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2.
Children (Basel) ; 8(11)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34828689

RESUMO

After primary infection, varicella zoster virus (VZV) causes prolonged latent infections that may reactivate, depending on the immunologic status of the host. We present a case of VZV reactivation in a 10-year-old male patient that underwent unrelated peripheral blood stem cell transplantation (uPBSCT) for T-lymphoblastic lymphoma with lymphoma cutis lesions. This patient had a history of herpes zoster involving the right L2-5 dermatome and trigeminal V1 dermatome prior to uPBSCT. Three months post-uPBSCT, the patient's underlying disease relapsed, and the patient presented with lymphoma cutis lesions. A few days after a skin biopsy was performed to pathologically confirm skin relapse, vesicles appeared only involving the skin areas with lymphoma cutis. This case illustrates how decreased areas of epidermal immune mechanisms may cause atypical presentations of varicella infection.

3.
Medicina (Kaunas) ; 57(11)2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34833485

RESUMO

BACKGROUND AND OBJECTIVES: acute kidney injury (AKI), formerly called acute renal failure (ARF), is commonly defined as an abrupt decline in renal function, clinically manifesting as a reversible acute increase in nitrogen waste products-measured by blood urea nitrogen (BUN) and serum creatinine levels-over the course of hours to weeks. AKI occurs in about 20% of all hospitalized patients and is more common in the elderly. Therefore, it is necessary to prevent the occurrence of AKI, and to detect and treat early, since it is known that a prolonged period of kidney injury increases cardiovascular complications and the risk of death. Despite advances in modern medicine, there are no consistent treatment strategies for preventing the progression to chronic kidney disease. Through many studies, the safety and efficacy of natural products have been proven, and based on this, the time and cost required for new drug development can be reduced. In addition, research results on natural products are highly anticipated in the prevention and treatment of various diseases. In relation to AKI, many papers have reported that many natural products can prevent and treat AKI. CONCLUSIONS: in this paper, the results of studies on natural products related to AKI were found and summarized, and the mechanism by which the efficacy of AKI was demonstrated was reviewed. Many natural products show that AKI can be prevented and treated, suggesting that these natural products can help to develop new drugs. In addition, we may be helpful to elucidate additional mechanisms and meta-analysis in future natural product studies.

4.
J Pers Med ; 11(11)2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34834530

RESUMO

Post-stroke depression (PSD) affects approximately one-third of stroke patients. PSD not only impairs recovery and lowers quality of life, but has also serious neurological consequences, high mortality, and stroke recurrence risks. Studies on PSD-related prognostic factors are still lacking, especially environmental factors. Moreover, relieving factors after PSD in stroke patients has not been reported. This study aimed to investigate (study design 1) risk factors for PSD diagnosis after three months, and (study design 2) related factors for the relieving of early PSD after three months. This retrospective study included 227 patients hospitalized for acute ischemic stroke within three days at Jeonbuk National University Hospital from January to December 2019. The depressive status was assessed using the Hamilton Depression Rating Scale (HDRS) at admission and after three months. Clinical and laboratory data were analyzed for relevant prognostic factors. (Study design 1) HDRS score at admission (adjusted odds ratio (aOR) 1.22, 95% confidence interval (CI) 1.14-1.31; p < 0.001) and hospitalization period (aOR 1.11, 95% CI 1.02-1.20; p = 0.013) were confirmed as prognostic factors of PSD after three months. (Study design 2) The National Institute of Health Stroke Scale (NIHSS) score at discharge (aOR 0.80, 95% CI 0.68-0.94; p = 0.006) and HDRS score at admission (aOR 0.80, 95% CI 0.71-0.89; p < 0.001) were confirmed as prognostic factors of depression improvement after three months. In conclusion, environmental factors such as hospitalization period could be important in managing PSD. Factors related to PSD improvement are expected to be helpful in establishing a strategy for PSD recovery.

