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1.
Endocr Connect ; 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32520722

RESUMO

Despite recent improvements in the composition of the diet, lower mineral bone density and overweight tendencies are incoherently described in patients with phenylketonuria (PKU). The impact of dietary factors and plasma phenylalanine levels on growth, body mass index, body composition, and bone mineral density was investigated in our cohort of patients with hyperphenylalaninemia (HPA) with or without dietary treatment. The anthropometric, metabolic, body mass index and other nutritional indicators and bone mineral density were compared between the group of 96 treated patients with PKU (58 classic PKU (cPKU) and 38 patients with moderate-mild PKU defined as non-classic PKU (non-cPKU)) and the untreated group of 62 patients with benign HPA. Having compared the treated and untreated groups, there were normal outcomes and no statistically significant differences in body mass index, body composition, and bone mineral density. Lower body height standard deviation scores were observed in the treated as compared to the untreated group (p <0.001), but the difference was not significant when analyzing patients older than 18 years; however, cPKU adults were shorter compared to non-cPKU treated adults (p=0.012). Interestingly, the whole-body fat was statistically higher in non-cPKU as compared to cPKU patients. In conclusion, the dietary treatment ensures adequate nutrition without significant consequences in body mass index, body composition, and bone mineral density. A low protein diet may delay the growth in childhood, but the treated patients gain a normal final height. Mild untreated hyperphenylalaninemia characteristic for benign HPA has no negative physiological effect on bone mineral density.

2.
Int J Cardiol ; 289: 24-29, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31072633

RESUMO

BACKGROUND: Changes in cardiac autonomic regulation and P-wave characteristics are associated with the occurrence of atrial fibrillation. The purpose of this study was to evaluate whether combined preoperative non-invasive determination of cardiac autonomic regulation and PR interval allows for the identification of patients at risk of new-onset atrial fibrillation after cardiac surgery. METHODS: RR, PR and QT intervals, and linear and non-linear heart rate variability parameters from 20 min high-resolution electrocardiographic recordings were determined one day before surgery in 150 patients on chronic beta blockers undergoing elective coronary artery bypass grafting, aortic valve replacement, or both, electively. RESULTS: Thirty-one patients (21%) developed postoperative atrial fibrillation. In the atrial fibrillation group, more arterial hypertension, a greater age, a higher EuroSCORE II, a higher heart rate variability index (pNN50: 9 ±â€¯20 vs. 4 ±â€¯10, p = 0.050), a short PR interval (156 ±â€¯23 vs. 173 ±â€¯31 ms; p = 0.011), and a reduced short-term scaling exponent of the detrended fluctuation analysis (DFA1, 0.96 ±â€¯0.36 vs. 1.11 ±â€¯0.30 ms; p = 0.032) were found compared to the sinus rhythm group. Logistic regression modeling confirmed PR interval, DFA1 and age as the strongest preoperative predictors of postoperative atrial fibrillation (area under the receiver operating characteristic curve = 0.804). CONCLUSIONS: Patients developing atrial fibrillation after cardiac surgery presented with severe cardiac autonomic derangement and a short PR interval preoperatively. The observed state characterizes both altered heart rate regulation and arrhythmic substrate and is strongly related to an increased risk of postoperative atrial fibrillation.


Assuntos
Fibrilação Atrial/fisiopatologia , Sistema Nervoso Autônomo/fisiopatologia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Eletrocardiografia/métodos , Sistema de Condução Cardíaco/fisiopatologia , Frequência Cardíaca/fisiologia , Complicações Pós-Operatórias , Idoso , Fibrilação Atrial/etiologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Estudos Prospectivos
3.
Biofouling ; 35(3): 273-283, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31025585

RESUMO

There is a wide range of factors affecting bacterial adhesion and biofilm formation. However, in both food processing and medical settings, it is very hard to obtain suitably controlled conditions so that the factors that reduce surface colonisation and biofouling can be studied. The aim of this study was to evaluate the effect of glucose concentration, temperature and stainless steel (SS) surface roughness on biofouling by four common pathogens (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and L. monocytogenes). Among the tested variables, the untreated SS surface (3C) was shown to be fouled more than 3D polished, brushed or electropolished SS surfaces. Although an array of parameters influenced biofouling, the most promising control measure was the influence of low temperature (4 °C) that reduced biofouling even in the case of the psychrophilic Listeria monocytogenes. The study findings could significantly contribute to the prevention of SS surface contamination and consequential biofouling by food and healthcare associated pathogens.


