RESUMO
Allogeneic hematopoietic cell transplantation (alloHSCT) is a standard therapeutic approach for acute leukemias and many other hematologic malignancies. The proper choice of immunosuppressants applicable to different types of transplantations still requires strict and careful consideration, and data in this regard are divergent. For this reason, in this single-centered, retrospective study, we aimed to compare the outcome of 145 patients who received post-transplant cyclophosphamide (PTCy) for MMUD and haplo-HSCT or GvHD prophylaxis for MMUD-HSCT alone. We attempted to verify if PTCy is an optimal strategy in MMUD setting. Ninety-three recipients (93/145; 64.1%) underwent haplo-HSCT while 52 (52/145; 35.9%) underwent MMUD-HSCT. There were 110 patients who received PTCy (93 in haplo and 17 in MMUD group) and 35 patients received conventional GvHD prophylaxis based on antithymocyte globulin (ATG), cyclosporine (CsA), and methotrexate (Mtx) in the MMUD group only. Our study revealed that patients receiving post-transplant cyclophosphamide (PTCy) show decreased acute GvHD rates and CMV reactivation as well as a statistically lower number of CMV copies before and after antiviral treatment compared to the CsA + Mtx + ATG group. Taking into account chronic GvHD, the main predictors are donor age, ≥40 years, and haplo-HSCT administration. Furthermore, the survival rate of patients following MMUD-HSCT and receiving PTCy with tacrolimus and mycophenolate mofetil was more than eight times greater in comparison to patients receiving CsA + Mtx + ATG (OR = 8.31, p = 0.003). These data taken together suggest that the use of PTCy displays more benefits in terms of survival rate compared to ATG regardless of the type of transplantation performed. Nevertheless, more studies with a larger sample size are required to confirm the conflicting results in the literature studies.
Assuntos
Infecções por Citomegalovirus , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Humanos , Adulto , Doadores não Relacionados , Estudos Retrospectivos , Ciclofosfamida/uso terapêutico , Transplante de Células-Tronco Hematopoéticas/métodos , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/prevenção & controle , Doença Enxerto-Hospedeiro/tratamento farmacológico , Soro Antilinfocitário/uso terapêutico , Infecções por Citomegalovirus/tratamento farmacológicoRESUMO
Background and Objectives: This paper presents a unique study that links the physical conditions in the nasal passage with conditions that favour the development of bacterial strains and the colonization of the mucous membranes of the nose and paranasal sinuses. The physical parameters considered were air flow, pressure, humidity, and temperature. Materials and Methods: Numerical models of the human nose and maxillary sinus were retrospectively reconstructed from CT images of generally healthy young subjects. The state-of-the-art numerical methods and tools were then used to determine the temperature, humidity, airflow velocity, and pressure at specific anatomical locations. Results: The results were compared with optimal conditions for bacterial growth in the nose and sinuses. Conclusions: Temperature, humidity, air velocity, and pressure were shown to play critical roles in the selection and distribution of microorganisms. Furthermore, certain combinations of physical parameters can favour mucosal colonisation by various strains of bacteria.
Assuntos
Seio Maxilar , Cavidade Nasal , Humanos , Seio Maxilar/diagnóstico por imagem , Estudos Retrospectivos , Cavidade Nasal/diagnóstico por imagem , Simulação por Computador , TemperaturaRESUMO
Purpose: To assess the efficacy and safety of a low-dose, computed tomography (CT)-guided transthoracic biopsy of lung and pleural lesions. Material and methods: A total of 135 low-dose, CT-guided transthoracic lung and pleural lesions biopsies were performed. A cutting needle was utilized in 124 cases, and fine needle aspiration biopsy was performed in 14 cases. In all cases, 14- to 22-gauge biopsy needles were used. Results: Diagnostic material was obtained in 111 (82.2%) patients. In 97 (71.8%) cases neoplastic lesions were found, predominantly adenocarcinoma and non-small cell carcinoma. In 14 (12.6%) cases non atypical cells were reported. Biopsy failed to obtain material suitable for histopathological examination in 24 (17.7%) cases. Complications occurred in 31 patients, including pneumothorax in 28 patients and haematoma in 3 cases. Conclusions: Based on the obtained results, it can be stated that low-dose, CT-guided transthoracic biopsy of lung and pleural tissues is an accurate and safe procedure. Also, it is linked to a low risk of complications such as a small pneumothorax.
