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1.
Public Health ; 179: 90-99, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31760206

RESUMO

OBJECTIVES: The Australian National Bowel Cancer Screening Program (NBCSP) offers free 2-yearly immunochemical faecal occult blood testing to individuals aged 50-74 years; national participation in 2015-2016 was 41%. In 2017, a 7-week television-led mass-media campaign to increase participation in the Australian state of Victoria was associated with a 1.31-fold increase in participation for 11 weeks. We aimed to evaluate the cost-effectiveness and health benefits of the 2017 campaign and scaled-up equivalent campaigns run over 4 years in Victoria and nationally. STUDY DESIGN: This study used microsimulation modelling. METHODS: A comprehensive microsimulation model of colorectal cancer (CRC), Policy1-Bowel, was used to simulate three scenarios. Scenario 1 simulated the 2017 campaign in Victoria; Scenarios 2 and 3 assumed that campaigns were run three times annually from 2019 to 2022 in Victoria and Australia-wide, respectively. Total campaign costs of AUD$1million, AUD$10million, and AUD$40million were assumed for Scenarios 1, 2, and 3, respectively. The incremental effects and costs of the campaign on the NBCSP were assessed. A governmental perspective was used. RESULTS: All campaign scenarios were predicted to be highly cost-effective, with cost-effectiveness ratios under AUD$4,800/life-year saved. The actual 2017 campaign in Victoria is estimated to prevent 319 CRC cases and 183 deaths over the following 40 years. A 4-year campaign would prevent 1,750 CRC cases and 987 deaths if conducted in Victoria, and 8,100 cases and 4,330 deaths if conducted Australia-wide. CONCLUSION: Mass-media participation campaigns could be highly cost-effective and maximise the potential life-saving impact of bowel screening. These results support ongoing investment in major bowel screening campaigns.


Assuntos
Neoplasias Colorretais/prevenção & controle , Detecção Precoce de Câncer/estatística & dados numéricos , Promoção da Saúde/economia , Meios de Comunicação de Massa , Idoso , Análise Custo-Benefício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vitória
2.
Scand J Med Sci Sports ; 22(6): 816-21, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21564307

RESUMO

Imagery can improve functional outcomes post-anterior cruciate ligament repair (ACLR). Research is needed to investigate potential mechanisms for this effect. The aim of this study was to (a) evaluate the effectiveness of an imagery intervention to improve functional outcomes post-ACLR, and (b) explore potential mechanisms. A randomized-controlled pilot trial was conducted. Participants were randomized to guided imagery and standard rehabilitation or standard rehabilitation alone (control). The primary outcome was knee strength 6-month post-operatively. Secondary outcomes were knee laxity at 6-months, and change in psychological (self-efficacy) and neurohormonal (adrenaline, noradrenaline, dopamine) variables. Participants (n=21; 62% male) were 34.86 (SD 8.84) years. Following the intervention, no statistical differences between groups for knee strength extension at 180°/s (t=-0.43, P=0.67), or at 60°/s (t=-0.72, P=0.48) were found. A statistically significant effect was found for knee laxity, F=4.67, P<0.05, mean difference of -3.02 (95% CI -4.44 to -1.60), favoring the intervention. No differences were found for self-efficacy; however, an overall effect was found for noradrenaline, F(1, 19) 19.65, P<0.001, η(2) =0.52, and dopamine, F(1, 19) 6.23, P=0.02, η(2) =0.29, favoring the intervention. This imagery intervention improved knee laxity and healing-related neurobiological factors.


Assuntos
Reconstrução do Ligamento Cruzado Anterior/psicologia , Reconstrução do Ligamento Cruzado Anterior/reabilitação , Imagens, Psicoterapia , Instabilidade Articular/fisiopatologia , Articulação do Joelho/fisiologia , Adulto , Análise de Variância , Dopamina/sangue , Epinefrina/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Norepinefrina/sangue , Projetos Piloto , Recuperação de Função Fisiológica , Autoeficácia , Método Simples-Cego
3.
Drug Metab Dispos ; 39(9): 1674-9, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21677062