Assuntos
Incrustação Biológica , Glucose/metabolismo , Bactérias Gram-Negativas , Bactérias Gram-Positivas , Aço Inoxidável , Aderência Bacteriana , Temperatura
4.
Artif Organs ; 41(5): 481-489, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27862029

RESUMO

Acute kidney injury (AKI) represents frequent complication after cardiac surgery using cardiopulmonary bypass (CPB). In the hope to enhance earlier more reliable characterization of AKI, we tested the utility of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC) in addition to standard creatinine for early determination of AKI after cardiac surgery using CPB. Forty-one patients met the inclusion criteria. Arterial blood samples collected after induction of general anesthesia were used as baseline, further sampling occurred at CPB termination, 2 h after CPB, on the first and second day after surgery. According to AKIN classification 18 patients (44%) developed AKI (AKI1-2 groups) and 23 (56%) did not (non-AKI group). Groups were similar regarding demographics and operative characteristics. CysC levels differed already preoperatively (non-AKI vs. AKI2; P = 0.045; AKI1 vs. AKI2; P = 0.011), while postoperatively AKI2 group differed on the first day and AKI1 on the second regarding non-AKI group (P = 0.004; P = 0.021, respectively). NGAL and creatinine showed significant difference already 2 h after CPB between groups AKI2 and non-AKI and later on the first postoperative day between groups AKI1 and AKI2 (P = 0.028; P = 0.014, respectively). This study shows similar performance of early plasma creatinine and NGAL in patients with preserved preoperative renal function. It demonstrates that creatinine, as well as NGAL, differentiate subsets of patients developing AKI of clinically more advanced grade early after 2 h, also when used single and uncombined.


Assuntos
Lesão Renal Aguda/sangue , Lesão Renal Aguda/etiologia , Ponte Cardiopulmonar/efeitos adversos , Creatinina/sangue , Cistatina C/sangue , Lipocalina-2/sangue , Lesão Renal Aguda/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia
5.
Brain Lang ; 163: 10-21, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27631161

RESUMO

Broca's region and adjacent cortex presumably take part in working memory (WM) processes. Electrophysiologically, these processes are reflected in synchronized oscillations. We present the first study exploring the effects of a stroke causing Broca's aphasia on these processes and specifically on synchronized functional WM networks. We used high-density EEG and coherence analysis to map WM networks in ten Broca's patients and ten healthy controls during verbal WM task. Our results demonstrate that a stroke resulting in Broca's aphasia also alters two distinct WM networks. These theta and gamma functional networks likely reflect the executive and the phonological processes, respectively. The striking imbalance between task-related theta synchronization and desynchronization in Broca's patients might represent a disrupted balance between task-positive and WM-irrelevant functional networks. There is complete disintegration of left fronto-centroparietal gamma network in Broca's patients, which could reflect the damaged phonological loop.


Assuntos
Afasia de Broca/etiologia , Afasia de Broca/fisiopatologia , Eletroencefalografia , Memória de Curto Prazo , Acidente Vascular Cerebral/complicações , Idoso , Estudos de Casos e Controles , Córtex Cerebral/fisiopatologia , Fenômenos Eletrofisiológicos , Função Executiva , Feminino , Ritmo Gama , Humanos , Masculino , Pessoa de Meia-Idade , Ritmo Teta
6.
Innovations (Phila) ; 10(6): 398-405, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26680751

