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1.
Clin Transplant ; : e14297, 2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33768630

RESUMO

INTRODUCTION: COVID-19 is an ongoing pandemic with high morbidity and mortality and with reported high risk of severe disease in kidney transplant recipients (KTR). AIM: We aimed to report the largest number of COVID-19 positive cases in KTR in a single centre and to discuss their demographics, management, and evolution. METHODS: We enrolled all the two thousand KTR followed up in our centre in Kuwait and collected the data of all COVID-19-positive KTR (104) from the start of the outbreak till the end of July 2020 and have reported the clinical features, management details, and both patient and graft outcomes. RESULTS: Out of the one hundred and four cases reported, most were males aged 49.3±14.7 years. Eighty two of them needed hospitalization, of which thirty one were managed in the intensive care unit (ICU). Main comorbidities among these patients were hypertension in 64.4%, diabetes in 51%, and ischemic heart disease in 20.2%. Management strategies included anticoagulation in 56.7%, withdrawal of antimetabolites in 54.8%, calcineurin inhibitor (CNI) withdrawal in 33.7%, addition of antibiotics in 57.7%, Tocilizumab in 8.7%, and antivirals in 16.3%. During a follow up of 30 days, the reported number of acute kidney injury (AKI) was 28.7%, respiratory failure requiring oxygen therapy 46.2 %, and overall mortality rate was 10.6% with hospital mortality of 13.4% including an ICU mortality rate of 35.5%. CONCLUSION: Better outcome of COVID-19 positive KTR in our cohort during this unremitting stage could be due to the younger age of patients and early optimized management of anticoagulation, modification of immunosuppression, and prompt treatment of secondary bacterial infections. Mild cases can successfully be managed at home without any change in immunosuppression.

2.
Entropy (Basel) ; 22(5)2020 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33286276

RESUMO

In this manuscript, an innovative concept of producing power from a thermoelectric generator (TEG) is evaluated. This concept takes advantage of using the exhaust airflow of all-air heating, ventilating, and air-conditioning (HVAC) systems, and sun irradiation. For the first step, a parametric analysis of power generation from TEGs for different practical configurations is performed. Based on the results of the parametric analysis, recommendations associated with practical applications are presented. Therefore, a one-dimensional steady-state solution for the heat diffusion equation is considered with various boundary conditions (representing applied configurations). It is revealed that the most promising configuration corresponds to the TEG module exposed to a hot fluid at one face and a cold fluid at the other face. Then, based on the parametric analysis, the innovative concept is recognized and analyzed using appropriate thermal modeling. It is shown that for solar radiation of 2000 W/m2 and a space cooling load of 20 kW, a 40 × 40 cm2 flat plate is capable of generating 3.8 W of electrical power. Finally, an economic study shows that this system saves about $6 monthly with a 3-year payback period at 2000 W/m2 solar radiation. Environmentally, the system is also capable of reducing about 1 ton of CO2 emissions yearly.

3.
Tuberc Respir Dis (Seoul) ; 83(4): 295-302, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32871066

RESUMO

BACKGROUND: Weaning failure is common in mechanically ventilated patients, and if ultrasound can predict weaning outcome remains controversial. The purpose of this study was to evaluate the diaphragmatic function (thickness and excursion) measured by ultrasound as a predictor of the extubation outcome. METHODS: We included 62 mechanically ventilated patients from the chest intensive care unit in this study. Sixty-two patients who successfully passed the spontaneous breathing trial (SBT) were enrolled. The transthoracic ultrasound of the diaphragm was performed during an SBT to the assess diaphragmatic function (excursion and thickness), and they were classified into the successful extubation group and the failed extubation group. RESULTS: There was a statistically significant increase in the successful extubation group in the diaphragmatic excursion and thickness fraction (p<0.001), a statistically significant negative correlation between the diaphragmatic function and the duration of the mechanical ventilation, and a statistically significant negative correlation between the diaphragmatic excursion and the Acute Physiology and Chronic Health Evaluation II. The diaphragmatic excursion cutoff value predictive of weaning was 1.25 cm, with a specificity of 82.1% and a sensitivity of 97.1% respectively, and the diaphragmatic thickness cut-off value predictive of weaning was 21.5%, with a specificity of 60.7% and a sensitivity of 91.2%, respectively. CONCLUSION: The diaphragmatic ultrasonography was found to be a promising tool for predicting the extubation outcome for mechanically ventilated patients.

