RESUMO
We sought to assess the proportion of elicited close contacts diagnosed with coronavirus disease 2019 at the start of and before exiting quarantine in San Francisco. From June 8 to August 31, 6946 contacts were identified: 3008 (46.3%) were tested, 940 (13.5%) tested positive, and 90% tested positive in the first 9 days of quarantine.
RESUMO
OBJECTIVE: To compare the efficacy of massed vs. spaced group cognitive behavioural therapy (CBT) for patients with panic disorder with or without agoraphobia (PD). METHOD: Thirty-nine PD patients were randomly assigned to massed group CBT (daily 4-h sessions in week 1, two 2-h sessions in week 2 and one 2-h session in week 3) or traditional spaced weekly group CBT (13 consecutive, weekly 2-h sessions). The content and number of hours in the two treatment schedules were identical. Outcome was assessed after treatment, and at 3, 6 and 18 months of follow-up. RESULTS: Both treatment groups achieved significant improvement on all measures with large pre- to post-treatment and pre-treatment to follow-up effect sizes. No between-group differences were registered. Adherence and patient satisfaction did not differ between groups. CONCLUSION: The massed, 3-week group CBT schedule proved to be effective and feasible for PD patients with outcomes comparable with that of standard, spaced group CBT.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtorno de Pânico/terapia , Psicoterapia de Grupo/métodos , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Seguimentos , Humanos , Masculino , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/psicologia , Índice de Gravidade de Doença , Inquéritos e Questionários , Fatores de Tempo , Resultado do TratamentoRESUMO
The objective of the present study was to determine, in growing pigs, the ileal starch digestibility and ileal digestible starch content of 8 different genotypes of barley, rye, triticale, and wheat each. Therefore, 4 experiments were conducted with 34 ileally cannulated growing pigs (initial BW of 24 to 32 kg) in total. The experimental diets were formulated to contain 1 of the 8 genotypes of each cereal grain at an inclusion level of 95%. Cereal grains were ground through a 2-mm sieve and were the sole dietary source of starch. All diets were supplemented with plant oil, minerals and vitamins, and titanium dioxide as an indigestible marker. The experiments were arranged either as a row-column design with 8 periods of 6 d each and 9 pigs (for barley and wheat) or according to an 8 × 8 Latin square design with 8 periods of 6 (rye) or 7 d (triticale) and 8 pigs. Experimental periods comprised 4 (barley, rye, and wheat) or 5 d (triticale) for adaptation followed by 2 d for ileal digesta collection. The daily feed intake amounted to 4% of pigs' average BW, corresponding to about 3 times the animals' energy requirement for maintenance (106 kcal of ME [as-fed basis]/kg of metabolic BW). Ileal starch digestibility was different ( < 0.05) within barley and triticale genotypes, with values ranging between 90.1 and 95.0% for barley and between 96.5 and 98.1% for triticale and tended to differ within rye genotypes ( < 0.1). Ileal digestible starch content was different ( < 0.05) within all cereal grains. On average, ileal starch digestibility amounted to 92.7, 95.0, 97.3, and 92.2% for barley, rye, triticale, and wheat, respectively, and was different among cereal grains ( < 0.001). Average ileal digestible starch content was greatest ( < 0.001) in triticale (68.3%, DM basis) followed by wheat (66.1%, DM basis), rye (61.1%, DM basis), and barley (57.6%, DM basis). Differences in ileal starch digestibility and ileal digestible starch content within and among grain genotypes may reflect variations in contents of several fiber fractions such as NDF, ADF, and nonstarch polysaccharides (NSP). For most cereal grains, ileal starch digestibility and ileal digestible starch content decreased ( < 0.05) with increasing contents of soluble, insoluble, and total NSP. In conclusion, in the present study, triticale is superior when compared with the other cereal grains due to its relatively low fiber and high starch content and its high ileal starch digestibility values.
