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1.
Allergy Asthma Proc ; 42(3): 228-234, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33980336

RESUMO

Objective: This study aimed to explore the usefulness of the peripheral blood eosinophil count (PBEC) in assessing the level of fractional exhaled nitric oxide (FeNO) and predicting bronchodilation test results. Methods: We retrospectively analyzed the data of 384 outpatients who underwent FeNO measurement at our Department of Respiratory and Critical Care Medicine from March to June 2019. The FeNO level was compared among different PBECs to explore the association among them. Furthermore, the sensitivity and specificity of PBECs in predicting bronchodilation test results were assessed by using receiver operating characteristic (ROC) curve analysis. Results: There was a moderate correlation between PBECs and FeNO levels (r = 0.414; p < 0.05). In the subjects with PBECs ≥ 0.3 × 109/L, the median FeNO level was 39 ppb (interquartile range, 22.5-65.5 ppb), significantly higher than in the subjects with PBECs < 0.3 × 109/L. The area under the ROC curve was 0.707 (p < 0.05). The maximum Youden index (0.348) was at PBECs = 0.205 × 109/L, which achieved sensitivity and specificity of 63% and 71.8%, respectively. Conclusion: PBECs ≥ 0.3 × 109/L can predict a positive bronchodilation test result and a high FeNO level, with a probability of 50% in the subjects with chronic cough and shortness of breath; in the absence of corresponding symptoms and a low PBEC, the predictive value was small. For hospitals not able to conduct FeNO measurements, for outpatients with poor economic conditions, and for patients with confirmed or suspected novel coronavirus disease 2019, the PBEC, in conjunction with a patient's clinical symptoms, can improve the diagnostic accuracy of allergic asthma and assessment of airway inflammation while reducing the risk of infection.


Assuntos
COVID-19/epidemiologia , Eosinófilos/patologia , Contagem de Leucócitos/estatística & dados numéricos , Testes de Função Respiratória/estatística & dados numéricos , SARS-CoV-2/fisiologia , Adulto , Idoso , Broncodilatadores/metabolismo , Expiração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Estudos Retrospectivos , Controle Social Formal
2.
J Bus Contin Emer Plan ; 14(4): 333-353, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33962702

RESUMO

In response to the COVID-19 pandemic, there has been a global surge in the development and implementation of digital interventions to diagnose, track, prevent and mitigate the spread of the SARS-CoV-2 coronavirus. To date, however, there has been little research to characterise the vast scope and scale of these novel, ad hoc and widely varied digital tools. This paper helps fill this gap by providing a descriptive summary of the digital response to COVID-19. The research finds that the digital response can be broken into four main categories: 1) tracking the spread of the virus (contact tracing); 2) controlling social behaviour during the outbreak (social behaviour monitoring); 3) information gathering and dissemination about the virus (one-way and two-way public communications); and 4) diagnosis and treatment (remote diagnostics and treatment). This paper describes the four response categories and provides examples of the digital technologies being developed and implemented for these purposes. This descriptive understanding provides a contextual foundation for subsequent research to analyse the opportunities and challenges associated with the development, implementation and uptake of digital interventions, alongside the development of analytical frameworks and guidance.


Assuntos
COVID-19 , Planejamento em Desastres , Tecnologia Digital , Humanos , Pandemias/prevenção & controle , SARS-CoV-2 , Controle Social Formal
4.
Nutrients ; 13(4)2021 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-33917707

RESUMO

Probiotics are live microorganisms that confer health benefits on the host. However, in recent years, several concerns on their use have been raised. In particular, industrial processing and storage of probiotic products are still technological challenges as these could severely impair cell viability. On the other hand, safety of live microorganisms should be taken into account, especially when administered to vulnerable people, such as the elderly and immunodeficient individuals. These drawbacks have enhanced the interest toward new products based on non-viable probiotics such as paraprobiotics and postbiotics. In particular, paraprobiotics, defined as "inactivated microbial cells (non-viable) that confer a health benefit to the consumer," hold the ability to regulate the adaptive and innate immune systems, exhibit anti-inflammatory, antiproliferative and antioxidant properties and exert antagonistic effect against pathogens. Moreover, paraprobiotics can exhibit enhanced safety, assure technological and practical benefits and can also be used in products suitable for people with weak immunity and the elderly. These features offer an important opportunity to prompt the market with novel functional foods or nutraceuticals that are safer and more stable. This review provides an overview of central issues on paraprobiotics and highlights the urgent need for further studies aimed at assessing safety and efficacy of these products and their mechanisms of action in order to support decisions of regulatory authorities. Finally, a definition is proposed that unambiguously distinguishes paraprobiotics from postbiotics.


