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We present a novel fiber-interferometric device that achieves dual functionality: simultaneous amplification of the pulsed input signal and generation of its second harmonic while effectively suppressing the intensity noise in both modes, reaching the standard quantum-limit. The underlaying mechanism is based on phase-biased nonlinear polarization rotation coupled with type-I phase-matched second harmonic generation, a concept that is both theoretically investigated and experimentally verified. In the experiment, a fiber-optic system is constructed capable of generating 42â MHz ultra-low noise sub-150 fs output pulse trains simultaneously at 1030â nm and 515â nm, with average powers of 165â mW and 50â mW, respectively. Systematic frequency-resolved intensity noise measurements confirm dual wavelength, quantum-limited noise suppression beyond 100 kHz offset-frequency, with suppression levels up to 14â dB, showing correlation with local maxima in average power in both fundamental and second harmonic mode.
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BACKGROUND: Nurses have significant levels of depression, anxiety, and stress as a result of their exposure to various stressors at work. Emotional intelligence and resilience are relatively new notions essential for nurses to naturalize high levels of psychological problems. The study aimed to investigate the relationship between emotional intelligence and resilience and their impact on depression, anxiety, and stress among nurses. METHODS: A cross-sectional descriptive design was used and recruited 152 nurses from three private hospitals in Jordan. Variables were measured using the Depression Anxiety Stress Scale, Brief Resilience Scale, and Brief Emotional Intelligence Scale. RESULTS: The participants' average age was 27.6 years, and they were mostly female (66.4 %). Resilience earned an average of 3.1, while emotional intelligence averaged 31.7. Depression, anxiety, and stress were all significantly higher among nurses. Also, negative relationships were found between emotional intelligence, resilience, and psychological problems (p < .001). Emotional intelligence is positively associated with resilience (r = 0.83, p < .001). In addition, emotional intelligence and resilience were both significant predictors of depression, anxiety, and stress. CONCLUSION: Emotional intelligence is critical to nurses' well-being. Higher emotional intelligence is associated with higher resilience and lower levels of depression, anxiety, and stress among nurses. Interventions and education programs emphasizing emotional intelligence and resilience are essential to improving their mental health. Healthcare organizations and governments should promote these attributes to enhance nurses' psychological wellness in challenging healthcare settings.
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Ansiedad , Depresión , Inteligencia Emocional , Distrés Psicológico , Resiliencia Psicológica , Humanos , Jordania , Femenino , Masculino , Adulto , Estudios Transversales , Depresión/psicología , Ansiedad/psicología , Encuestas y Cuestionarios , Enfermeras y Enfermeros/psicología , Estrés Psicológico/psicologíaRESUMEN
In this work, we investigate an approach to scale up the output pulse energy in an all-polarization-maintaining 17.3 MHz Yb-doped fiber oscillator via implementation of a 25 µm core-diameter large-mode-area fiber. The artificial saturable absorber is based on a Kerr-type linear self-stabilized fiber interferometer, enabling non-linear polarization rotation in polarization-maintaining fibers. Highly stable mode-locked steady states in the soliton-like operation regime are demonstrated with 170 mW average output power and a total output pulse energy of â¼10n J distributed between two output ports. An experimental parameter comparison with a reference oscillator constructed with 5.5 µm core-sized standard fiber components reveals an increase of pulse energy by a factor of 36 with simultaneously reduced intensity noise in the high-frequency range >100k H z.