Assuntos
Fibras na Dieta/metabolismo , Amido/metabolismo , Suínos/fisiologia , Ração Animal/análise , Animais , Dieta/veterinária , Fibras na Dieta/análise , Suplementos Nutricionais , Digestão , Grão Comestível/genética , Hordeum/genética , Íleo/metabolismo , Secale/genética , Amido/análise , Triticale/genética , Triticum/genéticaRESUMO
To determine chemical composition, physical characteristics and standardized ileal digestibility (SID) of CP and amino acids (AA) in eight current hulled barley genotypes, an experiment with growing pigs has been conducted. These genotypes included Yool, Campanile, Lomerit, Travira, Anisette, Canberra, Metaxa and Fridericus. Growing barrows with an average initial BW of 30±2 kg were surgically fitted with simple T-cannulas at the distal ileum, and allotted to an 8×9 Youden square design with eight periods of 6 days each and nine pigs. Barley was the sole dietary source of CP and AA. On average, the eight genotypes contained on as-fed basis 10.7% CP, 15.2% total non-starch polysaccharides (NSP), 17.1% NDF and 4.1% ß-glucan, and had a mean test weight (TW) of 72.2 kg/hl. The SID of CP in the barley genotypes varied from 69% to 74%, and was greater (P<0.01) for genotypes Travira, Anisette and Metaxa compared to Yool and Campanile. Standardized ileal digestibility of Lys, Met and Trp (P<0.05) but not of Thr differed between genotypes. Moreover, barley genotypes differed in their standardized ileal digestible content (cSID) of CP and AA. Furthermore, SID and cSID of CP and most AA linearly decreased (P<0.05) with increasing NDF and total sugar content. Standardized ileal digestibility of CP and some AA and cSID of CP and most AA decreased linearly with increasing TW (P<0.05). Additionally, SID and cSID of CP and AA of most barley genotypes were lower when compared to tabulated values. In conclusion, a comprehensive database on chemical composition and SID of CP and AA in eight current barley genotypes has been made available. However, as present SID values are lower compared to feed tables, adjustments are required to minimize the risk of overestimating the actual protein value of barley for pigs.
Assuntos
Aminoácidos/metabolismo , Ração Animal/análise , Dieta/veterinária , Digestão/fisiologia , Hordeum/genética , Suínos/fisiologia , Fenômenos Fisiológicos da Nutrição Animal , Animais , Genótipo , Hordeum/metabolismo , Íleo/metabolismo , Masculino , beta-GlucanasRESUMO
A study with growing pigs was conducted to determine the chemical composition and standardized ileal digestibility (SID) of CP and AA of 8 wheat genotypes that have recently been added to the German Descriptive Variety List. These genotypes included Tabasco, KWS Erasmus, Tobak, Skalmeje, Mulan, Event, Tommi, and Adler. The 8 genotypes were grown under identical environmental conditions on the same site, and they were harvested and processed under the same conditions. Nine barrows with an initial BW of 32 ± 2 kg were surgically fitted with simple ileal T-cannulas and allotted to a row-column design with 9 pigs and 8 periods of 6 d each. Wheat was the sole dietary source of CP and AA. Among the 8 wheat genotypes, contents of CP ranged from 10.9 to 13.3% (as-fed basis), whereas contents of total nonstarch polysaccharides ranged from 8.0 to 9.4% (as-fed basis). The SID of CP in the 8 genotypes ranged from 83 to 87%, with greatest ( = 0.01) values for Event and lowest ( = 0.01) for all other wheat genotypes. Intermediate SID of CP values were obtained for Adler and KWS Erasmus. For Lys, greater ( < 0.05) SID was observed in Adler (73%) and KWS Erasmus (74%) in comparison to Tommi, Tobak, and Mulan (69%). Adler had greater SID of Met (88%; = 0.01) when compared to Tabasco (86%); Tobak, Skalmeje, and Mulan (85%); and Tommi (84%). Among the 8 wheat genotypes, standardized ileal digestible content (cSID) of CP followed total CP content and ranged from 9.1 to 11.3% (as-fed basis). Standardized ileal digestible content of both CP and AA were greater ( < 0.001) in Adler compared to all other genotypes. For most AA, Tabasco had the lowest ( < 0.001; except for His, Trp, Asp, and Cys) cSID values of all wheat genotypes. The cSID of CP decreased ( < 0.001) as the starch content in the 8 wheat genotypes increased, but cSID of CP increased ( < 0.001) as the CP content in the 8 genotypes increased. Because SID and cSID of CP and most AA increased ( < 0.05) with lower test weight and falling number, these variables may aid to predict SID and cSID in wheat batches, whereas other nutrients such as fiber fractions are not suitable due to low variation among the 8 genotypes. The present study provides a comprehensive database on nutritional composition and SID of CP and AA of 8 wheat genotypes grown under identical conditions. Because the SID values in these genotypes are lower when compared to literature data, digestibility values in actual feed tables for wheat may overestimate their protein values and need to be updated.
Assuntos
Aminoácidos/metabolismo , Digestão/fisiologia , Íleo/metabolismo , Suínos/metabolismo , Triticum/genética , Ração Animal/análise , Ração Animal/normas , Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Animais , Dieta/normas , Dieta/veterinária , Fibras na Dieta/metabolismo , Proteínas Alimentares/metabolismo , Genótipo , Masculino , Polissacarídeos/metabolismo , Distribuição Aleatória , Análise de Regressão , Estações do Ano , Suínos/crescimento & desenvolvimento , Triticum/metabolismoRESUMO
Three major assumptions emerged from these clinical and endocrine long-term studies. First, buserelin, given pernasally in the conventional doses, and Decapeptyl microcapsules administered intramuscularly in 5-week intervals are equally effective in terms of their long-term castration effect in previously untreated patients with prostatic carcinoma. However, Decapeptyl causes complete LH and subsequent testosterone down-regulation 1 week earlier than buserelin. Furthermore, this treatment is more convenient, and the compliance is better. Both LHRH analogues are equally well tolerated. Second, in groups of prostate cancer patients with far advanced disease treated with palliative intention, only true subjective or objective remission should be considered a positive treatment response. Third, our results comparing PAP and PSA as the two most useful tumor markers with the corresponding testosterone levels suggest a close correlation.
