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1.
Acta Psychiatr Scand ; 2024 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-38825333

RESUMEN

BACKGROUND: It is unclear whether treatment early after onset in bipolar disorder may improve the long-term illness course. The early intervention in affective disorders (EIA) randomised controlled trial found that 2-years treatment in a specialised mood disorder clinic combining evidence-based pharmacological treatment with group psychoeducation improved clinical outcomes compared with standard treatment in patients with bipolar disorder discharged after their 1st, 2nd, or 3rd hospital admission. We aimed to assess the 16 years long-term outcomes after randomisation of the participants in the EIA trial. METHODS: Data were obtained by linking nation-wide Danish population-based registers. All 158 participants of the EIA trial (Trial Registration Number NCT00253071) were followed from time of randomisation (2005-2009) to end of study (31 December 2021). The primary outcome was risk of psychiatric readmission. Secondary outcomes were total admissions and costs, medication use, intentional self-harm or suicide attempt or suicide, and socio-economic measures. RESULTS: The absolute mean risk of psychiatric readmission was 49.3% in the intervention group and 59.8% in the control group, with no statistically significant difference between the groups (b = -0.10, 95% CI: -0.26 to 0.047, p = 0.18). Compared with the control group, patients in the intervention group had numerically fewer total admission days (mean (SD) 44 (77) versus 62 (109)), lower total cost of psychiatric hospital admissions and hospital-based outpatient visits (mean (SD) 22,001 (36793) euros versus 29,822 (52671) euros) and higher use of lithium and antipsychotics, but the differences were not statistically significant. Fewer patients in the intervention group had an event of intentional self-harm or suicide attempt or suicide during follow-up (OR 0.25, 95% CI: 0.15-0.40, p < 0.001) compared with the control group and more patients in the intervention group used antiepileptics (OR 2.21, 95% CI: 1.08-4.60, p = 0.031). CONCLUSION: Analyses of very long-term outcomes of the EIA trial may potentially indicate a beneficial effect of the intervention at the long term but were likely underpowered to detect a more subtle effect and for most outcomes the differences between groups were not statistically significant.

2.
Heliyon ; 10(11): e31263, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38845910

RESUMEN

Effective implementation of the Environmental Impact Assessment (EIA) is recognised as a global issue, in particular the impact prediction stage, which is the 'core' of EIA. Consisting of four stages: impact identification, impact assessment, significance evaluation, and mitigation measures on the possible environmental repercussions of project developmental activities, the efficacy of impact prediction can define the quality of the EIA process, which will better align environmental decision-making to sustainable development. The weakness of impact prediction in EIA demands more study to enhance practice. Although this is widely explored in the context of developed countries such as the UK, it is particularly concerning in India. A specialised review package built from several sources is utilised to assess the efficacy of air quality impact prediction, based on Lee & Colley (1991). 20 EIA reports of Category A (mega-scale projects causing significant environmental impacts) are reviewed. This study's evaluation indicates that significance evaluation and mitigation actions are the weakest phases and a major concern while assessing air quality studies conducted as a part of EIA. Recommendations to improve the process include prioritising the cumulative impact assessment within the regulatory framework, enhancing capacity building, embedding public participation and instilling accountability among stakeholders, which can be adopted globally. Additional recommendations specifically for India are revising the National Ambient Air Quality Standards (NAAQS), restructuring the EIA review mechanism by EAC and improving mitigation measures by adopting GIS and remote sensing technologies.

