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1.
BMJ ; 368: l7057, 2020 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-31996343

RESUMO

OBJECTIVE: To study the impact of maternal smoking during pregnancy on fractures in offspring during different developmental stages of life. DESIGN: National register based birth cohort study with a sibling comparison design. SETTING: Sweden. PARTICIPANTS: 1 680 307 people born in Sweden between 1983 and 2000 to women who smoked (n=377 367, 22.5%) and did not smoke (n=1 302 940) in early pregnancy. Follow-up was until 31 December 2014. MAIN OUTCOME MEASURE: Fractures by attained age up to 32 years. RESULTS: During a median follow-up of 21.1 years, 377 970 fractures were observed (the overall incidence rate for fracture standardised by calendar year of birth was 11.8 per 1000 person years). The association between maternal smoking during pregnancy and risk of fracture in offspring differed by attained age. Maternal smoking was associated with a higher rate of fractures in offspring before 1 year of age in the entire cohort (birth year standardised fracture rates in those exposed and unexposed to maternal smoking were 1.59 and 1.28 per 1000 person years, respectively). After adjustment for potential confounders the hazard ratio for maternal smoking compared with no smoking was 1.27 (95% confidence interval 1.12 to 1.45). This association followed a dose dependent pattern (compared with no smoking, hazard ratios for 1-9 cigarettes/day and ≥10 cigarettes/day were 1.20 (95% confidence interval 1.03 to 1.39) and 1.41 (1.18 to 1.69), respectively) and persisted in within-sibship comparisons although with wider confidence intervals (compared with no smoking, 1.58 (1.01 to 2.46)). Maternal smoking during pregnancy was also associated with an increased fracture incidence in offspring from age 5 to 32 years in whole cohort analyses, but these associations did not follow a dose dependent gradient. In within-sibship analyses, which controls for confounding by measured and unmeasured shared familial factors, corresponding point estimates were all close to null. Maternal smoking was not associated with risk of fracture in offspring between the ages of 1 and 5 years in any of the models. CONCLUSION: Prenatal exposure to maternal smoking is associated with an increased rate of fracture during the first year of life but does not seem to have a long lasting biological influence on fractures later in childhood and up to early adulthood.


Assuntos
Fraturas Ósseas , Gestantes/psicologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Fumar , Adulto , Fatores Etários , Criança , Correlação de Dados , Feminino , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/epidemiologia , Humanos , Lactente , Masculino , Gravidez , Sistema de Registros/estatística & dados numéricos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Suécia/epidemiologia
2.
Am J Orthod Dentofacial Orthop ; 157(1): 98-104, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31901288

RESUMO

INTRODUCTION: Esthetic improvement is a key motivator in undergoing orthodontic treatment. This study aims to quantify the contribution of the smile and other facial components to the overall esthetics of attractiveness. METHODS: The attractiveness of 60 subjects (30 men, 30 women), aged 18-35 years, before orthodontic treatment, was retrospectively evaluated by 8 laypersons using the Visual Analog Scale. Pearson and stepwise correlations were calculated between the attractiveness of the smiling face and the attractiveness of facial components; namely the smile, nose, eyes, hair, chin, eyebrows, and skin. RESULTS: A strong correlation between the face and smile attractiveness was found (r = 0.71) for the whole sample. No significant correlations were found between attractiveness and the other facial components. When divided by gender, the smile (r = 0.70) and the eyes (r = 0.51) correlated with the attractiveness of the smiling face for men. For women, the face registered a significant correlation with the smile (r = 0.83) and the skin (r = 0.37). CONCLUSIONS: In general, smile attractiveness was strongly correlated with the attractiveness of the smiling face, which is the only significant component. For men, the smile was responsible for 49% of the variation in the attractiveness of the smiling face, the eyes for 22%, and the hair for 6%. For women, 69% of the variation in facial attractiveness could be attributed to smile.


Assuntos
Correlação de Dados , Sorriso , Adolescente , Adulto , Estudos Transversais , Estética Dentária , Feminino , Humanos , Masculino , Estudos Retrospectivos , Adulto Jovem
3.
Ann Otol Rhinol Laryngol ; 129(2): 149-156, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31559862

RESUMO

OBJECTIVES: We aimed to determine whether certain maxillofacial fracture patterns and injury mechanisms were more prevalent in an urban environment. In addition, we aimed to determine if maxillofacial trauma incidence correlated with income. METHODS: Data was collected from Einstein Healthcare Network and Temple University Health System. These data were compared to the 2016 National Trauma Data Bank© (NTDB©) using chi-square analysis. Multivariate analysis was used to identify correlations between demographic variables and fracture patterns. Sociodemographic data was further characterized utilizing neighborhood mapping. RESULTS: A total of 252 patients from our urban campuses and 14 447 patients from the NTDB© were identified with facial fractures. Maxillofacial trauma patients in the urban population were more likely to be minorities and less likely to be Caucasian compared to the NTDB© (P < .001). Patients in the urban setting were more likely to sustain mandibular and orbital fractures, and less likely to sustain maxillary fractures and multiple fractures (P < .001). Urban maxillofacial trauma patients were more likely to sustain assault and sporting injuries, and less likely to sustain injuries from motor vehicle accidents and self-harm (P < .001). CONCLUSIONS: Maxillofacial trauma patterns and injury mechanisms were shown to be significantly different in an urban environment as compared to national data.