4.
Eur J Ophthalmol ; : 1120672120942691, 2020 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-32659124

RESUMO

PURPOSE: To determine the prevalence of keratoconus (KC) among children with ocular allergy. METHODS: A cross-sectional study was conducted on all children presenting with ocular allergic disease from September 2017 to September 2018. All study participants were subjected to history taking (a specially designed questionnaire), routine ophthalmological examination, and corneal tomography. RESULTS: A total of 79% of the study patients had vernal keratoconjunctivitis (VKC) while the remaining had perennial allergic conjunctivitis (10%), seasonal allergic conjunctivitis (9%) and atopic keratoconjunctivitis (2%). Manifest KC was seen in 7% of cases, suspect KC was found in 27% of cases, and 66% had no evidence of KC. For the manifest KC, 56% had clinical signs, while 44% were diagnosed by tomography. For the purpose of statistical analysis, the cohort was divided into group KC (manifest or suspicious KC) and group non-KC (no KC). The mean age was 11.2 years in group KC, and 9 years in group non-KC (p < 0.001). The mean duration of allergic symptoms was 3.75 years in group KC, and 2.5 years in group non-KC (p = 0.001). The mean duration of eye rubbing was 2.5 years in group KC, and 0.83 years in group non-KC (p = 0.02). Systemic atopy was present in 35.3% of group KC, and in 12.5% in group non-KC (p = 0.005). CONCLUSION: The overall prevalence of KC was 34%. Risk factors for the development of KC in patients with ocular allergy were age, duration of symptoms specially eye rubbing, systemic atopy and VKC. Tomographic diagnosis of KC can be present in absence of clinical signs.

5.
Adv Respir Med ; 88(6): 548-557, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33393647

RESUMO

Instroduction: Obstructive sleep apnea is a common disorder, characterized by recurrent narrowing and closure of the upper airway accompanied by intermittent oxyhemoglobin desaturation and sympathetic activation. Ultrasound imaging of the airways has advantages of being safe, quick, repeatable, portable and widely available. Airway ultrasound can visualize and assess the mouth and tongue, oropharynx, hypopharynx, epiglottis, larynx, vocal cords, cricothyroid membrane, cricoid cartilage, trachea, and cervical esophagus. MATERIAL AND METHODS: This study assessed the role of ultrasonography in detecting the level and degree of obstruction of airway passages in patients with obstructive sleep apnea (OSA) and its relation to OSA severity. It included thirty-three patients diagnosed as OSA, and ten healthy subjects as a control group. All participants were ≥ 18 years and were subjected to full medical history, Epworth sleepiness score (ESS), thorough clinical examination, complete overnight polysomnography and neck ultrasonography. RESULTS: Ultrasonography findings showed a statistically significant increase in lateral parapharyngeal wall thickness (LPWT) (P < 0.001) and a significant increase in distance between lingual arteries (DLA) (P < 0.01) among OSA patients. Moreover, there was a significant statistical decrease in the retropalatal pharynx transverse diameter (RPD) (P < 0.05) in the OSA group compared to those without OSA. LPWT and DLA are parameters that can be used to predict the severity of OSA. Combination of LPWT and RPD can achieve a 100% sensitivity and specificity. CONCLUSIONS: Ultrasound is more objective and convenient than the questionnaire because it doesn't require overnight time consumption. It is also more relevant than pulse oximetry for examining pharyngeal airspace. Also, this study demonstrated that submental ultrasonography is sufficiently sensitive for differentiating OSA severity.