3.
Heliyon ; 10(11): e31647, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38845953

RESUMEN

Rapid urbanization and development projects in Korea have posed significant threats to biodiversity; thus, effective mitigation measures are required to preserve natural habitats. Nevertheless, the factors underlying variations in mitigation measure effectiveness according to the disturbance level and surrounding environmental conditions have not been clarified. This study evaluated the effectiveness of mitigation measures implemented in environmental impact assessments (EIAs) of development projects in Korea, with a focus on their effectiveness with respect to the disturbance level and surrounding environmental conditions. A review of 288 EIA reports from selected projects that implemented all 10 mitigation measures classified according to the Wildlife Conservation Comprehensive Plan was conducted. Using the biodiversity tipping point framework, the effects of mitigation measures on biodiversity were categorized into four levels and analyzed. Analysis of variance and redundancy analysis were then performed to discern the variance in mitigation measure effectiveness in terms of the disturbance level, surrounding environment, and species. The results revealed significant variations in the effectiveness of mitigation measures depending on the surrounding environment and disturbance level. Linear projects exhibited a clear impact on various species as the disturbance level increased, whereas area-based projects did not exhibit such pronounced effects. All species demonstrated a negative relationship with development duration, development area, and distance from urban centers. Notably, avian and amphibian species showed a strong negative correlation with the digital elevation model while reptiles and mammals exhibited a strong positive relationship with pre-development biodiversity and distance from protected areas, respectively. Mitigation measures play a key role in alleviating the adverse effects of development projects; therefore, our findings indicate the need for spatially tailored mitigation plans to augment their effectiveness.

4.
J Am Vet Med Assoc ; : 1-6, 2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38848745

RESUMEN

OBJECTIVE: To determine the sensitivity and specificity of a commercial whole blood real-time PCR assay (RT-PCR) for the diagnosis of histoplasmosis when compared to direct organism identification and/or urine antigen quantification by enzyme immunoassay (UA-EIA). A secondary objective was to compare the sensitivity and specificity of RT-PCR to anti-Histoplasma immunoglobulin G antibody detection by enzyme immunoassay (IgG-EIA) and IgG-EIA to UA-EIA. ANIMALS: Cats presented to the Kansas State University Veterinary Health Center from February through September of 2023 in which histoplasmosis was diagnosed or suspected. METHODS: From February through September of 2023, cats were tested by RT-PCR, IgG-EIA, and UA-EIA if histoplasmosis was diagnosed cytologically or was a differential diagnosis for the presenting clinical signs. Cats were excluded if all 3 tests were not submitted or if the diagnosis of histoplasmosis could not be excluded despite a negative UA-EIA result. Cats with cytologically or histologically confirmed histoplasmosis were designated as proven histoplasmosis cases, and cats with a positive UA-EIA result without cytological or histological confirmation were designated as probable histoplasmosis cases. RESULTS: 10 cats were diagnosed with either proven (n = 6) or probable (4) histoplasmosis, and 10 cats were considered true negatives. Whole blood RT-PCR results were negative in all 20 cats (sensitivity, 0%; 95% CI, 0% to 30.85%). The IgG-EIA was 90% sensitive (95% CI, 55.50% to 99.75%) and 70% specific (95% CI, 34.75% to 93.33%). The UA-EIA results were positive in all cats with proven histoplasmosis. CLINICAL RELEVANCE: This commercial RT-PCR is insensitive when used on whole blood collected in EDTA and should not be used to diagnose feline histoplasmosis. Further studies are required to determine whether alternate RT-PCR protocols for EDTA-collected whole blood could be useful for diagnosing histoplasmosis in cats.

5.
J Feline Med Surg ; 26(6): 1098612X241248984, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38857445

RESUMEN

OBJECTIVES: The aim of the present study was to evaluate minimally invasive diagnostic techniques, such as the semi-quantitative indirect IgG antibody enzyme immunoassay (EIA) using blood serum and the urinary lateral flow assay (LFA), for the detection of Histoplasma capsulatum in cats with histoplasmosis. METHODS: Eight client-owned domestic cats diagnosed with histoplasmosis were selected based on cytological, histopathological, mycological, molecular or antigenic techniques. The blood serum of these animals was tested in a semi-quantitative indirect IgG antibody EIA for the detection of H capsulatum. Urine samples were tested for H capsulatum antigen using LFA. RESULTS: Five cats were seropositive on IgG EIA (5/8, with diagnostic sensitivity equal to 62.5%; 95% confidence interval [CI] 24.5-91.5) and five cats were positive on H capsulatum antigen LFA (5/7, with diagnostic sensitivity equal to 71.4%; 95% CI 29.0-96.3). The combined diagnostic sensitivity when interpreted in parallel was 87.5% (7/8, 95% CI 47.3-99.7). The specificity for the anti-Histoplasma IgG EIA was 100% (95% CI 71.5-100) and for the H capsulatum antigen LFA it was also 100% (95% CI 71.5-100). CONCLUSIONS AND RELEVANCE: The semi-quantitative indirect IgG antibody EIA for the detection of H capsulatum in blood serum and the urinary LFA for the detection of the same agent emerge as new minimally invasive diagnostic techniques that can assist in the approach to disseminated and pulmonary feline histoplasmosis, especially when both techniques are considered together.