Assuntos
Traumatismos Maxilofaciais/epidemiologia , Adolescente , Adulto , Idoso , Correlação de Dados , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos/epidemiologia , Saúde da População Urbana , Adulto Jovem
4.
BMJ ; 367: l6322, 2019 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-31818913

RESUMO

OBJECTIVE: To study the effects of recent political events on mood among young physicians. DESIGN: Prospective cohort study. SETTING: United States medical centres. PARTICIPANTS: 2345 medical interns provided longitudinal mood data as part of the Intern Health Study between 2016 and 2018. MAIN OUTCOME MEASURES: Mean mood score during the week following influential political and non-political events as compared with mean mood during the preceding four week control period. RESULTS: We identified nine political events and eight non-political events for analysis. With the start of internship duties in July, the mean decline in mood for interns was -0.30 (95% confidence interval -0.33 to -0.27, t=-17.45, P<0.001). The decline in mood was of similar magnitude following the 2016 presidential election (mean mood change -0.32, 95% confidence interval -0.45 to -0.19, t=-4.73, P<0.001) and subsequent inauguration (mean mood change -0.25, 95% confidence interval -0.37 to -0.12, t=-3.93, P<0.001). Further, compared with men, women reported greater mood declines after both the 2016 election (mean gender difference 0.31, 95% confidence interval 0.05 to 0.58, t=2.33, P=0.02) and the inauguration (mean gender difference 0.25, 95% confidence interval 0.01 to 0.49, t=2.05, P=0.04). Overall, there were statistically significant changes in mood following 66.7% (6/9) of political events assessed. In contrast, none of the non-political events included in the analysis were statistically significantly associated with a change in mood. CONCLUSIONS: Macro level factors such as politics may be correlated with the mood of young doctors. This finding signals the need for further evaluation of the consequences of increasing entanglement between politics and medicine moving forward for young physicians and their patients.


Assuntos
Afeto , Corpo Clínico Hospitalar/psicologia , Política , Centros Médicos Acadêmicos/estatística & dados numéricos , Adulto , Estudos de Coortes , Correlação de Dados , Feminino , Humanos , Internato e Residência , Masculino , Saúde Mental , Pesquisa Qualitativa , Fatores Sexuais , Estados Unidos
5.
Medicine (Baltimore) ; 98(47): e17950, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764795

RESUMO

OBJECTIVE: To investigate the role of YKL-40 in ST segment elevation myocardial infarction (STEMI) and its relationship to C-reactive protein (CRP) and matrix metalloproteinase-9 (MMP-9). METHODS: This prospective study included 358 STEMI patients who were sent to the Emergency Department of our hospital from April 2014 to December 2017. Serum levels of YKL-40, CRP and MMP-9 were determined using commercially available Enzyme linked immunosorbent assay (ELISA) kits. Major adverse cardiovascular events (MACE) and overall survival time were analyzed. RESULTS: GRACE scores (P < .001) and the levels of YKL-40 (P < .001), MMP-9 (P < .001), and CRP (P < .001) were significantly higher in deceased patients compared to those that survived. The levels of CRP (P = .007) and MMP-9 (P = .022) were significantly higher in the high YKL-40 group. The GRACE scores were also significantly elevated (P = .011, 95% CI 2.1 (-9.7 to -1.3)). Cumulative MACE rates and cardiac death rates were significantly higher in the high YKL-40 group (P < .001, 95% CI 3.9 (1.9-8.2)). Overall survival times were significantly longer in patients with lower YKL-40 levels (P < .0001). CONCLUSION: Elevated YKL-40 levels positively correlate with CRP and MMP-9 levels and are associated with clinical outcomes including MACE and 6-month survival in STEMI patients.