RESUMO

1-Aminobenzotriazole (ABT) has been used widely as a nonselective in vitro and in vivo inhibitor of cytochrome P450 enzymes. To date, however, it has not been evaluated as an inhibitor of UDP-glucuronosyltransferase (UGT), sulfotransferase (SULT), and N-acetyltransferase (NAT). In the present study, ABT was shown not to inhibit UGT and SULT activity (acetaminophen and 7-hydroxycoumarin as substrates) in rat liver microsomes and rat liver 9000 g supernatant fraction (RLS9), respectively. However, it did inhibit the RLS9-catalyzed N-acetylation of procainamide (IC(50) ∼ 30 µM), and no preincubation time dependence was evident. In agreement, oral ABT (100 mg/kg, 2 h predose) decreased the clearance of intravenous procainamide (45%) in rats, accompanied by a decreased N-acetylprocainamide-to-procainamide ratio in urine (0.74 versus 0.21) and plasma (area under the curve ratio 0.59 versus 0.11). Additional studies with human forms of NAT (hNAT1 and hNAT2) revealed that ABT is a more potent inhibitor of hNAT2 compared with hNAT1 (IC(50) 158 µM versus > 1 mM). Consistent with the IC(50) estimate, formal inhibition studies revealed that inhibition of hNAT2 was competitive with an inhibition constant of 67 µM. In accordance with the competitive inhibition, ABT was shown to undergo N-acetylation in the presence of both human NAT forms, with hNAT1 exhibiting less activity under the same assay conditions (∼40% of hNAT2). In summary, the results described herein indicate that ABT is a substrate and inhibitor of NAT. Such an interaction should be considered when using ABT as a nonselective inhibitor of P450, especially when NAT-dependent metabolism is also involved.


Assuntos
Inibidores das Enzimas do Citocromo P-450 , Sistema Enzimático do Citocromo P-450/metabolismo , Triazóis/metabolismo , Triazóis/farmacologia , Acetaminofen/metabolismo , Acetilação/efeitos dos fármacos , Animais , Arilamina N-Acetiltransferase/antagonistas & inibidores , Arilamina N-Acetiltransferase/metabolismo , Glucuronosiltransferase/metabolismo , Humanos , Isoenzimas/antagonistas & inibidores , Isoenzimas/metabolismo , Masculino , Microssomos Hepáticos/enzimologia , Microssomos Hepáticos/metabolismo , Procainamida/metabolismo , Ratos , Ratos Sprague-Dawley , Sulfotransferases/metabolismo , Umbeliferonas/metabolismo
4.
Vet Comp Orthop Traumatol ; 24(4): 272-8, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21451886

RESUMO

OBJECTIVE: To determine the effect of stifle angle on the magnitude of the radiographic tibial plateau angle (TPA) in normal and cranial cruciate ligament (CCL) -deficient stifles. METHODS: Three pairs of canine cadaver hindlimbs from three skeletally mature dogs were positioned in a custom-made positioning device. A lateral radiograph of each specimen was obtained before and after transection of the CCL at four stifle angles (90°, 110°, 135° and 140-150° [i.e. maximum extension]), based on goniometric measurements. Four observers determined the radiographic TPA twice for each radiograph with a minimum of two days between each measurement. The radiographic TPA measurements in all specimens at different stifle angles with intact CCL and transected CCL were compared with mixed-model ANOVA. The effect of stifle angle, CCL transection, and interaction between the two on observer TPA measurement variability was also determined using the coefficient of variation. RESULTS: Tibial plateau angle was not statistically different in the stifle angles for either the intact or transected CCL. There was also no statistical difference for TPA between intact and transected CCL groups at each of the stifle angles. Stifle angle, CCL transection and interaction between the two did not have any significant effect for intra-observer and inter-observer variation. CLINICAL SIGNIFICANCE: The angle of the stifle during radiography does not influence the magnitude of the TPA measurement as determined on true lateral radiographs of the stifle and tibia in cadaveric canine limbs.


