the CZT matrix. The addition of Se was found to be very effective in arresting the formation of sub-grain boundaries and its networks, significantly reducing Zn segregation, improving compositional homogeneity and resulting in much lower concentrations of Te inclusions/precipitates. Growth of the new quaternary crystal Cd1-xZnxTe1-ySey (CZTS) by the Traveling Heater Method (THM) is reported in this paper. We have demonstrated the production of much higher yield according to its compositional homogeneity, with substantially lower sub-grain boundaries and their network, and a lower concentration of Te inclusions/precipitates.

8.
J Cardiothorac Surg ; 14(1): 28, 2019 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-30717747

RESUMO

BACKGROUND: Isolated right atrial rupture (IRAR) from blunt chest trauma is rare. There are no physical exam findings and non-invasive testing specific to the condition, which result in diagnostic delays and poor outcomes. We present a case of IRAR along with a systematic review of similar cases in the literature. CASE REPORT: A 23-year-old male presented following a motor vehicle accident (MVA). He was bradycardic and hypotensive during transportation; and required intubation. There were contusions along the right chest wall with clear breath sounds, and no jugular venous distension, muffled heart sounds. Hemodynamic status progressively worsened, ultimately leading to his death. However, no external sources of bleeding or evidence of cardiac tamponade was found. METHODS: A search of PubMed, Ovid, and the Cochrane Library using: (Blunt OR Blunt trauma) AND (Laceration OR Rupture OR Tear) AND (Right Atrium OR Right Atrial). Articles were included if they were original articles describing cases of IRAR. RESULTS: Forty-five reports comprising seventy-five (n = 75) cases of IRAR. CONCLUSION: IRAR most commonly occurs following MVAs as the result of blunt chest trauma. Rupture occurs at four distinct sites and is most commonly at the right atrial appendage. IRAR is a diagnostic challenge and requires a high index of suspicion, as patients' hemodynamics can rapidly deteriorate. The presentations vary depending on multiple factors including rupture size, pericardial integrity, and concomitant injuries. Cardiac tamponade may have a protective effect by prompting the search for a bleeding source. A pericardial window can be diagnostic and therapeutic in IRAR. Outcomes are favourable with timely recognition and prompt surgical intervention.


Assuntos
Apêndice Atrial/lesões , Traumatismos Cardíacos/diagnóstico , Ferimentos não Penetrantes/complicações , Acidentes de Trânsito , Evolução Fatal , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/fisiopatologia , Hemodinâmica , Humanos , Masculino , Adulto Jovem
9.
J Burn Care Res ; 39(6): 1043-1047, 2018 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-29931215

RESUMO

The use of electronic cigarettes (ECs) has been on the rise with increased number of battery explosions causing burns. This study is a retrospective review of patients who presented with burns caused by EC explosions.Here, we present a case series of eight patients sustaining burns from EC explosions, within a year, to elucidate the pattern of such burns and to provide a treatment guideline.All of them were males. Five patients had partial-thickness burns and three had full-thickness burns. TBSA ranged from 4 to 16% (burns to lower extremity [n = 7], hand [n =3], scrotum/penis [n =2], chest [n = 1]). None had inhalation injuries. Two patients (29%) required skin grafting. EC explosion is predominantly attributed to its lithium-ion battery. Several types of injuries can occur, including chemical and thermal burns, inhalation injuries, metal poisoning, etc. There are currently no specific guidelines on the management of burns due to lithium-ion battery exposure. Herein, we recommend the following: Initial assessment of injuries should accompany the Advanced Trauma Life Support guidelines; serum levels of lithium, cobalt, and manganese should be checked and elevated levels should be monitored; patients should be monitored for signs of metal toxicity; wound should be extensively debrided and irrigated to remove any residual materials; and litmus test should be performed to check for alkali pH prior to irrigation with water or other aqueous solutions.


Assuntos
Queimaduras/etiologia , Queimaduras/cirurgia , Fontes de Energia Elétrica/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina , Explosões , Lítio , Adolescente , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Pele
10.
J Med Virol ; 90(4): 639-643, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29091325

RESUMO

Crimean Congo hemorrhagic fever (CCHF) is a viral zoonotic disease with high mortality rate. There are only a few studies on viral load in CCHF. In our study, we revealed the dynamics of viral load and its relationship with mortality in early phase of the disease. A total of 138 serum samples were collected from 23 patients. All patients had positive PCR for CCHF on admission. Serum samples were obtained daily from all patients for the first 6 days of hospitalization and stored at -80°C for viral load measurement. We found statistically significant difference between mean number of viremic serum samples of fatal and non-fatal patients. Furthermore, non-fatal cases' viral loads demonstrated statistically significant decreases over time; however, we could not observe a similar trend in viral loads of fatal cases. Limited number of studies on CCHF indicate that score of the contest between CCHF virus and immune system determines the survival in CCHF and viral load is found to be the most prognostic factor. In our study, we found that there is a notable decrease trend in viral loads of non-fatal patients over time and this clearance of CCHF virus is significantly related with survival.