RESUMO
Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease involving the axial skeleton, peripheral joints, and extra-articular manifestations like psoriasis, inflammatory bowel disease, or uveitis. A deterioration of quality of life (QoL) affects the disease management and therapeutic decision-making. This meta-analysis focused on the influence of biological drugs on the QoL in SA compared to the effects of other therapeutic modalities. We searched the databases of MedLine, Academic Search Ultimate, CINAHL Complete, and Health Source - Nursing/Academic Edition for articles related to AS treatment using the terms "ankylosing spondylitis" OR "rheumatoid spondylitis" OR "spondylitis" AND "quality of life" OR "patient-reported outcomes" OR "well-being" OR "health-related quality of life" OR "biological treatment". The search came up with 10 English-language articles published between 2010 and 2020. Patients were evaluated with the following indexes and questionnaires: Assessment of Spondyloarthritis International Society (ASAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Quality of Life (ASQoL), 36-Item Short-Form Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and the Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Functional (BASFI) Indexes. We found that the QoL, assessed with the ASQoL, improved significantly better in patients treated with biological drugs when compared to those treated with other standard therapies or placebo at a 4-month follow-up. However, improvements in other disease characteristics could not be differentiated based on the therapy modality. The finding that biological drugs are superior in improving the QoL should strengthen the recommendations for their use in patients with AS.
Assuntos
Produtos Biológicos , Espondilite Anquilosante , Produtos Biológicos/uso terapêutico , Humanos , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Índice de Gravidade de Doença , Espondilite Anquilosante/tratamento farmacológico , Inquéritos e QuestionáriosRESUMO
The aim of the study was to assess the incidence and severity of the frailty syndrome assessed with the Edmonton Frailty Scale. This is a cross-sectional study conducted among 382 patients (236 men and 146 women, mean age 71.9 years). The Edmonton Frailty Scale was administered during the patient's admission to the hospital. The Polish adaptation was performed using the standard methodology. The Cronbach's alpha coefficient for the whole Edmonton Frailty Scale was 0.709. The mean correlation between positions and the overall result was r = 0.180. There were no statistically significant differences between women and men in the area of Edmonton Frailty Scale mean score (p < 0.05). The socio-clinical analysis, showed statistically significant differences in the age of respondents, educational attainment, occupational activity, number of drugs taken and co-occurrence of chronic diseases. A higher values of the Edmonton Frailty Scale were indicated for individuals >70 years than for those <70 years (p < 0.001). The Edmonton Frailty Scale proved to be a reliable tool which may be used in the Polish population. The use of this questionnaire for frailty syndrome may be helpful in everyday clinical practice.
Assuntos
Fragilidade , Avaliação Geriátrica/métodos , Múltiplas Afecções Crônicas , Pesos e Medidas , Idoso , Estudos Transversais , Feminino , Idoso Fragilizado , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Humanos , Masculino , Múltiplas Afecções Crônicas/epidemiologia , Múltiplas Afecções Crônicas/terapia , Polônia/epidemiologia , Fatores Sexuais , Fatores SocioeconômicosRESUMO
Sleep disorders are common in patients with chronic obstructive pulmonary disease (COPD) and are associated with greater disease severity, more frequent exacerbations, greater use of emergency health care, and higher mortality. They may contribute to worsening of COPD course by reducing patients' adherence to treatment. The aim of this study was to evaluate quality of sleep in COPD patients and to assess the relationship between impaired sleep and adherence to inhalation therapy. The study included 106 COPD patients who were asked to answer the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Adherence to Refills and Medications Scale (ARMS). Clinical and demographic data were also collected. We found that over 60% of patients presented with sleep disorders (PSQI ≥5) and 75% with daytime sleepiness. None of the patients presented with optimal adherence to pharmacotherapy. Worse adherence was correlated with greater sleep disorders (r = 0.56; p < 0.001). ARMS questionnaire proved to be of high overall internal consistency (Cronbach's alpha = 0.85). In conclusion, poor quality of sleep coexists with poor adherence to treatment among COPD patients. ARMS was proved to be a reliable tool for the assessment of adherence. Interventions aimed at improving sleep quality may be helpful to improve adherence to inhalation therapy in COPD patients.
