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2.
Waste Manag ; 124: 17-25, 2021 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-33596535

RESUMO

Management of agro-waste is a major challenge globally due to inefficient disposal techniques, which concominantly leads pollution and loss of renewable bioenergy. Anaerobic digestion of agro-waste is one of the ways to tackle this problem but hindered by the recalcitrant nature of agro-waste. This study investigated the effect of granular activated carbon (GAC) and granular biochar (GBC) addition to enhance the thermophilic anaerobic co-digestion of wheat husk and sewage sludge. The conductive materials (particle size: 2-5 mm) were added separately at five different concentrations: 10, 20, 30, 40, 50 g/Linoculum. The findings revealed that samples amended with GAC and GBC at 20 g/L dosage had the highest biogas yield of 263 and 273 mL/gVSadded, respectively, corresponding to 22 and 27% higher yield than the control. Additionally, a shorter lag phase was observed in both cases compared to the Control. However, the GBC amended samples showed relatively stable biogas production compared to GAC and consistent results regarding pH, alkalinity, total volatile fatty acids, and soluble chemical oxygen demand. The preliminary techno-economic analysis indicates that addition of GAC or GBC may not be feasible and require other innovative engineered solutions for the addition of conductive materials. This study confirms that GAC and GBC amendments enhance the biogas productivity and process stability in anaerobic digestion of recalcitrant agro-waste under the high-temperature regime and calls for further research in this direction.

3.
Work ; 2021 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-33612507

RESUMO

BACKGROUND: Vibration therapy (VT) causes an increase in motor unit activation tendency, an involuntary recruitment of earlier sedentary motor units, which increases the muscle fiber force generating capacity and muscle performance. OBJECTIVE: To evaluate the effect of vibratory massage therapy at 23 Hz and 35 Hz on grip strength, endurance, and forearm muscle performance (in terms of EMG activity). METHODS: Ten healthy and right-handed men participated voluntarily in this study. The experiment was characterized by the measurement of MVC (maximal voluntary contraction) grip strength and grip endurance time at 50%MVC, accompanied by the corresponding measurement of the EMG signals of the muscles viz., flexor digitorum superficialis (FDS); flexor carpi ulnaris (FCU); extensor carpi radialis brevis (ECRB); and extensor carpi ulnaris (ECU) in supine posture. RESULTS: MANCOVA results showed significant effects of VT frequency on endurance time (p <  0.001); but no significant effect on the grip strength (p = 0.161) and muscle performance (in terms of EMG activities of the forearm muscles). However, VT improves the MVC grip strength and grip endurance time (better at 35 Hz). The Pearson correlation was significant between: weight, palm length, palm circumference, and forearm length with MVC grip strength; and the palm length with the endurance time. In addition, the palm length, palm circumference, and forearm circumference generally serve to better predict MVC grip strength and grip endurance time. CONCLUSIONS: Vibration therapy at 35 Hz for 10 minutes on the forearms had a significant positive effect on the neuromuscular performance to enhance muscle performance of upper extermitites and can be used as the optimal range to study the effect of VT. Findings may be used to prepare guidelines for VT in rehabilitation, healthcare, sports, and medical for therapists.

4.
Dalton Trans ; 50(5): 1599-1603, 2021 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-33502425

RESUMO

The CXCR4 chemokine receptor is an important biomolecular target in cancer diagnostics and therapeutics. In a new multivalent approach, iron oxide nanoparticles were conjugated with multiple binding units of a low affinity azamacrocylic CXCR4 antagonist. The silica coated nanostructure has good suspension stability, a mode size of 72 nm and high affinity for CXCR4, showing >98% inhibition of anti-CXCR4 mAb binding in a receptor binding competition assay on Jurkat cells.