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OBJECTIVE: The objective of the article is to compare the results of using new screwed Amplatz sheath with results of the conventional Amplatz sheath regarding success and complications during percutaneous nephrolithotomy. METHODS: 100 patients aged more than 18 years with renal calculi more than 2 cm with guy's score 1 from December 2018 till July 2020 were randomly stratified by closed envelope in group A (50 patients) with using conventional sheath and group B (50 patients) with new screwed sheath. We exclude morbid obese patients and patients with contraindication for PNL. RESULTS: There were no significant differences between both groups regarding patients demographic and stone demographic. Operative time and fluoroscopy time were significantly lower in group B rather than group A. Tract stability was in favor of group B as no tract loss recorded while in group A, 5 cases were recorded. In overall complications there were no significant differences between both groups. Bleeding was higher in group A (14%) than in group B (4%), but it was not statistically significant. Success rates were 78% for group A and 88% for group B but it was not statistically significant. CONCLUSION: The screwed Amplatz sheath had showed less operative and fluoroscopy time. Also it enables urologists to have stable PNL tract. So it may be a promising tool to make PNL easier with higher success rate and lower complications.
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Cálculos Renales/cirugía , Nefrolitotomía Percutánea/instrumentación , Adulto , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
Doxorubicin (DOX), an anthracycline antibiotic, is an important antineoplastic agent due to its high antitumor efficacy in hematological as well as in solid malignancies. The clinical use of DOX is limited due to its cardiotoxic effects. The present study aimed to investigate the possible protective effect of olmesartan (Olm), l-carnitine (L-CA), and their combination in cardiotoxicity induced by DOX in rats. Male albino rats were randomly divided into seven experimental groups (n = 8): group I: normal control, group II: L-CA, group III: Olm, group IV: DOX. The other three groups were treated with Olm (10 mg/kg), L-CA (300 mg/kg), and their combination for 2 weeks after induction of cardiotoxicity by a single dose of DOX (20 mg/kg). In the results, DOX showed a significant elevation in serum troponin I, creatine kinase-MB (CK-MB), and lactate dehydrogenase (LDH) together with increased inflammation manifested by the rise of tumor necrosis factor-alpha (TNF-α), intercellular adhesion molecules-1 (ICAM-1), interleukin IL-1ß (IL-1ß), myeloperoxidase (MPO), nuclear factor-kappa B (NF-κB), and transforming growth factor beta (TGF-ß) in cardiac tissues as well as DOX-induced oxidative stress by increasing in malondialdehyde (MDA) and decreasing in superoxide dismutase (SOD) and glutathione (GSH) in heart tissues. In addition, caspase-3 activity was boosted as indication of increased apoptosis. On the other hand, administration of L-CA and Olm attenuated the DOX-evoked disturbances in the abovementioned parameters. In addition, DOX exhibited echocardiographic changes and severe histopathological changes, which were significantly reversed by L-CA and Olm treatment. In conclusion, the present study data confirm the protective role of L-CA and Olm in DOX-induced cardiotoxicity, which may be related to its antioxidant, antiinflammatory, and antiapoptotic agents.
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Cardiotoxicidad/tratamiento farmacológico , Carnitina/farmacología , Doxorrubicina/farmacología , Imidazoles/farmacología , Sustancias Protectoras/farmacología , Tetrazoles/farmacología , Animales , Antioxidantes/farmacología , Apoptosis/efectos de los fármacos , Cardiotoxicidad/etiología , Cardiotoxicidad/metabolismo , Forma MB de la Creatina-Quinasa/metabolismo , Corazón/efectos de los fármacos , Inflamación/tratamiento farmacológico , Inflamación/metabolismo , L-Lactato Deshidrogenasa/metabolismo , Masculino , Malondialdehído/metabolismo , Miocardio/metabolismo , Estrés Oxidativo/efectos de los fármacos , Ratas , Troponina I/metabolismo , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