Asunto(s)
Enfermedades de los Gatos , Histoplasma , Histoplasmosis , Sensibilidad y Especificidad , Gatos , Animales , Histoplasmosis/veterinaria , Histoplasmosis/diagnóstico , Enfermedades de los Gatos/diagnóstico , Enfermedades de los Gatos/microbiología , Histoplasma/aislamiento & purificación , Histoplasma/inmunología , Masculino , Femenino , Anticuerpos Antifúngicos/sangre , Técnicas para Inmunoenzimas/veterinaria , Inmunoglobulina G/sangre
6.
Appl Opt ; 63(12): 3317-3325, 2024 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-38856483

RESUMEN

The traditional digital three-dimensional (3D) display suffers from low resolution and a narrow depth of field (DoF) due to the lack of planar pixels transformed into view perspectives and the limitation of the diffraction effect of the lens, respectively, which are the main drawbacks to restrict the commercial application of this display technology. Here, the neural network-enabled multilayer view perspective fitting between the reconstructed and original view perspectives across the desired viewing depth range is proposed to render the optimal elemental image array (EIA) for enhancing the viewing resolution as well as the DoF of the digital 3D display. Actually, it is an end-to-end result-oriented coding method to render the fusion EIA with optimal multidepth fusion and resolution enhancement with high registration accuracies for both view perspective and depth reconstructions by using a depth-distributed fitting neural network paradigm. The 3D images presented in the simulations and optical experiments with improved viewing resolution and extended viewing depth range are demonstrated, verifying the feasibility of the proposed method.

7.
Sci Rep ; 14(1): 13247, 2024 06 10.
Artículo en Inglés | MEDLINE | ID: mdl-38853155

RESUMEN

The primary objective of this study was to compare short-term outcomes between Intracorporeal ileocolic anastomosis (IIA) and extracorporeal ileocolic anastomosis (EIA) after laparoscopic right hemicolectomy in patients with visceral obesity. The secondary objective was to identify risk factors associated with prolonged postoperative ileus (PPOI) after laparoscopic right hemicolectomy. This single-center retrospective study analyzed visceral obesity patients who underwent laparoscopic right hemicolectomy for primary bowel cancer between January 2020 and June 2023. Patients were categorized into IIA and EIA groups based on the type of anastomosis, and a 1:1 propensity score-matched analysis was performed. A total of 129 patients were initially included in this study, with 45 patients in each group following propensity score matching. The IIA group had significantly longer anastomosis times (p < 0.001), shorter incision length (p < 0.001), and shorter length of stay (p = 0.003) than the EIA group. Meanwhile, the IIA group showed a shorter time to first flatus (p = 0.044) and quicker tolerance of a solid diet (p = 0.030). On multivariate analysis, postoperative use of opioid analgesics is an independent risk factor for PPOI (OR: 3.590 95% CI 1.033-12.477, p = 0.044), while IIA is an independent protective factor (OR: 0.195 95% CI 0.045-0.843, p = 0.029). IIA remains a safe and feasible option for visceral obesity patients. It is also associated with a quicker recovery of bowel function and shorter length of stay when compared to EIA. Additionally, IIA is an independent protective factor for PPOI.


