Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.470
Filtrar
1.
Pancreas ; 50(7): 1030-1036, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34629457

RESUMO

OBJECTIVES: Organ failure (OF) and infected necrosis (IN) are the most important predictors of mortality in necrotizing acute pancreatitis (AP). We studied the relationship between timing (onset and duration) and patterns of OF with mortality and the impact of IN on mortality. METHODS: Consecutive patients with necrotizing AP between January 2017 and February 2020 were analyzed retrospectively for OF and its impact on outcome. Organ failure was divided as single OF, simultaneous multiple OF (SiMOF) and sequential multiple OF (SeMOF). Mortality was compared for timing of onset, total duration and patterns of OF. RESULTS: Among 300 patients with necrotizing AP, 174 (58%) had OF. Mortality was not associated with onset of OF (P = 0.683) but with duration of OF (P = 0.006). Mortalities for single OF, SiMOF, and SeMOF were 11.8%, 30.4%, and 69.2% respectively (P < 0.001). On Cox proportional hazard analysis, adjusted hazard ratio of risk of mortality for OF with IN versus IN, SiMOF versus single OF and SeMOF versus single OF was 3.183, 2.878, and 8.956, respectively (P = 0.023, <0.030, and <0.001, respectively). CONCLUSIONS: Duration of OF was associated with increased mortality and SeMOF had worse outcome than single OF and SiMOF.

2.
Hipertens Riesgo Vasc ; 38(4): 164-169, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34602382

RESUMO

OBJECTIVE: The American Heart association in December 2016 published a position paper concluding that there was insufficient data to make evidence-based recommendations on the relationship between hypertension and cognition of a person. The aim of the study was to study the effect of increased blood pressure on cognitive function. METHODS: A cross sectional study of hypertensives (cases) and normotensive (controls) was done between January 2018 and December 2019. Subjects were recruited by convenience sampling. Subjects who were known cases of hypertension and had been on antihypertensive drug therapy for at least more than six months were considered as cases. Controls were those subjects who were having normal blood pressure and not suffering from any disease known to affect cognition. Out of 413 subjects, data from 388 subjects was used in the study (200 cases, 188 controls). The subjects were allowed to rest for 5min before measuring their blood pressure. Blood pressure was measured with a mercury sphygmomanometer in the right arm with the subject in seated position. Neuropsychological battery consisted of tests for domains of memory (auditory, visual, spatial), learning ability, attention, visuo-spatial construction, working memory. RESULTS: On the neuropsychological tests, patients with hypertension had lower scores in the different domains. Age, hypertension duration, and educational level were the best predictors of cognitive impairment in patients with hypertension. CONCLUSION: Middle aged adults with hypertension have reduced cognitive functions as compared to normotensives.

3.
J Contemp Dent Pract ; 22(7): 833-839, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34615791

RESUMO

AIM: The purpose of this study was to evaluate force systems to bring about the en masse retraction of maxillary anterior teeth having reduced bone levels using finite element analysis. MATERIALS AND METHODS: This is a prospective study. Three-dimensional finite element models of maxillary dentition having normal alveolar bone level and 2, 4, and 6 mm bone loss with first premolar extraction were constructed from a spiral CT scan of a skull. Archwire and brackets were modeled on the facial surfaces of teeth. Retraction force of 175 gm was applied from an orthodontic mini-implant placed bilaterally between the second premolar and first molar and 12 mm above plane of the archwire to anterior retraction hook (ARH) fixed at two heights of 6 and 10 mm above the archwire. RESULTS: Maximum displacement and periodontal ligament (PDL) stress were calculated for different combinations of bone levels and ARH. As the bone loss increased, the tipping tendency, amount of intrusion, and maximum von Mises stress in PDL also increased, showing a direct correlation. CONCLUSION: To minimize tipping and PDL stress, the height of ARH should be increased in alveolar bone loss conditions to allow retraction force to pass through or even above the center of resistance of anterior teeth. Even then, pure bodily retraction may not be achieved, but tipping tendency can be reduced. Nevertheless, it may not be suitable to increase ARH beyond a limit owing to chances of irritation to the vestibular mucosa. Alternative methods should be contemplated to reduce the tipping behavior. CLINICAL SIGNIFICANCE: The alternative is to apply a lighter retraction force to reduce lingual tipping. A higher counter-moment in the archwire or bracket can also be incorporated.


Assuntos
Implantes Dentários , Procedimentos de Ancoragem Ortodôntica , Análise de Elementos Finitos , Estudos Prospectivos
4.
Anim Biotechnol ; : 1-9, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34487479

RESUMO

Brucellosis is a widely prevalent zoonotic disease of major public health significance. A collection of Brucella melitensis and Brucella abortus field isolates of animal and human origin were subjected to MLVA-15 typing followed by phylogeography studies. The MLVA-15 analysis of B. melitensis (n = 65) field isolates resulted in 48 different profiles. The panel I marker bruce45 was found to be most conserved, while the rest of the panel I markers showed low to moderate length polymorphism. Among the panel II markers, bruce04, bruce16 and bruce30 showed a high discriminatory index. The MLVA-15 typing of 13 B. abortus field isolates revealed 13 different genotypes with panel II markers showing higher discriminatory ability vis-à-vis panel I. The minimum spanning tree analysis (MST) in comparison with isolates from the international database revealed that all B. melitensis and B. abortus isolates from this study belonged to the 'Eastern Mediterranean' and the 'abortus C' lineage, respectively. The MLVA-15 typing could differentiate field isolates of B. abortus and B. melitensis originating from different regions, reaffirming the technique's potential of high resolution and suitability for local epidemiological studies. The MLVA scheme also has the advantage of comparison of local isolates with a worldwide database, allowing for phylogeographical studies.