Assuntos
Proteína C-Reativa/análise , Proteína 1 Semelhante à Quitinase-3/sangue , Metaloproteinase 9 da Matriz/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Doença Aguda , Correlação de Dados , Tratamento de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
6.
Medicine (Baltimore) ; 98(48): e18189, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770275

RESUMO

Sparse is the research on the relationship between iron metabolism and mild cognitive impairment (MCI) in adults aged over 60 years with non-alcoholic fatty liver disease (NAFLD). The soluble transferrin receptor (sTfR), serum iron (SI), serum ferritin (SF), transferrin (TRF) and hemoglobin (HB) are indicators of iron metabolism.This study examined whether iron metabolism is associated with cognitive impairment in older individuals.A cross-sectional study was held in patients from a Chinese center. Individuals with NAFLD aged over 60 years were included if they did not have excessive alcohol intake and were free of stroke or dementia. Their cognitive function was assessed by the same neurologist. 3.0T H proton magnetic resonance spectroscopy (H-MRS) was performed to evaluate the hippocampus of the participants without contraindication. t test and Chi-square test were used to analyze the data. Binary logistic regression was used for correlation analysis.Fifty four (54%) of participants were diagnosed with MCI by the psychiatrist. MCI was significantly associated with higher sTfR after adjustment of all the covariates (OR = 2.565, 95%CI: 1.334∼4.934; P = .005). No statistically significant associations were observed between MCI and age or blood glucose or choline (Cho) /creatine (Cr) of theright hippocampus head.Increased age and low levels of sTfR and HB were associated with MCI in NAFLD individuals aged over 60 years.


Assuntos
Disfunção Cognitiva , Hemoglobinas/análise , Hipocampo/diagnóstico por imagem , Ferro , Hepatopatia Gordurosa não Alcoólica , Receptores da Transferrina/sangue , Idoso , China/epidemiologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/metabolismo , Correlação de Dados , Estudos Transversais , Feminino , Ferritinas/análise , Humanos , Ferro/sangue , Ferro/metabolismo , Espectroscopia de Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/psicologia , Transferrina/análise
7.
Medicine (Baltimore) ; 98(48): e18218, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770283

RESUMO

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by joint destructions and human leukocyte antigen (HLA)-DRB1 is an important genetic risk factor for RA and influences the phenotype of RA. The clinical features of elder age onset RA (EORA) were known to be different from those of younger age onset RA (YORA). Previous studies reported the different association pattern of DRB1 alleles with YORA or EORA. The associations of DRB1 genotype with these RA subsets remained almost unknown. We investigated the genotype association of DRB1 with YORA or EORA in Japanese populations.HLA genotyping was performed in Japanese RA patients and the association of allele or genotype carrier frequencies were analyzed.The genotype frequency of DRB104:05/DRB104:06 (P = .0204, OR 7.69, 95%CI 1.39-42.72), DRB104:05/DRB112:01 (P = .0050, OR 5.53, 95%CI 1.71-17.88), and DRB104:05/DRB115:01 (P = .0124, OR 3.34, 95%CI 1.39-8.02) in YORA was higher than EORA. However, the frequencies of DRB101:01/DRB104:05 in YORA was tended to be lower than EORA (P = .0784, OR 0.14, 95%CI 0.01-2.42). The gene dosage effect of the shared epitope alleles was detected in EORA, but not in YORA. Trans-complementing DQ heterodimer molecules, formed by DQA1 and DQB1 of the haplotypes with and without shared epitope alleles, might explain the higher genotype frequencies of "shared epitope /not shared epitope". Linear regression analyses showed the primary role of DQB104:01 allele for the age at onset of RA.This is the first report for the associations of DRB1 genotype with YORA or EORA in the Japanese population and the differential distribution of the genotypes was noted between these RA subsets. The involvement of DQ molecules for the age at onset of RA was suggested.


Assuntos
Idade de Início , Artrite Reumatoide , Cadeias HLA-DRB1/genética , Adulto , Idoso , Alelos , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/genética , Correlação de Dados , Feminino , Frequência do Gene , Predisposição Genética para Doença , Humanos , Testes Imunológicos/métodos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade
8.
J Athl Train ; 54(10): 1115-1122, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31633417

RESUMO

CONTEXT: Sport specialization is thought to be a primary contributor to the throwing-related injury risk in youth baseball players. OBJECTIVE: To (1) establish arm-injury incidence in a cohort of male youth (9-12 years old) baseball players and (2) examine sport specialization and the frequency of arm injuries in the same cohort. DESIGN: Cohort study. SETTING: Greenville, South Carolina, youth baseball programs and tournaments. PATIENTS OR OTHER PARTICIPANTS: A total of 159 asymptomatic youth baseball players (age = 11.1 ± 1.1 years) were physically assessed and then were prospectively followed for 6.7 ± 1.5 months. MAIN OUTCOME MEASURE(S): Athlete demographics and playing and injury histories were initially recorded. Athlete-exposures and presence of arm injury were prospectively tracked. All injuries were physically confirmed by a licensed physical therapist. RESULTS: Youth players demonstrated an arm-injury incidence rate of 2.22 per 1000 athlete-exposures. Parents and players underestimated sport-specialization status based on the standard research definition (self versus research based: 31% versus 83%, respectively; P = .001). The frequency of arm injuries was higher in specialized players (100%) than in nonspecialized players (80%, P = .03) but did not differ between pitchers and position players (13.2% each, P = 1.00). CONCLUSIONS: Sport specialization was associated with throwing-related arm injuries in a small cohort of youth baseball players. It is concerning that 57.9% of parents and specialized players were unaware of the athletes' status. Larger studies with longer follow-up periods are needed to further evaluate injury-risk profiles in physically developing youth populations.