Assuntos
Doença Pulmonar Obstrutiva Crônica , Terapia Respiratória , Transtornos do Sono-Vigília , Cooperação e Adesão ao Tratamento , Humanos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/terapia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/terapia , Inquéritos e Questionários , Cooperação e Adesão ao Tratamento/estatística & dados numéricosRESUMO
The evaluation of cerebellar growth in the fetal period forms a part of a widely used examination to identify any features of abnormalities in early stages of human development. It is well known that the development of anatomical structures, including the cerebellum, does not always follow a linear model of growth. The aim of the study was to analyse a variety of mathematical models of human cerebellar development in fetal life to determine their adequacy. The study comprised 101 fetuses (48 males and 53 females) between the 15th and 28th weeks of fetal life. The cerebellum was exposed and measurements of the vermis and hemispheres were performed, together with statistical analyses. The mathematical model parameters of fetal growth were assessed for crown-rump length (CRL) increases, transverse cerebellar diameter and ventrodorsal dimensions of the cerebellar vermis in the transverse plane, and rostrocaudal dimensions of the cerebellar vermis and hemispheres in the frontal plane. A variety of mathematical models were applied, including linear and non-linear functions. Taking into consideration the variance between models and measurements, as well as correlation parameters, the exponential and Gompertz models proved to be the most suitable for modelling cerebellar growth in the second and third trimesters of pregnancy. However, the linear model gave a satisfactory approximation of cerebellar growth, especially in older fetuses. The proposed models of fetal cerebellar growth constructed on the basis of anatomical examination and objective mathematical calculations could be useful in the estimation of fetal development.
Assuntos
Cerebelo/anatomia & histologia , Cerebelo/embriologia , Feto/anatomia & histologia , Feto/embriologia , Modelos Teóricos , Vermis Cerebelar/anatomia & histologia , Vermis Cerebelar/embriologia , Feminino , Idade Gestacional , Humanos , Modelos Lineares , Masculino , Gravidez , Terceiro Trimestre da GravidezRESUMO
The aim of this study was to estimate virulence potential of Salmonella enterica strains colonizing the gut of free-living sand lizards (Lacerta agilis L.). The strains belonged to three Salmonella serovars: Abony, Schleissheim, and Telhashomer. Adhesion and invasion abilities of the strains were determined in quantitative assays using the gentamicin protection method. Induction of apoptosis was assessed using HeLa cell monolayers. PCR assays were used for detection of 26 virulence genes localised within mobile elements: pathogenicity islands, virulence plasmids, and prophage sequences. In vitro studies revealed that all strains had adhesion and invasion abilities to human epithelial cells. The isolates were cytotoxic and induced apoptosis of the cells. The serovars differed in the number of virulence-associated genes: up to 18 genes were present in Salmonella Schleissheim, 17 in Salmonella Abony, whereas as few as six genes were found in Salmonella Telhashomer. Generally, Salmonella Abony and Salmonella Schleissheim did not differ much in gene content connected with the presence SPI-1 to -5. All of the strains lacked genes localised within bacteriophages and plasmids. The presence of virulence-associated genes and in vitro pathogenicity assays suggest that Salmonella sp. strains originating from autochthonous, free-living lizards can potentially infect and cause disease in humans.