Assuntos
Lesões do Ligamento Cruzado Anterior , Cães/lesões , Joelho de Quadrúpedes/cirurgia , Animais , Ligamento Cruzado Anterior/cirurgia , Fenômenos Biomecânicos , Cadáver , Joelho de Quadrúpedes/lesões , Joelho de Quadrúpedes/fisiologia , Tíbia/cirurgia
5.
J Small Anim Pract ; 60(4): 247-253, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30693513

RESUMO

OBJECTIVE: To develop a perceived exertion scale for dogs exercising on a treadmill and to assess intra- and inter-observer variability. MATERIALS AND METHODS: Fifteen healthy client-owned dogs participated in paired exercise trials. Measurements of lactate, glucose, heart rate, temperature, respiratory rate and regional tissue oximetry were obtained before, during and after exercise. Perceived exertion scale scores were recorded during exercise and using video recordings to evaluate inter-observer variability. Correlations were evaluated using the Spearman's non-parametric method. RESULTS: Thirteen dogs completed both trials. Dogs walked or trotted on the treadmill with an average perceived exertion score of 2 in both trials. Holter heart rate was positively correlated with perceived exertion scale scores from all observers for both trials. In trial 1, plasma glucose decreased in association with increase in perceived exertion and, in trial 2, cutaneous oximetry decreased, respiratory rate increased and temperature increased with increases on the perceived exertion scale. Inter-observer perceived exertion scale scores were positively correlated in both trials. There was no intra-observer variability between trials. CLINICAL SIGNIFICANCE: The perceived exertion scale correlated with the measured physiologic parameters in dogs exercising at mild to moderate intensity. The perceived exertion scale was consistent and repeatable but larger study numbers and further validation are needed before it can be widely applied.


Assuntos
Condicionamento Físico Animal , Esforço Físico , Animais , Cães , Teste de Esforço/veterinária , Frequência Cardíaca , Caminhada
6.
J Anim Sci ; 95(7): 2907-2916, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28727103

RESUMO

Our objective was to evaluate the short-term effects of calcium fructoborate (CFB) on gait, joint range of motion, serum inflammatory markers, and owner perception of pain in client-owned dogs. We used 59 osteoarthritic dogs with impairment, with dogs being randomly assigned to 4 treatments: placebo (60 mg fructose; = 15), low dose (69 mg CFB; = 14), high dose (127 mg CFB; = 14), or combination (69 mg CFB, 500 mg glucosamine hydrochloride and 200 mg chondroitin sulfate; = 16). Dogs up to 22.9 kg received 1 capsule/d, while dogs weighing 23 to 50 kg received 2 capsules/d. A physical examination, radiographs, goniometry measurements, gait analysis, blood sample collection, and a canine brief pain inventory questionnaire were performed on d 0 and 28. Change from baseline values were statistically analyzed among groups. After 28 d, dogs fed the low and high doses had an improved ( < 0.05) ability to rise from a lying position compared to placebo. Dogs fed the high dose also had a greater ( = 0.05) increase in soluble receptor for advanced glycation end products concentration than dogs fed the placebo. Sub-analysis of only large dogs (> 23 kg) showed that dogs fed the low dose had decreased ( < 0.05) pain severity score and pain at its worst compared to dogs fed the placebo. Large dogs fed the low dose also were shown to improve ( < 0.05) in their ability to rise from a lying position compared to dogs fed the placebo. Overall, CFB supplementation was well-tolerated and may aid in mitigating joint discomfort in dogs.


Assuntos
Boratos/administração & dosagem , Suplementos Nutricionais , Doenças do Cão/dietoterapia , Frutose/análogos & derivados , Osteoartrite/veterinária , Dor/veterinária , Animais , Boratos/farmacologia , Cálcio da Dieta/administração & dosagem , Cálcio da Dieta/farmacologia , Doenças do Cão/patologia , Cães , Método Duplo-Cego , Frutose/administração & dosagem , Frutose/farmacologia , Marcha , Inflamação/sangue , Inflamação/veterinária , Articulações/efeitos dos fármacos , Articulações/patologia , Osteoartrite/complicações , Osteoartrite/dietoterapia , Osteoartrite/patologia , Dor/tratamento farmacológico , Dor/etiologia , Medição da Dor/efeitos dos fármacos , Distribuição Aleatória , Amplitude de Movimento Articular/efeitos dos fármacos
7.
Tob Control ; 15(3): 270-1, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16728761

RESUMO

Banning the display of tobacco products represents a major step in tobacco control and will help to reduce tobacco sales.


