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1.
Eur Arch Otorhinolaryngol ; 281(1): 245-256, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37650929

RESUMO

PURPOSE: The aim of this prospective longitudinal study was to assess both subjective quality of life using questionnaires and objective examination of nasal function with regard to olfaction, nasal air flow and mucociliary clearance in patients after minimally invasive, turbinate-preserving endoscopic transnasal trans-sphenoidal pituitary surgery. METHODS: Patients undergoing endoscopic transnasal pituitary surgery were recruited prospectively and examined during three study visits, preoperatively and 3 and 6 months postoperatively. We examined nasal function using sniffin' sticks test, rhinomanometry, saccharin transit time test, and endoscopic and radiological scores. In addition, the influence on subjective quality of life and mental health was recorded using the Sinonasal-Outcome-Test-20 (SNOT-20) and the Hospital-Anxiety-and-Depression-Scale (HADS). RESULTS: 20 patients undergoing endoscopic pituitary tumor resections were included. No significant changes in olfaction or mucociliary clearance were noted. Nasal air flow showed a tendency to increase in the postoperative course lacking significance. Both the endoscopy and the radiological scores showed a significant deterioration, especially after 3 months, with a trend towards improvement over time. However, neither the SNOT-20 nor the HADS showed significant changes compared to baseline. CONCLUSIONS: Our concept of minimally invasive endoscopic tumor resections on the pituitary gland with preservation of nasal turbinates shows low morbidity for the patient. Despite objectifiable surgery-associated changes in the nose, nasal physiology in terms of smell, airflow and mucociliary clearance can be preserved and the subjective quality of life of our patients remains stable.


Assuntos
Doenças da Hipófise , Neoplasias Hipofisárias , Humanos , Qualidade de Vida , Estudos Prospectivos , Estudos Longitudinais , Neoplasias Hipofisárias/cirurgia , Resultado do Tratamento , Endoscopia , Hipófise/cirurgia , Conchas Nasais/cirurgia
2.
Sensors (Basel) ; 24(14)2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-39065828

RESUMO

This study aimed to investigate the interrelationships between key harmful emission components, nitrogen oxides (NOx), and particulate numbers (PNs) in diesel engine exhaust and the control actuators of diesel engines. This research involved conducting a series of experiments under fixed parameters within an engine brake laboratory environment to elucidate these correlations. The objectives of this study were to conduct a comprehensive review of the relevant emissions technology literature and a comparative assessment of particle measurement methods based on dilution ratios and develop innovative aerosol preparation principles tailored to condensation particle measurement. Additionally, this research involved designing and implementing an aerosol preparation unit based on the newly developed principles, along with the creation of test cell control programs using the AVL PUMA Open TST editor interface and Visual Basic. Furthermore, this study was concerned with conducting evaluations of fixed-parameter engine dynamometer tests to explore the functional relationships between the emission of 10/23 nm particles, NOx emissions, common rail pressure variations, and exhaust gas recirculation levels. This study aimed to enhance the understanding of diesel engine emissions dynamics and contribute valuable insights for developing more efficient and environmentally friendly engine control strategies.

3.
Sensors (Basel) ; 23(2)2023 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-36679389

RESUMO

Passenger and commercial transportation significantly contribute to hazardous air pollution. Exhaust gas after-treatment technology advances closely to the emission regulations throughout the world. The upcoming legislation will be EURO VII in European Union, which requirements are not set yet, but the Solid Particle Number (SPN) diameter range is expected to be more severe compared to EURO VI. This paper will revisit the measurement principle differences between over 10 nm and over 23 nm diameter particles in theory and practical engine bench measurement. Two different types of particle counters have performed the soot particle counting measurement; therefore, the applied sensors are different in terms of applied counting principles. The measurement principles of both devices will be introduced, and the experiment's result will reflect on the sensor differences. From this, a conclusion can be derived in order to determine the severity of the upcoming EURO VII legislation in terms of SPN, and the experiment will also reflect on the measurement sensor differences. The overall results suggested that extending the lower range of the measurement increases the tailpipe particle emission by 20%, although the DPF filtration efficiency is still over 99%.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Material Particulado/análise , Emissões de Veículos/análise , Automóveis , Tamanho da Partícula
4.
Eur Radiol ; 32(10): 7217-7226, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35524783