Assuntos
Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Febre Hemorrágica da Crimeia/virologia , Soro/virologia , Carga Viral , Adolescente , Adulto , Idoso , Feminino , Febre Hemorrágica da Crimeia/mortalidade , Febre Hemorrágica da Crimeia/patologia , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prognóstico , Análise de Sobrevida , Fatores de Tempo , Adulto Jovem
11.
Scand J Trauma Resusc Emerg Med ; 25(1): 99, 2017 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-28982391

RESUMO

BACKGROUND: Conventional coagulation tests do not provide an accurate representation of the complex nature of trauma induced coagulopathy. Thrombelastography provides a prompt global overview of all dynamic sequential aspects of trauma induced coagulopathy. The objective of this study was to evaluate the impact of using thrombelastography on blood products utilization, crystalloids utilization, hospital, and intensive care using length of stay, and cost savings. METHODS: We retrospectively reviewed 134 patients (May of 2012 to February of 2015) meeting Class I trauma activation. Outcome data was compared between two groups: patients prior to thrombelastography implementation (n = 87) and patients with thrombelastography guided trauma resuscitation (n = 47). Blood product usage was compared for three time periods: first 4 h, the next 20 h, and first 24 h. RESULTS: For the first 24 h of treatment, patients with thrombelastography guided trauma resuscitation had lower packed red blood cells (p = 0.0022) and fresh frozen plasma (p = 0.0474), but higher jumbo pack platelets (p = 0.0476) utilization when compared to the patients prior to thrombelastography implementation. There was no statistical significant difference in the utilization of crystalloids for any of the three time intervals. Patients with thrombelastography guided trauma resuscitation had a shorter hospital length of stay (p = 0.0011) and intensive care unit length of stay (p = 0.0059) than the patients prior to thrombelastography implementation. Cost savings in blood products transfusion were most pronounced in patients with penetrating injuries. DISCUSSION: Using visco-elastic tests to guide blood transfusion was first used for liver transplant patients and then applied to cardiovascular surgery and trauma. Similar to other studies, this study showed using visco-elastic tests for trauma patietns corresponded to an overall reduction in the use of packed red blood cells and fresh frozen plasma during the first 24 hours of resuscitation. In addition, this study showed using visco-elastic tests corresponded to a significant reduction in both hospital and intensive care unit length of stay. CONCLUSION: This study demonstrates that Thrombelastography guided trauma resuscitation decreases the overall transfusion requirements of packed red blood cells and fresh frozen plasma. However, given the nature of under-recognized jumbo pack platelets dysfunction in the conventional laboratory parameters, jumbo pack platelets utilization is higher when following Thrombelastography directed resuscitation. The utilization of Thrombelastography corresponded to a reduction in hospital length of stay, intensive care unit length of stay and cost of transfused blood products.


Assuntos
Transtornos da Coagulação Sanguínea/terapia , Transfusão de Sangue/métodos , Cuidados Críticos/métodos , Diagnóstico Precoce , Ressuscitação/métodos , Tromboelastografia/métodos , Ferimentos e Lesões/complicações , Adulto , Coagulação Sanguínea , Transtornos da Coagulação Sanguínea/sangue , Transtornos da Coagulação Sanguínea/etiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Ferimentos e Lesões/sangue , Ferimentos e Lesões/terapia
12.
BMJ Case Rep ; 20172017 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-28647716

RESUMO

Pyosalpinx is a severe sequel of chronic pelvic inflammatory disease, whereby the fallopian tubes become filled with pus.1 2 Pyosalpinx often affects sexually active women and rarely is seen in celibate adolescent girls.3 We report a case of a 12-year-old girl with no prior sexual history who presented to our emergency department with complaints of severe right lower quadrant pain of 1-day duration. Ultrasonography and CT scan of the abdomen and pelvis revealed free fluid collections in the pelvis without visualisation of the appendix. A preoperative diagnosis of acute ruptured appendicitis was given and she was taken to the operating room. Peroperative findings included bilaterally distended, pus-filled pyosalpinges. A definitive diagnosis of bilateral pyosalpinx was then made. Two-week antibiotic therapy was successful but the patient returned with recurrent pyosalpinx and a pelvic abscess 9 weeks later.