Assuntos
Marketing/normas , Indústria do Tabaco/normas , Publicidade/normas , Austrália , Humanos , Prevenção do Hábito de Fumar
8.
J Comp Neurol ; 309(1): 141-9, 1991 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-1894767

RESUMO

The development of type 2 (Colonnier, '81) synapses on the cell bodies of thalamic recipient spiny stellate neurons in layers 4C alpha and 4C beta of primary visual cortex neurons was examined over the first 36 postnatal weeks and in the adult monkey. The type 2 synapses, known to be GABAergic (Ribak, '78) and therefore presumed to be inhibitory, developed faster on the alpha neurons than the beta neurons. Both neuron groups show a marked increase and then decline in the percentage of the somatic membrane covered by type 2 synaptic appositions during this 36-week time period. The time course of the type 2 synapses development is compared to that of the spine synapse development described in previous studies (Lund and Holbach, '91; Lund et al., '91), and it is clear that on both neuron groups this inhibitory synapse population is put in place and refined later than the spine synapses. These findings suggest that each cortical neural circuit has a unique time course for its early development within an overall time window (Rakic et al., '86), or sensitive period (Hubel and Wiesel, '70). Visual deprivation, although causing the alpha and beta neurons to adopt a more similar temporal and numerical developmental pattern than normal, did not prevent acquisition and loss phases of type 2 synapses or the assumption of a normal numerical loading by 36 weeks of age.


Assuntos
Macaca nemestrina/crescimento & desenvolvimento , Neurônios/fisiologia , Sinapses/fisiologia , Tálamo/crescimento & desenvolvimento , Córtex Visual/crescimento & desenvolvimento , Envelhecimento , Animais , Escuridão , Microscopia Eletrônica , Neurônios/ultraestrutura , Valores de Referência , Sinapses/ultraestrutura , Tálamo/anatomia & histologia , Tálamo/fisiologia , Visão Ocular , Córtex Visual/anatomia & histologia , Córtex Visual/fisiologia
9.
J Med Chem ; 44(23): 3764-7, 2001 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-11689063

RESUMO

Multiple delayed rectifier potassium currents, including I(Ks), are responsible for the repolarization and termination of the cardiac action potential, and blockers of these currents may be useful as antiarrhythmic agents. Modification of compound 5 produced 19(S) that is the most potent I(Ks) blocker reported to date with >5000-fold selectivity over other cardiac ion channels. Further modification produced 24A with 23% oral bioavailability.


Assuntos
Benzamidas/síntese química , Oxidiazóis/síntese química , Bloqueadores dos Canais de Potássio , Bloqueadores dos Canais de Potássio/síntese química , Canais de Potássio de Abertura Dependente da Tensão da Membrana , Administração Oral , Animais , Benzamidas/química , Benzamidas/farmacologia , Disponibilidade Biológica , Cromatografia Líquida de Alta Pressão , Cristalografia por Raios X , Desenho de Fármacos , Técnicas In Vitro , Canais de Potássio KCNQ , Canal de Potássio KCNQ1 , Oócitos/metabolismo , Oócitos/fisiologia , Oxidiazóis/química , Oxidiazóis/farmacologia , Técnicas de Patch-Clamp , Bloqueadores dos Canais de Potássio/química , Bloqueadores dos Canais de Potássio/farmacologia , Canais de Potássio/metabolismo , Ratos , Estereoisomerismo , Relação Estrutura-Atividade , Xenopus
10.
Am J Clin Pathol ; 77(5): 614-8, 1982 May.
Artigo em Inglês | MEDLINE | ID: mdl-6805309

RESUMO

A collaborative study was carried out to determine the suitability of commercial assayed plasmas for one-stage factor VIII assays. Activated partial thromboplastin times were performed on successive days on serially diluted paired freeze-dried reference plasmas (one sample buffered with HEPES), a freeze-dried test plasma and local laboratory standards-commercial assayed plasmas and in-house frozen pooled plasmas calibrated against commercial plasmas. The factor VIII activity levels of the study reference plasmas relative to average normal plasma were arrived at cumulatively by assaying them against a large number of individual fresh normal plasmas. Estimates of the activity of the test plasma relative to the claimed activity of local standards showed significant discrepancies from the expected value. However the estimates were more precise when the activity was assessed relative to the activity of the local standards derived by calibration against the reference plasmas. The study also showed that a HEPES buffered reference plasma may not contribute to inter-laboratory variability of one-stage factor VIII assays.