5.
Cell Rep ; 34(3): 108638, 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33472068

RESUMO

Histone acetylation levels are regulated by histone acetyltransferases (HATs) and histone deacetylases (HDACs) that antagonistically control the overall balance of this post-translational modification. HDAC inhibitors (HDACi) are potent agents that disrupt this balance and are used clinically to treat diseases including cancer. Despite their use, little is known about their effects on chromatin regulators, particularly those that signal through lysine acetylation. We apply quantitative genomic and proteomic approaches to demonstrate that HDACi robustly increases a low-abundance histone 4 polyacetylation state, which serves as a preferred binding substrate for several bromodomain-containing proteins, including BRD4. Increased H4 polyacetylation occurs in transcribed genes and correlates with the targeting of BRD4. Collectively, these results suggest that HDAC inhibition functions, at least in part, through expansion of a rare histone acetylation state, which then retargets lysine-acetyl readers associated with changes in gene expression, partially mimicking the effect of bromodomain inhibition.

6.
Int J Mol Sci ; 22(2)2021 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-33467089

RESUMO

Life-threatening bacterial infections have been managed by antibiotics for years and have significantly improved the wellbeing and lifetime of humans. However, bacteria have always been one step ahead by inactivating the antimicrobial agent chemically or by producing certain enzymes. The alarming universal occurrence of multidrug-resistant (MDR) bacteria has compelled researchers to find alternative treatments for MDR infections. This is a menace where conventional chemotherapies are no longer promising, but several novel approaches could help. Our current review article discusses the novel approaches that can combat MDR bacteria: starting off with potential nanoparticles (NPs) that efficiently interact with microorganisms causing fatal changes in the morphology and structure of these cells; nanophotothermal therapy using inorganic NPs like AuNPs to destroy pathogenic bacterial cells; bacteriophage therapy against which bacteria develop less resistance; combination drugs that act on dissimilar targets in distinctive pathways; probiotics therapy by the secretion of antibacterial chemicals; blockage of quorum sensing signals stopping bacterial colonization, and vaccination against resistant bacterial strains along with virulence factors. All these techniques show us a promising future in the fight against MDR bacteria, which remains the greatest challenge in public health care.

7.
Int J Mol Sci ; 21(23)2020 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-33260627

RESUMO

Squamosa promoter binding protein (SBP)-box genes are plant-specific transcription factors involved in plant growth and development, morphogenesis and biotic and abiotic stress responses. However, these genes have been understudied in pepper, especially with respect to defense responses to Phytophthora capsici infection. CaSBP11 is a SBP-box family gene in pepper that was identified in our previous research. Silencing CaSBP11 enhanced the defense response of pepper plants to Phytophthora capsici. Without treatment, the expression of defense-related genes (CaBPR1, CaPO1, CaSAR8.2 and CaDEF1) increased in CaSBP11-silenced plants. However, the expression levels of these genes were inhibited under transient CaSBP11 expression. CaSBP11 overexpression in transgenic Nicotiana benthamiana decreased defense responses, while in Arabidopsis, it induced or inhibited the expression of genes in the salicylic acid and jasmonic acid signaling pathways. CaSBP11 overexpression in sid2-2 mutants induced AtNPR1, AtNPR3, AtNPR4, AtPAD4, AtEDS1, AtEDS5, AtMPK4 and AtNDR1 expression, while AtSARD1 and AtTGA6 expression was inhibited. CaSBP11 overexpression in coi1-21 and coi1-22 mutants, respectively, inhibited AtPDF1.2 expression and induced AtPR1 expression. These results indicate CaSBP11 has a negative regulatory effect on defense responses to Phytophthora capsici. Moreover, it may participate in the defense response of pepper to Phytophthora capsici by regulating defense-related genes and the salicylic and jasmonic acid-mediated disease resistance signaling pathways.