5.
Nutrients ; 13(11)2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34836379

RESUMO

BACKGROUND: The World Health Organization declared COVID-19 a global pandemic on 11 March 2020, due to the number of newly reported confirmed cases and the rapid increase in deaths. Therefore, countries around the world limited their population to policies such as "social distancing" or "staying at home" to prevent the spread of the virus. The purpose of this study was to evaluate differences in lifestyle pre and post the outbreak COVID-19 among older adults in South Korea and to identify the impact of lifestyle differences on depression and quality of life. METHODS: An online single questionnaire covering sociodemographic data, lifestyle details, depression status, and quality of life level was distributed using mailing lists and social media. To assess lifestyles differences in older people pre and post the outbreak of COVID-19 pandemic, the online single questionnaire was used post COVID-19 pandemic. Based on the participants' memories, they responded lifestyles at two time points (pre and post COVID-19 pandemic). RESULTS: The results showed that there was a significant decrease in physical activity and activity participation during the pandemic. In terms of nutrition, there was no statistically significant change pre and post the outbreak COVID-19, except for the intake of protein, fat, and vitamins. Additionally, the results showed that the resulting lifestyle differences seem to have had a negative impact on depression and quality of life among older adults in South Korea. CONCLUSION: There was a significant difference the lifestyle patterns among the participants in South Korea between the current period and pre COVID-19 pandemic. Additionally, it is observed that these differenced lifestyles were associated with depression and quality of life among the participants. Our findings may help to develop public health programs that support healthy lifestyles in pandemic conditions.

6.
J Foot Ankle Surg ; 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34801378

RESUMO

Hallux valgus is a progressive angular deformity of the big toe, the degree of which is aggravated in weightbearing stance. Hallux valgus and intermetatarsal angles on postoperative weightbearing images are usually larger than those of intraoperative fluoroscopic and immediate postoperative non-weightbearing images. Here, we hypothesized that various angular parameters of hallux valgus would increase postoperatively with weightbearing. A total of 66 feet (58 patients) of moderate to severe hallux valgus were reviewed on consecutive plain foot anteroposterior radiographs. The changes of hallux valgus, intermetatarsal, hallux valgus interphalangeal, and distal metatarsal articular angles were compared. Hallux valgus and intermetatarsal angles were significantly increased with weightbearing postoperatively (p < .001). Hallux valgus interphalangeal and distal metatarsal articular angles did not show significant changes with weightbearing (p > .5). Hallux valgus and intermetatarsal angles were increased with weightbearing after hallux valgus surgery. Mean angular changes were 5.3 and 2.7 degrees, respectively. These values should be considered in the preoperative planning and intraoperative correction processes.

7.
Artigo em Inglês | MEDLINE | ID: mdl-34775136

RESUMO

PURPOSE: The recent evidence suggested substantial anxiolytic efficacy of lavender. The aim of this study is to examine the efficacy of lavender for anxiety, depression and physiological parameters and to elucidate the differential effects of lavender on anxiety and depression by study characteristics. METHODS: A systematic review and meta-analysis was performed following the PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature databases for randomized controlled trials investigating the efficacy of lavender on anxiety, depression or physiologic parameters in humans. We assessed risk of bias within studies with the revised Cochrane risk of bias tool for randomized trials. We used random effect model to estimate the average effect and computed bias corrected standardized mean difference as effect size metric, Hedges' g for all outcomes. RESULTS: Lavender was superior to placebo or no treatment in reducing anxiety (Hedges' g= -0.72, 95% CI; -0.90 to -0.55, p-value<.001), depression (Hedges' g= -0.43, 95% CI; -0.59 to -0.27, p-value<.001) and systolic blood pressure (Hedges' g=-0.23, 95% CI; -0.41to -0.05, p-value=.01). The moderator analysis by meta-regression indicated that route of administration accounted 6.5% (p-value=.187) for the heterogeneity in anxiolytic effects, sessions of treatment accounted 13.2% (p-value=.055), and participants' health state accounted 8.9% (p-value=.131) for the variance in anxiolytic effects. CONCLUSIONS: Lavender aromatherapy showed substantial effect in reducing anxiety and depression, and sessions of administration increased the anxiolytic effects. The effects on physiological parameters showed small with inconsistent significances and randomized controlled trials on effect of lavender on depression were scarce. Future trials on depression and physiologic parameters are recommended and increasing the sessions of administration is recommended.

8.
Comput Biol Med ; : 104960, 2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34776096

RESUMO

Photothermal therapy (PTT) requires tight thermal dose control to achieve tumor ablation with minimal thermal injury on surrounding healthy tissues. In this study, we proposed a real-time closed-loop system for monitoring and controlling the temperature of PTT using a non-contact infrared thermal sensor array and an artificial neural network (ANN) to induce a predetermined area of thermal damage on the tissue. A cost-effective infrared thermal sensor array was used to monitor the temperature development for feedback control during the treatment. The measured and predicted temperatures were used as inputs of fuzzy control logic controllers that were implemented on an embedded platform (Jetson Nano) for real-time thermal control. Three treatment groups (continuous wave = CW, conventional fuzzy logic = C-Fuzzy, and ANN-based predictive fuzzy logic = P-Fuzzy) were examined and compared to investigate the laser heating performance and collect temperature data for ANN model training. The ex vivo experiments validated the efficiency of fuzzy control with temperature method on maintaining the constant interstitial tissue temperature (80 ± 1.4 °C) at a targeted surface of the tissue. The linear relationship between coagulation areas and the treatment time was indicated in this study, with the averaged coagulation rate of 0.0196 cm2/s. A thermal damage area of 1.32 cm2 (diameter ∼1.3 cm) was observed under P-Fuzzy condition for 200 s, which covered the predetermined thermal damage area (diameter ∼1 cm). The integration of real-time feedback temperature control with predictive ANN could be a feasible approach to precisely induce the preset extent of thermal coagulation for treating papillary thyroid microcarcinoma.