BACKGROUND: Pediatric-onset SLE (pSLE) is a multisystem autoimmune disease. Recently, the ficolin-2 (FCN2) gene has emerged as a potential candidate gene for susceptibility to SLE. OBJECTIVES: The objective of this study was to evaluate the association of the FCN2 gene polymorphisms at positions -986 (G/A), -602 (G/A), -4 (A/G) and SNP C/T (rs3124954) located in intron 1, with susceptibility to pSLE in Egyptian children and adolescents. METHODS: This was a multicenter study of 280 patients diagnosed with pSLE, and 280 well-matched healthy controls. The FCN2 promoter polymorphisms at -986 G/A (rs3124952), -602 G/A (rs3124953), -4 A/G (rs17514136) and SNP C/T (rs3124954) located in intron 1 were genotyped by polymerase chain reaction, while serum ficolin-2 levels were assessed using enzyme-linked immunosorbent assay. RESULTS: The frequencies of the FCN2 GG genotype and G allele at -986 and -602 positions were significantly more represented in patients with pSLE than in controls (p < 0.001). Conversely, the FCN2 AA genotype and A allele at position -4 were more common in patients than in controls (p < 0.001). Moreover, patients carrying the FCN2 GG genotype in -986 position were more likely to develop lupus nephritis (odds ratio: 2.6 (95% confidence interval: 1.4-4.78); p = 0.006). The FCN2 AA genotype at position -4 was also identified as a possible risk factor for lupus nephritis (odds ratio: 3.12 (95% confidence interval: 1.25-7.84); p = 0.024). CONCLUSION: The FCN2 promoter polymorphisms may contribute to susceptibility to pSLE in Egyptian children and adolescents. Moreover, the FCN2 GG genotype at position -986 and AA genotype at position -4 were associated with low serum ficolin-2 levels and may constitute risk factors for lupus nephritis in pSLE.
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Predisposición Genética a la Enfermedad , Lectinas/genética , Lupus Eritematoso Sistémico/genética , Nefritis Lúpica/genética , Adolescente , Alelos , Estudios de Casos y Controles , Niño , Egipto , Femenino , Humanos , Modelos Logísticos , Masculino , Polimorfismo de Nucleótido Simple , Estudios Prospectivos , Factores de Riesgo , FicolinasRESUMEN
AIM: To further verify the effectiveness of diffusion-weighted (DWI) magnetic resonance imaging (MRI) and 1H magnetic resonance spectroscopy (MRS) using a 3 T MRI system to differentiate benign leiomyomas from uterine sarcoma; to investigate the benefit of adding MRS to the apparent diffusion coefficient (ADC) for improving the specificity of the benign/malignant classification. MATERIALS AND METHODS: The dataset included 21 uterine sarcoma from 14 patients and 84 benign leiomyomas from 51 patients. T1-and T2-weighted images as well as DWI were obtained using a 3-T MRI system. Approximately 60% of patients also underwent MRS. The chi-square test was used to compare the percentage of malignant lesions that showed choline peaks, lipid peaks, and restricted diffusion to the corresponding percentage of benign masses. Using the area under a receiver operating characteristic (AUC) curve, the efficacy of different parameters for distinguishing uterine sarcomas from leiomyomas was measured. RESULTS: The visual assessment of DWI images showed that 100% of malignant lesions exhibited restricted diffusion while the corresponding figure for benign leiomyomas was only 5%. The mean ADC of malignant tumours differed significantly from that of benign ones (p<0.001). The percentage of malignant lesions for which choline and lipid peaks were present was significantly higher than that of benign lesions. By combining the ADC and MRS findings, an accuracy of 98.3 (95.1-100) was achieved. CONCLUSIONS: The findings suggested that a combination of DWI and MRS could be useful in the preoperative assessment of uterine masses to differentiate benign leiomyomas from leiomyosarcoma.