Assuntos
Lagartos/microbiologia , Salmonella enterica/classificação , Animais , Animais Selvagens , Aderência Bacteriana , Células HeLa , Humanos , Salmonelose Animal/microbiologia , Salmonella enterica/genética , Salmonella enterica/isolamento & purificação , Salmonella enterica/patogenicidade , Sorogrupo , Virulência/genéticaRESUMO
BACKGROUND: This report presents a case of a 57- year old female with advanced Hepatic Alveolar Echinococcosis causing a secondary Budd-Chiari Syndrome due to infiltration of the suprahepatic inferior vena cava treated successfully by liver transplantation. CASE PRESENTATION: A temporary veno-venous bypass was introduced, but a typical end to end cavo-caval anastomosis wasn't possible in this case. In order to access a disease free part of the inferior vena cava, an oval window of the diaphragm was excised, providing communication between the peritoneum and pericardium. A vascular clamp was placed onto the right atrium which allowed for an atrial-caval anastomosis. The remainder of hepatectomy was performed in a conventional manner. In the post-operative period and during the 18 month follow-up there were no complications. The patient remains in good general condition with optimal graft function. CONCLUSIONS: A hepato-atrial anastomosis with a pericardial-peritoneum window during liver transplantation is feasible and extends the curability potential for patients with advanced Hepatic Alveolar Echinococcosis considered for liver transplantation.
Assuntos
Síndrome de Budd-Chiari/etiologia , Equinococose Hepática/cirurgia , Transplante de Fígado , Equinococose Hepática/complicações , Feminino , Seguimentos , Hepatectomia/métodos , Humanos , Pessoa de Meia-Idade , Pericárdio , Peritônio , Veia Cava InferiorRESUMO
Fleas infecting northern white-breasted hedgehogs, Erinaceus roumanicus (Barrett-Hamilton), collected from 2009-2011 in Budapest (Hungary) were studied. A total of 305 white-breasted hedgehogs were captured and 1,251 fleas were collected. The flea community comprised two species, the hedgehog flea Archaeopsylla erinacei (Bouche, 1835) and the dog flea Ctenocephalides canis (Curtis, 1826), although the latter was only found on three hedgehogs. Fleas were found on half of the host specimens (51%; n = 156) where their distribution was strongly aggregated. The sex ratio of A. erinacei was biased towards females and was correlated with host size. Interestingly, the sex ratio of fleas became more equal on heavier hosts. It had been expected that, under high competition, the sex ratio would be female biased because it is known that female ectoparasites dominate on poorer hosts. The body size of a random sample of 200 fleas (100 female and 100 male) was measured under a microscope. The analyses showed directional asymmetry in two features - the distance between the top of the head and the eye, and head length. In this two body traits the left side was significantly greater than right side in both sexes of A. erinacei. Our data shed light on the complex nature of the flea population infecting northern white-breasted hedgehogs in an urban area.
Assuntos
Infestações por Pulgas/veterinária , Ouriços/parasitologia , Sifonápteros/classificação , Animais , Coinfecção/veterinária , Feminino , Infestações por Pulgas/parasitologia , Hungria , Modelos Lineares , Masculino , Sifonápteros/anatomia & histologiaRESUMO
The aim of the study was to describe the dependence on ambient temperature of distal joint temperature at the forelimbs of racehorses. The study also investigated the influence of differing ambient temperatures on the temperature difference between joints: this was measured ipsilaterally (i.e. between the carpal and fetlock joints along each forelimb) and contralaterally (i.e. between the same joints of the left and right forelimbs). Sixty-four healthy racehorses were monitored over 10 months. At each session, three thermographic images were taken of the dorsal, lateral and medial aspects of the distal forelimbs. Temperature measurements were made from regions of interest (ROIs) covering the carpal and fetlock joints. There was a strong correlation between ambient temperature and absolute joint temperature at all ROIs. The study also observed a moderate correlation between ambient temperature and the ipsilateral temperature differences between joints when measured from the medial and lateral aspects. No significant correlation was noted when measured dorsally. The mean contralateral temperature differences between joints were all close to 0°C. The data support previous reports that the temperature distribution between the forelimbs of the healthy equine is generally symmetric, although some horses differ markedly from the average findings.