9.
Artigo em Inglês | MEDLINE | ID: mdl-34763380

RESUMO

Objective: Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating cerebrovascular event; patients are routinely admitted to the intensive care unit (ICU) for initial management. Because complications may be delayed, unplanned ICU readmissions can occur. Therefore, in this study we evaluate the rate of and factors associated with readmission after aSAH and identify if readmission is associated with poor clinical outcomes. Methods: We retrospectively reviewed the medical records of all patients receiving surgical or endovascular treatment for aSAH and admitted to the ICU between January 2008 and December 2019. We categorized patients by readmission and analyzed their clinical parameters. Results: Of the 345 patients who transferred to ward-level care after an initial ICU stay (Group 2), 27 (7.3%) were readmitted to the ICU (Group 1). History of hypertension (HTN), initial Glasgow Coma Scale (GCS) score, modified Fisher grade, and vasospasm therapy during first ICU stay were significantly different between the groups. The most common reason for readmission was delayed cerebral ischemia (DCI; 70.3%; OR 5.545; 95% CI 1.25-24.52; p=0.024). Comorbid HTN (OR 5.311; 95% CI 1.75-16.12; p=0.03) and vasospasm therapy during first ICU stay (OR 7.234; 95% CI 2.41-21.7; p<0.01) also were associated with readmission. Readmitted patients had longer hospital stay and lower GCS scores at discharge (p<0.01). Conclusions: DCI was the most common cause of ICU readmission in patients with aSAH. Readmission may indicate clinical deterioration, and patients who are at a high risk for DCI should be monitored to prevent readmission.

10.
Ophthalmol Retina ; 5(11): 1096, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34752303
11.
Food Sci Nutr ; 9(11): 6060-6068, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34760237

RESUMO

The objective of this study was to determine biological effects of Cirsium japonicum extract and its main component cirsimaritin on high-fat diet (HFD)-induced metabolic dysfunction-associated fatty liver disease (MAFLD) in a mouse model. Mice were fed with a HFD to induce MAFLD and simultaneously administered with C. japonicum extract (CJE) or cirsimaritin. Various MAFLD biomarkers were evaluated using biological methods. Results demonstrated that triglyceride, aspartate aminotransferase, alanine aminotransferase, and malondialdehyde levels in the liver of mice were significantly reduced upon administration of CJE or cirsimaritin. Treatment with CJE or cirsimaritin also reduced the severity of liver injury in the experimental mouse model of MAFLD by inhibiting hepatic steatosis, oxidative stress, inflammation, and liver fibrosis. These results demonstrate that CJE and cirsimaritin as its main compound have a preventive action against the progression of hepatic steatosis to fibrosis and cirrhosis. Our study suggests that CJE and cirsimaritin might be promising agents for preventing and/or treating MAFLD.

12.
Mar Drugs ; 19(11)2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34822472

RESUMO

With the advancement of nanotechnology, several nanoparticles have been synthesized as antimicrobial agents by utilizing biologically derived materials. In most cases, the materials used for the synthesis of nanoparticles from natural sources are extracts. Natural extracts contain a wide range of bioactive components, making it difficult to pinpoint the exact component responsible for nanoparticle synthesis. Furthermore, the bioactive component present in the extract changes according to numerous environmental factors. As a result, the current work intended to synthesize gold (AuNPs) and zinc oxide (ZnONPs) nanoparticles using pure phloroglucinol (PG). The synthesized PG-AuNPs and PG-ZnONPs were characterized using a UV-Vis absorption spectrophotometer, FTIR, DLS, FE-TEM, zeta potential, EDS, and energy-dispersive X-ray diffraction. The characterized PG-AuNPs and PG-ZnONPs have been employed to combat the pathogenesis of Pseudomonas aeruginosa. P. aeruginosa is recognized as one of the most prevalent pathogens responsible for the common cause of nosocomial infection in humans. Antimicrobial resistance in P. aeruginosa has been linked to the development of recalcitrant phenotypic characteristics, such as biofilm, which has been identified as one of the major obstacles to antimicrobial therapy. Furthermore, P. aeruginosa generates various virulence factors that are a major cause of chronic infection. These PG-AuNPs and PG-ZnONPs significantly inhibit early stage biofilm and eradicate mature biofilm. Furthermore, these NPs reduce P. aeruginosa virulence factors such as pyoverdine, pyocyanin, protease, rhamnolipid, and hemolytic capabilities. In addition, these NPs significantly reduce P. aeruginosa swarming, swimming, and twitching motility. PG-AuNPs and PG-ZnONPs can be used as control agents for infections caused by the biofilm-forming human pathogenic bacterium P. aeruginosa.