Assuntos
Suplementos Nutricionais , Alimento Funcional , Probióticos/farmacologia , Animais , Laticínios , Humanos , Controle de Qualidade , Controle Social Formal
5.
Nutrients ; 13(4)2021 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-33917974

RESUMO

Efforts to address Micronutrient deficiencies (MNDs) in lower-and middle-income countries (LMICs) have been gaining pace in recent years. Commodities such as staple foods (e.g., cereals, roots, and tubers) and condiments (e.g., salt) have been targeted as 'vehicles' for fortification and biofortification through numerous projects and initiatives. To date, there have been mixed experiences with delivery and coverage with very little documented on the range of business models applied in different geographies, business conditions and polities and this makes classification and measurement of success and failure difficult. This research aims to address this gap in knowledge through proposing a typology that clarifies similarities (internal heterogeneity) and differences (external heterogeneity) between models and that can allow all types to be defined by the combination of attributes. Building on a comprehensive literature review; NVivo was used to code initiatives from 34 key references (955 cases in total) which have been grouped into 17 categories. Using non-metric multidimensional scaling (NMDS) we find evidence of four business model groupings that typify fortification initiatives: (1) Large-scale private, unregulated, (2) Mixed-Scale, private, unregulated (3) Large-scale, public-private, regulated; and (4) Large-scale, private, regulated. We characterise these four groups with country examples and suggest that this typology can help the discourse around viability of food fortification initiatives.


Assuntos
Biofortificação , Alimentos Fortificados , Modelos Econômicos , Análise por Conglomerados , Países Desenvolvidos/economia , Países em Desenvolvimento/economia , Propriedade , Controle Social Formal
6.
Expert Rev Med Devices ; 18(4): 319-332, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33765395

RESUMO

INTRODUCTION: Several software and hardware advances in the field of deep brain stimulation (DBS) have been realized in recent years and devices from three manufacturers are available. The Percept™ PC platform (Medtronic, Inc.) enables brain sensing, the latest innovation. Clinicians should be familiar with the differences in devices, and with the latest technologies to deliver optimized patient care.Areas covered: In this device profile, the sensing capabilities of the Percept™ PC platform are described, and the system capabilities are differentiated from other available platforms. The development of the preceding Activa™ PC+S research platform, an investigational device to simultaneously sense brain signals and provide therapeutic stimulation, is provided to place Percept™ PC in the appropriate context.Expert opinion: Percept™ PC offers unique sensing and diary functions as a means to refine therapeutic stimulation, track symptoms and correlate them to neurophysiologic characteristics. Additional features enhance the patient experience with DBS, including 3 T magnetic resonance imaging compatibility, wireless telemetry, a smaller and thinner battery profile, and increased battery longevity. Future work will be needed to illustrate the clinical utility and added value of using sensing to optimize DBS therapy. Patients implanted with Percept™ PC will have ready access to future technology developments.


Assuntos
Estimulação Encefálica Profunda/instrumentação , Doença de Parkinson/terapia , Potenciais de Ação/fisiologia , Encéfalo/fisiopatologia , Análise Custo-Benefício , Estimulação Encefálica Profunda/economia , Humanos , Doença de Parkinson/diagnóstico , Doença de Parkinson/fisiopatologia , Vigilância de Produtos Comercializados , Controle Social Formal
8.
Nat Commun ; 12(1): 1367, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33649338

RESUMO

Effective control of pain management has the potential to significantly decrease the need for prescription opioids following a surgical procedure. While extended release products for pain management are available commercially, the implementation of a device that safely and reliably provides extended analgesia and is sufficiently flexible to facilitate a diverse array of release profiles would serve to advance patient comfort, quality of care and compliance following surgical procedures. Herein, we review current polymeric systems that could be utilized in new, controlled post-operative pain management devices and highlight where opportunities for improvement exist.