5.
Autoimmun Rev ; : 102927, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34474172

RESUMO

OBJECTIVES: The treatment for COVID-19 often utilizes immune-modulating drugs. These drugs are also used in immune mediated inflammatory diseases (IMIDs). We performed a systematic review about seroconversion after SARS-CoV-2 vaccination in patients with IMIDs and impact of various drugs on seroconversion rates. METHODS: Electronic databases were searched to identify relevant studies reporting seroconversion rates following SARS-CoV-2 vaccination in IMIDs. We calculated the pooled seroconversion rates after a single or two doses of vaccination, pooled seroconversion rates in patients with specific IMIDs, and rates in patients on various drugs/drug classes. RESULTS: Twenty-five studies were included in the systematic review. The pooled seroconversion rates after two doses of mRNA vaccination were higher (83.1, 95%CI: 74.9-89.0, I2 = 90%) as compared to a single dose (69.3, 52.4-82.3, I2 = 95%). The odds of seroconversion were lower in IMIDs as compared to healthy controls (0.05, 0.02-0.13, I2 = 21%). The seroconversion rates in patients with inflammatory bowel disease (95.2, 95%CI: 92.6-96.9, I2 = 0%), spondyloarthropathy (95.6, 95% CI: 83.4-98.9, I2 = 35%), and systemic lupus erythematosus (90.7, 95%CI: 85.4-94.2, I2 = 0%) were higher as compared to rheumatoid arthritis (79.5, 95% CI: 65.1-88.9, I2 = 85%), and vasculitis (70.5, 95% CI: 52.9-83.5, I2 = 51%). The seroconversion rates following double dose of mRNA were excellent (>90%) in those on anti-tumour necrosis factor (TNF), anti-integrin (vedolizumab), anti-IL 17 (secukinumab), anti-IL6 (Tocilizumab) and anti-IL12/23 (Ustekinumab) therapies but attenuated (<70%) in patients on anti-CD20 (Rituximab) or anti-cytotoxic T lymphocyte associated antigen (CTLA-4) therapies (Abatacept). The seroconversion rates were good (70-90%) with steroids, hydroxychloroquine, JAK inhibitors, mycophenolate mofetil and leflunomide. Combination of anti-TNF with immunomodulators (azathioprine, 6-meracptopurine, methotrexate) resulted in an attenuated vaccine response as compared to anti-TNF monotherapy. CONCLUSION: Seroconversion rates after SARS-CoV-2 vaccination are lower in patients with IMIDs. Certain therapies (anti-TNF, anti-integrin, anti-IL 17, anti-IL6, anti-12/23) do not impact seroconversion rates while others (anti-CD20, anti-CTLA-4) result in poorer responses.

7.
Chemosphere ; 287(Pt 2): 132216, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34517234

RESUMO

Landfilling is the most prominently adopted disposal technique for managing municipal solid waste across the globe. However, the main drawback associated with this method is the generation of leachate from the landfill site. Leachate, a highly concentrated liquid consisting of both organic and inorganic components arises environmental issues as it contaminates the nearby aquifers. Landfill leachate treatment by conventional methods is not preferred as the treatment methods are not much effective to remove these pollutants. Advanced oxidation processes (AOPs) based on both hydroxyl and sulfate radicals could be a promising method to remove the micropollutants completely or convert them to non-toxic compounds. The current review focuses on the occurrence of micropollutants in landfill leachate, their detection methods and removal from landfill leachate using AOPs. Pharmaceuticals and personal care products occur in the range of 10-1 to more than 100 µg L-1 whereas phthalates were found below the detectable limit to 384 µg L-1, pesticides in the order of 10-1 µg L-1 and polyaromatic hydrocarbons occur in concentration from 10-2 to 114.7 µg L-1. Solid-phase extraction is the most preferred method for extracting micropollutants from leachate and liquid chromatography (LC) - mass spectrophotometer (MS) for detecting the micropollutants. Limited studies have been focused on AOPs as a potential method for the degradation of micropollutants in landfill leachate. The potential of Fenton based techniques, electrochemical AOPs and ozonation are investigated for the removal of micropollutants from leachate whereas the applicability of photocatalysis for the removal of a wide variety of micropollutants from leachate needs in-depth studies.

8.
J Obstet Gynaecol India ; : 1-7, 2021 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-34511782

RESUMO

Aim: Obstetric patients presenting to the intensive care units (ICU) with or without underlying medical or surgical comorbidities can be a challenge to both the treating obstetrician and the intensivist. They occasionally present with near-miss events which if left untreated, can result in death. Objectives: To study the prevalence, indications of ICU admissions, near-miss events, and their effect on mortality in obstetric and puerperal patients. Material & methods: We conducted a retrospective analysis of the health records of all the obstetric and puerperal patients (pregnant and until 6 weeks postpartum) admitted to our tertiary care hospital from January 2019 to December 2020. Patient demographic characteristics, obstetric, surgical, and medical conditions, acute physiology, and chronic health evaluation (APACHE) II scores, organ failures, treatment, ICU and hospital length of stay, and mortality outcomes were studied. Results: A total of 22 obstetric patients were admitted to the ICU during the above study period. Mean age was 28.7 ± 6.24 years, mean gestation was 34.4 ± 6.61 weeks, mean APACHE II score was 12.68 ± 5.67, median ICU length of stay was 5 days, and median duration of hospital length of stay was 10 days. The antepartum risk factors such as severe preeclampsia (27%), antepartum bleeding (14%), and postpartum complications like postpartum haemorrhage (33%), sepsis with multiorgan failure (25%) are the commonest indications that resulted in ICU admission. Conclusion: Higher APACHE II scores at the time of ICU admission, prolonged ICU, and hospital length of stay may be associated with high maternal mortality.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...