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Imagen de Difusión por Resonancia Magnética/métodos , Leiomioma/diagnóstico por imagen , Espectroscopía de Resonancia Magnética/métodos , Miometrio/diagnóstico por imagen , Neoplasias Uterinas/diagnóstico por imagen , Adolescente , Adulto , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Sensibilidad y Especificidad , Útero/diagnóstico por imagen , Adulto JovenRESUMEN
AIM: Tamoxifen engages mitochondrial estrogen receptor beta as an antagonist, increases mitochondrial cytotoxicity and induces tumor cell death. Tamoxifen also engages plasma membrane estrogen receptor alpha as an agonist, while it is suggested that in some users its activation is put into action by mechanism of resistance to tamoxifen. Apoptotic inducers have been shown to promote tamoxifen-induced cell death, which might be of great importance in overcoming tamoxifen resistance. Considering the pleiotropic effects of statins, in the present study, we investigated the effects of atorvastatin on tamoxifen-induced intrinsic apoptotic pathway activity in melanoma cells. METHODS: Melanoma B16F10 cells were treated for 24 and 48 h with various concentrations of tamoxifen, atorvastatin and combination of tamoxifen + atorvastatin. Cells with no treatment were considered a control group, and the study was then followed by quantitative RT- PCR assay. Bax and cytochrome c gene expressions were calculated by ΔΔct method. RESULTS: Co-treatment of atorvastatin + tamoxifen could strongly enhance the expression of pro/apoptotic factors of Bax and cytochrome c in melanoma cells compared to the tamoxifen and atorvastatin groups. CONCLUSION: In general, we conclude that the atorvastatin-induced increase in Bax and cytochrome c gene expression might be a permissive response to tamoxifen-induced cell death (Fig. 2, Ref. 37).
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Apoptosis/efectos de los fármacos , Atorvastatina/farmacología , Melanoma Experimental , Tamoxifeno/farmacología , Animales , Línea Celular Tumoral , Citocromos c/metabolismo , Sinergismo Farmacológico , Ratones , Proteína X Asociada a bcl-2/metabolismoRESUMEN
The European Society of Endodontology and the American Association for Endodontists have released position statements and clinical considerations for regenerative endodontics. There is increasing literature on this field since the initial reports of Iwaya et al. (Dental Traumatology, 17, 2001, 185) and Banchs & Trope (Journal of Endodontics, 30, 2004, 196). Endogenous stem cells from an induced periapical bleeding and scaffolds using blood clot, platelet rich plasma or platelet-rich fibrin have been utilized in regenerative endodontics. This approach has been described as a 'paradigm shift' and considered the first treatment option for immature teeth with pulp necrosis. There are three treatment outcomes of regenerative endodontics; (i) resolution of clinical signs and symptoms; (ii) further root maturation; and (iii) return of neurogenesis. It is known that results are variable for these objectives, and true regeneration of the pulp/dentine complex is not achieved. Repair derived primarily from the periodontal and osseous tissues has been shown histologically. It is hoped that with the concept of tissue engineering, namely stem cells, scaffolds and signalling molecules, that true pulp regeneration is an achievable goal. This review discusses current knowledge as well as future directions for regenerative endodontics. Patient-centred outcomes such as tooth discolouration and possibly more appointments with the potential for adverse effects needs to be discussed with patients and parents. Based on the classification of Cvek (Endodontics and Dental Traumatology, 8, 1992, 45), it is proposed that regenerative endodontics should be considered for teeth with incomplete root formation although teeth with near or complete root formation may be more suited for conventional endodontic therapy or MTA barrier techniques. However, much is still not known about clinical and biological aspects of regenerative endodontics.
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Endodoncia Regenerativa/métodos , Endodoncia Regenerativa/tendencias , Hidróxido de Calcio/uso terapéutico , Bases de Datos Factuales , Pulpa Dental , Cavidad Pulpar , Necrosis de la Pulpa Dental/terapia , Desinfección/métodos , Ácido Edético/uso terapéutico , Predicción , Humanos , Péptidos y Proteínas de Señalización Intercelular/uso terapéutico , Enfermedades Periapicales/patología , Enfermedades Periapicales/terapia , Irrigantes del Conducto Radicular/uso terapéutico , Tratamiento del Conducto Radicular/métodos , Trasplante de Células Madre , Células Madre , Trombosis , Ingeniería de Tejidos/métodos , Andamios del Tejido , Ápice del Diente , Raíz del Diente/crecimiento & desarrollo , Raíz del Diente/cirugía , Resultado del TratamientoRESUMEN
Swallowing foreign body in adult is uncommon. This mostly occurs accidentally or in psychologically unsound patient. A 32-years-old male patient with abdominal pain admitted in surgery department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh with a history of swallowing various objects. After endoscopic confirmation and psychological evaluation he underwent laparotomy and 29 different objects were removed from his stomach by Gastrotomy. He was psychiatrically evaluated after recovery from operation and was found to be suffering from Schizophrenia with cannabis use. The aim of reporting this case can raise awareness at the patients complains should be taken seriously to prevent morbidity and even mortality.