13.
Toxins (Basel) ; 13(11)2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34822557

RESUMO

IL-13 induces mucus metaplasia, which causes airway obstruction in asthma. Bee venom (BV) and its components have shown anti-inflammatory effects in allergic diseases such as atopic dermatitis and asthma. In this study, we investigated the effect of BV on IL-13-induced mucus metaplasia through activation of the signal transducer and activator of transcription (STAT6), and regulation of SAM-pointed domain containing Ets-like factor (SPDEF) and forkhead box A2 (FOXA2) in the airway epithelia cell line A549. In A549 cells, BV (1.0 µg/mL) inhibited IL-13 (10 ng/mL)-induced AKT phosphorylation, increase in SPDEF protein expression, and decrease in FOXA2 protein expression-but not STAT6 phosphorylation. BV also prevented the IL-13-induced increase in mucin 5AC (MUC5AC) mRNA and protein expression. Moreover, we observed that inhibition of phosphoinositide 3 kinase (PI3K)/AKT using LY294002 (50 µM) could reverse the alterations in FOXA2 and MUC5AC expression -by IL-13 and BV. However, LY294002 did not affect IL-13- and BV-induced changes in SPDEF expression. These findings indicate that BV inhibits MUC5AC production through the regulation of SPDEF and FOXA2. The inhibition of MUC5AC production through FOXA2 is mediated via the suppression of PI3K/AKT activation by BV. BV may be helpful in the prevention of mucus metaplasia in asthma.

14.
Vet Sci ; 8(11)2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34822618

RESUMO

An 8.5-year-old intact female lion (Panthera leo) with a history of vomiting, lethargy, and anorexia was referred to our institution. On physical examination, the lion weighed 180 kg and had a rectal temperature of 40 °C. Blood analysis showed mild neutrophilic leukocytosis, and abdominal ultrasonography revealed an enlarged uterus with echogenic fluid. Based on the clinical signs and hematologic and ultrasonographic findings, the lion was tentatively diagnosed with pyometra. Ovariohysterectomy was performed using the lateral flank approach to avoid complications that can occur with ventral celiotomy. Surgery was performed successfully despite unexpected rupture of the uterus which had occurred before the surgery. The lion recovered uneventfully and continued to do well at the 1 year follow up after surgery. To the best of our knowledge, this is the first reported case of ovariohysterectomy with the lateral flank approach in a lion with pyometra. Our report suggests that ovariohysterectomy with the lateral flank approach could be considered as an alternative method for pyometra in wild big cats with risk of complications at the surgical site.

15.
Pediatr Int ; 2021 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-34606653

RESUMO

BACKGROUND: With the coronavirus disease 2019 (COVID-19) pandemic lasting for more than a year, it is imperative to identify the associated changes in the use of emergency medical care for efficient operation of the PED. This study was conducted to determine the long-term impact of the COVID-19 pandemic on the patterns of PED visits. METHODS: This is a retrospective observational study of visits to the PED of six hospitals, between January 1, 2017, and December 31, 2020. We compared changes in the characteristics of patients before and during the COVID-19 pandemic. RESULTS: A total of 245,022 visits were included in this analysis. After the first case of COVID-19 was reported in Korea, we observed a significant decrease (54.2%) in PED visits compared to the annual average number of visits in the previous three years. Since then, the weekly number of PED visits decreased by 11.9 person/week (95% CI: -15.3 to -8.4, P<0.001), which included an increase of 0.21% (95% CI: 0.15% to 0.26%, P<0.001) per week in high acuity patients. From 2017 to 2020, the proportion of infectious respiratory diseases by year was 25.9%, 27.0%, 28.6%, and 16.3%, respectively, demonstrating a significant decrease in 2020 (P<0.001). CONCLUSIONS: During the COVID-19 pandemic, the number of patient visits to PEDs continues to decline, especially among those with infectious diseases. However, the disease severity of patients has gradually increased. There has been a change in the characteristics of visits to PEDs after COVID-19 which will require an appropriate response from a long-term perspective.