Assuntos
Abdome/patologia , Abscesso/etiologia , Tubas Uterinas/patologia , Ductos Paramesonéfricos/anormalidades , Pelve/patologia , Salpingite/diagnóstico , Comportamento Sexual , Abscesso/diagnóstico , Doença Aguda , Apendicite/complicações , Criança , Feminino , Humanos , Doença Inflamatória Pélvica/diagnóstico , Doença Inflamatória Pélvica/etiologia , Salpingite/etiologia , Ultrassonografia
13.
Cureus ; 9(11): e1857, 2017 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-29375943

RESUMO

Obturator artery injury (OAI) from pelvic gunshot wounds (GSW) is a rarely reported condition. Hemorrhages from pelvic trauma (PT) are mostly venous. Arterial hemorrhages represent about 10-20% of PTs. When arterial hemorrhages from PT occur, they are a severe and deadly complication often causing significant hemodynamic instability and eventual shock. A 23-year-old male presented to our emergency service via a private vehicle with multiple gunshot wounds to both thighs and to the lower back, resulted in rectal and obturator artery (OA) injuries. The patient underwent a successful coil-embolization of the right OA. Given the density of structures within the pelvis, patients who sustain gunshot wounds to the pelvic region are at high risk for injury to the small bowel, sigmoid colon, rectum, bladder, and/or vascular structures. While bleeding is the major cause of early mortality in PT, rectal injuries carry the highest mortality due to visceral injuries. A high clinical index of suspicion is needed to diagnose an iliac artery injury or injury to its branches. Prompt computed tomographic angiogram (CTA) and embolization of the OA is the best method to control and stop the bleeding and improve the mortality outcome. Clinicians caring for patients presenting with pelvic gunshot wounds should pay attention to the delayed presentation of internal hemorrhage from the OAs. A multidisciplinary team approach is crucial in the successful management of penetrating injuries to the obturator artery.

14.
Ann Saudi Med ; 36(3): 216-22, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27236394

RESUMO

BACKGROUND: Knowing risk factors for colistin resistance is important since colistin is the only remaining choice for the treatment of infections caused by multi-drug resistant microorganisms. OBJECTIVE: Evaluate risk factors associated with infection by colistin-resistant microorganisms. DESIGN: Retrospective study. SETTING: Tertiary healthcare centers. PATIENTS AND METHODS: An e-mail including the title and purpose of the study was sent to 1500 infec.tious disease specialists via a scientific and social web portal named "infeksiyon dunyasi (infection world)". Demographic and clinical data was requested from respondents. MAIN OUTCOME MEASURE(S): Colistin-resistance. RESULTS: Eighteen infectious disease specialists from twelve tertiary care centers responded to the invitation data was collected on 165 patients, 56 cases (39.9%) and 109 (66.0%) age- and sex-matched controls. The colistin-resistant microorganisms isolated from cases were 29 Acinetobacter baumannii (51.8%), 18 Pseudomonas aeruginosa (32.1%) and 9 Klebsiella spp. Colistin, carbapenem, and quinolone use in the last three months were risk factors for colistin resistance in the univariate analysis. Previous quinolone use in the last three months (P=.003; RR:3.2; 95% Ci:1.5-6,7) and previous colistin use in the last three months (P=.001; RR: 3.6; 95% CI: 1.63-7.99) were significant risk factors in the multivariate analysis. CONCLUSION: Clinicians should limit the use of quinolones and remain aware of the possibility of resistance developing during colistin use. LIMITATIONS: The lack of a heteroresistance analysis on the isolates. no data on use of a loading dose or the use of colistin in combination.


Assuntos
Antibacterianos/farmacologia , Colistina/farmacologia , Farmacorresistência Bacteriana Múltipla , Bactérias Gram-Negativas/efeitos dos fármacos , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Acinetobacter/epidemiologia , Acinetobacter baumannii/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Carbapenêmicos/uso terapêutico , Estudos de Casos e Controles , Colistina/uso terapêutico , Feminino , Humanos , Klebsiella/efeitos dos fármacos , Infecções por Klebsiella/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/epidemiologia , Pseudomonas aeruginosa/efeitos dos fármacos , Quinolonas/uso terapêutico , Estudos Retrospectivos , Fatores de Risco
15.
Sci Rep ; 6: 26384, 2016 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-27216387