RESUMO

OBJECTIVES: Volumetric evaluation of coronary artery disease (CAD) allows better prediction of cardiac events. However, CAD segmentation is labor intensive. Our objective was to create an open-source deep learning (DL) model to segment coronary plaques on coronary CT angiography (CCTA). METHODS: Three hundred eight individuals' 894 CCTA scans with 3035 manually segmented plaques by an expert reader (considered as ground truth) were used to train (186/308, 60%), validate (tune, 61/308, 20%), and test (61/308, 20%) a 3D U-net model. We also evaluated the model on an external test set of 50 individuals with vulnerable plaques acquired at a different site. Furthermore, we applied transfer learning on 77 individuals' data and re-evaluated the model's performance using intra-class correlation coefficient (ICC). RESULTS: On the test set, DL outperformed the currently used minimum cost approach method to quantify total: ICC: 0.88 [CI: 0.85-0.91] vs. 0.63 [CI: 0.42-0.76], noncalcified: 0.84 [CI: 0.80-0.88] vs. 0.45 [CI: 0.26-0.59], calcified: 0.99 [CI: 0.98-0.99] vs. 0.96 [CI: 0.94-0.97], and low attenuation noncalcified: 0.25 [CI: 0.13-0.37] vs. -0.01 [CI: -0.13 to 0.11] plaque volumes. On the external dataset, substantial improvement was observed in DL model performance after transfer learning, total: 0.62 [CI: 0.01-0.84] vs. 0.94 [CI: 0.87-0.97], noncalcified: 0.54 [CI: -0.04 to 0.80] vs. 0.93 [CI: 0.86-0.96], calcified: 0.91 [CI:0.85-0.95] vs. 0.95 [CI: 0.91-0.97], and low attenuation noncalcified 0.48 [CI: 0.18-0.69] vs. 0.86 [CI: 0.76-0.92]. CONCLUSIONS: Our open-source DL algorithm achieved excellent agreement with expert CAD segmentations. However, transfer learning may be required to achieve accurate segmentations in the case of different plaque characteristics or machinery. KEY POINTS: • Deep learning 3D U-net model for coronary segmentation achieves comparable results with expert readers' volumetric plaque quantification. • Transfer learning may be needed to achieve similar results for other scanner and plaque characteristics. • The developed deep learning algorithm is open-source and may be implemented in any CT analysis software.


Assuntos
Doença da Artéria Coronariana , Aprendizado Profundo , Placa Aterosclerótica , Angiografia por Tomografia Computadorizada , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Humanos , Placa Aterosclerótica/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
5.
Eur Arch Otorhinolaryngol ; 279(2): 609-618, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33591388

RESUMO

PURPOSE: We aimed to investigate the effect of interval length and total count of intratympanic steroid (ITS) injections in salvage treatment of patients with idiopathic sudden sensorineural hearing loss (ISSNHL). METHODS: This retrospective case-control study included 64 patients with ISSNHL, who were treated with ITS injections as salvage therapy at a tertiary referral centre. From September 2019 to December 2020, 32 patients received up to four injections every 2-4 days (revised-protocol group). These patients were 1:1 matched to patients, who received up to three injections at 1-week intervals between January 2014 and August 2019 (initial-protocol group). Hearing outcomes of the two groups were compared. RESULTS: Both ITS salvage treatment protocols resulted in a statistically significant hearing improvement (p < 0.05). The initial-protocol declined hearing thresholds by 12 ± 11.7 dB (p < 0.001, d = 1, P = 99%). Mean hearing function was improved by 13.4 ± 19.1 dB in the revised-protocol group [p < 0.001, d = 0.7, P = 98%]. A clinically significant hearing improvement (> 10 dB) was seen in 18 patients (58.1%) in the initial-protocol group and in 14 patients (41.9%) in the revised-protocol group. A comparison of the hearing outcomes between protocol groups revealed no statistically significant differences (p > 0.05). CONCLUSION: These results indicate that a shorter injection interval does not lead to better hearing outcomes in ITS salvage treatment for ISSNHL. Moreover, fewer ITS injections may reduce costs, physical/mental stress of the patients and lower the risk of persistent tympanic perforations.