8.
Am Surg ; : 3134820956276, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33316169

RESUMO

BACKGROUND: Rib fractures are the most common injuries diagnosed after blunt thoracic trauma and are a source of significant morbidity and mortality. Early identification of at-risk patients and initiation of effective analgesia are keys to mitigating complications from these injuries. Multiple tools exist to predict pulmonary decompensation after rib fractures; however, none has found a widespread acceptance. A clinical practice guideline (CPG) utilizing Forced vital capacity (FVC) has been in place at a single institution. The goal of this study is to update the CPG to use percentage of predicted FVC (FVC%) instead of FVC to triage patients with rib fractures. MATERIALS AND METHODS: A retrospective study of 266 patients with rib fractures was conducted. Patients were divided into 3 groups based on FVC of <1000 mL, 1001-1500 mL, or >1500 mL for analysis. Data were analyzed with analysis of variance, and Youden's J Index was used to identify inflection points. RESULTS: Patients in the high-risk category were more likely to be women, older than 65 years, admitted to the intensive care unit (ICU), transferred to the ICU, require intubation, and have overall longer hospital and ICU stays. The updated CPG triage cutoffs for admission to ICU, stepdown, and floor were redefined as FVC% values of <25%, 25-45%, and >45%, respectively. DISCUSSION: The updated CPG using FVC% may more accurately identify patients with compromised physiology and be a better tool to help predict patients who are at risk for decompensation following rib fractures. A validation study for the updated CPG is in progress.

10.
Int J Mol Sci ; 21(21)2020 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-33171626

RESUMO

Heat shock transcription factor (Hsf) plays an important role in regulating plant thermotolerance. The function and regulatory mechanism of CaHsfA1d in heat stress tolerance of pepper have not been reported yet. In this study, phylogenetic tree and sequence analyses confirmed that CaHsfA1d is a class A Hsf. CaHsfA1d harbored transcriptional function and predicted the aromatic, hydrophobic, and acidic (AHA) motif mediated function of CaHsfA1d as a transcription activator. Subcellular localization assay showed that CaHsfA1d protein is localized in the nucleus. The CaHsfA1d was transcriptionally up-regulated at high temperatures and its expression in the thermotolerant pepper line R9 was more sensitive than that in thermosensitive pepper line B6. The function of CaHsfA1d under heat stress was characterized in CaHsfA1d-silenced pepper plants and CaHsfA1d-overexpression Arabidopsis plants. Silencing of the CaHsfA1d reduced the thermotolerance of the pepper, while CaHsfA1d-overexpression Arabidopsis plants exhibited an increased insensitivity to high temperatures. Moreover, the CaHsfA1d maintained the H2O2 dynamic balance under heat stress and increased the expression of Hsfs, Hsps (heat shock protein), and antioxidant gene AtGSTU5 (glutathione S-transferase class tau 5) in transgenic lines. Our findings clearly indicate that CaHsfA1d improved the plant thermotolerance via regulating the expression of stress- and antioxidant-related genes.

11.
J Bodyw Mov Ther ; 24(4): 325-335, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33218530

RESUMO

BACKGROUND: Vibration Therapy (VT) stimulate the muscle spindles, which in turn enhances its afferent activities. OBJECTIVE: The present study was designed to investigate the effect of VT at 23 and 35 Hz on muscle performance. The EMG features (six time-domain (TD) and four frequency-domain (FD)) and a new formula for computing neuromuscular performance were used as dependent variables to evaluate the effect of VT. METHOD: The EMG recording was performed at 50% MVC during grip endurance test before and after VT. The EMG features were extracted out of raw EMG signals acquired from four forearm muscles, viz., flexor digitorum superficialis (FDS); flexor carpi ulnaris (FCU); extensor carpi radialis brevis (ECRB); and extensor carpi ulnaris (ECU) in supine position. Fatigue assessments were evaluated based on the pattern of TD and FD features. RESULTS: Statistical analysis showed a significant difference in the effect of vibration exposure frequency on IEMG (p < 0.001), MAV (p = 0.041), SSI (p = 0.032), and WL (p < 0.001) of FCU muscle. In addition, the greatest increase in neuromuscular efficiency (NME) was observed in the performance of ECRB after 35 Hz of VT and ECU muscles after 23 Hz of VT. CONCLUSIONS: The features of EMG signals could be used for fatigue analysis. However, the slope based on the median frequency regression line may be the best feature for fatigue assessment.