Asunto(s)
Anastomosis Quirúrgica , Colectomía , Laparoscopía , Obesidad Abdominal , Complicaciones Posoperatorias , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anastomosis Quirúrgica/métodos , Anastomosis Quirúrgica/efectos adversos , Obesidad Abdominal/cirugía , Estudios Retrospectivos , Laparoscopía/métodos , Laparoscopía/efectos adversos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/epidemiología , Resultado del Tratamiento , Anciano , Colectomía/efectos adversos , Colectomía/métodos , Íleon/cirugía , Colon/cirugía , Factores de Riesgo , Tiempo de Internación , Ileus/etiología
8.
Conserv Physiol ; 12(1): coae035, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38840751

RESUMEN

Animals face several challenges in their natural environment, and to cope with such conditions, they may exhibit contrasting physiological responses that directly affect their overall well-being and survival. In this study, we assessed physiological responses via faecal glucocorticoid metabolite (fGCM) measurements in free-ranging mugger crocodiles inhabiting diverse habitats in Gujarat, India. We sampled muggers within Charotar, a rural area (Zone A) with local people having high tolerance towards the presence of muggers, and Vadodara, a region having both urban (Zone B) and rural (Zone C) areas with high levels of human-mugger conflict (HMC). Further, muggers in Vadodara live in water bodies that are mostly polluted due to sewage disposal from adjoining chemical industries. To measure fGCM (mean ± SEM, ng/g dry faeces) levels in muggers, scats were collected during both breeding (N = 107 scats) and non-breeding (N = 22 scats) seasons from all three zones. We used captive muggers (a focal enclosure) to biologically validate (via capture and restraint) the selected fGCM assay (11-oxoetiocholanolone assay). We showed a significant (P < 0.05) 11-fold increase in fGCM levels between pre-capture (540.9 ± 149.2, N = 11) and post-capture (6259.7 ± 1150.5, N = 11) samples. The validated assay was applied to free-ranging muggers during the breeding season, and Zone A showed significantly (P < 0.05) lower fGCM levels (542.03 ± 71.3) compared to muggers of Zone B (1699.9 ± 180.8) and Zone C (1806.4 ± 243.2), both zones having high levels of HMC with polluted water bodies. A similar contrast in fGCM levels was also observed during the non-breeding season. Overall, the study demonstrated that fGCM levels in muggers varied across habitats, and such variation could be due to a multitude of ecological factors that the species experience in their immediate local environment. Moreover, high fGCM levels in muggers of Vadodara during both breeding and non-breeding seasons may indicate a condition of chronic stress, which could be maladaptive for the species.

9.
J Infect Dev Ctries ; 18(5): 672-678, 2024 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-38865391

RESUMEN

INTRODUCTION: The severity and clinical outcome of COVID-19 depend on virus-specific factors and the host's inflammatory response. Identifying biomarkers of severe COVID-19 is a crucial condition and predicts disease severity. METHODOLOGY: This study enrolled a total of 167 patients with COVID-19. These patients were categorized into three groups based on the severity of the disease: moderate course - 78 individuals, severe course - 52 individuals, and extremely severe course - 37 individuals. We analyzed chemokines (IP-10, CXCL9, CCL17) and cytokine IL28B levels using the enzyme immunoassay (EIA) method. RESULTS: CXCL9 levels were increased in severe and extremely severe cases compared to moderate ones. The CCL17 chemokine demonstrated significant elevation in severe cases. However, there was no significant difference in the level of IP-10, and IL28B in the compared groups. CONCLUSIONS: Our findings suggest that CXCL9 and CCL17 chemokines could be used as biomarkers to assess the clinical status of patients with COVID-19 and can relate to disease severity. These biomarkers could aid in identifying patients at high risk for severe disease and help guide clinical decision-making for the effective management of COVID-19.


Asunto(s)
Biomarcadores , COVID-19 , Quimiocina CXCL9 , Índice de Severidad de la Enfermedad , Humanos , Quimiocina CXCL9/sangre , Biomarcadores/sangre , COVID-19/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Adulto , Anciano , SARS-CoV-2 , Quimiocina CCL17/sangre
10.
J Endovasc Ther ; : 15266028241256507, 2024 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-38813976

