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1.
Sci Rep ; 14(1): 14717, 2024 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-38926546

RESUMO

Choosing appropriate tillage methods and applying the right amount of chemical fertilizers are pivotal for optimizing wheat management and enhancing wheat quality. This study investigated the influence of conservation agriculture and phosphorus levels on nutrient content, yield components, and quality traits of wheat in a corn-wheat rotation. Conducted over five years in field conditions, the study employed a randomized complete block design with tillage treatments (conventional tillage, CT; minimum tillage, MT; and no tillage, NT) and phosphorus levels (no fertilizer use, P0; and 100% fertilizer recommendation, PR) as factors. Soil samples were collected during the fourth year (2021-2022). Results revealed significant impacts of tillage methods and phosphorus levels on wheat straw and grain nutrient composition, yield components, and quality traits. Conventional tillage yielded the highest values for protein content (12%), Zeleny sedimentation volume (20.33 mL), hardness index (45), water absorption (64.12%), and wet gluten content (25.83%). Additionally, phosphorus fertilizer application positively influenced protein percentage, gluten weight, and gluten index. The study highlights the potential of strategic soil management, particularly conventional tillage combined with phosphorus fertilization, to enhance wheat quality and yield. By elucidating these relationships, the findings contribute to optimizing wheat cultivation practices and advancing the development of superior wheat cultivars for baking applications.


Assuntos
Fertilizantes , Fósforo , Triticum , Zea mays , Triticum/crescimento & desenvolvimento , Fósforo/análise , Fertilizantes/análise , Zea mays/crescimento & desenvolvimento , Grão Comestível/crescimento & desenvolvimento , Solo/química , Agricultura/métodos , Produção Agrícola/métodos
2.
Acta Microbiol Immunol Hung ; 70(3): 206-212, 2023 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-37342895

RESUMO

Globally, the spread of carbapenem-resistant strains has limited treatment options for multidrug-resistant (MDR) Pseudomonas aeruginosa infections. This study aimed to determine the role of point mutations as well as the expression level of the oprD gene in the emergence of imipenem-resistant P. aeruginosa strains isolated from patients referred to Ardabil hospitals. A total of 48 imipenem-resistant clinical isolates of P. aeruginosa collected between June 2019 and January 2022 were used in this study. Detection of the oprD gene and its amino acid alterations was performed using the polymerase chain reaction (PCR) and DNA sequencing techniques. The expression level of the oprD gene in imipenem-resistant strains was determined using the real-time quantitative reverse transcription PCR (RT-PCR) method. All imipenem-resistant P. aeruginosa strains were positive for the oprD gene based on the PCR results, and also five selected isolates indicated one or more amino acid alterations. Detected amino acid alterations in the OprD porin were Ala210Ile, Gln202Glu, Ala189Val, Ala186Pro, Leu170Phe, Leu127Val, Thr115Lys, and Ser103Thr. Based on the RT-PCR results, the oprD gene was downregulated in 79.1% of imipenem-resistant P. aeruginosa strains. However, 20.9% of strains showed overexpression of the oprD gene. Probably, resistance to imipenem in these strains is associated with the presence of carbapenemases, AmpC cephalosporinase, or efflux pumps. Owing to the high prevalence of imipenem-resistant P. aeruginosa strains due to various resistance mechanisms in Ardabil hospitals, the implementation of surveillance programs to reduce the spread of these resistant microorganisms along with rational selection and prescription of antibiotics is recommended.