Assuntos
Sistemas de Liberação de Medicamentos , Manejo da Dor , Dor Pós-Operatória/tratamento farmacológico , Polímeros/química , Analgésicos/administração & dosagem , Analgésicos/uso terapêutico , Animais , Humanos , Controle Social Formal
11.
Molecules ; 26(5)2021 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-33671085

RESUMO

Seaweeds have a long history of use as food, as flavouring agents, and find use in traditional folk medicine. Seaweed products range from food, feed, and dietary supplements to pharmaceuticals, and from bioenergy intermediates to materials. At present, 98% of the seaweed required by the seaweed industry is provided by five genera and only ten species. The two brown kelp seaweeds Laminaria digitata, a native Irish species, and Macrocystis pyrifera, a native New Zealand species, are not included in these eleven species, although they have been used as dietary supplements and as animal and fish feed. The properties associated with the polysaccharides and proteins from these two species have resulted in increased interest in them, enabling their use as functional foods. Improvements and optimisations in aquaculture methods and bioproduct extractions are essential to realise the commercial potential of these seaweeds. Recent advances in optimising these processes are outlined in this review, as well as potential future applications of L. digitata and, to a greater extent, M. pyrifera which, to date, has been predominately only wild-harvested. These include bio-refinery processing to produce ingredients for nutricosmetics, functional foods, cosmeceuticals, and bioplastics. Areas that currently limit the commercial potential of these two species are highlighted.


Assuntos
Aquicultura/métodos , Misturas Complexas/química , Laminaria/química , Macrocystis/química , Alga Marinha/química , Animais , Suplementos Nutricionais , Europa (Continente) , Alimentos , Humanos , Legislação como Assunto , Preparações Farmacêuticas , Polissacarídeos/química , Proteínas/química , Controle Social Formal , Estados Unidos
12.
Goiânia; SES-GO; 17 mar. 2021. 1-4 p. ilus.
Não convencional em Português | LILACS, Coleciona SUS, CONASS, SES-GO | ID: biblio-1247697

RESUMO

Formulada em 1908, pelo dinamarquês Agner Krarup Erlang, a teoria das filas é um método estatístico que utiliza cálculos matemáticos de probabilidade com o objetivo de prover um modelo que explique a formação de uma fila com base no padrão de entrada, atendimento e saída (OLIVEIRA et al., 2017). A finalidade de tais estudos é melhorar o desempenho do serviço e reduzir os custos. Foram citados três aplicações da teoria no serviço público: um trabalho realizado em Duque de Caxias (RJ); um estudo de caso realizado no Hospital das Clínicas de Uberlândia e um realizado no Estado do Rio de Janeiro


Formulated in 1908 by the Danish Agner Krarup Erlang, the theory of queues is a statistical method that uses mathematical probability calculations in order to provide a model that explains the formation of a queue based on the pattern of entry, service and exit (OLIVEIRA et al., 2017). The purpose of such studies is to improve service performance and reduce costs. Three applications of theory in the public service were mentioned: a work carried out in Duque de Caxias (RJ); a case study conducted at the Hospital das Clínicas de Uberlândia and one conducted in the State of Rio de Janeiro


Assuntos
Controle Social Formal/métodos , Políticas, Planejamento e Administração em Saúde/organização & administração , Saúde Pública/métodos
13.
San Salvador; MINSAL; feb. 09, 2021. 18 p. ilus, graf.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1177211

RESUMO

En cumplimiento de los principios constitucionales relacionados con la salud pública de la población salvadoreña y el marco legal referente a la legislación en salud, la Dirección de Regulación se constituye dentro de la institución, como la dependencia responsable de conducir los procesos de elaboración y publicación de los documentos regulatorios del Ministerio de Salud


In compliance with the constitutional principles related to the public health of the Salvadoran population and the legal framework regarding health legislation, the Regulation Directorate is constituted within the institution, as the agency responsible for conducting the processes of preparation and publication of regulatory documents of the Ministry of Health


Assuntos
Saúde Pública , Legislação como Assunto , Manuais como Assunto , Controle Social Formal
14.
BMC Complement Med Ther ; 21(1): 67, 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33602181

RESUMO

BACKGROUND: This descriptive study provides the first examination of global naturopathic education, regulation and practice frameworks that have potential to constrain or assist professional formation and integration in global health systems. Despite increasing public use, a significant workforce, and World Health Organization calls for national policy development to support integration of services, existent frameworks as potential barriers to integration have not been examined. METHODS: This cross-sectional survey utilized purposive sampling of 65 naturopathic organisations (educational institutions, professional associations, and regulatory bodies) from 29 countries. Organizational representatives completed an on-line survey, conducted between Nov 2016 - Aug 2019. Frequencies and cross-tabulation statistics were analyzed using SPSSv.25. Qualitative responses were hand-coded and thematically analysed where appropriate. RESULTS: Sixty-five of 228 naturopathic organizations completed the survey (29% response rate) from 29 of 46 countries (63% country response rate). Most education programs (68%) were delivered via a national framework. Higher education qualifications (60%) predominated. Organizations influential in education were professional associations (75.4%), particularly where naturopathy was unregulated, and accreditation bodies (41.5%) and regulatory boards (33.8%) where regulated. Full access to controlled acts, and to health insurance rebates were more commonly reported where regulated. Attitude of decision-makers, opinions of other health professions and existing legislation were perceived to most impact regulation, which was globally heterogeneous. CONCLUSION: Education and regulation of the naturopathic profession has significant heterogeneity, even in the face of global calls for consistent regulation that recognizes naturopathy as a medical system. Standards are highest and consistency more apparent in countries with regulatory frameworks.