Assuntos
Fator VIII/análise , Plasma/análise , Padrões de Referência , Adulto , Estudos de Avaliação como Assunto , Feminino , Liofilização , HEPES , Humanos , Indicadores e Reagentes , Masculino , Tempo de Tromboplastina Parcial
11.
Am J Clin Pathol ; 75(2): 197-200, 1981 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-6781330

RESUMO

The reliability of "standard" plasmas used by clinical laboratories to assay factor VIII concentrations of patients' plasmas was studied by assessing the credibility of their reference values. Two of three commercial reference plasmas were considered to be unreliable. The third commercial reference plasma appeared to be suitable when assayed against frozen pools of fresh normal plasma with an assigned value of 100% activity. However, assays using fresh pools of normal plasma suggested that the reference value may lack credibility. This study also showed that assignment of 100% activity to frozen pools of fresh normal plasma prepared locally in laboratories may be fallacious.


Assuntos
Fator VIII/análise , Padrões de Referência , Estudos de Avaliação como Assunto , Fator VIII/normas , Humanos
12.
Tob Control ; 12(2): 231-3, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12773737

RESUMO

"Smoking is a powerful re-inforcement for the trance-inducing rituals associated with gambling."


Assuntos
Jogo de Azar/psicologia , Fumar/psicologia , Humanos , Renda , Reforço Psicológico , Fumar/economia , Poluição por Fumaça de Tabaco/prevenção & controle , Vitória
13.
Prev Vet Med ; 45(3-4): 201-20, 2000 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-10821961

RESUMO

This paper documents ethnoveterinary medicines used to treat dogs in Trinidad and Tobago. In 1995, a 4-stage process was used to conduct the research and document the ethnoveterinary practices. Twenty-eight ethnoveterinary respondents were identified using the school-essay method, which is a modified rapid rural appraisal (RRA) technique. Semi-structured interviews were held with these respondents as well as with 30 veterinarians, 27 extension officers and 19 animal-health assistants and/or agricultural officers, and the seven key respondents that they identified. The final step involved hosting four participatory workshops with 55 of the respondents interviewed to discuss the ethnoveterinary data generated from the interviews and to determine dosages for some of the plants mentioned. Supplementary interviews were conducted in 1997 and 1998. Seeds of Carica papaya, and leaves of Cassia alata, Azadirachta indica, Gossypium spp., Cajanus cajan and Chenopodium ambrosiodes are used as anthelmintics. The anthelmintics Gossypium spp. and Chenopodium ambrosiodes are the most frequently used species. Crescentia cujete pulp, Musa spp. stem exudate, the inside of the pods of Bixa orellana, leaves of Cordia curassavica and Eclipta alba plant tops are used for skin diseases. Musa spp. stem exudate, seeds of Manilkara zapota, Pouteria sapota and Mammea americana and leaves of Cordia curassavica, Scoparia dulcis and Nicotiana tabacum are used to control ectoparasites. Dogs are groomed with the leaves of Cordia curassavica, Bambusa vulgaris and Scoparia dulcis. Psidium guajava buds and leaves and the bark of Anacardium occidentale are used for diarrhoea. Owners attempt to achieve milk let-down with a decoction of the leaves of Stachytarpheta jamaicensis. The plant uses parallel those practised in human folk medicine in other Caribbean countries and in other tropical countries.


Assuntos
Doenças do Cão/tratamento farmacológico , Fitoterapia , Plantas Medicinais/uso terapêutico , Animais , Cães , Etnofarmacologia , Extratos Vegetais/uso terapêutico , Inquéritos e Questionários , Trinidad e Tobago , Drogas Veterinárias/uso terapêutico
14.
Artigo em Inglês | MEDLINE | ID: mdl-11737880