6.
Open Access Maced J Med Sci ; 7(19): 3205-3210, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31949517

RESUMO

BACKGROUND: Patients undergoing heart surgery involving cardiopulmonary bypass (CPB) experience global myocardial ischemia with subsequent reperfusion which, despite cardioplegic protection, may result in different degrees of transient ventricular dysfunction. Levosimendan is a "calcium sensitisers", it improves myocardial contractility by sensitising troponin C to calcium without increasing myocardial oxygen consumption and without impairing relaxation and diastolic function. AIM: To evaluate the adding effect of a calcium sensitiser (levosimendan) compared to the conventional inotropic and vasoactive agent used in the patient with poor left ventricular function undergoing cardiac surgery on different measured hemodynamic variables and the effect on the outcome. METHODS: It is prospective observational studies were patients were divided into 2 groups of 30 patients each. The first Group received conventional inotropic and vasoactive treatment at different doses, while the other group received levosimendan additionally at a loading dose of 6-12mic/kg according to mean arterial pressure over 0.5 hr followed by 24 hrs infusion at 0.05 to 0.2 mic/kg/min. Hemodynamic data were collected at the end and 30 minutes after CPB, after that at 6, 12, 24, and 36 hours post CPB. Mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR), mixed venous saturation (Svo2), and base deficit (BD) were measured. RESULTS: Levosimendan had significantly improved postoperative hemodynamic values as in the mixed venous pressure at different times postoperative (p < 0.05), also the base deficit at different times postoperative (p < 0.05), while there was a significant reduction in systemic vascular resistance as decreased mean arterial pressure in levosimendan group compared to conventional group at 6hrs postoperative mean 77.50 ± 10.81 vs 83.73 ± 10.81 with (p = 0.029), and at 12 hrs postoperative mean 77.37 ± 10.10vs 84.23 ± 13.81 with (p = 0.032), and there was no significant difference in heart rate at different times postoperative between both groups (p > 0.05), while there was no significant effect on mortality between both groups (p = 0.781). CONCLUSION: Levosimendan had improved hemodynamic parameters significantly with no effect on mortality compared to conventional inotropic agents in a patient with poor left ventricular function undergoing cardiac surgery.

7.
BMC Oral Health ; 17(1): 141, 2017 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-29187169

RESUMO

BACKGROUND: Electronic apex locators (EALs) are modern devices used to determine the working length during root canal preparation. The newest endodontic motors provide an integrated EAL with auto-stop function to prevent instrumentation beyond the predefined working length during rotary root canal preparation. The aim of this study was to compare the accuracy of the auto-stop function of the VDW.Gold RECIPROC motor (VDW, Munich, Germany), the EndoPilot motor (Schlumbohm, Brokstedt, Germany) and the manual measurement with Raypex 6 (VDW, Munich, Germany) to detect the apical constriction (AC). METHODS: Ninety human teeth were chosen and randomly assigned to three experimental groups (30 teeth each): VDW.Gold RECIPROC motor continuous measuring (RCM), EndoPilot continuous measuring (ECM) and Raypex 6 manual measuring (RMM). When the measurement file reached the AC, the file was fixed in the tooth. The tooth was embedded in acrylic resin and the root tip was exposed, so that the histologic structure of the root canal and the file tip was visible for microscopic analysis. Afterwards, the distance of the file tip to the AC (DAC) was automatically computed with a specially developed software tool. RESULTS: The mean DAC were -13.18 µm (SD 88.46 µm) for RMM, -22.70 µm (SD 91.57 µm) for RCM and 18.74 µm (SD 88.11 µm) for ECM. The differences were not statistically significant (P = 0.181). The rates for instrumentation beyond the AC were not statistically different (Chi2 = 4.753, p = 0.096). CONCLUSIONS: All measurement methods showed a high accuracy in detecting the AC. The auto-stop function of these endodontic motors is a reliable addition to the endodontic armamentarium.