12.
Work ; 67(2): 441-448, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33074207

RESUMO

BACKGROUND: Despite extensive industrial use, no major modifications to the bench drilling machine, with respect to ease of operation, have been undertaken. OBJECTIVE: The objectives of the study were to design a new feed handle (NFH) to perform the drilling task on a bench drilling machine and evaluate the existing (EFH) and new feed handles on the basis of performance measures like drilling productivity in terms of metal removal rate (MRR) and worker performance in terms of perceived discomfort score (PDS). METHODS: Participants performed the drilling task on a steel block for three different working durations at two drilling speeds. RESULTS: ANOVA analysis carried out for the MRR data showed that drilling speed had a statistically significant effect on the task performance of the operator for both handles. However, the task duration was found to be statistically significant only for the EFH. The ANOVA results obtained on the PDS data showed that the task duration and drilling speed had a statistically significant effect on the task performance of the operator for both systems. CONCLUSIONS: The MRR obtained was higher when the drilling task was carried out using NFH. An appreciable decrease in PDS was also observed using the proposed system.

13.
Am Surg ; 86(9): 1062-1066, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33049165

RESUMO

BACKGROUND: Direct oral anticoagulants (DOACs) have overtaken warfarin as the preferred anticoagulants for stroke prevention with atrial fibrillation and for treatment of venous thromboembolism. Despite the increased prevalence of DOACs, literature studying their impact on trauma patients with intracranial hemorrhage (ICH) remains limited. Most DOAC reversal agents have only been recently available, and concerns for worse outcomes with DOACs among this population remain. This study aims to assess the outcomes of patients with traumatic ICH taking DOACs compared with those taking warfarin. METHODS: A retrospective analysis of patients with traumatic ICH over a 5-year period was conducted. Demographics, injury severity, medication, and outcome data were collected for each patient. Patients taking warfarin and DOACs were compared. RESULTS: 736 patients had traumatic ICH over the study period, 75 of which were on either DOACs (25 patients) or warfarin (50 patients). The median age of the anticoagulated patients was 78 years; 52% were female, and 91% presented secondary to a fall. DOACs were reversed at close to half the rate of warfarin (40% vs 77%; P = .032). Despite this, the 2 groups had similar rates of worsening examination, need for operative intervention, and in-hospital mortality. In the follow-up, fewer patients taking DOACs had died at 6-months postinjury compared with those taking warfarin (8% vs 30%; P = .041). DISCUSSION: Despite DOACs being reversed at nearly half the rate of warfarin, patients presenting with traumatic ICH on warfarin had higher 6-month mortality suggesting a potential survival advantage for DOACs over warfarin in this population.


Assuntos
Fibrilação Atrial/tratamento farmacológico , Hemorragia Intracraniana Traumática/complicações , Acidente Vascular Cerebral/prevenção & controle , Varfarina/administração & dosagem , Administração Oral , Idoso , Anticoagulantes/administração & dosagem , Fibrilação Atrial/complicações , Coagulação Sanguínea/efeitos dos fármacos , Feminino , Seguimentos , Humanos , Hemorragia Intracraniana Traumática/sangue , Hemorragia Intracraniana Traumática/mortalidade , Masculino , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Taxa de Sobrevida/tendências , Fatores de Tempo , Estados Unidos/epidemiologia
14.
Cureus ; 12(8): e9835, 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32953342

RESUMO

Objective We aimed to evaluate and compare the diagnostic performance of ultrasound (US) and 99m-Tc sestamibi scintigraphy for the preoperative localization of primary hyperparathyroidism (PHPT). Methods This retrospective study was conducted at the Aga Khan University Hospital in Karachi, Pakistan, and comprised the data of patients with PHPT who underwent parathyroidectomy from 2008 to 2017. Preoperative US and 99m-Tc sestamibi scintigraphy findings were recorded and compared to surgical and histological findings, which were taken as a reference standard. Results The sensitivity of US in the preoperative localization of PHPT was 88.3%, positive predictive value (PPV) was 94.6%, and accuracy was 84.1%. The sensitivity of 99m-Tc sestamibi scintigraphy was 90.4%, PPV was 94.3%, and accuracy was 85.7%. Conclusion US neck is an efficient tool for the preoperative localization of PHPT, demonstrating a comparable diagnostic yield with 99m-Tc sestamibi, and can serve as a credible first-line imaging modality in a resource-constrained healthcare setup.