RESUMO

CdZnTe (CZT) has made a significant impact as a material for room-temperature nuclear-radiation detectors due to its potential impact in applications related to nonproliferation, homeland security, medical imaging, and gamma-ray telescopes. In all such applications, common metals, such as gold, platinum and indium, have been used as electrodes for fabricating the detectors. Because of the large mismatch in the thermal-expansion coefficient between the metal contacts and CZT, the contacts can undergo stress and mechanical degradation, which is the main cause for device instability over the long term. Here, we report for the first time on our use of Al-doped ZnO as the preferred electrode for such detectors. The material was selected because of its better contact properties compared to those of the metals commonly used today. Comparisons were conducted for the detector properties using different contacts, and improvements in the performances of ZnO:Al-coated detectors are described in this paper. These studies show that Al:ZnO contacts to CZT radiation detectors offer the potential of becoming a transformative replacement for the common metallic contacts due to the dramatic improvements in the performance of detectors and improved long-term stability.

16.
J Inflamm (Lond) ; 13: 13, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27110221

RESUMO

BACKGROUND: Hyperglycemia is a frequent and important metabolic derangement that accompanies severe sepsis and septic shock. Matrix-Metalloproteinase 9 (MMP-9) has been shown to be elevated in acute stress hyperglycemia, chronic hyperglycemia, and in patient with sepsis. The objective of this study was to examine the clinical and pathogenic link between MMP-9 and blood glucose (BG) levels in patients with early severe sepsis and septic shock. METHODS: We prospectively examined 230 patients with severe sepsis and septic shock immediately upon hospital presentation and before any treatment including insulin administration. Clinical and laboratory data were obtained along with blood samples for the purpose of this study. Univariate tests for mean and median distribution using Spearman correlation and analysis of variance (ANOVA) were performed. A p value ≤ 0.05 was considered statistically significant. RESULTS: Patients were grouped based on their presenting BG level (mg/dL): BG <80 (n = 32), 80-120 (n = 53), 121-150 (n = 38), 151-200 (n = 23), and > 201 (n = 84). Rising MMP-9 levels were significantly associated with rising BG levels (p = 0.043). A corresponding increase in the prevalence of diabetes for each glucose grouping from 6.3 to 54.1 % (p = 0.0001) was also found. As MMP-9 levels increased a significantly (p < 0.001) decreases in IL-8 (pg/mL) and ICAM-1 (ng/mL) were noted. CONCLUSION: This is the first study in humans demonstrating a significant and early association between MMP-9 and BG levels in in patients with severe sepsis and septic shock. Neutrophil affecting biomarkers such as IL-8 and ICAM-1 are noted to decrease as MMP-9 levels increase. Clinical risk stratification using MMP-9 levels could potentially help determine which patients would benefit from intensive versus conventional insulin therapy. In addition, antagonizing the up-regulation of MMP-9 could serve as a potential treatment option in severe sepsis or septic shock patients.

18.
Math Biosci ; 269: 104-16, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26367184

RESUMO

In computational cardiovascular models, parameters are one of major sources of uncertainty, which make the models unreliable and less predictive. In order to achieve predictive models that allow the investigation of the cardiovascular diseases, sensitivity analysis (SA) can be used to quantify and reduce the uncertainty in outputs (pressure and flow) caused by input (electrical and structural) model parameters. In the current study, three variance based global sensitivity analysis (GSA) methods; Sobol, FAST and a sparse grid stochastic collocation technique based on the Smolyak algorithm were applied on a lumped parameter model of carotid bifurcation. Sensitivity analysis was carried out to identify and rank most sensitive parameters as well as to fix less sensitive parameters at their nominal values (factor fixing). In this context, network location and temporal dependent sensitivities were also discussed to identify optimal measurement locations in carotid bifurcation and optimal temporal regions for each parameter in the pressure and flow waves, respectively. Results show that, for both pressure and flow, flow resistance (R), diameter (d) and length of the vessel (l) are sensitive within right common carotid (RCC), right internal carotid (RIC) and right external carotid (REC) arteries, while compliance of the vessels (C) and blood inertia (L) are sensitive only at RCC. Moreover, Young's modulus (E) and wall thickness (h) exhibit less sensitivities on pressure and flow at all locations of carotid bifurcation. Results of network location and temporal variabilities revealed that most of sensitivity was found in common time regions i.e. early systole, peak systole and end systole.