Assuntos
Imipenem , Infecções por Pseudomonas , Humanos , Imipenem/farmacologia , Imipenem/metabolismo , Imipenem/uso terapêutico , Pseudomonas aeruginosa/genética , Porinas/genética , Porinas/metabolismo , Porinas/uso terapêutico , Aminoácidos/metabolismo , Aminoácidos/uso terapêutico , Infecções por Pseudomonas/tratamento farmacológico , Antibacterianos/uso terapêutico , beta-Lactamases/genética , beta-Lactamases/metabolismo , Testes de Sensibilidade Microbiana
3.
Genomics ; 115(2): 110588, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36841311

RESUMO

Gall oak (Quercus infectoria) is a native tree of Iran, whose gall extract is used to treat many diseases. The presence of abundant secondary metabolites with various bioactivities in this plant has made it medically important. Despite its medicinal value, due to the lack of genomic information, the biosynthetic pathways of these compounds in this species are still unknown. The current research was aimed at observing, characterizing, and investigating the biosynthetic pathways of these compounds in Q.infectoria. De novo transcriptome assembly was conducted using the RNA sequencing technique. A total of 89,335 unigenes were generated, of which 6928 unigenes showed differential expression in leaves compared to root tissue. Gene ontology examination of DEGs revealed GO-term enrichment was related to cellular processes and enzyme activity. KEGG enrichment analysis for DEGs showed that most unigenes were related to metabolic pathways and biosynthesis of secondary metabolites. Moreover, 39 families of transcription factors were identified, of which the C2H2, bZIP, bHLH, and ERF TFs had the highest frequency. In the absence of a reference genome, the overall study of transcriptome will provide a reference for future functional and comparative studies. Moreover, the data obtained from sequencing and de novo assembly can be a valuable scientific resource for Q.infectoria.


Assuntos
Quercus , Quercus/genética , Anotação de Sequência Molecular , Perfilação da Expressão Gênica , Transcriptoma , Redes e Vias Metabólicas , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Regulação da Expressão Gênica de Plantas
4.
Ann Oper Res ; 322(1): 321-344, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35967839

RESUMO

Organisations need to develop long-term strategies to ensure they incorporate innovation for environmental sustainability (IES) to remain competitive in the market. This can be challenging given the high level of uncertainty regarding the future (e.g., following the COVID pandemic). Supplier selection is an important decision that organisations make and can be designed to support IES. While the literature provides various criteria in the field of IES strategies, it does not identify the criteria which can be utilised to assist organisations in their supplier selection decisions. Moreover, the literature in this field does not consider uncertainty related to the occurrence of possible future events which may influence the importance of these criteria. To address this gap, this paper develops a novel criteria decision framework to assist supplier evaluation in organisations, taking into consideration different events that may occur in the future. The framework that combines three decision-making methods: the stratified multi-criteria decision-making method, best worst method, and technique for order of preference by similarity to ideal solution. The framework, proposed in this paper, can also be adopted to enable effective and sustainable decision making under uncertainty in various fields.

5.
Appl Soft Comput ; 125: 109157, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35755298

RESUMO

From the triple bottom line, the social aspect has received relatively limited attention during the Corona Virus Disease (COVID-19) pandemic, particularly in the emerging economies. Social innovation factors help improve the sustainability performance of the companies. This study develops a social innovation decision framework and analyses the interrelationships among social innovation factors considering the COVID-19 situation. For this purpose, the Decision-Making Trial and Evaluation Laboratory (DEMATEL) is extended by integrating the Z numbers and rough fuzzy set theory into its computational procedure. Z-numbers address the uncertainty of the decision and experts' confidence in the evaluation and rough numbers are used for aggregating the experts' opinions. On this basis, the mutual influence of social innovation factors and the influence weights of these factors are investigated. The results suggest that a quick response to market demand for sustainable products is the most influential factor in attaining social sustainability innovation during the pandemic. This article is concluded by providing insights for industrial experts and decision-makers to understand the underpinnings of social sustainability innovation during unforeseen situations.