RESUMO

BACKGROUND: Ethnomedicines are used by hunters for themselves and their hunting dogs in Trinidad. Plants are used for snakebites, scorpion stings, for injuries and mange of dogs and to facilitate hunting success. RESULTS: Plants used include Piper hispidum, Pithecelobium unguis-cati, Bauhinia excisa, Bauhinia cumanensis, Cecropia peltata, Aframomum melegueta, Aristolochia rugosa, Aristolochia trilobata, Jatropha curcas, Jatropha gossypifolia, Nicotiana tabacum, Vernonia scorpioides, Petiveria alliacea, Renealmia alpinia, Justicia secunda, Phyllanthus urinaria,Phyllanthus niruri,Momordica charantia, Xiphidium caeruleum, Ottonia ovata, Lepianthes peltata, Capsicum frutescens, Costus scaber, Dendropanax arboreus, Siparuma guianensis, Syngonium podophyllum, Monstera dubia, Solanum species, Eclipta prostrata, Spiranthes acaulis, Croton gossypifolius, Barleria lupulina, Cola nitida, Acrocomia ierensis (tentative ID). CONCLUSION: Plant use is based on odour, and plant morphological characteristics and is embedded in a complex cultural context based on indigenous Amerindian beliefs. It is suggested that the medicinal plants exerted a physiological action on the hunter or his dog. Some of the plants mentioned contain chemicals that may explain the ethnomedicinal and ethnoveterinary use. For instance some of the plants influence the immune system or are effective against internal and external parasites. Plant baths may contribute to the health and well being of the hunting dogs.


Assuntos
Doenças do Cão/tratamento farmacológico , Medicina Tradicional , Infestações por Ácaros/veterinária , Fitoterapia/métodos , Ferimentos e Lesões/veterinária , Animais , Mordeduras e Picadas/tratamento farmacológico , Cães , Humanos , Doenças dos Macacos/tratamento farmacológico , Plantas/classificação , Plantas Medicinais , Picadas de Escorpião/tratamento farmacológico , Escorpiões , Mordeduras de Serpentes/tratamento farmacológico , Trinidad e Tobago , Febre Amarela/tratamento farmacológico , Febre Amarela/veterinária
15.
J Am Acad Audiol ; 5(2): 99-109, 1994 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-8180434

RESUMO

In the present study, we measured preferred real-ear insertion gain (REIG) under different levels of speech and noise to assess whether current automatic gain control (AGC) and automatic signal processing (ASP) hearing aids are operating optimally. Preferred REIG for optimal speech clarity was determined under seven speech and noise conditions. In four conditions, speech (discourse passages) was varied from 55 dB SPL to 85 dB SPL in 10-dB steps at a fixed signal-to-noise ratio (S/N) of +5. In the remaining conditions, speech was fixed at 65 dB SPL while the noise level was varied in 5-dB steps to yield S/Ns from +10 to -5. The results showed that subjects selected less gain as speech or noise levels were increased. In general, less overall gain was selected as speech level was increased, and less overall gain, especially in the low-frequency region, was selected as the S/N ratio became progressively poorer. These results are discussed in relation to how hearing aids with adaptive frequency/gain responses should respond to varying input levels to achieve optimal clarity of speech.


Assuntos
Auxiliares de Audição , Perda Auditiva Neurossensorial/fisiopatologia , Percepção Sonora , Percepção da Fala , Adulto , Idoso , Desenho de Equipamento , Estudos de Avaliação como Assunto , Perda Auditiva Bilateral/fisiopatologia , Perda Auditiva Bilateral/reabilitação , Perda Auditiva Neurossensorial/reabilitação , Humanos , Pessoa de Meia-Idade , Ruído , Satisfação do Paciente
16.
West Indian Med J ; 49(4): 271-5, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11211533

RESUMO

We developed an open-chest porcine model of acute coronary occlusion and surgical reperfusion, and attempted to prevent intra-operative ischaemic ventricular fibrillation (VF) by a Retrograde Intracoronary Glyceryl trinitrate (RIG) infusion into the occluded vessel. Five Yorkshire pigs (weight 50 +/- 1.1 kg), randomized into 3 groups, underwent median sternotomy under general anaesthesia. One pig (Group 1, control) underwent sternotomy and pericardiotomy only. Four pigs underwent acute left anterior descending (LAD) coronary occlusion. Two pigs were not reperfused (Group 2). Two pigs underwent surgical reperfusion (Group 3) via left internal mammary artery (LIMA) grafting to the LAD using the Off-Pump Coronary Artery Bypass (OPCAB) technique. Ischaemic injury was assessed using 7-lead electrocardiography (ECG) and transthoracic/epimyocardial echocardiography (ECHO). Group 1: transient intraoperative hypotension and VF occurred. Successful resuscitation and 10-week survival (until sacrifice) with normal left ventricular (LV) function was achieved. Group 2: there were ECG and ECHO evidence of acute LV ischaemic dysfunction in both pigs. The surviving pig had persistent anterior hypokinesis at 8 1/2 months. The other died intra-operatively following progressive ischaemic LV dysfunction despite resuscitative attempts. Group 3: the surviving pig had normal LV function at 8 months. Initial anterior LV akinesis normalized within 7 days. The other developed post-occlusion haemodynamic instability and died intra-operatively despite reperfusion. In this porcine model, acute LAD artery occlusion modified by the novel RIG infusion technique, followed by surgical reperfusion (OPCAB) is feasible. This model would facilitate further development of OPCAB surgical expertise and understanding of the pathophysiology of ischaemia-reperfusion injury.