Assuntos
Perda Auditiva Neurossensorial , Perda Auditiva Súbita , Corticosteroides/uso terapêutico , Audiometria de Tons Puros , Estudos de Casos e Controles , Dexametasona/uso terapêutico , Glucocorticoides/uso terapêutico , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Súbita/tratamento farmacológico , Humanos , Injeção Intratimpânica , Estudos Retrospectivos , Terapia de Salvação , Resultado do Tratamento
6.
Eur Arch Otorhinolaryngol ; 279(2): 785-791, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33966108

RESUMO

OBJECTIVE: To evaluate the frequency, type and indications of nasal turbinate (NT) resection during endoscopic, anterior skull base surgery and to analyze factors that may have an impact on the need of NT removal. METHODS: In this retrospective cohort study, 306 subjects (150 males and 156 females, mean age 55.4 ± 15.3 years) who underwent multidisciplinary, transnasal, endoscopic tumor surgery of the anterior skull base using 4-handed techniques between 2011 and 2019 at the Department of Otorhinolaryngology, Medical University of Graz, were included. RESULTS: In the majority of interventions (n = 281/306; 91.8%), all NT were preserved. Significant factors influencing the need of NT resections turned out to be type of endoscopic approach (p < 0.001; V = 0.304), sagittal (p = 0.003; d = 0.481) and transversal (p = 0.017; d = 0.533) tumor diameter, tumor type (p < 0.001; V = 0.355) and tumor location (p < 0.001; V = 0.324). CONCLUSIONS: NT can be preserved in the majority of patients undergoing tumor resection in anterior, transnasal, skullbase surgery and routine resection of NT should be avoided. Variables that have an impact on the need of NT resections are types of endoscopic approaches, sagittal and transversal tumor extension and tumor type. These factors should be considered in planning of surgery and preoperative information of patients.


Assuntos
Neoplasias da Base do Crânio , Conchas Nasais , Adulto , Idoso , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Estudos Retrospectivos , Base do Crânio/diagnóstico por imagem , Base do Crânio/cirurgia , Neoplasias da Base do Crânio/diagnóstico por imagem , Neoplasias da Base do Crânio/cirurgia , Conchas Nasais/cirurgia
7.
Audiol Neurootol ; 26(6): 425-434, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33789267

RESUMO

INTRODUCTION: Intratympanic steroid (ITS) injections represent an increasingly used salvage treatment option for patients with idiopathic sudden sensorineural hearing loss -(ISSHL) after systemic treatment. The most effective corticosteroid for this treatment modality still remains unclear. Triamcinolone acetonide has been used for ITS treatment in various clinical settings. However, there are limited clinical data of its usage in the therapeutic management of ISSHL. The aim of this study was to determine the efficacy of intratympanic triamcinolone acetonide injections as a salvage treatment for ISSHL. METHODS: We conducted a retrospective chart review on patients affected by ISSHL with insufficient hearing recovery after primary systemic corticosteroid therapy and who were treated with intratympanic triamcinolone acetonide as a salvage therapy between January 2014 and August 2019. The patients were divided into groups according to their degree of hearing recovery, and we evaluated potential predictors of hearing recovery. Audiometric results were then compared to historic studies using dexamethasone or methylprednisolone. RESULTS: One-hundred and fifty-two patients received up to 3 intratympanic injections with triamcinolone acetonide at 1-week intervals. The mean hearing improvement due to ITS salvage treatment was 15.9 ± 18.9 dB. Complete hearing recovery was noted in 15 patients (9.9%), while 73 patients (48%) obtained partial recovery, and 64 patients (42.1%) had no recovery. Primary systemic treatment delay, hearing improvement by primary systemic treatment, and severity of initial hearing loss were identified as significant predictors of hearing improvement. The first of the 3 injections resulted in the greatest hearing improvement. CONCLUSION: The use of triamcinolone acetonide in ITS salvage treatment resulted in similar hearing improvements as the use of the commonly used corticosteroids, namely, dexamethasone and methylprednisolone. Longer treatment delays, lower hearing improvement by primary systemic treatment, and higher initial hearing loss are associated with poorer prognoses of hearing recovery.