Assuntos
Traumatismos do Braço , Beisebol/lesões , Especialização , Esportes Juvenis/lesões , Traumatismos do Braço/epidemiologia , Traumatismos do Braço/etiologia , Atletas/estatística & dados numéricos , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Criança , Estudos de Coortes , Correlação de Dados , Feminino , Humanos , Incidência , Masculino , Estudos Prospectivos , Estados Unidos/epidemiologia
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1071-1076, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594148

RESUMO

Objective: To investigate the expression of IL-18 in peripheral blood of HBsAg positive parturients in intrauterine transmission of HBV. Methods: A case-control study was conducted in 282 HBsAg positive parturients and 43 health parturients (control group) in Northwest Women and Children Hospital of Shaanxi Province. Enzyme-linked immunosorbent assay (ELISA) was used to detect five serological makers of hepatitis B, real time PCR was used to detect HBV DNA, and flow liquid chip method was used to detect IL-18 levels in peripheral blood of parturients and newborns. Results: The incidence of dominant HBV infection (DBI), occult HBV infection (OBI) and intrauterine transmission of HBV were 8.42% (24/285), 40.00% (114/285) and 48.42% (138/285), respectively. The level of IL-18 in peripheral blood of HBsAg-negative parturients were significantly lower than those of HBsAg-positive parturients (P=0.001), non-HBV intrauterine transmission (NBIT) group (P=0.001) and OBI group (P<0.001). The level of IL-18 in HBeAg negative group was significantly lower than that in HBeAg positive group (P=0.023). When HBV DNA load was ≥10(3) copies/ml, the level of IL-18 was significantly higher than that in HBsAg-negative group (P<0.01). With the increase of HBV DNA load in maternal blood, the level of IL-18 increased (P=0.024). When HBV DNA load was 10(3)-10(6) copies/ml, the level of IL-18 in DBI group was significantly lower than that in NBIT group (P=0.022), and increased with the increase of HBV DNA load in maternal blood (P=0.016). With the increased severity of intrauterine transmission of HBV, the level of IL-18 in non-hepatitis B vaccine group decreased significantly (P=0.044). The level of IL-18 in non-hepatitis B vaccine group and immunoglobulin injection group was significantly higher than that in NBIT group (P<0.05). Multivariate analysis showed that the linear relationship between maternal HBeAg status and maternal IL-18 levels had statistical significance (P=0.01). Conclusions: IL-18 is a higher level balance regulator of Th1/Th2 immune network. Monitoring the level of IL-18 in HBsAg-positive parturients can be used not only for predicting the probability of DBI and OBI, but also as an intervention mean, especially for those who are HBeAg-positive and had HBV DNA load ≥10(3) copies/ml, to improve maternal cellular immune function, which is conducive to interrupting intrauterine transmission and providing a theoretical basis for the prevention and control of HBV intrauterine transmission.


Assuntos
Hepatite B/metabolismo , Interleucina-18/metabolismo , Complicações Infecciosas na Gravidez/metabolismo , Estudos de Casos e Controles , Criança , Correlação de Dados , DNA Viral , Feminino , Antígenos de Superfície da Hepatite B , Antígenos E da Hepatite B , Vírus da Hepatite B , Humanos , Recém-Nascido , Transmissão Vertical de Doença Infecciosa , Gravidez , Complicações Infecciosas na Gravidez/virologia
10.
Zhongguo Zhong Yao Za Zhi ; 44(15): 3157-3161, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31602867

RESUMO

In order to study the interaction between Pterocephalus hookeri and bitter taste receptors,three-dimensional structural models of bitter taste receptors TAS2 R16,TAS2 R14 and TAS2 R13 were established by homology modeling in this paper. Maestro software was used for docking the chemical constituents of P. hookeri with bitter taste receptors. The results showed that 25 chemical components of P. hookeri can regulate three bitter taste receptors. And these components were mainly iridoid glycosides and phenolic acids.This research focused on the comprehensive application of homology modeling and molecular docking technology to explore the interaction between bitter chemical constituents of P. hookeri and bitter taste receptors. This study provided assistance in revealing pharmacodynamic basis of bitter Tibetan medicine at molecular level. It also provided new ideas and methods for the study of Tibetan medicine.