6.
Adv Mater ; 34(9): e2107878, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34921462

RESUMO

Biological ion channels feature angstrom-scale asymmetrical cavity structures, which are the key to achieving highly efficient separation and sensing of alkali metal ions from aqueous resources. The clean energy future and lithium-based energy storage systems heavily rely on highly efficient ionic separations. However, artificial recreation of such a sophisticated biostructure has been technically challenging. Here, a highly tunable design concept is introduced to fabricate monovalent ion-selective membranes with asymmetric sub-nanometer pores in which energy barriers are implanted. The energy barriers act against ionic movements, which hold the target ion while facilitating the transport of competing ions. The membrane consists of bilayer metal-organic frameworks (MOF-on-MOF), possessing a 6 to 3.4-angstrom passable cavity structure. The ionic current measurements exhibit an unprecedented ionic current rectification ratio of above 100 with exceptionally high selectivity ratios of 84 and 80 for K+ /Li+ and Na+ / Li+ , respectively (1.14 Li+ mol m-2 h-1 ). Furthermore, using quantum mechanics/molecular mechanics, it is shown that the combined effect of spatial hindrance and nucleophilic entrapment to induce energy surge baffles is responsible for the membrane's ultrahigh selectivity and ion rectification. This work demonstrates a striking advance in developing monovalent ion-selective channels and has implications in sensing, energy storage, and separation technologies.

7.
ACS Appl Mater Interfaces ; 13(37): 44904-44915, 2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34516096

RESUMO

With an ageing population, hearing disorders are predicted to rise considerably in the following decades. Thus, developing a new class of artificial auditory system has been highlighted as one of the most exciting research topics for biomedical applications. Herein, a design of a biocompatible piezoresistive-based artificial hair cell sensor is presented consisting of a highly flexible and conductive polyvinyl alcohol (PVA) nanocomposite with vertical graphene nanosheets (VGNs). The bilayer hydrogel sensor demonstrates excellent performance to mimic biological hair cells, responding to acoustic stimuli in the audible range between 60 Hz to 20 kHz. The sensor output demonstrates stable mid-frequency regions (∼4-9 kHz), with the greatest sensitivity as high frequencies (∼13-20 kHz). This is somewhat akin to the mammalian auditory system, which has remarkable sensitivity and sharp tuning at high frequencies due to the "active process". This work validates the PVA/VGN sensor as a potential candidate to play a similar functional role to that of the cochlear hair cells, which also operate over a wide frequency domain in a viscous environment. Further characterizations of the sensor show that increasing the sound amplitude results in higher responses from the sensor while taking it to the depth drops the sensor outputs due to attenuation of sound in water. Meanwhile, the acoustic pressure distribution of sound waves is predicted through finite element analysis, whereby the numerical results are in perfect agreement with experimental data. This proof-of-concept work creates a platform for the future design of susceptible, flexible biomimetic sensors to closely mimic the biological cochlea.


Assuntos
Materiais Biomiméticos/química , Hidrogéis/química , Nanocompostos/química , Biomimética/métodos , Condutividade Elétrica , Grafite/química , Células Ciliadas Auditivas/química , Álcool de Polivinil/química , Estudo de Prova de Conceito , Som
8.
Sustain Prod Consum ; 27: 1869-1881, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36118163

RESUMO

Innovation can be considered one of the fundamental elements for ensuring sustainability. Companies have started to enhance their sustainability level through the application of innovative practices. The importance of employing innovative social sustainability practices within the supply chain seems to have escalated with the advent of COVID-19. However, studies focusing on the social aspect of sustainability innovation when selecting suppliers during the COVID-19 disaster are non-existent. Selecting these types of suppliers can significantly help companies to be more socially innovative and obtain sustainable development targets. This work introduces a social sustainability innovation framework for assessing suppliers during the COVID-19 pandemic. A group grey-best worst method (Group GBWM) is utilized to identify the criteria weights and improved grey relational analysis (IGRA) is utilized for ranking the suppliers. Findings show that "safety and health practices", "remote working conditions", and "localization" are the most important social sustainability innovation criteria, respectively, in choosing suppliers during COVID-19. A manufacturing firm is utilized as an example for verifying the efficiency of the proposed model and framework. This work helps industrial experts and researchers to better understand and focus on the social aspect of sustainable innovation, particularly when selecting suppliers during the critical COVID-19 pandemic situation.