Assuntos
Membro Anterior/diagnóstico por imagem , Cavalos , Articulações/diagnóstico por imagem , Temperatura , Termografia/veterinária , Animais , Raios InfravermelhosRESUMO
BACKGROUND: This study was conducted to evaluate the predisposing factors, microbiology, treatment, and outcomes associated with hepatic abscess, a rare but serious complication which may accur after an orthotopic liver transplant (OLT). METHODS: This was a retrospective study based on a prospectively maintained database of 1100 patients who underwent OLT at the Medical University of Warsaw. An abscess was defined on imaging as solitary or multiple localized parenchymal collections in patients with clinical signs of infection, with or without positive cultures from blood or abscess aspirate. RESULTS: Fifteen patients (1.4%) developed hepatic abscess, including 12 (80%) with multiple abscesses. Predisposing factors included biliary pathology (eight patients), hepaticojejunostomy (six patients), and hepatic artery stenosis or thrombosis (five patients). Ten patients were treated using multiple percutaneous and endoscopic interventional procedures in addition to antimicrobial treatment whereas five were treated solely with antibiotics. Five patients (33.3%) died due to multi-organ failure secondary to abscess treatment, including one unsuccessful case of re-OLT. Thirteen patients (87%) had bacterial growth and five (33.3%) had fungal growth in their blood or abscess aspirates. CONCLUSIONS: Hepatic abscess after liver transplantation may be treated successfully with percutaneous and endoscopic intervention, along with antibiotics according to the results of microbial cultures of blood and/or abscess aspirates.
Assuntos
Infecções por Bactérias Gram-Negativas/etiologia , Infecções por Bactérias Gram-Positivas/etiologia , Abscesso Hepático/etiologia , Transplante de Fígado , Micoses/etiologia , Complicações Pós-Operatórias , Adulto , Anti-Infecciosos/uso terapêutico , Colangiografia , Terapia Combinada , Drenagem/métodos , Endoscopia , Feminino , Seguimentos , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Negativas/terapia , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/epidemiologia , Infecções por Bactérias Gram-Positivas/terapia , Humanos , Abscesso Hepático/diagnóstico , Abscesso Hepático/epidemiologia , Abscesso Hepático/terapia , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico , Micoses/epidemiologia , Micoses/terapia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/terapia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
ABSTRACT: The contribution of arterial functional and structural changes to left ventricular (LV) diastolic dysfunction has been the area of recent research. There are some studies on the relationship between arterial stiffness (a.s.) and left atrial (LA) remodelling as a marker of diastolic burden. Little is known about the association of arterial structural changes and LA remodelling in hypertension (H). AIM: The aim of this study was to examine the relationship between carotid a.s. and intima-media thickness (IMT) and LA volume in subjects with H. The study included 245 previously untreated hypertensives (166 women and 79 men, mean age 53.7 ± 11.8 years). Each patient was subjected to echocardiography with measurement of LA volume, evaluation of left ventricular hypertrophy (LVH) and LV systolic/diastolic function indices, integrated assessment of carotid IMT and echo-tracking of a.s. and wave reflection parameters. RESULTS: Univariate regression analysis revealed significant correlations between indexed LA volume and selected clinical characteristics, echocardiographic indices of LVH and LV diastolic/systolic function and a.s./wave reflection parameters. The following parameters were identified as independent determinants of indexed LA volume on multivariate regression analysis: diastolic blood pressure (beta = -0.229, P < 0.001), left ventricular mass index (LVMI; beta = 0.258, P < 0.001), E/e' index (ratio of early mitral flow wave velocity E to early diastolic mitral annular velocity e'; beta = 0.266, P = 0.001), augmentation index (AI; beta = 0.143, P = 0.008) and body mass index (BMI; beta = 0.132, P = 0.017). No correlations between indexed LA volume and IMT were found. CONCLUSION: There is a significant relationship between carotid arterial stiffness but not intima-media thickness and LA volume in patients with untreated hypertension.