Assuntos
Preparo de Canal Radicular/instrumentação , Ápice Dentário , Instrumentos Odontológicos , Desenho de Equipamento , Humanos , Técnicas In Vitro , Distribuição Aleatória
8.
Environ Sci Pollut Res Int ; 24(30): 23636-23645, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28856593

RESUMO

The decline of cadmium pollution in fish farms is needed by any adequate method. The present study was designed to explore the effect of dietary cadmium contamination and its amelioration by using dietary clay, probiotic (Bactocell®), vitamin C, and vitamin E supplementation in Nile tilapia fish diet on growth rate, feed efficiency, blood components, and cadmium residues. Fish were separated into 15 groups, each group of fish was stocked into three aquaria and each contains 20 fishes. The fish of the first five groups were fed the basal diet, the second five groups were fed the basal diet contaminated with 25 mg cadmium/kg, and the third five groups were fed the same diet contaminated with 50 mg cadmium/kg. Within each dietary cadmium level, the first group was fed the diet without any supplementation, the second was fed the diet supplemented with natural clay (bentonite) at level 3%, the third group was fed the diet supplemented with 1 g Bactocell®/kg, the fourth group was fed the diet supplemented 50 mg vitamin E/kg, and the fifth group was fed the diet supplemented with 100 mg vitamin C/kg. Live body weight, daily body weight gain, and feed intake of Nile tilapia decreased significantly (P < 0.001) with increasing dietary cadmium level, while feed conversion was impaired. Fish group fed on diets contaminated with 50 mg cadmium/kg recorded the lowest live body weight and weight gain. Serum total protein and albumin concentration significantly (P < 0.001) decreased, while serum creatinine, AST, and ALT significantly (P < 0.001) increased with increasing cadmium level in fish diets. Blood hemoglobin and total erythrocyte (RBCs) significantly (P < 0.001 or 0.05) decreased with cadmium contamination in fish diets, while leukocytes were insignificantly affected. Body cadmium residues increased significantly (P < 0.001) by increasing cadmium level in fish diets. Live body weight, daily body weight gain, and feed intake of Nile tilapia increased significantly (P < 0.001) with feed additive supplementation in diets, also while feed conversion improved. Fish group fed on diets supplemented with probiotic Bactocell® or natural clay recorded higher body weight and gain rate than the other experimental groups. Serum total protein, blood hemoglobin, and total erythrocyte increased, while urea-N, creatinine, ALT, AST, and leukocytes decreased as affected with the feed additive supplementation. Feed additive supplementation in fish diets significantly (P < 0.001) decreased cadmium residues in fish bodies. Irrespective of dietary cadmium level, feed additive supplementation in fish diet improved the growth rate and decreased the concentrations of serum creatinine and ALT. The obtained results indicated that feed additive supplementation could modify the function of the kidney and liver in fish exposed to the cadmium toxicity.


Assuntos
Ração Animal/análise , Cádmio/análise , Ciclídeos/crescimento & desenvolvimento , Dieta/veterinária , Suplementos Nutricionais , Contaminação de Alimentos/prevenção & controle , Animais , Bentonita/administração & dosagem , Cádmio/sangue , Ciclídeos/sangue , Pesqueiros , Contaminação de Alimentos/análise , Probióticos/administração & dosagem , Vitaminas/administração & dosagem
9.
Can J Neurosci Nurs ; 37(2): 42-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26647494