Assuntos
Perda Auditiva Neurossensorial , Perda Auditiva Súbita , Audiometria de Tons Puros , Dexametasona/uso terapêutico , Glucocorticoides/uso terapêutico , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Súbita/tratamento farmacológico , Humanos , Injeção Intratimpânica , Estudos Retrospectivos , Terapia de Salvação , Resultado do Tratamento , Triancinolona Acetonida/uso terapêutico
8.
Int J Mol Sci ; 22(19)2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34639032

RESUMO

Pituitary adenylate cyclase-activating peptide (PACAP) is a neuropeptide with a widespread occurrence and diverse effects. PACAP has well-documented neuro- and cytoprotective effects, proven in numerous studies. Among others, PACAP is protective in models of diabetes-associated diseases, such as diabetic nephropathy and retinopathy. As the neuropeptide has strong neurotrophic and neuroprotective actions, we aimed at investigating the effects of PACAP in a rat model of streptozotocin-induced diabetic neuropathy, another common complication of diabetes. Rats were treated with PACAP1-38 every second day for 8 weeks starting simultaneously with the streptozotocin injection. Nerve fiber morphology was examined with electron microscopy, chronic neuronal activation in pain processing centers was studied with FosB immunohistochemistry, and functionality was assessed by determining the mechanical nociceptive threshold. PACAP treatment did not alter body weight or blood glucose levels during the 8-week observation period. However, PACAP attenuated the mechanical hyperalgesia, compared to vehicle-treated diabetic animals, and it markedly reduced the morphological signs characteristic for neuropathy: axon-myelin separation, mitochondrial fission, unmyelinated fiber atrophy, and basement membrane thickening of endoneurial vessels. Furthermore, PACAP attenuated the increase in FosB immunoreactivity in the dorsal spinal horn and periaqueductal grey matter. Our results show that PACAP is a promising therapeutic agent in diabetes-associated complications, including diabetic neuropathy.


Assuntos
Neuropatias Diabéticas/etiologia , Neuropatias Diabéticas/metabolismo , Modelos Animais de Doenças , Suscetibilidade a Doenças , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/genética , Animais , Glicemia , Neuropatias Diabéticas/patologia , Imuno-Histoquímica , Neurônios/metabolismo , Neuroproteção , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/metabolismo , Ratos , Nervo Isquiático/metabolismo , Nervo Isquiático/ultraestrutura
9.
J Craniofac Surg ; 31(8): 2346-2349, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33136888

RESUMO

The aims of this study were to determine the sphenoid sinus volume in an Austrian population, evaluate the relationship between volume and different types of pneumatization and investigate possible age-related sphenoid sinus volume degeneration in the elderly. A total of 50 human cadaver including 25 male and 25 female samples (=100 sphenoid sinuses, age range 65-100, mean age 84.52 ±â€Š9.50) were selected to obtain volume and anatomical variants of pneumatization by using sphenoid sinus casts, made of quadrofunctional hydrophilic addition reaction silicone. The mean sphenoid sinus volume was 4.79 ±â€Š2.39 cm. Males showed statistically significant larger sinus volumes than females (P = 0.048). The volume differed statistically significant for the different types of pneumatization (P < 0.001). The combined type of sphenoid sinus pneumatization presented the largest volume with 7.20 cm, followed by lateral, clival, sphenoid body, presellar, and conchal sinus type with 5.72, 5.63, 4.25, 2.08, and 0.5 cm, respectively. No significant correlation between age and sphenoid sinus volume was found (P = 0.707). This study highlights the close relationship between volume and morphology of sphenoid sinus and confirms ethnic variability. Moreover, our data shows no age-related volume degeneration.