16.
J Integr Neurosci ; 20(3): 719-725, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34645106

RESUMO

Transient global amnesia is not rare, but its etiology remains unknown. Cerebral ischemia is a suspected cause because high signal intensity is observed on diffusion-weighted brain magnetic resonance imaging; however, previous studies have not established it as a cause. Of the 128 patients (114 females) enrolled in this study, 82 (64.6%) experienced extreme stress before transient global amnesia. The number of female patients with patent foramen ovale was more than that of males. The patent foramen ovale-positive group had fewer vascular risk factors and fewer old ischemic lesions on fluid-attenuated inversion recovery magnetic resonance imaging than the patent foramen ovale-negative group. Brain magnetic resonance imaging confirmed that high signal intensity was more likely to be detected on the initial diffusion-weighted imaging when there was an old lesion detected by fluid-attenuated inversion recovery. Furthermore, a longer period from symptom onset to brain magnetic resonance imaging was associated with a positive initial diffusion-weighted imaging result. It is difficult to attribute one underlying mechanism to all the transient global amnesia cases. This study confirmed that transient global amnesia patients with patent foramen ovale had lesser vascular risk factors and showed fewer old lesions on fluid-attenuated inversion recovery magnetic resonance imaging than those without. These results suggest that transient global amnesia may be caused by a paradoxical embolus rather than ischemia due to traditional vascular risk factors in patients with patent foramen ovale.

17.
Korean J Pain ; 34(4): 509-533, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34593669

RESUMO

Background: Postherpetic neuralgia (PHN) is a refractory complication of herpes zoster (HZ). To prevent PHN, various strategies have been aggressively adopted. However, the efficacy of these strategies remains controversial. Therefore, we aimed to estimate the relative efficacy of various strategies used in clinical practice for preventing PHN using a network meta-analysis (NMA). Methods: We performed a systematic and comprehensive search to identify all randomized controlled trials. The primary outcome was the incidence of PHN at 3 months after acute HZ. We performed both frequentist and Bayesian NMA and used the surface under the cumulative ranking curve (SUCRA) values to rank the interventions evaluated. Results: In total, 39 studies were included in the systematic review and NMA. According to the SUCRA value, the incidence of PHN was lower in the order of continuous epidural block with local anesthetics and steroids (EPI-LSE), antiviral agents with subcutaneous injection of local anesthetics and steroids (AV + sLS), antiviral agents with intracutaenous injection of local anesthetics and steroids (AV + iLS) at 3 months after acute HZ. EPI-LSE, AV + sLS and AV + iLS were also effective in preventing PHN at 1 month after acute HZ. And paravertebral block combined with antiviral and antiepileptic agents was effective in preventing PHN at 1, 3, and 6 months. Conclusions: The continuous epidural block with local anesthetics and steroid, antiviral agents with intracutaneous or subcutaneous injection of local anesthetics and a steroid, and paravertebral block combined with antiviral and antiepileptic agents are effective in preventing PHN.

20.
Artigo em Inglês | MEDLINE | ID: mdl-34596258

RESUMO

The aim of this prospective study was to construct a new pharmacokinetic model of vancomycin for target-concentration controlled infusion (TCI). As the first loading dose, 25 mg/kg of vancomycin was administered during 60-90 min. Arterial blood samples were obtained at pre-set intervals to measure the serum concentrations of vancomycin. Population pharmacokinetic analysis was performed using the NONMEM software (ICON Development Solutions). In total, 197 serum concentration measurements from 22 patients were used to characterise the pharmacokinetics of vancomycin. A three-compartment mammillary model best described the pharmacokinetics of vancomycin in critically ill patients. The ideal body weight was a significant covariate for the central and slow peripheral volume of distribution. The weight and age converted to categorical variables at a cut-off of 65 years were a significant covariate for the clearance. Based on the results of stochastic simulation, the TCI method maintained the therapeutic concentration range for the longest duration. In addition, assuming that vancomycin was administered by the TCI method for 7 days, the dose was reduced by about 15% compared with the standard administration methods. The daily area under the curve values were maintained between 500 mg·h/L and 600 mg·h/L. TCI has the potential to become a new infusion method for patient-tailored dosing in critically ill patients. To administer vancomycin via TCI in clinical practice, the newly constructed pharmacokinetic model should undergo proper external validation.

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