15.
J Environ Manage ; 263: 110365, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32883473

RESUMO

Nanoparticles (NPs) application in soil as nano-fertilizers to increase crop yield is getting attention due to their higher efficiency and less environmental risks. This study investigated the interactive effects of variable titanium dioxide nanoparticles (TiO2-NPs) levels (0, 30, 50 and 100 mg kg-1) superimposed to phosphorus (P) fertilizer application in soil at the rates of 0, 25 and 50 mg kg-1 on wheat crop. Physiological parameters of plants, their antioxidant enzymes activities (SOD, POD), and contents of crude protein, H2O2, MDA and metals/nutrients (Al, Ca, Mg, Fe, Zn and Cu) were measured. Data on physiological traits revealed that application of 50 mg kg-1 of TiO2-NPs without P fertilizer significantly enhanced the root and shoot length by 63 and 26%, respectively. Increased contents of nutrients in the shoots, viz., Ca (316%), Cu (296%), Al (171%) and Mg (187%) with 50 mg kg-1 TiO2-NPs treatment reflected improvement in crop growth and grain quality. Furthermore, P contents in plant tissues were raised up to 56% with 50 mg kg-1 of TiO2-NPs even in the absence of P fertilizer. In the soil, concentration of phytoavailable P was significantly increased up to 63.3% in the presence of 50 mg kg-1 TiO2-NPs as compared to control. Contents of crude protein in grain were also enhanced by 22.8% (at P50) and 17.4% (at P25) with 50 mg kg-1 TiO2-NPs application. Along with P application, TiO2-NPs triggered the activities of SOD (2.06-33.97%) and POD (up to 13.19%), and H2O2 production (50.6-138.8%). However, MDA contents were not elevated significantly at any level of TiO2-NPs, and remained at par with control. It was noteworthy that highest level of TiO2-NPs, viz., 100 mg kg-1 exhibited plant and nutrients response lower than that with 50 mg kg-1. Further, TiO2-NPs triggered the bioavailability of micronutrient heavy metals (Zn, Cu and Fe) and Al, which could have toxicity at higher concentrations. These results suggested that TiO2-NPs might have some affinities with phosphate compounds and metal ions in the soil to bring them in soluble form, which enhanced their bioavailability. Although it improved the crop yield and quality, but toxic or negative impact of TiO2-NPs was also apparent at higher dose. Therefore, investigations on the potential interactions of NPs with other nutrients and toxic metals are needed to enhance our understanding for the safer application of nano-fertilizer.


Assuntos
Nanopartículas , Poluentes do Solo/análise , Peróxido de Hidrogênio , Fósforo , Solo , Titânio , Triticum
16.
Groundw Sustain Dev ; 11: 100433, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32835071

RESUMO

The lockdown during COVID-19 pandemic has converted the world into new experimental laboratories, which may reveal temporal or spatial comparative analysis data. However, some startling information is gathered in terms of reduced premature mortality cases associated with air and water quality improvement, enhanced e-learning on a broader platform, work from home, and successful e-health. The decline in vehicular density on roads and congestion leads to reduced energy consumption and associated greenhouse gases (GHG) and other pollutants emission. The lockdown has also been identified as a possible emergency measure to combat severe air pollution episodes. Similarly, industrial pollution has been recognized as one of the primary causes of water resource pollution and would, therefore, bring change in policy vis-à-vis groundwater pollution control. Our findings suggest that the results of successful e-learning and work from home would be a permanent shift from conventional modes in the near future due to a drastic reduction in socio-economic cost. Our critical analysis also highlights that with such temporary lockdown measures acute/chronic ill-effects of anthropogenic perturbations on planet earth can be effectively estimated through sociocultural, socioeconomical and socio-political/sociotechnological nexus.