RESUMO

OBJECTIVE: Postoperative atrial fibrillation (POAF) is a frequent complication after heart surgery. It has been shown that cardiac autonomic derangement plays a significant role in the genesis of atrial fibrillation (AF) and that AF might also be promoted by altered repolarization. Thus, the aim of our study was to determine the levels of cardiac autonomic modulation and repolarization properties in patients developing POAF. METHODS: Seventy-nine patients scheduled for aortic and/or coronary artery bypass grafting surgery with cardiopulmonary bypass were enrolled prospectively. High-resolution 20-minute electrocardiogram recordings were obtained day before surgery to determine P, PR, QT, and QTc intervals, as well as linear (time and frequency domain) and nonlinear heart rate variability parameters (fractal dimension and detrended fluctuation analysis). QTc interval was calculated using Framingham correction. RESULTS: Twenty-nine patients developed POAF (AF group), and 50 did not (non-AF group). Groups were similar regarding demographics, surgery type, and perioperative characteristics, except for older age in the AF group. QT and QTc intervals (Framingham) were longer in the AF group [442 (44) vs 422 (28) milliseconds, P = 0.018; and 448 (44) vs 431 (24) milliseconds, P = 0.031 and P = 0.019, respectively]. Time domain heart rate variability parameter PNN50 (percentage of pairs of adjacent NN intervals differing >50 milliseconds) was higher [14% (21%) vs 8% (16%), P = 0.015], and nonlinear parameter detrended fluctuation analysis α2 was lower in the AF group [0.81 (0.21) vs 0.91 (0.20), P = 0.031]. CONCLUSIONS: Profound cardiac autonomic derangement, suggestive of parasympathetic excessive modulation, exists preoperatively in patients inclined to POAF after cardiac surgery, whereby parameters PNN50 and α2 differentiated the AF from the non-AF group. Prolonged QTc intervals are associated with an increased risk of POAF.


Assuntos
Fibrilação Atrial/fisiopatologia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Ponte de Artéria Coronária/efeitos adversos , Sistema de Condução Cardíaco/fisiopatologia , Antagonistas Adrenérgicos beta/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/etiologia , Eletrocardiografia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Sistema Nervoso Parassimpático/fisiopatologia , Período Pós-Operatório , Estudos Prospectivos , Fatores de Risco
7.
Neurol Sci ; 36(12): 2199-207, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26209929

RESUMO

Synchronization between prefrontal (executive) and posterior (association) cortices seems a plausible mechanism for temporary maintenance of information. However, while EEG studies reported involvement of (pre)frontal midline structures in synchronization, functional neuroimaging elucidated the importance of lateral prefrontal cortex (PFC) in working memory (WM). Verbal and spatial WM rely on lateralized subsystems (phonological loop and visuospatial sketchpad, respectively), yet only trends for hemispheric dissociation of networks supporting rehearsal of verbal and spatial information were identified by EEG. As oscillatory activity is WM load dependent, we applied an individually tailored submaximal load for verbal (V) and spatial (S) task to enhance synchronization in the relevant functional networks. To map these networks, we used high-density EEG and coherence analysis. Our results imply that the synchronized activity is limited to highly specialized areas that correspond well with the areas identified by functional neuroimaging. In both V and S task, two independent networks of theta synchronization involving dorsolateral PFC of each hemisphere were revealed. In V task, left prefrontal and left parietal areas were functionally coupled in gamma frequencies. Theta synchronization thus provides the necessary interface for storage and manipulation of information, while left-lateralized gamma synchronization could represent the EEG correlate of the phonological loop.


Assuntos
Mapeamento Encefálico , Córtex Cerebral/fisiologia , Sincronização Cortical/fisiologia , Fenômenos Eletrofisiológicos/fisiologia , Memória de Curto Prazo/fisiologia , Ritmo Teta/fisiologia , Adulto , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Tempo de Reação
8.
Artif Intell Med ; 58(2): 101-14, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23548472