Assuntos
Remodelamento Atrial , Artérias Carótidas , Espessura Intima-Media Carotídea , Átrios do Coração , Hipertensão , Rigidez Vascular , Adulto , Função do Átrio Esquerdo , Pressão Sanguínea , Artérias Carótidas/diagnóstico por imagem , Artérias Carótidas/fisiopatologia , Ecocardiografia/métodos , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Átrios do Coração/fisiopatologia , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Estatística como AssuntoRESUMO
Recently, there has been growing interest in an interplay of vascular mechanics and heart function (arterial-ventricular-atrial coupling). The contribution of arterial stiffness (AS) to left atrial (LA) enlargement is unclear. The aim of this study was to verify whether the association between carotid AS and LA volume in untreated arterial hypertension is independent of such confounders as age, sex, body mass index (BMI), blood pressure, left ventricular hypertrophy (LVH), left ventricular (LV) diastolic and systolic function. The study included 133 patients, among them 107 individuals with hypertension (51 men and 56 women, mean age 56.8 ± 10.3 years) and 26 matched controls. Each patient was subjected to echocardiography, ultrasonographic measurement of mean carotid intima-media thickness (IMT) and echo-tracking assessment of AS and wave reflection. LA volume was calculated by ellipsoid method. The indexed LA volume showed significant linear correlations with age (r = 0.32; p < 0.05), BMI (r = 0.21; p < 0.05), pulse pressure (r = 0.26; p < 0.05), B-type natriuretic peptide (r = 0.64; p < 0.05), LV end-diastolic volume (r = 0.42; p < 0.05), LV mass index (LVMI; r = 0.58; p < 0.05), septum thickness (r = 0.40; p < 0.05), posterior wall thickness (r = 0.34; p < 0.05), early filling wave of mitral inflow (E; r = 0.30; p < 0.05), early diastolic myocardial velocity of mitral annulus (e'; r = - 0.22; p < 0.05), E/e' ratio (r = 0.45; p < 0.05), IMT (r = 0.26; p < 0.05) and augmentation index (AI; r = 0.27; p < 0.05). Progressive multivariate analysis identified LVMI, age, AI and BMI as independent determinants of indexed LA volume in patients with arterial hypertension. The study showed the significant relationship between wave reflection expressed by AI and LA structural remodeling, which supports the hypothesis of arterial-atrial coupling in hypertension.
Assuntos
Átrios do Coração/fisiopatologia , Hipertensão/fisiopatologia , Rigidez Vascular/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This study was aimed at determining the cause for the high incidence of tuberculosis (TB) reactivation occurring in males with a low body mass index (BMI). Current thinking about pulmonary TB describes infection in the lung apex resulting in cavitation after reactivation. A different hypothesis is put forward for TB infection, suggesting that this occurs in subclinical apical cavities caused by increased pleural stress due to a low BMI body habitus. A finite element analysis (FEA) model of a lung was constructed including indentations for the first rib guided by paramedian sagittal CT reconstructions, and simulations were conducted with varying antero-posterior (AP) diameters to mimic chests with a different thoracic index (ratio of AP to the transverse chest diameters). A Pubmed search was conducted about gender and thoracic index, and the effects of BMI on TB. FEA modeling revealed a tenfold increase in stress levels at the lung apex in low BMI chests, and a four-fold increase with a low thoracic index, r(2) = 0.9748 P < 0.001. Low thoracic index was related to BMI, P = 0.001. The mean thoracic index was statistically significantly lower in males, P = 0.001, and increased with age in both genders. This article is the first to suggest a possible mechanism linking pulmonary TB reactivation to low BMI due to the flattened thoracic wall shape of young male adults. The low thoracic index in young males may promote TB reactivation due to tissue destruction in the lung apex from high pleural stress levels.