Assuntos
Educação Profissionalizante , Saúde Global , Naturopatia , Prática Profissional , Controle Social Formal , Acreditação , Atitude , Estudos Transversais , Atenção à Saúde , Humanos , Medicina Integrativa , Organizações , Inquéritos e Questionários
17.
Expert Rev Med Devices ; 18(2): 145-150, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33446005

RESUMO

INTRODUCTION: Ultrasound-guided percutaneous peripheral nerve stimulation (PNS) may be used to treat acute postoperative pain for various types of surgeries. This modality avoids several limitations of traditional local anesthetic-based peripheral nerve blocks including avoidance of motor blockade and sensory deficits. AREAS COVERED: In this review, we discuss the use of SPRINT (SPR Therapeutics, Cleveland, OH) neuromodulation system in the setting of acute postoperative pain management. EXPERT OPINION: PNS is a novel modality in regional anesthesia that has much promise in reducing overall opioid use after surgery. Placement of PNS is very similar to that of catheter-based regional anesthesia techniques. Ultrasound is used to guide the percutaneously placed introducer needle in proximity to the target nerve. There are several benefits of PNS over catheter-based approaches, including: 1) avoidance of motor or sensory blockade; 2) no medication bag required to be carried; and 3) electric leads may be kept in situ safely for up to 60 days. While several proof-of-concept studies have been published highlighting its use in various types of surgeries, large high-quality randomized controlled trials are still needed.


Assuntos
Dor Pós-Operatória/terapia , Nervos Periféricos/patologia , Estimulação Elétrica Nervosa Transcutânea , Humanos , Dor Pós-Operatória/diagnóstico por imagem , Nervos Periféricos/diagnóstico por imagem , Vigilância de Produtos Comercializados , Controle Social Formal , Estimulação Elétrica Nervosa Transcutânea/instrumentação , Ultrassonografia
18.
Mayo Clin Proc ; 96(1): 78-85, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33413837

RESUMO

OBJECTIVE: To examine differences in community mobility reduction and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outcomes across counties with differing levels of socioeconomic disadvantage. METHODS: The sample included counties in the United States with at least one SARS-CoV-2 case between April 1 and May 15, 2020. Outcomes were growth in SARS-CoV-2 cases, SARS-CoV-2-related deaths, and mobility reduction across three settings: retail/recreation, grocery/pharmacy, and workplace. The main explanatory variable was the social deprivation index (SDI), a composite socioeconomic disadvantage measure. RESULTS: Adjusted differences in outcomes between low-, medium-, and high-SDI counties (defined by tertile) were calculated using linear regression with state-fixed effects. Workplace mobility reduction was 1.75 (95% CI, -2.36 to -1.14; P<.001) and 3.48 percentage points (95% CI, -4.21 to -2.75; P<.001) lower for medium- and high-SDI counties relative to low-SDI counties, respectively. Mobility reductions in the other settings were also significantly lower for higher-SDI counties. In analyses adjusted for SARS-CoV-2 prevalence on April 1, medium- and high-SDI counties had 1.39 (95% CI, 0.85 to 1.93; P<.001) and 2.56 (95% CI, 1.77 to 3.34; P<.001) more SARS-CoV-2 cases/1000 population on May 15 compared with low-SDI counties, respectively. Deaths per capita were also significantly higher for higher-SDI counties. CONCLUSION: Counties with higher social deprivation scores experienced greater growth in SARS-CoV-2 cases and deaths, but reduced mobility at lower rates. These findings are consistent with evidence demonstrating that economically disadvantaged communities have been disproportionately impacted by the coronavirus disease 2019 pandemic. Efforts to socially distance may be more burdensome for these communities, potentially exacerbating disparities in SARS-CoV-2-related outcomes.


Assuntos
COVID-19/epidemiologia , Pneumonia Viral/epidemiologia , Condições Sociais , Controle Social Formal , COVID-19/mortalidade , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos/epidemiologia
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