Assuntos
Caprifoliaceae/química , Medicina Tradicional Tibetana , Simulação de Acoplamento Molecular , Receptores Acoplados a Proteínas-G/metabolismo , Correlação de Dados , Humanos , Paladar
11.
Medicine (Baltimore) ; 98(39): e17297, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574853

RESUMO

As a modifiable risk factor for cardiovascular disease, presence of hypertension (HT) necessitates the awareness of asymptomatic organ damage (AOD). The aim of this study was to measure plasma micro RNA-21 (miR-21) and the parameters that reflect AOD such as carotid intima-media thickness (CIMT), microalbuminuria (MAU) in hypertensive patients compared with healthy controls. In addition, the aim of this study was to evaluate plasma miR-21 levels in HT patients with AOD.This study was designed as a cross-sectional observational study. The study includes 2 groups: 32 patients with HT and 32 healthy controls. First, we compared these 2 groups. Then, to underline the relationship between plasma miR-21 and HT, hypertensive patients were divided into 2 groups: with AOD and without AOD.Sixteen patients with HT had AOD. MiR-21 levels significantly correlated with clinical systolic and diastolic blood pressure, MAU, C-reactive protein, and CIMT. CIMT, miR-21, and MAU levels were significantly higher in patients with AOD.Our study showed increased miR-21 levels in HT patients with AOD.


Assuntos
Albuminúria , Doenças Cardiovasculares , Hipertensão , MicroRNAs/sangue , Adulto , Albuminúria/diagnóstico , Albuminúria/etiologia , Doenças Assintomáticas/epidemiologia , Pressão Sanguínea/fisiologia , Proteína C-Reativa/análise , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Espessura Intima-Media Carotídea , MicroRNA Circulante/análise , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/genética , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Turquia/epidemiologia
12.
Medicine (Baltimore) ; 98(39): e17311, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574860

RESUMO

Immune infiltration of nasopharyngeal carcinoma (NPC) is closely associated with the patients' prognosis. However, previous studies have not interpreted the difference of infiltrating immune cells in NPC.We comprehensively analyzed the tumor-infiltrating immune cells present in NPC for the first time, which was based on a scientific deconvolution algorithm (CIBERSORT) and the gene expression data of GSE64634. The fractions of 22 immune cells were assessed to reveal the associations between normal samples and NPC samples.Profiles of immune infiltration vary significantly between normal samples and NPC samples, and the variation could characterize the individual differences. NPC samples contained a higher proportion for M1 macrophages, whereas memory B cells and CD4 memory resting T cells were relatively lower.Our data suggest that the differences in the infiltrating immune cells in NPC and these differences would probably facilitate patient consultation and individualized treatment.


Assuntos
Linfócitos do Interstício Tumoral , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas , Adulto , Algoritmos , Linfócitos B/imunologia , Linfócitos B/patologia , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/patologia , China , Correlação de Dados , Feminino , Expressão Gênica , Humanos , Memória Imunológica , Linfócitos do Interstício Tumoral/classificação , Linfócitos do Interstício Tumoral/imunologia , Linfócitos do Interstício Tumoral/patologia , Macrófagos/imunologia , Macrófagos/patologia , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/diagnóstico , Carcinoma Nasofaríngeo/imunologia , Carcinoma Nasofaríngeo/patologia , Neoplasias Nasofaríngeas/diagnóstico , Neoplasias Nasofaríngeas/imunologia , Neoplasias Nasofaríngeas/patologia , Prognóstico , Reprodutibilidade dos Testes
13.
Rev Lat Am Enfermagem ; 27: e3196, 2019 Oct 14.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31618389

RESUMO

OBJECTIVE: to identify the reasons for refusal of corneas. METHOD: this was a cross-sectional, retrospective, descriptive and correlational study composed of 5,560 optical corneas. The information was taken from the notification, organ procurement and distribution centers database as well as donor records. Descriptive statistics were used for the analysis of categorical variables and specific tests with a significance level of 5% for assessing the associations between variables. This study met the ethical aspects of scientific research. RESULTS: 60% of the donors were male and 40% died by circulatory problems. The main reason for refusal as informed by transplant teams is the donor's age and the endothelial cell count. For each year added to the donor's age, there is a 1% decrease in the chance that this cornea will be used for transplantation, and the increase of 100 cells per mm2 increases the chances that this cornea will be used by 9%. CONCLUSION: the main cause of refusal in the acceptance of corneal tissue is related to the age and the endothelial cell count.