Assuntos
Parede Torácica/anatomia & histologia , Tuberculose Pulmonar/epidemiologia , Índice de Massa Corporal , Feminino , Análise de Elementos Finitos , Humanos , Incidência , Masculino , Modelos Anatômicos , Radiografia Torácica/métodos , Recidiva , Fatores Sexuais , Parede Torácica/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
AIM: Disgust is one of the principal emotions, typically triggered by a variety of biological and social stimuli. Several questionnaire tools have been used to assess disgust. The aim of the study was to assess psychometric properties of the Polish version of the Questionnaire for the Assessment of Disgust Sensitivity (QADS), adapted from the tool prepared by the German researchers. METHODS: Eight hundred twenty subjects (631, 77% females and 189, 23% males) aged 18-69 (mean - 28 years) participated in the study. There are 3 subscale in the questionnaire: Core Disgust, Animal Reminder and Contamination. The tool consists of 37 items, the intensity of feeling of disgust is assessed based on 5-point Likert scale. RESULTS: Confirmatory factor analysis confirmed the adequacy of grouping of items in the three subscales: Core Disgust, Animal-Reminder, and Contamination-Interpersonal. In our sample, females had higher levels of disgust than males. Several other psychometric variables - high degree of correlations between the subscales, and high reliability -were in agreement with parameters of the original version. The Polish version compared favourably with the original, with Cronbach's alpha of 0.94 for the whole questionnaire and 0.85 - 0.90 for the subscales. CONCLUSIONS: The psychometric properties of the Polish version of QADS are sufficient to recommend this tool for diagnostic and research use.
Assuntos
Autoavaliação Diagnóstica , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Idoso , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/classificação , Polônia , Psicometria , Reprodutibilidade dos Testes , Adulto JovemRESUMO
In the fetal period, development of cerebellar lobes may proceed dissimilarly due to possible differentiated origins of the cells and diversified times of their migration to certain cerebellum regions. This can cause various growth trajectories for the external surfaces of cerebellar lobes. The goal of the study was to describe the development of the external surface of cerebellum lobes and fissures delineating them in the fetal period. The material consisted of 101 fetuses (48 males and 53 females)-crown rump length 89-229 mm corresponding to 15-28 weeks of fetal life. The methods were based on anthropometric measurements and preparation techniques combined with elicited image computer analysis. At the largest values of the cerebellum posterior lobe surface, the most dynamic growth rate was observed in the case of the anterior lobe. Among the cerebellar lobes, proportional change was observed as well as a gradual increase in anterior lobe surface area and a simultaneous decrease in the surface area of the flocculonodular lobe part of the cerebellum total external surface. This paper presents the different growth trajectories of cerebellar lobes and demonstrates the importance of the primary fissure as a delineating mark for two regions with different dynamics of development.
Assuntos
Cerebelo/embriologia , Cerebelo/anatomia & histologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Tamanho do ÓrgãoRESUMO
It is a well-known fact that high biodiversity is related to the health and proper functioning of environment. Recently, the attempts to search the relations between biodiversity and human health are also undertaken. A number of studies demonstrate that people living in undegraded environment are less exposed to the diseases of affluence. However, they are at a higher risk of contracting zoonoses. It is believed that the higher the number of animals, the higher is the number of ticks. Consequently, there is a serious risk of borreliosis and other tick-borne diseases. Such assumption, however, may be erroneous. A number of studies suggest a decreasing prevalence of tick-borne disease pathogens in high-biodiversity areas. In this paper, a promising hypothesis explaining this relation is discussed.