RESUMEN

INTRODUCTION: The distal landing zone in iliac arteries represents an important issue during endovascular repair of abdominal aortic aneurysms (EVAR). The aim of this study is to present a case series for landing in the external iliac artery (EIA) during EVAR while preserving blood flow in the internal iliac artery (IIA) with the covered endovascular reconstruction of the iliac bifurcation (CERIB) technique. METHODS: This is a single-center, retrospective analysis of prospectively collected data of patients that underwent EVAR either for intact abdominal aortic aneurysm (AAA) or previous failed EVAR from December 2022 up to September 2023. Indications for treatment were presence of common iliac artery aneurysm (CIAA), short CIA, or endoleak type Ib (ETIb). For the distal sealing zone, we used balloon-expandable covered stent (BXCS). Primary outcomes were technical success and first-month patency rate. Secondary outcomes were endoleak and re-intervention rate. RESULTS: Sixteen patients being treated with 20 CERIBs were included in the study. Four patients had a previous failed EVAR, while 3 patients were treated urgently for a symptomatic para-renal aneurysm. The indications for treatment were EIb (n=2), short CIA (n=4), CIAA with narrow lumen (n=3), and CIA aneurysm (n=11). Platforms that were used were the Cook Zenith Alpha (n=5), Gore C3 (n=2 and 3 limbs), Endurant IIs (n=2, and 3 limbs), and a t-branch device (n=3). Technical success rate was 100% with no adjunctive procedure. No death or re-intervention was recorded for all patients at postoperative 30-day period and at 6 months for 2 patients. At first-month CTA, patency rate was 100% (20/20), while in 2 patients that had 6-month CTA, the patency was also 100% (2/2). No kinking or stenosis was also noted. Two patients had ETIII after branched EVAR (BEVAR), 2 patients had ETII, and 1 patient had gutter ET in the area of the CERIB. CONCLUSION: The CERIB technique seems to be effective and safe in the early period. It is suitable with a variety of commercial endograft platforms. It may be a valuable alternative to iliac branch devices when there are anatomical considerations. Longer follow-up is needed to conclude for long-term patency and durability. CLINICAL IMPACT: The distal landing zone in iliac arteries represents an important issue during EVAR while it is important to preserve blood flow in the internal iliac artery. The covered endovascular reconstruction of the iliac bifurcation (CERIB) technique is a technique for the preservation of internal iliac arteries during EVAR, while it is suitable with a variety of commercial endograft platforms. The CERIB technique seems to be effective and safe in the early period. It may be valuable alternative to iliac branch devices when there are anatomical considerations.

11.
Rheumatol Adv Pract ; 8(2): rkae053, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38765191

RESUMEN

Objectives: To evaluate trust-level performance in time to initiation of DMARD therapy in patients with early inflammatory arthritis (EIA), with identification of the change in performance trajectories over time and investigation of trust characteristics associated with this change. Methods: We included 130 trusts from the UK contributing to the National Early Inflammatory Arthritis Audit (NEIAA) from 2018 to 2020. The primary outcome was days from referral to initiation of DMARD therapy in patients with EIA. Latent class growth mixture models were applied to identify distinct groups of trusts with similar trajectories of performance change over time. We used mixed effects linear and multinomial logistic regression models to evaluate the association between delay in treatment and trust-level characteristics. Results: The mean time to DMARD initiation was 53 days (s.d. 18), with an average 0.3-day decrease with each month over time. Four latent trajectories were identified in our cohort, with >77% of individual trusts showing ongoing improvements in decreasing treatment waiting times. Prior to separating by latent class, time to DMARD initiation was shorter in trusts with higher rheumatology staffing, a local EIA treatment pathway and those with access to musculoskeletal ultrasound. Trusts with more nurses in the rheumatology department were less likely to be in the worst performance group [odds ratio 0.69 (95% CI 0.49, 0.93)]. Conclusion: In this cohort study, we observed a reduction in treatment waiting time over time. Trusts with better staffed and improved EIA clinical structure are likely to initiate definitive treatment earlier in patients with EIA.

12.
Pediatr Blood Cancer ; : e31059, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38721864

RESUMEN

Levofloxacin prophylaxis during periods of neutropenia in pediatric hematopoietic stem cell transplant (HSCT) may reduce the number of febrile episodes and use of empiric intravenous antibiotics (EIA); however, the literature is conflicting. This retrospective review compared EIA use before and after implementation of levofloxacin prophylaxis at a children's hospital. Levofloxacin prophylaxis was associated with reduced use of certain EIA; however, did not reduce the number of positive blood cultures or clinical deteriorations. Therefore, levofloxacin prophylaxis may have implications for the stewardship of broad-spectrum intravenous antibiotics used in pediatric HSCT.