17.
Cureus ; 12(7): e9356, 2020 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-32850228

RESUMO

Background Primary percutaneous coronary intervention (PCI) is a treatment of choice for patients with ST-segment elevation myocardial infarction (STEMI). Of the various risk stratification scores that have been introduced, the thrombolysis in myocardial infarction (TIMI) score is among the most used modalities. Patients with a TIMI score of five or higher are classified as high-risk patients with higher rates of adverse events. Therefore, this study aimed to determine the rate of adverse events after primary PCI in patients presenting with STEMI and a TIMI score of five or higher. Methodology This descriptive study was conducted at the cardiology department of the Liaquat National Hospital, Karachi, from February 2018 to August 2018. The patients included in this study consisted of a total of 150 men and women who presented to the ED with concerns of chest pain and were diagnosed with STEMI and had a TIMI score of five or higher. Consultant cardiologists performed primary PCI procedures, and any post-procedure adverse events were recorded during the patients' hospital stays (up to one week), including mortality, heart failure, cardiogenic shock, and ventricular arrhythmias. Results The study population was 83.3% male and 16.7% female patients, and the mean age was 54.0 ± 9.4 years. The mean BMI was 27.34 ± 2.76 kg/m2. The mean TIMI score was 9.19 ± 2.71, with a TIMI score higher than eight for 52.7% of patients. Death was observed in 18.7% of cases, heart failure in 21.3% of cases, cardiogenic shock in 13.3% of cases, and ventricular arrhythmia in 22.0% of cases. Conclusion A TIMI risk score of five or higher can identify patients at high risk not only for mortality, but also for heart failure, cardiogenic shock, and ventricular arrhythmias.

18.
Am Surg ; 86(9): 1124-1128, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32841047

RESUMO

INTRODUCTION: Traumatic brain injury (TBI) remains a significant cause of morbidity and mortality. The purpose of this study is to examine outcomes after discharge and identify factors from the index admission that may contribute to long-term mortality. METHODS: The study population is composed of patients who survived to discharge from a previously published study examining TBI. Demographics, injury severity, and length of stay were abstracted from the index study. Phone surveys of surviving patients were performed to evaluate each patient's Glasgow Outcome Scale-Extended (GOSE). Patients who were deceased at the time of the survey were compared with those who were alive. RESULTS: 1615 patients were alive at the end of the first study period and 211 (13%) comprised the study population. Overall, the median age was 54 years, and the majority were male (74%). The median time to follow-up was 80 months. The population was severely injured, with a median injury severity score (ISS) of 25 and a median head abbreviated injury score (AIS) of 4. Overall mortality was 57%. The group that survived at the time of the survey was younger, more injured, less likely to have received beta-blockers (BB) during the index admission, and had a longer time to follow-up. After adjusting for ISS, age, base deficit, and BB, age was the only variable predictive of mortality (HR 1.03; HL 1.02-1.04). CONCLUSION: Despite being more severely injured, younger patients were more likely to survive to follow-up. Further investigation is needed to determine if aggressive care in older TBI patients in the acute phase leads to good long-term outcomes.


Assuntos
Lesões Encefálicas Traumáticas/fisiopatologia , Recuperação de Função Fisiológica/fisiologia , Centros de Traumatologia , Adulto , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/mortalidade , Feminino , Seguimentos , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Fatores de Tempo , Estados Unidos/epidemiologia
19.
J Affect Disord ; 277: 121-128, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32818775