9.
J Investig Clin Dent ; 6(4): 294-300, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25187021

RESUMO

AIM: The purpose of this study was to evaluate the effect of sandblasting, carbon dioxide (CO2), and erbium,chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers on the microshear bond strength of zirconia to resin cement. METHODS: Sixty-one sintered yttria stabilized tetragonal zirconia blocks (10 × 5 × 2 mm) were prepared and divided into four experimental groups (n = 15); one sample was retained as a control. The samples were treated by aluminium oxide air abrasion, CO24W, Er,Cr:YSGG 3W, and Er,Cr:YSGG 2W, respectively. One sample from each group and the control sample were analyzed by scanning electron microscope. Panavia F2.0 resin microcylinders were prepared and placed on treated surfaces, light cured, and incubated for 48 h. Microshear bond strength testing was done by a microtensile tester machine, and the type of bond failures were determined by stereomicroscope. Data were analyzed by one-way anova and Tukey's test at a significance level of P < 0.05. RESULTS: Air abrasion showed the highest microshear bond strength (P < 0.05) among all groups. CO2and Er,Cr:YSGG 3W laser showed significantly higher bond strength than Er,Cr:YSGG 2W (P < 0.05). Apparent micromechanical roughening and irregularities were seen in the air abrasion-treated samples, and the bond failure was mostly mixed type. In the laser-treated surfaces, the roughness was much less than the air abrasion-treated surfaces, and the mode of failure was almost pure adhesive. CONCLUSION: Air abrasion has a greater effect than CO2and Er,Cr:YSGG lasers in the treatment of zirconia ceramic surfaces to enhance the bonding strength of resin cement to zirconia. CO2laser at 4W and Er,Cr:YSGG laser at only 3-W output power can be regarded as surface treatment options for roughening the zirconia surface to establish better bond strength with resin cements.


Assuntos
Cerâmica/química , Colagem Dentária , Corrosão Dentária/métodos , Materiais Dentários/química , Lasers , Cimentos de Resina/química , Ítrio/química , Zircônio/química , Adesividade , Óxido de Alumínio/química , Corrosão Dentária/instrumentação , Análise do Estresse Dentário/instrumentação , Humanos , Umidade , Lasers de Gás , Lasers de Estado Sólido , Cura Luminosa de Adesivos Dentários/métodos , Teste de Materiais , Microscopia Eletrônica de Varredura/métodos , Resistência ao Cisalhamento , Estresse Mecânico , Propriedades de Superfície , Temperatura , Fatores de Tempo
11.
J Adhes Dent ; 16(4): 377-82, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25126623

RESUMO

PURPOSE: To evaluate the effect of Er,Cr:YSGG laser treatment on microshear bond strength of zirconia to resin cement before and after sintering. MATERIALS AND METHODS: Ninety pre-sintered yttrium-stabilized tetragonal zirconia specimens (4 × 3 × 2 mm) were divided into 6 groups (n = 15). In group C, sintered zirconia was not treated (control group). In groups AS2 and AS3, sintered zirconia blocks were irradiated by Er,Cr:YSGG using a power of 2 and 3 W, respectively. Groups PS2 and PS3 consisted of pre-sintered blocks conditioned by Er,Cr:YSGG at 2 and 3 W, respectively. In group AA, sintered zirconia was air abraded with 50-µm alumina powder. One block was made using the same preparations as mentioned above and was morphologically assessed by SEM. Microcylinders of Panavia F 2.0 were placed on the treated surface of the groups. Samples were incubated at 37°C and 98% humidity for 48 h and then subjected to microshear bond strength testing. The mode of failure was evaluated. Data were analyzed by one-way ANOVA and Tukey's HSD test (p < 0.05). RESULTS: There was a statistically significant difference between group AA and the others (p < 0.0001). A significant difference was also noted between groups AS3 and C (p = 0.031). Complete surface roughness was seen in group AA and the bond failure was mostly cohesive, while in laser-treated groups, the surfaces roughness was much lower vs other groups, and the mode of failure was mostly adhesive. CONCLUSION: Laser treatment of pre-sintered Y-TZP cannot be recommended for improving the bond. Although sandblasting of sintered Y-TZP yielded better results than the rest of the groups, 3 W power after sintering can also be effective in enhancing the bonding strength of resin cement to zirconia.