Assuntos
Seio Esfenoidal/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Variação Anatômica , Cadáver , Feminino , Humanos , Masculino , Base do Crânio/anatomia & histologia , Osso Esfenoide/anatomia & histologia
10.
Int J Mol Sci ; 19(4)2018 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-29596316

RESUMO

Pituitary adenylate cyclase activating polypeptide (PACAP) is a neuropeptide with widespread occurrence and diverse biological effects. Among its several different effects, of special importance is the action of PACAP on neuronal proliferation, differentiation and migration, and neuroprotection. The neuroprotective mechanism of PACAP is both direct and indirect, via neuronal and non-neuronal cells. Several research groups have performed transcriptomic and proteomic analysis on PACAP-mediated genes and proteins. Hundreds of proteins have been described as being involved in the PACAP-mediated neuroprotection. In the present review we summarize the few currently available transcriptomic data potentially leading to the proteomic changes in neuronal development and protection. Proteomic studies focusing on the neuroprotective role of PACAP are also reviewed and discussed in light of the most intriguing and promising effect of this neuropeptide, which may possibly have future therapeutic potential.


Assuntos
Diferenciação Celular/fisiologia , Movimento Celular/fisiologia , Neurônios/metabolismo , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/metabolismo , Proteoma/metabolismo , Transcriptoma/fisiologia , Animais , Humanos , Neurônios/citologia
11.
Neuro Endocrinol Lett ; 36(2): 143-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26071583

RESUMO

OBJECTIVE: Pituitary adenylate cyclase activating polypeptide (PACAP) is a pleiotropic and multifunctional neuropeptide, widely distributed throughout the body. It is involved in the regulation of various physiological and pathophysiological processes. Numerous studies have shown that PACAP is involved in the development of the central nervous system and has neuroprotective effects. Environmental enrichment is also protective in various injuries, partially through involvement of trophic factors. The interaction between PACAP levels in the brain and environmental effects has not been studied yet. The aim of the present study was to investigate whether environmental enrichment influences PACAP levels of different brain areas in rats. METHODS: Wistar rats were exposed to enriched environment in adulthood for 3 weeks. PACAP27- and PACAP38-like immunoreactivities were measured with a specific and sensitive radioimmunoassay in homogenates of different brain areas: brainstem, cerebellum, diencephalon and telencephalon. RESULTS: We found that levels of both PACAP27- and PACAP38-like immunoreactivities showed significant increases in most brain areas after a 3-week-long exposure to enriched conditions. Thus, similarly to several other CNS injuries, enriched environment induced elevation in PACAP levels. CONCLUSION: As PACAP has strong neuroprotective effects, the elevation observed after exposure to enriched environment is suggested to play a role in the protective effects of such an environment as part of the endogenous neuroprotective machinery in adult rats.


Assuntos
Encéfalo/metabolismo , Meio Ambiente , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/metabolismo , Animais , Masculino , Radioimunoensaio , Ratos , Ratos Wistar
12.
Orv Hetil ; 156(4): 122-34, 2015 Jan 25.
Artigo em Húngaro | MEDLINE | ID: mdl-25597316

RESUMO

The practising physician often meets patients with pain located in different parts of the face and facial skull, mouth opening restriction or other motion disorder of the mandible. It is not always easy to identify and explain the cause. It is not widely known among doctors that most of these problems are due to masticatory dysfunction. There is a special group of patients showing functional disorders and there are some others who present a variety of different symptoms and visit several doctors. The masticatory organ, a functional unit of the human organism has a definite and separate task and function. In the early years of life it is capable of adaptation, while later on it tends to compensation. The authors outline the functional anatomy of the masticatory organ and the characteristics of multicausal pathology, the dynamics of the process of the disease and their interdisciplinary aspects. They discuss the basic elements of craniomandibular dysfunction. Based on the diagnostic algorithm, they summarize treatment options for masticatory function disorders. They emphasize the importance that physicians should offer treatment, especially an irreversible treatment, without a diagnosis. It occurs very often that the causes are identified after the patients become symptom-free due to treatment. The aim of this report is to help the general practitioners, dentists, neurologists, ear-nose-throat specialists, rheumatologists or any other specialists in the everyday practice who have patients with different symptoms such as pain in the skull, acoustic phenomenon of the joint or craniomandibular dysfunction.