13.
Support Care Cancer ; 32(6): 369, 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38773008

RESUMEN

PURPOSE: This study aimed to validate the Chemotherapy-Induced Alopecia Distress Scale (CADS) in a diverse English-speaking population and patients with endocrine treatment-induced alopecia (EIA). OBJECTIVE: Chemotherapy and endocrine therapy commonly cause alopecia in breast cancer patients, leading to significant psychological and social challenges. The CADS was developed to assess the psychosocial impact of alopecia, but its generalizability beyond Korean patients requires further investigation. METHODS: Data from the CHANCE study (NCT02530177), which focused on non-metastatic breast cancer, was used. The cohort included 256 patients, and CADS data were collected at baseline, 6 months after chemotherapy completion, or 12 months after initiating endocrine therapy. The CADS questionnaire comprised 17 items covering physical and emotional health, daily activities, and relationships. Reliability was assessed using Cronbach's alpha, and responsiveness was measured by effect size. RESULTS: The CADS exhibited good reliability, with Cronbach's alpha of 0.91 for the overall score, indicating acceptable internal consistency in both chemotherapy (0.89) and endocrine therapy (0.86) groups. Longitudinal responsiveness was supported by an effect size of 0.49 between decreasing satisfaction with hair growth and increasing emotional distress. Cross-sectional validity was confirmed, with effect sizes of 0.91 and 0.92 for satisfaction with hair growth and emotional and activity domains, respectively. CONCLUSION: The CADS is a valid and responsive tool for assessing the psychosocial impact of chemotherapy-induced alopecia and endocrine treatment-induced alopecia in a diverse Western patient population.


Asunto(s)
Alopecia , Antineoplásicos , Neoplasias de la Mama , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Alopecia/inducido químicamente , Antineoplásicos/efectos adversos , Neoplasias de la Mama/tratamiento farmacológico , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
14.
Surg Radiol Anat ; 2024 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-38758426

RESUMEN

PURPOSE: Measure out of the standard interval in the aorta diameter is a clue for aortic aneurysm or hypoplasia. Pediatric studies focusing specifically on the normal diameter of the abdominal aorta (AA) were limited in the literature. Therefore, the main goal of this work was to determine changes in the effective diameter of AA in healthy children aged 1-18 years for diagnosis of vascular diseases. METHODS: This retrospective work focused on abdominopelvic computed tomography views of 180 children (sex: 90 males / 90 females, average age: 9.50 ± 5.20 years) without any abdominopelvic disease to measure diameters of AA, common iliac artery (CIA), external iliac artery (EIA), and first lumbar vertebra (L1). RESULTS: Vessel and vertebra diameters increased in pediatric subjects between 1 and 18 years (p < 0.001). Considering pediatric age periods, vessel diameters increased steadily, but L1 diameter showed an irregular growth pattern between age periods. All parameters were greater in males than females (p < 0.05), except from effective diameters of AA over the coeliac trunk (p = 0.084) and over the renal artery (p = 0.051). The ratios of diameters of vessels to L1 increased depending on ages between 1 and 18 years. Considering pediatric age periods, the ratios increased from infancy period to postpubescent period in irregular pattern; however, the ratios for right and left CIA, and AA over the aortic bifurcation did not alter after late childhood period. All ratios for males were similar to females (p > 0.05). CONCLUSION: Our age-specific ratios may be beneficial for surgeons and radiologists for the diagnosis of vascular disorders such as aortic aneurysm.