Assuntos
Córnea/anatomia & histologia , Transplante de Córnea/normas , Transplante de Tecidos/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Masculino , Eliminação de Resíduos de Serviços de Saúde , Pessoa de Meia-Idade , Preservação de Órgãos/normas , Controle de Qualidade , Estudos Retrospectivos , Fatores de Tempo , Doadores de Tecidos/estatística & dados numéricos , Coleta de Tecidos e Órgãos/normas , Adulto Jovem
14.
Rev Lat Am Enfermagem ; 27: e3197, 2019 Oct 14.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31618390

RESUMO

OBJECTIVE: to analyze the in-hospital complications of prolonged hospital stay in patients with ischemic stroke or transient ischemic attack, admitted to the stroke unit of a tertiary hospital. METHOD: this is an evaluative correlational study. All first-ever ischemic stroke or transient ischemic attack patients admitted were retrospectively analyzed. During hospital stay, the predictors of long-term hospitalization considered were: 1) clinical complications (pneumonia, urinary tract infection, pressure damage and deep vein thrombosis), and 2) neurological complications (malignant ischemic stroke and symptomatic hemorrhagic transformation). RESULTS: 353 patients were discharged in the study period. Mean age was 64.1±13.7 years old and 186 (52.6%) were men. The mean time of hospital stay was 13.7±14.3 days. Pneumonia (25.3±28.8 days, p<0.001), urinary tract infection (32.9±45.2 days, p<0.001) and malignant stroke (29.1±21.4 days, p<0.001) increased significantly the length of hospital stay compared to patients without any complications (11.2±7.1 days). CONCLUSION: this study showed that three complications delayed hospital discharge in patients admitted in a stroke unit, two preventable ones: pneumonia and urinary tract infection. More intense measures to avoid them should be included in the performance indicators to reduce the length of hospital stay in stroke units.


Assuntos
Hospitalização/estatística & dados numéricos , Ataque Isquêmico Transitório/prevenção & controle , Tempo de Internação/estatística & dados numéricos , Acidente Vascular Cerebral/prevenção & controle , Fatores Etários , Idoso , Correlação de Dados , Complicações do Diabetes/complicações , Feminino , Humanos , Hipertensão/complicações , Ataque Isquêmico Transitório/complicações , Masculino , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Pneumonia/complicações , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Infecções Urinárias/complicações
15.
Dent Mater ; 35(11): 1654-1664, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31554599

RESUMO

OBJECTIVE: Resin-based composites are widely used in dental restorations; however, their volumetric shrinkage during polymerization leads to several issues that reduce the restoration survival rates. For overcoming this problem, a deep study of shrinkage phenomena is necessary. METHODS: In this study, micro-tomography (µ-CT) is combined with digital volume correlation (DVC) to investigate the effect of several factors on the polymerization strain of dental composites in model cavities: the presence/absence of an adhesive, the use of transparent/blackened cavities, and irradiation times between 1 and 40s. RESULTS: The results indicate that the presence of an adhesive at the interface between the cavity and composite does not reduce the total strain but instead limits it to a preferential direction. In addition, regardless of the conditions, the main strain is generated along the axis parallel to the polymerization irradiation (the vertical axis). Finally, the total strain appears to occur in the first 5s of irradiation, with no further evolution observed for longer irradiation times. SIGNIFICANCE: This work provides new insight into resin-based composite shrinkage and demonstrates the benefit of coupling DVC and µ-CT to better understand the degradation mechanisms of these materials.


Assuntos
Resinas Compostas , Restauração Dentária Permanente , Correlação de Dados , Teste de Materiais , Polimerização
16.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(9): 1095-1101, 2019 Sep 15.
Artigo em Chinês | MEDLINE | ID: mdl-31512449