Assuntos
Biodiversidade , Doenças Transmissíveis Emergentes/epidemiologia , Controle Biológico de Vetores/estatística & dados numéricos , Doenças Transmitidas por Carrapatos/epidemiologia , Carrapatos , Zoonoses/epidemiologia , Animais , Clima , Doenças Transmissíveis Emergentes/prevenção & controle , Ecossistema , Humanos , Vigilância da População , Doenças Transmitidas por Carrapatos/prevenção & controle , Zoonoses/microbiologiaRESUMO
Progressive cachexia and malnutrition severely impact the physical and mental condition of cancer patients. Pain is a prognostic factor for shorter survival in cancer patients, and coping strategies are crucial for adapting to treatment and dietary regimens. This study assessed pain levels, pain-related beliefs, and coping strategies as factors increasing malnutrition risk in 257 lung cancer patients. Sociodemographic and clinical data were collected from medical records. The Mini Nutritional Assessment (MNA), Visual Analog Scale (VAS), Beliefs about Pain Control Questionnaire (BPCQ), and Coping Strategies Questionnaire (CSQ) were used. Overall, 42.8% of patients were at risk of malnutrition, and 17.5% were malnourished. Nutritional status negatively correlated with CSQ domains: reinterpretation of pain (RP: rho = -0.194; p = 0.002), catastrophizing (CP: rho = -0.414; p = 0.001), ignoring pain (IP: rho = -0.198; p = 0.001), praying/hoping (PH: rho = -0.253; p < 0.001), and coping self-statements (CS: rho = -0.172; p = 0.006); and BPCQ domains: the power of doctors (PD: rho = -0.196; p = 0.002) and VAS (rho = -0.451; p < 0.001). Nutritional status positively correlated with CSQ domains: pain control (PC: rho = 0.499; p < 0.001) and the ability to reduce pain (AR: rho = 0.512; p < 0.001). In multivariate regression analysis, a better nutritional status was associated with a younger age (ß = -0.094; p < 0.001), non-small-cell lung cancer (NSCLC) (ß = 1.218; p = 0.037), a greater ability to reduce pain (CSQ-AR) (ß = 0.901; p < 0.001), lower catastrophizing (CSQ-CP) (ß = -0.165; p = 0.001), and lower pain perceived (VAS) (ß = 0.639; p < 0.001). Statistical analyses included Spearman's correlation and multivariate regression with a significance level of p < 0.05. Patients with a normal nutritional status had reduced doctor involvement in pain control, less frequent negative coping strategies, and more common positive coping strategies. A normal nutritional status correlates with lower perceived pain. A better nutritional status is linked to a younger age, NSCLC, lower pain levels, greater pain reduction ability, and lower scores in pain catastrophizing.
Assuntos
Adaptação Psicológica , Neoplasias Pulmonares , Desnutrição , Avaliação Nutricional , Estado Nutricional , Humanos , Neoplasias Pulmonares/psicologia , Neoplasias Pulmonares/complicações , Masculino , Feminino , Estudos Transversais , Desnutrição/psicologia , Pessoa de Meia-Idade , Idoso , Fatores de Risco , Inquéritos e Questionários , Dor/psicologia , Caquexia/psicologia , Caquexia/etiologia , Medição da Dor , Capacidades de EnfrentamentoRESUMO
The study aimed to evaluate the impact of BEMER (Physical Vascular Therapy) on body surface temperature using infrared thermography (IRT) in the distal parts of the forelimbs in Thoroughbreds. The study tested the hypothesis that BEMER therapy leads to an increase in body surface temperature and blood vessel diameter in the distal parts of the forelimbs. The study involved 16 horses, split into 2 groups: active BEMER (n = 8) and sham (n = 8). The active BEMER group had BEMER boots applied to the distal parts of the forelimbs, whereas the sham group had BEMER boots applied without activation of the device. Both groups underwent IRT examination to detect changes in body surface temperature, followed by ultrasonographic examination to assess changes in vein and artery diameter before (BT) and just after (JAT) therapy. The IRT examination was repeated 15 min after BEMER therapy (15AT). There were no significant body surface temperature differences between BT and JAT in any regions of interest (ROIs) in either group. In the active BEMER group, the ROIs did not change significantly at 15AT, compared to the temperatures measured at BT (except for the hooves). At 15AT the temperature of all the ROIs (except the fetlock bone) dropped significantly in the sham group. In the ultrasonographic examination, there was a significant increase in vein and artery diameter in the study group JAT, whereas the sham group had a significant increase only in artery diameter JAT. These results suggest an effect of BEMER on stimulating blood circulation in the distal parts of the forelimbs in clinically healthy horses. IRT did not identify changes in skin surface temperature after BEMER therapy at the distal parts of the forelimbs.