RESUMO

BACKGROUND: Recently, a new test (Cuetos-Vega) was developed to detect patients with early symptoms of Alzheimer's disease (AD). This test is rapid, simple and could diagnose patients at early phases of cognitive disorders. The aim of our follow-up study is to evaluate the sensitivity, specificity and predictive values of this test in primary health care (PHC) facilities. METHODS: We obtained from our database of La Rambla (village with +/- 8,000 habitants at South Cordoba Health District) the list of asymptomatic independent patients between 66 and 75 years old. A pilot study was conducted with 20 users of La Rambla PHC Centre. This test was modified and adapted for application to our study population. All participants were selected randomly and assigned a date by telephone for the nursing outpatient clinic where the nurse proceeded to administer the screening test. All participants were invited to repeat the same test, together with Pfeiffer test (a short mental status questionnaire), 32 months after the pilot study. RESULTS: The average age of participants was 71.5 ± 2.9 years and 10 (50%) were men. The sensitivity of the new test after 32 months was 50% and the specificity 90.9%. The test had a positive predictive value of 75% and a negative predictive value of 76.9%. The overall accuracy of the test was 76.4%. CONCLUSION: We present a new test designed to detect patients with mild cognitive impairment and/or early symptoms of AD. A larger cohort is needed to improve the internal validity.


Assuntos
Doença de Alzheimer/diagnóstico , Doença de Alzheimer/enfermagem , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/enfermagem , Diagnóstico Precoce , Testes Neuropsicológicos , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Projetos Piloto , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Espanha
10.
Cent Eur J Public Health ; 23(2): 119-21, 2015 06.
Artigo em Inglês | MEDLINE | ID: mdl-26851421

RESUMO

AIM: An epidemiological cross-sectional study was conducted to evaluate the association between cutaneous melanoma, Hodgkin's lymphoma and non-Hodgkin's lymphoma in 40 European countries. METHODS: Incidence rates were obtained from the database of the International Agency for Research of Cancer (IARC). We analyzed age-adjusted and gender-stratified incidence rates for cutaneous melanoma, Hodgkin's lymphoma and non-Hodgkin's lymphoma in 40 European countries. All European countries included had registration systems that fulfilled the quality criteria of IARC. Normal distribution of the variables was examined using Kolmorov-Smirnov test before calculating their correlations using Pearson's Correlation test. RESULTS: In males, positive correlations were found between cutaneous melanoma, Hodgkin's lymphoma (r=0.14, p=0.38), and non-Hodgkin's lymphoma (r=0.64, p<0.001). In females, negative correlation was found between cutaneous melanoma and Hodgkin's lymphoma (r=0.28, p=0.08), however, positive correlation was found between cutaneous melanoma and non-Hodgkin's lymphoma (r=0.72, p<0.001). CONCLUSION: Our findings raise the hypothesis about common risk factors for cutaneous melanoma and non-Hodgkin's lymphoma. New epidemiological and genetic studies are needed to identify possible common risk factors.


Assuntos
Doença de Hodgkin/epidemiologia , Doença de Hodgkin/etiologia , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/etiologia , Melanoma/epidemiologia , Melanoma/etiologia , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Masculino , Fatores de Risco , Neoplasias Cutâneas
11.
J Public Health (Oxf) ; 37(4): 612-7, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25503580

RESUMO

BACKGROUND: Central obesity and diabetes mellitus are recorded at high percentages among Egyptians. The aim of this study is to determine the prevalence of metabolic syndrome (MetS) and cardiovascular risk factors among a group of middle-aged and elderly Egyptians. METHODS: Our study included 220 middle-aged and senior Egyptians voluntary screened in an Egyptian private hospital with 800-bed capacity. Detailed medical history was obtained from all subjects, followed by clinical examination with weight and height measurement, body mass index calculation, waist hip ratio and arterial blood pressure measurement. Laboratory investigations done were complete blood picture, lipid profile and fasting blood glucose measurements. The diagnosis of MetS was based on the American Heart Association/Updated NCEP ATP III criteria. Cardiovascular risk assessment was calculated for each subject based on the Framingham/ATP III criteria. RESULTS: The prevalence of MetS in this study was of 55% among the whole sample, 85.6% among diabetics and 76.6% among hypertensive patients. Based on Framingham scoring system, 48.2% of the sample had moderate to high risk of developing cardiovascular disease. Odds ratio for patients with MetS for developing cardiovascular disease in the next 10 years was 2.8 (95% confidence interval: 1.6-4.8). CONCLUSION: The high prevalence of MetS among middle-aged and elderly Egyptians with the documented high prevalence of chronic diseases in Egypt calls for a nationwide screening program to detect MetS and tackle preventive strategies to face the epidemic of obesity and outcomes of MetS, particularly cardiovascular diseases.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Idoso , Egito/epidemiologia , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Fatores de Risco
12.
Arab J Gastroenterol ; 15(2): 58-62, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25097047