Assuntos
Adenocarcinoma/tratamento farmacológico , Antineoplásicos/administração & dosagem , Busserrelina/administração & dosagem , Hormônio Liberador de Gonadotropina/análogos & derivados , Neoplasias da Próstata/tratamento farmacológico , Adenocarcinoma/sangue , Adenocarcinoma/patologia , Administração Intranasal , Antineoplásicos/efeitos adversos , Biomarcadores Tumorais/sangue , Busserrelina/efeitos adversos , Ensaios Clínicos como Assunto , Hormônio Liberador de Gonadotropina/administração & dosagem , Hormônio Liberador de Gonadotropina/efeitos adversos , Humanos , Injeções Intramusculares , Metástase Linfática , Masculino , Estadiamento de Neoplasias , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Fatores de Tempo , Pamoato de TriptorrelinaRESUMO
This meta-analysis aimed to estimate the standardized ileal digestibility (SID) and the basal ileal endogenous amino acid losses (IAAend) in barley for growing pigs. In total, 38 different barley treatments published in 26 peer-reviewed papers were used for the meta-analysis containing information on dietary composition including amino acid (AA) contents of the assay diets, and (or) barley samples, as well as apparent ileal digestibility (AID) of AA in barley. The SID of AA was determined by either correcting AID of AA for their IAAend or by regression analysis between the apparent ileal digestible and total dietary AA contents. The SID values obtained by correcting the AID values for their IAAend amounted to 70%, 77%, 74% and 63% for Lys, Met, Thr and Trp, whereas those based on regression analysis method were 82%, 82%, 69% and 55%, respectively. Estimates of basal ileal endogenous loss of CP in ileal digesta varied considerably and averaged 11.84 g/kg dry matter intake (DMI), whereas IAAend for indispensable AA ranged from 0.05 g/kg DMI for Trp to 1.90 g/kg DMI for Leu. In most cases, these estimates were considerably higher than previously reported values for IAAend. The results of the present regression analysis indicate for most AA higher SID values compared with SID of most AA that were obtained by correcting AID values for IAAend. In view of the observed high variations in IAAend and the low CP content of the barley samples, estimating SID of AA based on literature data by means of the regression method may improve accuracy of SID coefficients for barley. In contrast, transformation of AID values into their corresponding SID values by using a constant correction factor for IAAend adds an additional source of error, thereby reducing the precision in estimating SID of AA.
Assuntos
Aminoácidos/metabolismo , Hordeum/efeitos adversos , Suínos/fisiologia , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Proteínas Alimentares/metabolismo , Digestão , Alimentos Formulados , Íleo/metabolismo , Análise de RegressãoRESUMO
A study with growing barrows was conducted to evaluate of variations in particle size and degree of heat treatment during processing on standardized ileal digestibility (SID) of AA in soybean (Glycine max) meal (SBM). A commercial SBM batch was visually identified as being overtoasted due to its brownish color and was separated into small and large particles using a 1-mm sieve. In addition, 3 SBM were produced from 1 batch of soybean and exposed to different processing conditions (temperature and direct steam contact) referred to as mild (105°C; 34 min), medium (115°C; 45 min), and strong (139°C; 7 min). In total, 5 SBM-corn (Zea mays) starch-based diets were formulated to contain SBM as the sole protein source. This experiment was conducted according to a 6 × 6 Latin square design using 6 barrows (23 kg initial BW) fitted with a T-cannula at the distal ileum. With increasing particle size, SID of His and some dispensable AA increased (P < 0.05). Lower SID values in small compared to large SBM particles indicate more pronounced heat damage possibly due to increased surface area. The SID of CP and AA was lowest in the mild, intermediate in the strong, and highest in the medium toasted SBM (P < 0.001). These differences in SID are reflected in varying contents of trypsin inhibitors, Lys, reactive Lys, and NDF. In conclusion, both differences in particles size and variations in thermal processing conditions of SBM may affect SID of CP and AA.