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Cuerpos Extraños , Esquizofrenia , Adulto , Bangladesh , Cuerpos Extraños/cirugía , Humanos , Masculino , Estómago/cirugíaRESUMEN
Upper gastrointestinal hemorrhage (UGIH) is one of the most common and life-threatening gastrointestinal emergency. There are several risk scores for risk stratification in UGIB patients. The Modified Blatchford score, which relies only on clinical and laboratory parameters, is practical in the emergency setting The Modified Blatchford scoring system also known as Glasgow Blatchford Scoring (GBS) have been developed to stratify risk of non variceal upper gastrointestinal hemorrhage or need of medical or surgical intervention, endoscopic therapy. Objective of this study is to see risk stratification by The Modified Blatchford score and short term hospital outcome in non variceal upper GI hemorrhage patients. The observational study was carried out over a period of 6 months from October, 2014 to March, 2015 in Department of Department of Medicine, Gastroenterology and Surgery Mymensingh Medical College Hospital, Mymensingh. A total of 120 patients with non variceal UGIH were taken for the study during study period. Categorical variables were reported as percentage and Means and proportions were carried out using the Chi-square test (X2-test) of different variables by SPSS software version-18.0. Patients related variables age, sex; and main outcome variables the Modified Blatchford scoring system, Risk stratification, and short term hospital outcome were observed. Age frequency among total cases were 66(55%) <60 years, 50(41.67%) from 60-79 years and 4(3.3%) 80 years or above and sex distribution were 84(70%) were male and 36(30%) were female patients. Blatchford score of patients 1(0.83%) had score 0, 1(0.83%) had score 1, 2(1.67%) had score 2, 2(1.67%) had score 3, 2(1.67%) had score 4, 3(2.5%) had score 5, 12(10%) had score 6; 15(12.5%) had score 7, 16(13.33%) had score 8, 17(14.17%) had score 9, 16(13.33%) had score 10, 15(12.5%) had score 11, 10(8.33%) had score 12, 4(3.33% ) had score 13, 1(0.83%) had score 14, 2(1.67%) had score 15 and 1(0.83%) had score 16. Risk stratification showed 54(45%) had low risk (Mean GBS score 6.19±1.79), 66(55%) had high risk (Mean GBS score 11.03±1.83) Outcome of the patients were observed that 1(0.83%) died, 54(45%) was discharged without any medical or surgical intervention, and 65(54.17%) patients' needs medical or surgical intervention such as blood transfusion and endoscopy. Among total 120 patients with upper GI hemorrhage I have found that GBS score of three or less than three is predictive of low risk of adverse outcomes and can be discharged without any intervention.
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Hemorragia Gastrointestinal , Adulto , Transfusión Sanguínea , Femenino , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/terapia , Hospitales , Humanos , Masculino , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
Cholera is an important public health problem in Bangladesh. Interventions to prevent cholera depend on their cost-effectiveness which in turn depends on cholera incidence. Hospital-based diarrhoeal disease surveillance has been ongoing in six Bangladeshi hospitals where a systematic proportion of patients admitted with diarrhoea were enrolled and tested for Vibrio cholerae. However, incidence calculation using only hospital data underestimates the real disease burden because many ill persons seek treatment elsewhere. We conducted a healthcare utilization survey in the catchment areas of surveillance hospitals to estimate the proportion of severe diarrhoeal cases that were admitted to surveillance hospitals and estimated the population-based incidence of severe diarrhoea due to V. cholerae by combining both hospital surveillance and catchment area survey data. The estimated incidence of severe diarrhoea due to cholera ranged from 0.3 to 4.9/1000 population in the catchment area of surveillance hospitals. In children aged <5 years, incidence ranged from 1.0 to 11.0/1000 children. Diarrhoeal deaths were most common in the Chhatak Hospital's catchment area (18.5/100 000 population). This study provides a credible estimate of the incidence of severe diarrhoea due to cholera in Bangladesh, which can be used to assess the cost-effectiveness of cholera prevention activities.