RESUMO

BACKGROUND AND STUDY AIMS: To search for an immunological parameter that may correlate with the response to interferon (IFN) treatment is very crucial. The objective of this study was to correlate the levels of C3 and C4 complement components with the response to IFN treatment in patients with chronic hepatitis C virus (HCV) infection. PATIENTS AND METHODS: This study was conducted on 100 patients and control subjects classified into three groups. Group (I) consisted of 50 patients with chronic hepatitis C who were receiving IFN treatment and showed various responses; group (II) included 25 patients with chronic hepatitis C naive to IFN treatment; and group (III) included 25 healthy subjects matched for age and sex who served as controls. Measurement of the level of complement C3 and C4 was done by a quantitative turbidimetric test. Measurement of complement levels in group (I) was done at the end of treatment at the 48th week. RESULTS: Serum levels of C3 and C4 were found to be significantly reduced in all patients with chronic HCV infection in both groups (I and II) compared to the healthy control group (III) (p<0.05). Moreover, chronic HCV patients treated with IFN and ribavirin had significantly lower levels of C3 and C4 compared with patients naive to IFN and ribavirin treatment. At the end of treatment, both C3 and C4 had significantly increased in responders to IFN when compared to non-responders (p=0.025 and 0.05, respectively). There was a significant negative correlation between C3 and C4 levels and the concentration of serum alanine aminotransferase (ALT) measured simultaneously. CONCLUSION: Higher C3 and C4 serum concentrations were found to be positively correlated to the end-of-treatment response in patients with chronic HCV infection treated with IFN and ribavirin.


Assuntos
Antivirais/uso terapêutico , Complemento C3/análise , Complemento C4/análise , Hepatite C Crônica/sangue , Hepatite C Crônica/tratamento farmacológico , Adulto , Alanina Transaminase/sangue , Estudos de Casos e Controles , Quimioterapia Combinada , Feminino , Humanos , Interferon Tipo I/uso terapêutico , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/uso terapêutico , Ribavirina/uso terapêutico
13.
J Craniomaxillofac Surg ; 42(5): e195-203, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24099655

RESUMO

The bilateral sagittal split osteotomy (BSSO) is one of the main orthognathic surgery procedures used for managing skeletal mandibular excess, deficiency or asymmetry. It is known to be a technique-sensitive procedure with high reported incidences of inferior alveolar nerve injury, bad splits and post-surgical relapse. With the increasing use of computer-assisted techniques in orthognathic surgery, the accurate transfer of the virtual plan to the operating room is currently a subject of research. This study evaluated the efficacy of computer-generated device at maintaining the planned condylar position and minimizing inferior alveolar nerve injury during BSSO. The device was used in 6 patients who required isolated mandibular surgery for correction of their skeletal deformities. Clinical evaluation showed good recovery of the maximal incisal opening and a reproducible occlusion in 5 of the 6 patients. Radiographic evaluation showed better control of the condyle position in both the vertical and anteroposterior directions than in the mediolateral direction. The degree of accuracy between the planned and achieved screw positions were judged as good to excellent in all cases. Within the limitations of this study and the small sample size, the proposed device design allowed for good transfer of the virtual surgical plan to the operating room.