Assuntos
Transtornos Craniomandibulares/diagnóstico , Transtornos Craniomandibulares/terapia , Procedimentos Cirúrgicos Ortognáticos , Modalidades de Fisioterapia , Transtornos Craniomandibulares/complicações , Transtornos Craniomandibulares/etiologia , Transtornos Craniomandibulares/patologia , Transtornos Craniomandibulares/fisiopatologia , Oclusão Dentária , Humanos , Dor/etiologia , Dor/prevenção & controle , Transtornos Psicofisiológicos/diagnóstico , Transtornos Psicofisiológicos/terapia , Psicoterapia
13.
J Chem Phys ; 141(11): 114501, 2014 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-25240358

RESUMO

We developed transferable potentials for alkali and halide ions which are consistent with our recent model of water [P. T. Kiss and A. Baranyai, J. Chem. Phys. 138, 204507 (2013)]. Following the approach used for the water potential, we applied Gaussian charge distributions, exponential repulsion, and r(-6) attraction. One of the two charges of the ions is fixed to the center of the particle, while the other is connected to this charge by a harmonic spring to express polarization. Polarizability is taken from quantum chemical calculations. The repulsion between different species is expressed by the combining rule of Kong [J. Chem. Phys. 59, 2464 (1972)]. Our primary target was the hydration free energy of ions which is correct within the error of calculations. We calculated water-ion clusters up to 6 water molecules, and, as a crosscheck, we determined the density and internal energy of alkali-halide crystals at ambient conditions with acceptable accuracy. The structure of hydrated ions was also discussed.

14.
Nutrients ; 16(17)2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39275297

RESUMO

Chronic rhinosinusitis with nasal polyps (CRSwNP) significantly impacts quality of life and often presents therapeutic challenges, with biologics like dupilumab showing promise in managing severe, uncontrolled cases. The aim of this study was to assess the influence of overweight on the effectiveness of dupilumab in patients with uncontrolled CRSwNP. This retrospective study analyzed treatment outcomes of 75 CRSwNP patients receiving dupilumab, categorizing them into underweight/normal-weight (BMI ≤ 24.9 kg/m2) and overweight/obese (BMI ≥ 25 kg/m2) groups. Outcome measures included changes in nasal polyp score (NPS) and sinonasal outcome test (SNOT-22) scores. Results demonstrated that the underweight/normal-weight group experienced significantly greater improvements in NPS and a higher rate of total NPS improvement compared to the overweight/obese group. While SNOT-22 scores improved in both groups, no significant differences were observed. Among patients with comorbid asthma, the underweight/normal-weight subgroup also showed significantly better outcomes, including greater reductions in both NPS and SNOT-22 scores. Multiple regression analysis identified BMI as an independent prognostic factor for NPS outcomes. The findings suggest that overweight/obesity adversely affects the response to dupilumab in CRSwNP, emphasizing the need for personalized treatment strategies considering BMI.


Assuntos
Anticorpos Monoclonais Humanizados , Índice de Massa Corporal , Pólipos Nasais , Sobrepeso , Rinite , Sinusite , Humanos , Pólipos Nasais/tratamento farmacológico , Pólipos Nasais/complicações , Masculino , Feminino , Sinusite/tratamento farmacológico , Sinusite/complicações , Anticorpos Monoclonais Humanizados/uso terapêutico , Estudos Retrospectivos , Pessoa de Meia-Idade , Rinite/tratamento farmacológico , Rinite/complicações , Doença Crônica , Sobrepeso/complicações , Sobrepeso/tratamento farmacológico , Adulto , Resultado do Tratamento , Obesidade/complicações , Obesidade/tratamento farmacológico , Idoso , Qualidade de Vida , Rinossinusite
15.
Injury ; 55 Suppl 3: 111548, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39300621