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Cólera/epidemiología , Diarrea/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bangladesh/epidemiología , Áreas de Influencia de Salud , Niño , Preescolar , Cólera/microbiología , Diarrea/microbiología , Femenino , Hospitalización/estadística & datos numéricos , Hospitales , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Vibrio cholerae , Adulto JovenRESUMEN
During a study of the rhinebothriideans of rays in the Gulf of Oman, two new species of Rhinebothrium Linton, 1890, Rhinebothrium kruppi sp. n. and R. persicum sp. n., were identified in Glaucostegus granulatus (Cuvier). Some significant features that distinguish R. kruppi sp. n. from R. persicum sp. n. include: scolex characteristics (hinged with 42-46 loculi vs. fusiform with 68-62 loculi), number of testes (4-5 vs. 20-27), genital pore position (61.1-76.9% of proglottid length vs. 47.2-63.3%), ovarian morphology (lobulated vs. follicular), cirrus-sac expansion (past midline of proglottid vs. limited to poral side of proglottid), vas deferens configuration (spanning posteriorly to near ovarian isthmus vs. to the level of ovarian anterior margins) and details of microthrix morphology. In addition, a combination of the aforementioned characteristics can be used to distinguish these two new species from other valid species of Rhinebothrium. These are the first species of rhinebothriidean cestodes to be described systematically from the Gulf of Oman, Iran. The two new species reported here increase the number of valid species of Rhinebothrium to 43.
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Organismos Acuáticos/parasitología , Cestodos/clasificación , Cestodos/aislamiento & purificación , Infecciones por Cestodos/veterinaria , Elasmobranquios/parasitología , Enfermedades de los Peces/parasitología , Estructuras Animales/anatomía & histología , Animales , Cestodos/anatomía & histología , Infecciones por Cestodos/parasitología , Irán , MicroscopíaRESUMEN
A 35 years old man presented with retention of urine secondary to meatal stenosis with bulbar urethral stricture. He had a distended, palpable, tender urinary bladder. Urethral catheterization and dilatation was tried but failed. A trocar cystostomy was performed under local anaesthesia, which led to the injury to the small bowel when least expected. This is a rare but well recognized complication of small bowel injury following blind trocar suprapubic cystostomy when it was least expected and as such had a significant bearing on its management. We discuss its subsequent management and possible mechanism underlying this unexpected and unfortunate complication in the given circumstances.
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Cistostomía/efectos adversos , Perforación Intestinal/diagnóstico , Perforación Intestinal/cirugía , Intestino Delgado/lesiones , Adulto , Bangladesh , Cistostomía/instrumentación , Diagnóstico Diferencial , Humanos , Perforación Intestinal/etiología , Masculino , Resultado del Tratamiento , Estrechez Uretral/cirugíaRESUMEN
The management of the colon injury remains controversial in spite of a number of divergent reports during the past decade. Previously surgeons were reluctant to do primary anastomosis but now-a-days they are doing primary repair with good results. The present study is designed to see the early outcomes of primary repair in colonic injury. This prospective observational study performed at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2013 to June 2013 with allocation of 50 patients with colonic injury who underwent laparotomy with primary repair of that injury in the department of Casualty Surgery. A primary repair was performed after freshening the edges or by resection and primary anastomosis with 3.0 round-body Vicryl by single layer extra mucosal interrupted suture. Data processed using software SPSS version 16.0. For all analytical results a p value <0.05 was considered significant. In this study the commonest site of injury were transvers colon and sigmoid colon 38.0% in each. Out of 50 respondents, 5(10.0%) developed burst abdomen, 1(2.0%) developed entero-cutaneous fistula with none had paralytic ileus or septicaemia or pelvic collection. No mortality observed. This study showed that the increasing in colon injury scale (CIS) score culminate into increasing rate of postoperative complication & post operative complications were more at left colon (24%). On basis of our findings, we recommend the primary repair is a safe and effective surgical technique for addressing the large gut injury. Unnecessary proximal diversions should be avoided. According to our experience, we believe that the policy of primary repair of colon injuries can be applied more liberally in majority of patients with high success rate.