Assuntos
Doença das Coronárias/cirurgia , Modelos Animais de Doenças , Anastomose de Artéria Torácica Interna-Coronária/métodos , Traumatismo por Reperfusão Miocárdica/fisiopatologia , Suínos , Animais , Doença das Coronárias/fisiopatologia , Eletrocardiografia , Estudos de Viabilidade , Humanos , Reperfusão Miocárdica , Análise de Sobrevida , Disfunção Ventricular Esquerda
17.
J Med Assoc Ga ; 72(11): 795-7, 1983 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-6655381

RESUMO

PIP: In the US, the concept of eugenics has been limited to restrictions on the reproductive capabilities of criminals and the mentally defective. Moreover, the rights of persons subject to this restriction have been enhanced by recent judicial recognition of procreation as a fundamental right. Constitutional challenges have been mounted on the grounds that sterilization statutes constitute cruel or unusual punishment, a violation of the Equal Protection clause, an unlawful delegation of legislative or judicial powers, a bill of attainder, or a violation of the right to life, liberty, and the pursuit of happiness. These challenges have resulted in a reduction in the number of state-mandated sterilizations. This paper reviews the Georgia Supreme Court's recent invalidation of a 1970 statute authorizing the sterilization of mentally incompetent persons (O.C.G.A. 31-20-3). Motes v. Hall County Department of Family and Children Services, filed on behalf of a 21-year old retarded woman, challenged the statute as a violation of Motes' constitutional rights to due process and equal protection and contended that the state was required to prove the necessity of sterilization by more than a simple preponderance of the evidence. The Georgia Supreme Court negated both the sterilization order and the statute upon which it was based. In its decision, the Court recognized that an intrusion upon so fundamental a right as the ability to bear children requires proof by the state of at least "clear and convincing evidence" of the necessity of such an act.^ieng


Assuntos
Legislação Médica , Esterilização Reprodutiva , Feminino , Georgia , Humanos , Masculino
18.
J Med Assoc Ga ; 69(9): 785-7, 1980 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-7191438

RESUMO

PIP: Of late, there have been several court decisions of significance in the United States in the health care area. In 1 case the Supreme Court was faced with the question of whether or not states were required to fund abortions under the Medicaid program. In a 2nd case, a lower court was required to determine whether a Professional Standards Review Organization (PSRO) was a federal agency subject to the disclosure requirements of the federal Freedom of Information Act. Both of these issues are discussed. The Supreme Court authoritatively and conclusively established that a woman has no constitutional right to a state or federally funded abortion and with this ruling resolved several contrary lower court decisions and extended Congressional power to limit the expenditure of federal funds. Congress has established by a funding exclusion commonly referred to as the "Hyde Amendment," a limitation upon the expenditure of federally appropriated funds provided pursuant to Title 19 of the Social Security Act (Medicaid). A United States District Court in Georgia held that this exclusion was not to affect a state's duty to fund abortions deemed to be "medically necessary." A United States District Court in New York held the Hyde Amendment to be unconstitutional for failing to require funding of abortions that were deemed medically necessary. Contrary to the Georgia Court's ruling, the Supreme Court determined that the Medicaid program provides no unilateral funding obligation for a state which chooses to participate in the system. Contrary to the New York Court's ruling, the Sumpreme Court concluded that the Hyde Amendment is not constitutionally deficient. The Supreme Court determined that the limitation of abortion funding does not constitute a violation of the Establishment Clause of the 1st Amendment and that the limitation upon funding does not constitute a violation of the Equal Protection Clause of the 14th Amendment. The District Court in the District of Columbia determined that the PSRO was clothed with "indicia of agency status" and thus was an "agency" within the meaning of the Freedom of Information Act. This decision resulted in a furor among the numerous PSROs and among the persons and institutions providing information and records to those entitites. Recently, the District Court for the Eastern District of Pennsylvania refused to find that a PSRO was an "agency" within the meaning of the FOI Act.^ieng