RESUMO

Amputations take place in the operating rooms. At dangerous sites, circumstances may necessitate on-site amputation to save lives. Currently, there are no evidence-based guidelines for the execution of the amputation or the instruments to be chosen. Furthermore, there are no widely accepted criteria for the standardized characterization of amputation devices. The present study examined the effectiveness of commercially available cutting tools and instruments used by rescue services as possible on-site amputation tools. Five different tools (Holmatro type hydraulic cutter, with two cutting attachments, reciprocating saw, hacksaw, Gigli saw) were used to carry out amputations on designated locations on cadavers (brachial, antebrachial, femoral, and crural regions). During the experiment, the time required for amputation and the number of necessary cutting attempts to detach limbs were recorded. The proximal cut surfaces were analyzed with the help of post-amputation CT scan-based 3D models. An Amputation Index (AI) was determined for each device in each examined region based on the cut surface quality. An Amputation Score (AS) was calculated using the time required for cutting, the number of cutting attempts, and the AI. With the help of AS, the usability of the used devices was determined. According to our scoring system, the reciprocating saw proved the most effective tool. Based on our results, we recommend the consideration and further investigation of the reciprocating saw as a possible on-site amputation device, as well as the introduction of the Amputation Score as an objective and quantitative indicator in the future characterization of on-site amputation devices.


Assuntos
Amputação Cirúrgica , Cadáver , Humanos , Serviços Médicos de Emergência , Desenho de Equipamento
16.
Ann Anat ; 252: 152195, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38042354

RESUMO

BACKGROUND: In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries. METHODS: For this second update, we have asked authors from all European countries to contribute their national perspectives. By this enquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information. RESULTS: Perspectives on the legal and ethical framework governing body donation in Europe. CONCLUSIONS: We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies.


Assuntos
Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Humanos , Cadáver , Europa (Continente) , Corpo Humano
17.
J Chem Phys ; 138(20): 204507, 2013 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-23742493

RESUMO

Based on extensive studies of existing potentials we propose a new molecular model for water. The new model is rigid and contains three Gaussian charges. Contrary to other models, all charges take part in the polarization of the molecule. They are connected by harmonic springs to their gas-phase positions: the negative charge to a prescribed point on the main axis of the molecule; the positive charges to the hydrogens. The mechanical equilibrium between the electrostatic forces and the spring forces determines the polarization of the molecule which is established by iteration at every timestep. The model gives excellent estimates for ambient liquid properties and reasonably good results from high-pressure solids to gas-phase clusters. We present a detailed description of the development of this model and a large number of calculated properties compared to the estimates of the nonpolarizable TIP4P∕2005 [J. L. F. Abascal and C. Vega, J. Chem. Phys. 123, 234505 (2005)], the polarizable GCPM [P. Paricaud, M. Predota, A. A. Chialvo, and P. T. Cummings, J. Chem. Phys. 122, 244511 (2005)], and our earlier BKd3 model [P. T. Kiss and A. Baranyai, J. Chem. Phys. 137, 084506 (2012)]. The best overall performance is shown by the new model.

18.
Int J Mol Sci ; 14(9): 19054-66, 2013 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-24065102

RESUMO

Environmental enrichment is a popular strategy to enhance motor and cognitive performance and to counteract the effects of various harmful stimuli. The protective effects of enriched environment have been shown in traumatic, ischemic and toxic nervous system lesions. Monosodium glutamate (MSG) is a commonly used taste enhancer causing excitotoxic effects when given in newborn animals. We have previously demonstrated that MSG leads to a delay in neurobehavioral development, as shown by the delayed appearance of neurological reflexes and maturation of motor coordination. In the present study we aimed at investigating whether environmental enrichment is able to decrease the neurobehavioral delay caused by neonatal MSG treatment. Newborn pups were treated with MSG subcutaneously on postnatal days 1, 5 and 9. For environmental enrichment, we placed rats in larger cages, supplemented with different toys that were altered daily. Normal control and enriched control rats received saline treatment only. Physical parameters such as weight, day of eye opening, incisor eruption and ear unfolding were recorded. Animals were observed for appearance of reflexes such as negative geotaxis, righting reflexes, fore- and hindlimb grasp, fore- and hindlimb placing, sensory reflexes and gait. In cases of negative geotaxis, surface righting and gait, the time to perform the reflex was also recorded daily. For examining motor coordination, we performed grid walking, footfault, rope suspension, rota-rod, inclined board and walk initiation tests. We found that enriched environment alone did not lead to marked alterations in the course of development. On the other hand, MSG treatment caused a slight delay in reflex development and a pronounced delay in weight gain and motor coordination maturation. This delay in most signs and tests could be reversed by enriched environment: MSG-treated pups kept under enriched conditions showed no weight retardation, no reflex delay in some signs and performed better in most coordination tests. These results show that environmental enrichment is able to decrease the neurobehavioral delay caused by neonatal excitotoxicity.