15.
Vascular ; : 17085381241254430, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38730279

RESUMEN

OBJECTIVES: The angiosome concept has significantly impacted diabetic foot ulcer management by highlighting the vascular anatomy's role in wound healing. However, its clinical applicability and validity remain debated due to complexities in foot blood supply and ulcer location determination. METHODS: A cross-sectional study was conducted on 84 individuals with diabetic foot ulcers undergoing lower limb angiography. Demographics, ulcer characteristics, and angiographic data were collected and analyzed using descriptive statistics and relevant tests. RESULTS: Digital subtraction angiography assessed 89 limbs with diabetic foot ulcers; males comprised 54.8%, primarily type 2 diabetes (96.4%), averaging 64.36 ± 10.09 years. Of 129 angiosomes, angiosome 2 (40.3%) had the highest ulcer incidence. Posterior tibial artery (PTA) involvement was predominant (72.9%), while external iliac artery (EIA) and profunda femoris artery (PFA) were least affected (2.4% each). Posterior tibial artery showed 46.5% complete occlusion. Angiosome 2 correlated notably with anterior tibial artery (ATA), peroneal artery (CPA), and PTA, but categorizing angiosomes by supply patterns showed no significant artery correlation (p > .05). CONCLUSIONS: The research indicates inconsistent support for below-the-knee artery involvement correlating with foot ulcer locations in angiosomes. While aiding vascular comprehension, the angiosome concept may not fully elucidate lower limb vascular complexities and ulcer genesis. Factors like collateral circulation should be noticed to understanding ulcer localization and severity, extending beyond angiosomal arterial supply.

16.
Animals (Basel) ; 14(9)2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38731382

RESUMEN

Society is showing a growing concern about the welfare of cetaceans in captivity as well as cetaceans in the wild threatened by anthropogenic disturbances. The study of the physiological stress response is increasingly being used to address cetacean conservation and welfare issues. Within it, a newly described technique of extracting cortisol from epidermal desquamation may serve as a non-invasive, more integrated measure of a cetacean's stress response and welfare. However, confounding factors are common when measuring glucocorticoid hormones. In this study, we validated a steroid hormone extraction protocol and the use of a commercial enzyme immunoassay (EIA) test to measure cortisol concentrations in common bottlenose dolphin (Tursiops truncatus) and beluga (Delphinapterus leucas) epidermal samples. Moreover, we examined the effect of sample mass and body location on cortisol concentrations. Validation tests (i.e., assay specificity, accuracy, precision, and sensitivity) suggested that the method was suitable for the quantification of cortisol concentrations. Cortisol was extracted from small samples (0.01 g), but the amount of cortisol detected and the variability between duplicate extractions increased as the sample mass decreased. In common bottlenose dolphins, epidermal skin cortisol concentrations did not vary significantly across body locations while there was a significant effect of the individual. Overall, we present a contribution towards advancing and standardizing epidermis hormone assessments in cetaceans.

17.
Biomedicines ; 12(5)2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38790916

RESUMEN

Background: The mechanisms of the formation of immunological competence against tuberculosis (TB), and especially those associated with HIV co-infection, remain poorly understood. However, there is an urgent need for risk recurrence predictive biomarkers, as well as for predictors of successful treatment outcomes. The goal of the study was to identify possible immunological markers of TB recurrence in individuals with HIV/TB co-infection. Methods: The plasma levels of IFN-γ, TNF-α, IL-10, and IL-1ß (cytokines which play important roles in the immune activation and protection against Mycobacterium tuberculosis) were measured using ELISA EIA-BEST kits. The cytokine concentrations were determined using a standard curve obtained with the standards provided by the manufacturer of each kit. Results: A total of 211 individuals were enrolled in the study as follows: 62 patients with HIV/TB co-infection, 52 with HIV monoinfection, 52 with TB monoinfection, and 45 healthy donors. Out of the 62 patients with HIV/TB, 75.8% (47) of patients were newly diagnosed with HIV and TB, and 24.2% (15) displayed recurrent TB and were newly diagnosed with HIV. Decreased levels of IFN-γ, TNF-α, and IL-10 were observed in patients with HIV/TB when compared with HIV and TB patients. However, there was no difference in IFN-γ, TNF-α, or IL-10 secretion between both HIV/TB groups. At the same time, an almost 4-fold decrease in Il-1ß levels was detected in the HIV/TB group with TB recurrence when compared with the HIV/TB group (p = 0.0001); a 2.8-fold decrease when compared with HIV patients (p = 0.001); and a 2.2-fold decrease with newly diagnosed TB patients (p = 0.001). Conclusions: Significantly decreased Il-1ß levels in HIV/TB patients' cohort with secondary TB indicate that this cytokine can be a potential biomarker of TB recurrence.