Assuntos
Artérias Carótidas/anatomia & histologia , Artérias Carótidas/fisiologia , Modelos Cardiovasculares , Algoritmos , Simulação por Computador , Hemorreologia , Humanos , Conceitos Matemáticos , Fluxo Sanguíneo Regional , Incerteza
19.
Actas dermo-sifiliogr. (Ed. impr.) ; 106(5): 350-364, jun. 2015. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-139840

RESUMO

Los sistemas de luz pulsada intensa han evolucionado desde su introducción en la medicina hace 20 años. La luz pulsada consiste en una energía lumínica policromática, no coherente y no colimada que abarca varias longitudes de onda pudiendo actuar sobre diferentes cromóforos. Este hecho permite una gran versatilidad, pudiendo tratar diferentes enfermedades, desde lesiones pigmentadas o vasculares hasta fotodepilación y fotorrejuvenecimiento, con una alta tasa de cobertura de la piel gracias al gran tamaño del haz. Al tratarse de sistemas no ablativos resulta una opción en auge actualmente, ya que los pacientes no están dispuestos a asumir los efectos secundarios de otros procedimientos que además requieren tiempos prolongados de ausencia de la vida laboral y social. Su eficacia es similar en muchos casos a los tratamientos con láser. El abanico de posibilidades y aplicaciones se incrementará en los próximos años gracias a esa gran versatilidad junto a la comodidad y seguridad


Intense pulsed light (IPL) systems have evolved since they were introduced into medical practice 20 years ago. Pulsed light is noncoherent, noncollimated, polychromatic light energy emitted at different wavelengths that target specific chromophores. This selective targeting capability makes IPL a versatile therapy with many applications, from the treatment of pigmented or vascular lesions to hair removal and skin rejuvenation. Its large spot size ensures a high skin coverage rate. The nonablative nature of IPL makes it an increasingly attractive alternative for patients unwilling to accept the adverse effects associated with other procedures, which additionally require prolonged absence from work and social activities. In many cases IPL is similar to laser therapy in effectiveness, and its versatility, convenience, and safety will lead to an expanded range of applications and possibilities in coming years


Assuntos
Humanos , Terapia de Luz Pulsada Intensa/efeitos adversos , Dermatopatias/terapia , Remoção de Cabelo/métodos , Terapia a Laser/efeitos adversos , Fotoquimioterapia , Lesões Pré-Cancerosas/tratamento farmacológico , Rejuvenescimento
20.
J Infect Dev Ctries ; 9(5): 476-85, 2015 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-25989167

RESUMO

INTRODUCTION: Colistin use has increased over the last ten years because of multidrug-resistant microorganisms. The aim of this study was to compare the clinical and microbiological efficacy of colistin alone or in combination with sulbactam or carbapenem in the treatment of ventilator-associated pneumonia (VAP) due to multidrug-resistant (MDR) and extremely drug-resistant (XDR) A. baumannii. METHODOLOGY: Cases treated for VAP because of MDR and XDR A. baumannii between January 2011 and January 2013 were included in the study. The primary and secondary outcome for colistin alone, colistin with sulbactam, and colistin with carbapenems were evaluated. The primary outcomes were clinical efficacy and microbiological efficacy; the secondary outcomes were nephrotoxicity, length of hospitalization, and mortality. RESULTS: A total of 70 VAP patients were evaluated. A total of 17 patients (24.3%) were administered colistin alone, 20 patients (28.6%) were administered colistin and sulbactam, and 33 patients (47.1%) were administered colistin and carbapenem. Clinical and microbiological response rates were higher in the carbapenem combination group (63.6% and 63.6% in both) than in the sulbactam combination group, which registered 55.0% and 60.0%, respectively. However, this did not represent a significant difference statistically (p > 0.05). There was also no significant difference between colistin alone and the combination groups regarding clinical and microbiological efficacy and mortality. CONCLUSIONS: Neither the administration of colistin alone nor colistin combined with either sulbactam or carbapenem had any noticeable advantage in the treatment of VAP in terms of clinical response, microbiological response, nephrotoxicity, length of hospitalization, and mortality.


Assuntos
Infecções por Acinetobacter/tratamento farmacológico , Antibacterianos/uso terapêutico , Carbapenêmicos/uso terapêutico , Colistina/uso terapêutico , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico , Sulbactam/uso terapêutico , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/efeitos adversos , Carbapenêmicos/efeitos adversos , Colistina/efeitos adversos , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Associada à Ventilação Mecânica/microbiologia , Insuficiência Renal/induzido quimicamente , Estudos Retrospectivos , Sulbactam/efeitos adversos , Resultado do Tratamento
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