RESUMO

Objective: To evaluate the correlation between the Mohawk (MKX) expression level and the collagen fiber diameter of autologous hamstring tendon graft during the stable graft remodeling phase after anterior cruciate ligament (ACL) reconstruction. Methods: Between January 2018 and August 2018, patients who underwent arth-roscopic single-bundle anatomical ACL reconstruction with autologous hamstring tendons for at least 48 months and also underwent second-look arthroscopy were enrolled in study. During the second-look arthroscopic procedures, ACL graft biopsies were performed from the surface of central part of the ligament. MKX expressions of ACL grafts were analysed by real-time fluorescent quantitative PCR (qRT-PCR). The ultrastructure of collagen fibers of grafts were evaluated by transmission electron microscopy, which included average diameter of collagen fibers (D c), average diameter of large-diameter collagen fibers (D L), average diameter of small-diameter collagen fibers (D S), and large-small collagen fibers ratio (R L/S). The correlation between MKX expression level and graft collagen fiber diameter was calculated. Results: Twenty-six patients met the selection criteria and their ACL graft specimens were enrolled in the study. The interval between ACL reconstruction and second-look arthroscopy was 52-128 months, with an average of 78.6 months. Arthroscopic graft remodeling score was 3-6 (mean, 4.8). There were 17 cases of excellent remodeling and 9 cases of fair remodeling. All ACL grafts showed typical bimodal distributions of both large-diameter collagen fibers and small-diameter collagen fibers, but the ultrastructural characteristics of the graft collagen fibers were different according to different remodeling status under arthroscopy. The D C, D L, D S, and R L/S of the graft specimens were (65.2±9.3) nm, (91.6±10.5) nm, (45.7±8.6) nm, and 0.73±0.12, respectively. The relative expression level of MKX was 1.42±0.11, which was positively linearly correlated with D C, D L, and R L/S, and the correlation coefficient was statistically significant ( r=0.809, P=0.000; r=0.861, P=0.000; r=0.942, P=0.000), while there was no significant correlation between D S and relative expression level of MKX ( r=0.147, P=0.238). Regression analysis showed that the relative expression level of MKX could predict the D C, D L, and R L/S results of the ACL graft specimens ( P<0.05). Conclusion: After autologous hamstring tendon grafts stepped into stabilized remodeling phase, MKX expression level could predict the diameter measurement results of collagen fibers and be used as an important evaluation basis for graft collagen anabolic metabolism.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Colágeno , Regulação da Expressão Gênica no Desenvolvimento , Tendões dos Músculos Isquiotibiais , Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/patologia , Lesões do Ligamento Cruzado Anterior/cirurgia , Artroscopia , Colágeno/metabolismo , Colágeno/ultraestrutura , Correlação de Dados , Tendões dos Músculos Isquiotibiais/citologia , Tendões dos Músculos Isquiotibiais/metabolismo , Tendões dos Músculos Isquiotibiais/cirurgia , Proteínas de Homeodomínio/genética , Humanos , Transplante Autólogo
18.
Urology ; 134: 72-78, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31487513

RESUMO

OBJECTIVE: To assess the symptoms associated with long-term Double-J ureteral stenting including the influence of biofilms on ureteral stents. METHODS: Patients with long-term (>8 weeks) uni- or bilateral ureteral stents completed the Ureteral Stent Symptoms Questionnaire (USSQ) at the day of stent exchange. Repeated assessment of patients was possible to allow for analysis of intraindividual changes. Assessment of biofilm mass on the stents was performed according to a validated method, its correlation with the USSQ total score was defined as primary outcome. Secondary outcomes included further analyses of stent-associated symptoms and their temporal course. RESULTS: A total of 87 stent indwelling periods in 35 patients were investigated. Median USSQ total score did not differ significantly between unilateral and bilateral stenting (42 vs 39 points; P = .17). An increasing total stent treatment time up to study inclusion did not correlate with the USSQ total score, but was significantly correlated with less urinary symptoms and a better quality of life. USSQ total score and subscores within individual patients did not significantly increase or decrease over the sequence of stent indwelling periods. Higher total biofilm masses were not associated with higher USSQ total scores or subscores. CONCLUSION: Long-term Double-J stenting provides a valuable treatment option, if stent-associated symptoms are low during the initial indwelling period. Thus, symptoms remain stable over the long-term course and the majority of patients are satisfied with the treatment. Furthermore, biofilm formation on ureteral stents does not seem to be the relevant driver of symptoms.


Assuntos
Bactérias , Biofilmes , Efeitos Adversos de Longa Duração , Implantação de Prótese , Infecções Relacionadas à Prótese , Qualidade de Vida , Stents , Obstrução Ureteral/cirurgia , Idoso , Bactérias/classificação , Bactérias/isolamento & purificação , Correlação de Dados , Remoção de Dispositivo/métodos , Remoção de Dispositivo/estatística & dados numéricos , Feminino , Humanos , Efeitos Adversos de Longa Duração/diagnóstico , Efeitos Adversos de Longa Duração/microbiologia , Efeitos Adversos de Longa Duração/psicologia , Masculino , Desenho de Prótese , Implantação de Prótese/efeitos adversos , Implantação de Prótese/instrumentação , Implantação de Prótese/métodos , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/etiologia , Infecções Relacionadas à Prótese/psicologia , Stents/efeitos adversos , Stents/microbiologia , Inquéritos e Questionários , Suíça , Avaliação de Sintomas/métodos
19.
Eur Arch Otorhinolaryngol ; 276(11): 3165-3171, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31473780