Assuntos
Aborto Legal/economia , Organizações de Normalização Profissional/legislação & jurisprudência , Feminino , Financiamento Governamental , Humanos , Gravidez , Estados Unidos
19.
Vet Comp Orthop Traumatol ; 27(6): 436-40, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25328081

RESUMO

OBJECTIVE: To compare the ultimate tensile strength (UTS) and load to 1 and 3 mm gap formation of smooth (3-metric) and knotless barbed (4-metric) polypropylene sutures placed in a three-loop pulley pattern for canine gastrocnemius tendon repair. STUDY DESIGN: In vitro. SAMPLE SIZE: Thirty-three paired bone-tendon units with one of each pair assigned to each suture type. Barbed suture size was based on previously published materials testing results. METHODS: Each unit was placed in a servo-hydraulic testing machine and tested under single cycle tensile loading until repair failure. RESULTS: There was a significantly higher UTS for smooth polypropylene compared to the barbed polypropylene repairs. The loads resulting in 1 and 3 mm gaps for the barbed repairs were consistently significantly less than the corresponding smooth polypropylene repair values. CONCLUSION: The knotted smooth polypropylene repair was consistently stronger than the knotless barbed polypropylene repair when placed in a three-loop pulley pattern for gastrocnemius repair. CLINICAL SIGNIFICANCE: Knotless barbed polypropylene suture should not be considered equivalent to knotted smooth polypropylene of comparable tensile strength when placed in a three-loop pulley pattern for canine gastrocnemius tendon repair. The low failure loads of the barbed repair are probably due to failure of the barbs to anchor consistently throughout the tendon in the knotless configuration.


Assuntos
Polipropilenos , Técnicas de Sutura/veterinária , Suturas/veterinária , Traumatismos dos Tendões/veterinária , Animais , Cães/lesões , Cães/cirurgia , Técnicas de Sutura/instrumentação , Traumatismos dos Tendões/cirurgia , Resistência à Tração
20.
Vet Comp Orthop Traumatol ; 26(3): 208-17, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23460337

RESUMO

OBJECTIVE: To evaluate the effect of two tibial attachment sites for lateral suture stabilization (LSS) on the three-dimensional femorotibial translational and rotational movements of the cranial cruciate ligament- deficient canine stifle during the early, middle and late stance phases. STUDY DESIGN: In vitro biomechanical study: 32 hindlimbs from 16 canine cadavers. METHODS: Limbs were mounted in a testing jig and an electromagnetic tracking system was used to determine the three-dimensional femorotibial translational and rotational movements under 33% of body weight load during early, middle and late stance in the following sequence: cranial cruciate ligament-intact, cranial cruciate ligament-deficient and LSS with the distal anchor through the tibial tuberosity (LSSTT) or through the cranial eminence of the extensor groove (LSSEG). The proximal anchor point was the lateral femorofabellar ligament. RESULTS: Post-LSS stifle three-dimensional femorotibial translational and rotational movements were more comparable to normal than post-transection movements for both techniques. Both LSS techniques restored femorotibial movements in cranial cruciate ligament-deficient stifles to varying amounts but neither technique successfully restored normal three-dimensional femorotibial movements. The LSSEG improved femorotibial movements of the cranial cruciate ligament-deficient stifle in the medial-lateral direction and axial rotation but performed poorly in restoring femorotibial movements in the cranial-caudal direction as compared to the LSSTT. CLINICAL SIGNIFICANCE: Both the LSSTT and LSSEG techniques failed to completely restore normal three-dimensional femorotibial translational and rotational movements in cranial cruciate ligament-deficient stifles in vitro.


Assuntos
Ligamento Cruzado Anterior/cirurgia , Cães , Joelho de Quadrúpedes/cirurgia , Técnicas de Sutura/veterinária , Animais , Fenômenos Biomecânicos , Cadáver
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