RESUMO

OBJECTIVE: The early detection of breast cancer is one of the most important predictors in determining the prognosis for women with malignant tumours. Dynamic contrast-enhanced magnetic-resonance imaging (DCE-MRI) is an important imaging modality for detecting and interpreting the different breast lesions from a time sequence of images and has proved to be a very sensitive modality for breast-cancer diagnosis. However, DCE-MRI exhibits only a moderate specificity, thus leading to a high rate of false positives, resulting in unnecessary biopsies that are stressful and physically painful for the patient and lead to an increase in the cost of treatment. There is a strong medical need for a DCE-MRI computer-aided diagnosis tool that would offer a reliable support to the physician's decision providing a high level of sensitivity and specificity. METHODS: In our study we investigated the possibility of increasing differentiation between the malignant and the benign lesions with respect to the spatial variation of the temporal enhancements of three parametric maps, i.e., the initial enhancement (IE) map, the post-initial enhancement (PIE) map and the signal enhancement ratio (SER) map, by introducing additional methods along with the grey-level co-occurrence matrix, i.e., a second-order statistical method already applied for quantifying the spatiotemporal variations. We introduced the grey-level run-length matrix and the grey-level difference matrix, representing two additional, second-order statistical methods, and the circular Gabor as a frequency-domain-based method. Each of the additional methods is for the first time applied to the DCE-MRI data to differentiate between the malignant and the benign breast lesions. We applied the least-square minimum-distance classifier (LSMD), logistic regression and least-squares support vector machine (LS-SVM) classifiers on a total of 115 (78 malignant and 37 benign) breast DCE-MRI cases. The performances were evaluated using ten experiments of a ten-fold cross-validation. RESULTS: Our experimental analysis revealed the PIE map, together with the feature subset in which the discriminating ability of the co-occurrence features was increased by adding the newly introduced features, to be the most significant for differentiation between the malignant and the benign lesions. That diagnostic test - the aforementioned combination of parametric map and the feature subset achieved the sensitivity of 0.9193 which is statistically significantly higher compared to other diagnostic tests after ten-experiments of a ten-fold cross-validation and gave a statistically significantly higher specificity of 0.7819 for the fixed 95% sensitivity after the receiver operating characteristic (ROC) curve analysis. Combining the information from all the three parametric maps significantly increased the area under the ROC curve (AUC) of the aforementioned diagnostic test for the LSMD and logistic regression; however, not for the LS-SVM. The LSMD classifier yielded the highest area under the ROC curve when using the combined information, increasing the AUC from 0.9651 to 0.9755. CONCLUSION: Introducing new features to those of the grey-level co-occurrence matrix significantly increased the differentiation between the malignant and the benign breast lesions, thus resulting in a high sensitivity and improved specificity.


Assuntos
Inteligência Artificial , Neoplasias da Mama/diagnóstico , Meios de Contraste , Diagnóstico por Computador/métodos , Interpretação de Imagem Assistida por Computador , Imagem por Ressonância Magnética , Área Sob a Curva , Neoplasias da Mama/classificação , Neoplasias da Mama/patologia , Técnicas de Apoio para a Decisão , Detecção Precoce de Câncer , Feminino , Humanos , Análise dos Mínimos Quadrados , Modelos Logísticos , Valor Preditivo dos Testes , Curva ROC , Fatores de Tempo
9.
Rheumatol Int ; 33(11): 2885-8, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22955878

RESUMO

Tumour necrosis factor-alpha (TNF-α) inhibitors are widely used in the management of patients with rheumatoid arthritis (RA) and spondylarthritides. However, TNF-α inhibition may lead to adverse events, including liver injury. The RA patients are frequently treated with several potentially hepatotoxic drugs concomitantly; hence, a causative link between TNF-α inhibitors and liver injury is usually difficult to establish. We report two cases of RA patients who developed histologically manifest liver injury shortly after the introduction of treatment with two different TNF-α inhibitors. Furthermore, we present the analysis of the laboratory data from the BioRx.si registry (the Slovenian national registry of rheumatologic patients treated with biologicals) and provide evidence that elevated levels of serum aminotransferase can be observed in patients treated with TNF-α inhibitors. Additionally, our analysis suggests no significant differences between the impact of adalimumab and etanercept on aminotransferase levels. Although the use of TNF-alpha inhibitors is safe and efficient, we suggest that continuous careful monitoring of aminotransferase levels in patients treated with these agents is probably warranted.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Antirreumáticos/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , Produtos Biológicos/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Adalimumab , Adulto , Anticorpos Monoclonais Humanizados/uso terapêutico , Antirreumáticos/uso terapêutico , Produtos Biológicos/uso terapêutico , Quimioterapia Combinada , Humanos , Isoxazóis/uso terapêutico , Leflunomida , Masculino , Metotrexato/uso terapêutico , Metilprednisolona/uso terapêutico , Sistema de Registros , Eslovênia , Sulfassalazina/uso terapêutico , Fator de Necrose Tumoral alfa/antagonistas & inibidores
10.
IEEE Trans Pattern Anal Mach Intell ; 31(4): 736-41, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19229087

RESUMO

An edit-distance model that can be used for the approximate matching of contiguous and non-contiguous timed strings is presented. The model extends the concept of the weighted string-edit distance by introducing timed edit operations and by making the edit costs time dependent. Special attention is paid to the timed null symbols that are associated with the timed insertions and deletions. The usefulness of the presented model is demonstrated on the classification of phone-recognition errors using the TIMIT speech database.

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