Assuntos
Desenho Assistido por Computador , Osteotomia Sagital do Ramo Mandibular/instrumentação , Cirurgia Assistida por Computador/instrumentação , Adulto , Parafusos Ósseos , Cefalometria/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Oclusão Dentária , Seguimentos , Humanos , Imageamento Tridimensional/métodos , Má Oclusão de Angle Classe II/cirurgia , Má Oclusão de Angle Classe III/cirurgia , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Nervo Mandibular/patologia , Placas Oclusais , Osteotomia Sagital do Ramo Mandibular/métodos , Planejamento de Assistência ao Paciente , Amplitude de Movimento Articular/fisiologia , Traumatismos do Nervo Trigêmeo/prevenção & controle , Interface Usuário-Computador , Adulto Jovem
14.
Vaccine ; 29(37): 6366-8, 2011 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-21840463

RESUMO

In June 2009, WHO declared the maximum phase alert against H1N1 pandemic flu. Health care workers (HCWs) are considered a strategic target for prevention of the occurrence of H1N1 influenza since they had the greatest risk of acquiring infection. The objectives of our study were (1) identifying the uptake of influenza A(H1N1) 2009 monovalent vaccine by primary health care workers in the southern part of Cordoba, and (2) reporting of the adverse events occurred after vaccination. We followed 240 HCWs in 12 primary health care centres at southern part of Cordoba for vaccine uptake and the occurrence of adverse events. The coverage rate with H1N1 vaccine was 20.5% which was lower compared to seasonal influenza vaccination rate 44.2% in 2009. Males had higher H1N1 vaccination rate compared to females with no significant difference. Senior HCWs complied more with seasonal influenza vaccine while this finding was not consistent with H1N1 vaccination. Multivariate analysis showed that the only independent variable that affected H1N1 vaccine was the compliance to the seasonal flu vaccine in the past three years with OR 5.1 and 95% CI (2.4-10.8). Adverse events occurred among 26.5% of those who complied with H1N1 vaccination. Those were local pain, irritation and induration at site of injection (38.5%), fever (15.4%), fever cough and rhinorrhea (15.4%) generalized pain and lumber pains (23.1%). The low vaccination rate in this study is consistent with previous studies done in many parts of the world and in Spain. Further studies should be done to explore the factors that hindered the uptake and resistance of HCWs to vaccination to H1N1 vaccine.


Assuntos
Atitude do Pessoal de Saúde , Vírus da Influenza A Subtipo H1N1/imunologia , Vacinas contra Influenza , Surtos de Doenças/prevenção & controle , Feminino , Pessoal de Saúde , Humanos , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/imunologia , Masculino , Cooperação do Paciente , Atenção Primária à Saúde , Espanha , Inquéritos e Questionários , Vacinação
16.
Hepatology ; 40(6): 1434-41, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15565610

RESUMO

Previous Western studies showed a consistent and marked reduction in health-related quality of life (HRQOL) in patients chronically infected with hepatitis C virus (HCV). However, these studies were conducted on patients whose knowledge of their serological status may have affected their HRQOL. This HRQOL survey conducted in the Egyptian rural population provides a unique opportunity to clarify this issue among a population whose serological status is unknown. HRQOL was assessed by an Arabic translation of the Short-Form 12, and a visual analog scale of the relative severity of one's health status. HCV chronic infection was defined by positive tests for anti-HCV antibody and HCV-RNA. HRQOL was compared according to HCV chronic infection status in linear mixed models adjusted for potential confounding factors, such as age, sex, education, and health care-related risk factors, and adjusted for interviewer as a random effect. One hundred forty-six Egyptians chronically infected with HCV had similar Short-Form 12 and visual analog scale scores, compared with 1,140 uninfected controls from the same rural community. In individuals chronically infected with HCV, serum aminotransferase levels did not correlate with HRQOL. In conclusion, this study did not find a significant reduction of HRQOL in patients chronically infected with HCV compared with uninfected, contemporaneous controls. This may be explained in part by a lower morbidity amongst patients chronically infected with HCV in rural Egypt and a higher morbidity amongst uninfected controls as compared with those of Western studies, as well as a lack of awareness of hepatitis C serological status.


Assuntos
Hepatite C Crônica/epidemiologia , Hepatite C Crônica/psicologia , Qualidade de Vida , Adulto , Egito/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , População Rural , Transaminases/sangue
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