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Traumatismos Abdominales , Colon , Traumatismos Abdominales/cirugía , Anastomosis Quirúrgica , Bangladesh , Colon/lesiones , Colon/cirugía , Humanos , Complicaciones Posoperatorias , Estudios Prospectivos , Resultado del TratamientoRESUMEN
The objective of our analysis was to describe the aetiology, clinical features, and socio-demographic background of adults with diarrhoea attending different urban and rural diarrhoeal disease hospitals in Bangladesh. Between January 2010 and December 2011, a total of 5054 adult diarrhoeal patients aged ⩾20 years were enrolled into the Diarrhoeal Disease Surveillance Systems at four different hospitals (two rural and two urban) of Bangladesh. Middle-aged [adjusted odds ratio (aOR) 0·28, 95% confidence interval (CI) 0·23-0·35, P < 0·001] and elderly (aOR 0·15, 95% CI 0·11-0·20, P < 0·001) patients were more likely to present to rural diarrhoeal disease facilities than urban ones. Vibrio cholerae was the most commonly isolated pathogen (16%) of the four pathogens tested followed by rotavirus (5%), enterotoxigenic Escherichia coli (ETEC) (4%), and Shigella (4%). Of these pathogens, V. cholerae (19% vs. 11%, P < 0·001), ETEC (9% vs. 4%, P < 0·001), and rotavirus (5% vs. 3%, P = 0·013) were more commonly detected from patients presenting to urban hospitals than rural hospitals, but Shigella was more frequently isolated from patients presenting to rural hospitals than urban hospitals (7% vs. 2%, P < 0·001). The isolation rate of Shigella was higher in the elderly than in younger adults (8% vs. 3%, P < 0·001). Some or severe dehydration was higher in urban adults than rural adults (P < 0·001). Our findings indicate that despite economic and other progress made, conditions facilitating transmission of V. cholerae and Shigella prevail in adults with diarrhoea in Bangladesh and further efforts are needed to control these infections.
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Deshidratación/etiología , Diarrea/complicaciones , Diarrea/epidemiología , Diarrea/microbiología , Adulto , Anciano , Bangladesh/epidemiología , Cólera/epidemiología , Cólera/microbiología , Deshidratación/epidemiología , Deshidratación/microbiología , Deshidratación/virología , Diarrea/virología , Disentería Bacilar/epidemiología , Disentería Bacilar/microbiología , Escherichia coli Enterotoxigénica/aislamiento & purificación , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Femenino , Instituciones de Salud , Humanos , Masculino , Persona de Mediana Edad , Rotavirus/aislamiento & purificación , Infecciones por Rotavirus/epidemiología , Infecciones por Rotavirus/virología , Población Rural , Shigella/aislamiento & purificación , Factores Socioeconómicos , Población Urbana , Vibrio cholerae/aislamiento & purificación , Adulto JovenRESUMEN
There is limited information on percent expenditure of household income due to childhood diarrhoea especially in rural Bangladesh. A total of 4205 children aged <5 years with acute diarrhoea were studied. Percent expenditure was calculated as total expenditure for the diarrhoeal episode divided by monthly family income, multiplied by 100. Overall median percent expenditure was 3·04 (range 0·01-94·35). For Vibrio cholerae it was 6·42 (range 0·52-82·85), for enterotoxigenic Escherichia coli 3·10 (range 0·22-91·87), for Shigella 3·17 (range 0·06-77·80), and for rotavirus 3·08 (range 0·06-48·00). In a multinomial logistic regression model, for the upper tertile of percent expenditure, significant higher odds were found for male sex, travelling a longer distance to reach hospital (⩾median of 4 miles), seeking care elsewhere before attending hospital, vomiting, higher frequency of purging (⩾10 times/day), some or severe dehydration and stunting. V. cholerae was the highest and rotavirus was the least responsible pathogen for percent expenditure of household income due to childhood diarrhoea.