RESUMO

OBJECTIVE: To investigate the presence of sulcus vocalis in patients who underwent phonomicrosurgery due to benign vocal cord lesions. METHODS: Between January 2013 and June 2018, the records of 133 patients who underwent operations for benign vocal fold pathology were retrospectively reviewed. Intraoperative findings of the patients were noted. Patients were divided into two groups: patients with only benign vocal fold lesions (BVFL) and patients with benign vocal fold lesions and accompanying sulcus vocalis (SV + BVFL). RESULTS: In total, 67 patients (50.4%; 38 females, 29 males) had BVFL and 66 (49.6%; 37 females, 29 males) had SV + BVFL. The patients in the SV + BVFL group were significantly younger than those in the BVFL group (p = 0.039). The sulcus was unilateral in 60.6% of the patients. The presence of sulcus vocalis was 49% and 47.6% in patients with a diagnosis of polyps (n = 51) and cysts (n = 42), respectively. A total of 12 of 13 patients with multiple benign vocal fold lesions had accompanying sulcus vocalis. CONCLUSION: Approximately half of the patients who underwent operations for benign vocal fold lesions had accompanying sulcus vocalis. More than half of the sulcus associated with benign lesions was unilateral.


Assuntos
Cistos , Pólipos , Prega Vocal , Adulto , Correlação de Dados , Cistos/patologia , Cistos/cirurgia , Feminino , Humanos , Doenças da Laringe/patologia , Doenças da Laringe/cirurgia , Músculos Laríngeos/patologia , Masculino , Pessoa de Meia-Idade , Pólipos/patologia , Pólipos/cirurgia , Estudos Retrospectivos , Prega Vocal/patologia , Prega Vocal/cirurgia
20.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(7): 554-560, sept. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-ET2-3296

RESUMO

Introducción y objetivos: La hidradenitis supurativa (HS) es una enfermedad inflamatoria crónica de la piel que influencia negativamente la calidad de vida. En la actualidad no existen escalas en español que la evalúen. El objetivo del presente estudio fue desarrollar y validar un cuestionario específico para evaluar la calidad de vida en pacientes con HS. Material y métodos: Se desarrolló un estudio multicéntrico en España entre 2016 y 2017 para elaborar un cuestionario. Para ello se consideró tanto el marco conceptual como el conocimiento de la situación del paciente mediante la revisión de la bibliografía, reuniones de profesionales de diferentes áreas y entrevistas con pacientes. El cuestionario resultante se pasó a un grupo de 30 pacientes con 30 ± 10 días de intervalo entre uno y otro. Resultados: El análisis de fiabilidad muestra una buena consistencia interna y reproductibilidad con puntuación alfa de Cronbach de 0,920 (test) y 0,917 (retest) y coeficiente de correlación intraclase con DLQI y Skindex-29 de 0,698 IC 95% (0,456-0,844) y 0,900 IC 95% (0,801-0,951) respectivamente. Se establecieron puntos de corte para su uso y se comprobó que el instrumento es sensible al cambio. Conclusiones: El cuestionario HSQoL-24 es la primera prueba autoadministrada específica para evaluar la calidad de vida en HS en español. Sencillo de usar y puntuar por los profesionales. Este estudio demuestra que el instrumento es fiable, válido y sensible al cambio, pendiente de realizar estudio confirmatorio con una muestra mayor con 100 pacientes con HS


Introduction and objectives: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin with a negative impact on quality of life. Up to now, there are no disease specific instruments in Spanish to assess quality of life in HS. The objective of this study was to develop and validate a questionnaire to evaluate the quality of life in patients with HS. Material and methods: A multicentre study was carried out in Spain between 2016 and 2017 to develop the questionnaire. Both the conceptual framework and understanding of the patient's situation were considered through a review of the literature, consensus of professionals from different related health areas, and in-depth interviews with patients. The resulting questionnaire was passed to a group of 30 patients with 30±10 days of interval between both assessments. Results: The reliability analysis shows a good internal consistency and reproducibility with Cronbach's alpha score of 0.920 (test) and 0.917 (retest) and intraclass correlation coefficient with DLQI and Skindex-29 of 0.698 IC 95% (0.456-0.844) and 0.900 IC 95% (0.801-0.951) respectively. Cut-off points were established for its use and the instrument was found to be sensitive to change. Conclusions: The HSQoL-24 is the first disease-specific self-administered instrument to assess quality of life in patients with HS in Spanish. It is user friendly, and easy to score. This study shows that the instrument is reliable, valid and sensitive to change, pending confirmatory study with a larger sample of 100 patients with HS


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Hidradenite Supurativa/diagnóstico , Qualidade de Vida , Estudos de Validação como Assunto , Psicometria/instrumentação , Reprodutibilidade dos Testes , Inquéritos e Questionários , Correlação de Dados
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