Assuntos
Sistema Nervoso/efeitos dos fármacos , Glutamato de Sódio/toxicidade , Animais , Animais Recém-Nascidos , Comportamento Animal/efeitos dos fármacos , Meio Ambiente , Atividade Motora/efeitos dos fármacos , Sistema Nervoso/crescimento & desenvolvimento , Ratos , Aumento de Peso/efeitos dos fármacos
19.
Int J Mol Sci ; 14(11): 22258-73, 2013 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-24232451

RESUMO

Perinatal asphyxia during delivery produces long-term disability and represents a major problem in neonatal and pediatric care. Numerous neuroprotective approaches have been described to decrease the effects of perinatal asphyxia. Enriched environment is a popular strategy to counteract nervous system injuries. The aim of the present study was to investigate whether enriched environment is able to decrease the asphyxia-induced neurobehavioral developmental delay in neonatal rats. Asphyxia was induced in ready-to-deliver mothers by removing the pups by caesarian section after 15 min of asphyxia. Somatic and neurobehavioral development was tested daily and motor coordination weekly. Our results show that rats undergoing perinatal asphyxia had a marked developmental delay and worse performance in motor coordination tests. However, pups kept in enriched environment showed a decrease in the developmental delay observed in control asphyctic pups. Rats growing up in enriched environment did not show decrease in weight gain after the first week and the delay in reflex appearance was not as marked as in control rats. In addition, the development of motor coordination was not as strikingly delayed as in the control group. Short-term neurofunctional outcome are known to correlate with long-term deficits. Our results thus show that enriched environment could be a powerful strategy to decrease the deleterious developmental effects of perinatal asphyxia.


Assuntos
Asfixia Neonatal/patologia , Deficiências do Desenvolvimento/patologia , Traumatismos do Sistema Nervoso/patologia , Animais , Asfixia Neonatal/complicações , Deficiências do Desenvolvimento/etiologia , Deficiências do Desenvolvimento/terapia , Meio Ambiente , Humanos , Recém-Nascido , Desempenho Psicomotor/fisiologia , Ratos , Traumatismos do Sistema Nervoso/complicações , Traumatismos do Sistema Nervoso/terapia
20.
Int J Mol Sci ; 14(8): 16111-23, 2013 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-23921682

RESUMO

Exposure to an enriched environment has been shown to have many positive effects on brain structure and function. Numerous studies have proven that enriched environment can reduce the lesion induced by toxic and traumatic injuries. Impoverished environment, on the other hand, can have deleterious effects on the outcome of neuronal injuries. We have previously shown that enriched conditions have protective effects in retinal injury in newborn rats. It is well-known that the efficacy of neuroprotective strategies can depend on age and gender. The aim of the present study, therefore, was to examine the effects of environmental enrichment and social isolation in retinal ischemia. We used bilateral common carotid artery occlusion to induce retinal hypoperfusion in adult Wistar rats of both genders. Groups were housed in standard, enriched or impoverished conditions. Impoverished environment was induced by social isolation. Retinas were processed for histological analysis after two weeks of survival. In the present study, we show that (1) enriched environment has protective effects in adult ischemic retinal lesion, while (2) impoverished environment further increases the degree of ischemic injury, and (3) that these environmental effects are gender-dependent: females are less responsive to the positive effects of environmental enrichment and more vulnerable to retinal ischemia in social isolation. In summary, our present study shows that the effects of both positive and negative environmental stimuli are gender-dependent in ischemic retinal lesions.


Assuntos
Estenose das Carótidas/metabolismo , Retina/lesões , Retina/metabolismo , Meio Social , Isolamento Social , Animais , Artérias Carótidas/cirurgia , Feminino , Isquemia/cirurgia , Masculino , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Wistar , Fatores Sexuais , Traumatismos do Sistema Nervoso/metabolismo
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