Assuntos
Aminoácidos/metabolismo , Digestão/fisiologia , Glycine max/química , Temperatura Alta , Íleo/fisiologia , Suínos/crescimento & desenvolvimento , Ração Animal , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Manipulação de Alimentos , Masculino , Tamanho da Partícula , Suínos/fisiologiaRESUMO
The wrist-palm conduction time for the median and ulnar nerves was determined using antidromic technique in thirty normal subjects. For the median nerve, the conduction time was 1.6 msec. to initial deflection from baseline and 1.7 msec. to peak of the initial negative deflection for the mean plus 2 SD. The median wrist-palm conduction time was then compared to the difference between the median and ulnar wrist-digit conduction times (mean plus 2 SD of 0.5 msec. measured either to initial deflection or peak negative deflection) in order to determine which technique aids more in the electrodiagnosis of patients with a presumptive clinical diagnosis of carpal tunnel syndrome but which normal distal sensory latencies. It was found in ten patients that the results of these two electrodiagnostic methods paralleled each other, and neither appeared more sensitive than the other in establishing the diagnosis.
Assuntos
Síndrome do Túnel Carpal/diagnóstico , Eletromiografia/métodos , Nervo Mediano/fisiologia , Condução Nervosa , Nervo Ulnar/fisiologia , Adulto , Idoso , Síndrome do Túnel Carpal/fisiopatologia , Humanos , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Nervo Ulnar/fisiopatologiaRESUMO
This paper compares the results of detailed sensibility testing with nerve conduction studies done in patients with carpal tunnel syndrome. Forty-three patients with 74 symptomatic hands were examined. Median and ulnar distal sensory and motor latencies were obtained bilaterally. Sensibility testing included assessment of perception of vibratory stimuli, classic two-point discrimination, and moving two-point discrimination. Comparison of the results were made in the overall group of patients, and patients were also grouped according to the severity of symptoms. In the 74 hands, nerve conduction studies were abnormal in 81% and sensory examination was abnormal in 66%, for an overall combined abnormality rate of 92%. In the most severely involved hands, both nerve conduction and sensory testing were abnormal in approximately 80%. However, in the least severely involved group, nerve conduction studies were abnormal in 80%. However, in the least severely involved group, nerve conduction studies were abnormal in 80%, while sensory examination was abnormal in only 10%.
Assuntos
Síndrome do Túnel Carpal/fisiopatologia , Nervo Mediano/fisiopatologia , Condução Nervosa , Nervo Ulnar/fisiopatologia , Vias Aferentes/fisiopatologia , Vias Eferentes/fisiopatologia , Humanos , Exame Neurológico , Estudos RetrospectivosRESUMO
Radial sensory conduction has traditionally been performed by stimulating the nerve at the wrist, recording from the thumb or the base of the first web space. This paper describes a technique for measuring conduction in the more distal branches on the dorsum of the hand. Comparison is made with dorsal ulnar sensory conduction, and the area supplied by each nerve on the dorsum of the hand is investigated. Radial conduction was found obtainable to the area between the second and third metacarpals (MCPs) in all patients with a velocity of 56.8 +/- 4.2 m/sec. Conduction to the space between the third and fourth MCPs could be obtained in only 65% of the hands with a mean velocity of 58.9 +/- 4.5 m/sec. Dorsal ulnar sensory conduction to the same area was 59 +/- 4.2 m/sec and was present in 73% of the hands. Forty percent of patients have both radial and ulnar innervation to the area between the third and fourth MCPs on at least one side, while 33% have both radial and ulnar innervation to this area bilaterally.
Assuntos
Mãos/inervação , Condução Nervosa , Nervo Radial/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nervo Radial/anatomia & histologia , Nervo Radial/lesõesRESUMO
This report reviews the syndrome of entrapment of the superficial branch of the radial nerve (SBRN) in the forearm, and electrodiagnostic techniques to aid in diagnosis are presented. Normal mean radial sensory conduction in the forearm was found to be 61.4 +/- 3.1 m/sec. Three patients are presented. In two of these comparison of conduction in the SBRN to the lateral antebrachial cutaneous nerve (LACN) and contralateral SBRN was abnormal, whereas the absolute SBRN conduction appeared normal. Normal LACN-SBRN difference in the same arm was 1.9 +/- 1.6 m/sec, with a range of 0-7.0 m/sec; mean SBRN difference in opposite arms of the same subject was 1.8 +/- 1.6 m/sec.
Assuntos
Síndromes de Compressão Nervosa/diagnóstico , Condução Nervosa/fisiologia , Nervo Radial , Adulto , Idoso , Eletromiografia , Feminino , Humanos , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/fisiopatologiaRESUMO
This report describes an antidromic technique for studying conduction in the sensory branch of the musculocutaneous nerve, the lateral cutaneous nerve of the forearm. Surface stimulation was done at the elbow where the nerve becomes superficial, and surface recordings were made 12 cm distally over the course of the nerve. Sixty nerves in 30 normal persons were examined. The mean latency to onset of the action potential was 1.8 +/- 0.1 msec with a mean conduction velocity of 65 +/- 3.6 meters/sec. Mean amplitude of the action potential was 24 +/- 7.2 muv.