18.
Artículo en Inglés | MEDLINE | ID: mdl-38791858

RESUMEN

Environmental impact assessment (EIA) performance has remained of interest, and over the past ten years, the evaluation technique has evolved. Thailand implemented an EIA with a health impact assessment (HIA) as an environmental health impact assessment (EHIA), which necessitated investigating and developing these instruments; however, its implementation performance has been questioned. The main goal of this study is to comparatively assess how well EIAs and EHIAs are performed in projects in an area in Thailand. Six projects in various sectors that were implemented in Eastern Thailand were studied. The 162 residents (nine local authorities and 153 villagers) closest to the project completed a survey and evaluated the performance according to three aspects (i.e., substantive, procedural, and transactive), using a rating scale and evaluation checklists. The results were presented as a percentage of the total scores and interpreted according to the five scales. The overall performance reached a satisfactory level, albeit not significantly different between cases; however, it was pointed out that the shortcomings of EHIAs and EIAs, particularly their dependability, lack of public involvement, and the need for more transparency, could be addressed through the establishment of an open access database, which would help to simplify the assessment of all stages of EIAs and EHIAs.


Asunto(s)
Evaluación del Impacto en la Salud , Tailandia , Humanos , Salud Ambiental , Encuestas y Cuestionarios , Femenino , Masculino
19.
J Environ Manage ; 360: 120926, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38772227

RESUMEN

In the Republic of Korea, Environmental Impact Assessment (EIAs) precedes development projects to predict and analyze potential environmental effects. Generally, EIA noise evaluations utilize 2D noise prediction equations and correction coefficients. This method, however, offers only a sectional noise evaluation and has limitations in complex environments with diverse noise sources. Moreover, the determination of various variables during the EIA process based on subjective human judgment raises concerns about the reliability of the results. Thus, this study aims to develop software accessible via a web environment for user-friendly EIA noise evaluations. This software supports integrated data management and generates a 3D noise prediction model for more precise and realistic analysis of noise impacts, specifically focusing on road-traffic noise at this stage of development. The 3D noise prediction model and noise map generated by the developed software have been validated against through comparison with the results of onsite noise measurements and commercial EIA software, SoundPLAN. This validation aimed to assess the practical utility of the application.


Asunto(s)
Programas Informáticos , República de Corea , Ruido , Humanos , Ruido del Transporte , Monitoreo del Ambiente/métodos , Internet , Ambiente , Reproducibilidad de los Resultados
20.
Lab Med ; 2024 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-38801239

RESUMEN

OBJECTIVE: In evaluation of systemic lupus erythematosus (SLE), anti-double-stranded DNA antibodies (anti-dsDNA) play a significant role in diagnosis, monitoring SLE activity, and assessing prognosis. However, evaluations of the performance and limitations for recently developed methods for anti-dsDNA assessment are sparse. METHODS: Specimens used for antinuclear antibody testing (n = 129) were evaluated for anti-dsDNA assay comparability across 4 medical centers in the United States. The methods compared were Werfen Quanta Lite dsDNA, Zeus Scientific dsDNA Enzyme Immunoassay, Bio-Rad multiplex immunoassay (MIA) dsDNA, ImmunoConcepts Crithidia, and Bio-Rad Laboratories Crithidia. RESULTS: For quantitative anti-dsDNA measurements, Spearman's correlation coefficient was highest between Zeus and Werfen (ρ = 0.86; CI, 0.81-0.90; P < .0001). Comparison of MIA to Werfen or Zeus yielded similar results to each other (ρ = 0.58; CI, 0.44-0.68; P < .0001; and ρ = 0.59; CI, 0.46-0.69; P < .0001, respectively), but lower than the correlation between Zeus and Werfen. Positive concordance between assays ranged from 31.4% to 97.1%, and negative concordance between assays ranged from 58.5% to 100%. The detection of anti-dsDNA in those with SLE diagnosis ranged from 50.9% to 77.4% for quantitative assays and 15.1% to 24.5% for Crithidia assays. CONCLUSION: Current quantitative anti-dsDNA assays are not interchangeable for patient follow-up. Crithidia-based assays demonstrate high negative concordance and lack positive concordance among the methods.

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