RESUMO

BACKGROUND: COVID-19 is imposing threat both on physical and mental health since its outbreak. Bangladesh adopted lockdown strategy with potential consequences on day to day life, mental and physical health and this study aims to explore the impact of COVID-19 on mental health and wellbeing among Bangladeshi students. METHODS: A cross-sectional study was conducted between 9th and 23rd April 2020 among 505 college and university students. Data was collected by using online questionnaire including DASS 21 and IES. Descriptive analysis and bivariate linear regression were performed to examine the association of variables. RESULTS: 28.5 % of the respondents had stress, 33.3% anxiety, 46.92% depression from mild to extremely severe, according to DASS 21 and 69.31% had event-specific distress from mild to severe in terms of severity according to IES. Perceiving physical symptoms as COVID-19 was significantly associated with DASS stress subscale (B = 3.71, 95% CI: 1.01 to 6.40), DASS anxiety subscale (B = 3.95, 95% CI: 1.95 to 5.96), DASS depression subscale (B = 3.82, 95% CI: 0.97 to 6.67) and IES scale (B = 7.52, 95% CI: 3.58 to 11.45). Additionally, fear of infection, financial uncertainty, inadequate food supply, absence of physical exercise and limited or no recreational activity had significant association with stress, anxiety, depression and post-traumatic symptoms. CONCLUSION: This COVID-19 outbreak imposes psychological consequences on people to a great extent which requires attention from the concerned authorities to cope with this situation mentally. The perception about the outbreak can also play a big role in psychological impact.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Pandemias , Pneumonia Viral , Estresse Psicológico/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Ansiedade/psicologia , Transtornos de Ansiedade/epidemiologia , Bangladesh/epidemiologia , Betacoronavirus , Estudos Transversais , Depressão/psicologia , Status Econômico , Exercício Físico , Feminino , Abastecimento de Alimentos , Humanos , Masculino , Saúde Mental , Projetos Piloto , Quarentena/psicologia , Recreação , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Estudantes/psicologia , Inquéritos e Questionários , Universidades , Adulto Jovem
20.
Am Surg ; 86(8): 991-995, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32757761

RESUMO

BACKGROUND: The modified brain injury guidelines (mBIG) provide an algorithm for surgeons to manage some mild traumatic brain injury (TBI) with intracranial hemorrhage (ICH) without neurosurgical consultation or repeat imaging. Currently, antiplatelet use among patients with any ICH classifies a patient at the highest level, mBIG 3. This study assesses the risk of clinical progression among patients taking antiplatelet medications with mild TBI with ICH. METHODS: A retrospective analysis of patients with traumatic ICH over a 5-year period was conducted. Demographics, injury severity, and outcome data were collected for each patient. Patients taking antiplatelet agents were reclassified as if they were not taking these medications. Patients who would have met criteria for a lower classification (mBIG 1 or 2) without antiplatelet agents were designated mBIG 3 Antiplatelet and compared with all other mBIG 1 and 2 patients. RESULTS: 736 patients met the inclusion criteria. 158 patients were taking antiplatelet medications and 53 were reclassified as mBIG 3 Antiplatelet. When comparing mBIG 3 Antiplatelet to the 226 patients originally classified as mBIG 1 and 2, mBIG 3 Antiplatelet patients were more likely to undergo repeat head computed tomography (98.1% vs 76.6%; P < .001) and neurosurgical consultation (94.2% vs 76.5%; P < .001) but had no significant differences in outcomes. No mBIG 3 Antiplatelet patients had a worsening examination or needed operative intervention. DISCUSSION: This data suggests that antiplatelet medication use should not automatically classify a patient as mBIG 3. Adoption of this strategy would better utilize resources and avoid unnecessary costs without sacrificing care.


Assuntos
Concussão Encefálica/complicações , Tomada de Decisão Clínica/métodos , Hemorragia Intracraniana Traumática/etiologia , Inibidores da Agregação de Plaquetas/efeitos adversos , Índices de Gravidade do Trauma , Algoritmos , Concussão Encefálica/diagnóstico , Concussão Encefálica/terapia , Feminino , Humanos , Hemorragia Intracraniana Traumática/diagnóstico , Hemorragia Intracraniana Traumática/terapia , Masculino , Guias de Prática Clínica como Assunto , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
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