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Diarrea/economía , Gastos en Salud/estadística & datos numéricos , Renta/estadística & datos numéricos , Enfermedad Aguda , Bangladesh/epidemiología , Preescolar , Diarrea/epidemiología , Diarrea/microbiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Vigilancia de la Población , Factores de Riesgo , Población Rural , Encuestas y CuestionariosRESUMEN
The purposes of this study were to determine if (a) the log-transformed model can be applied to dynamic exercise and (b) the slope and y-intercept terms can provide additional information above and beyond the polynomial regression analyses. Eleven physically active individuals performed incremental cycle ergometry on a single occasion. Electromyographic electrodes were placed on the three superficial quadriceps muscles to record muscle activation during the exercise test. The patterns of responses for electromyographic amplitude vs power output were analyzed with polynomial and log-transformed regression models. The results of the polynomial regression for the composite data indicated that the best-fit model for the vastus lateralis muscle was linear (R(2) = 0.648, P < 0.0001), whereas the best-fit model for the rectus femoris (R(2) = 0.346, P = 0.013) and vastus medialis (R(2) = 0.764,P = 0.020) muscles was quadratic. One-way repeated measures analyses indicated no significant differences(P > 0.05) across the three superficial quadriceps muscles for the slope and y-intercept terms. These findings suggest that the log-transformed model may be a more versatile statistical approach to examining neuromuscular responses during dynamic exercise.
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Electromiografía , Ejercicio Físico/fisiología , Modelos Estadísticos , Músculo Cuádriceps/fisiología , Adulto , Prueba de Esfuerzo , Femenino , Humanos , Modelos Lineales , Masculino , Análisis de Regresión , Adulto JovenRESUMEN
MRI is a valuable noninvasive tool that helps in predicting the type of cardiac tumors and guiding management decisions. Several reports have described the appearance of cardiac fibromas on MRI, which typically show hyperenhancement on myocardial delayed enhancement (MDE) imaging, with or without a dark core. This report demonstrates the unique appearance of a large solitary ventricular septal cardiac fibroma in a 5-month-old patient on MDE imaging, with two discrete dark cores, each surrounded by a hyperenhancing pseudocapsule.
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Fibroma/diagnóstico , Fibroma/patología , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/patología , Imagen por Resonancia Magnética/métodos , Diagnóstico Diferencial , Femenino , Humanos , LactanteRESUMEN
The development of effluent removal prediction is crucial in providing a planning tool necessary for the future development and the construction of a septic sludge treatment plant (SSTP), especially in the developing countries. In order to investigate the expected functionality of the required standard, the prediction of the effluent quality, namely biological oxygen demand, chemical oxygen demand and total suspended solid of an SSTP was modelled using an artificial intelligence approach. In this paper, we adopt the clonal selection algorithm (CSA) to set up a prediction model, with a well-established method - namely the least-square support vector machine (LS-SVM) as a baseline model. The test results of the case study showed that the prediction of the CSA-based SSTP model worked well and provided model performance as satisfactory as the LS-SVM model. The CSA approach shows that fewer control and training parameters are required for model simulation as compared with the LS-SVM approach. The ability of a CSA approach in resolving limited data samples, non-linear sample function and multidimensional pattern recognition makes it a powerful tool in modelling the prediction of effluent removals in an SSTP.