Assuntos
Colagem Dentária , Lasers de Estado Sólido , Cimentos de Resina/química , Ítrio/efeitos da radiação , Zircônio/efeitos da radiação , Óxido de Alumínio/química , Compostos Inorgânicos de Carbono/química , Corrosão Dentária/métodos , Polimento Dentário/métodos , Temperatura Alta , Umidade , Teste de Materiais , Microscopia Eletrônica de Varredura , Doses de Radiação , Resistência ao Cisalhamento , Compostos de Silício/química , Propriedades de Superfície , Temperatura , Fatores de Tempo , Ítrio/química , Zircônio/química
12.
Iran J Reprod Med ; 12(1): 47-56, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24799861

RESUMO

BACKGROUND: Preterm birth is a leading cause of perinatal mortality and long-term morbidity as well as the long-term health consequences and cognitive outcomes. OBJECTIVE: Present study was conducted to determine prevalence and risk factors associated with preterm birth in Ardabil, Iran. MATERIALS AND METHODS: A case control study was conducted between Nov 2010 and July 2011 in all three maternal hospitals in Ardabil. All the live newborns during the study period were investigated. Of 6705 live births during the study period 346 births occurred in <37 weeks were taken as a case and 589 term neonates were taken as a control group. Data were obtained through review of prenatal and hospital delivery records. Univariate and multivariate logistic regression analysis were applied to obtain magnitude of association between independent variables and preterm birth. RESULTS: The prevalence rate of preterm birth was 5.1%. History of previous preterm birth (OR=12.7,CI: 3.9-40.4, p<0.001), hypertension (OR=7.3, CI:2.1-25.4, p=0.002), Oligohydramnios (OR=3.9, CI:1.6-9.5, p=0.002), spouse abuse (OR=3.7, CI:1.1-11.8, p=0.024), preeclampsia (OR=3.6, CI:1.3-10.3, p=0.014), premature rupture of membrane (OR=3.1, CI:1.9-4.9, p=0.000), bleeding or spotting during pregnancy (OR=2.0, CI:1.0-3.8, p=0.037), Hyperemesis Gravid arum (OR=2.0, CI: 1.1-3.8, p=0.015), urinary tract infection in 26-30 weeks , (OR=1. 8 CI:1.0-3.2, p=0.04), diastolic blood pressure ≤60 mmg (OR=1.5, CI: 0.99-2.2, p=0.049) were determined as significant risk factors for preterm birth. CONCLUSION: Early detection and treatment of diseases or disorders among pregnant women especially hypertension, Oligohydramnios, preeclampsia, bleeding or spotting, Hyperemesis Gravid arum, urinary tract infection, and low diastolic blood pressure as well as the improving health care quality delivered to pregnant women may reduce preterm prevalence rate.

13.
Dent Traumatol ; 29(4): 323-7, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22882995

RESUMO

INTRODUCTION: To analyze the push-out bond strength of Angelus WMTA (Angelus Dental Products), a nano-modification of WMTA (Kamal Asgar Research Center) and Bioaggregate (Innovative Bioceramix). METHODS: Sixty 2-mm-thick root sections were prepared from 60 single-rooted human teeth. The dentin disks were randomly divided into three groups (n = 20) and filled with Angelus WMTA, Nano-WMTA, or Bioaggregate, respectively. Push-out bond strength values of the specimens were measured by a universal testing machine and examined under scanning electron microscope at × 40 magnification to determine the nature of the bond failure. The data were analyzed with a Kruskal-Wallis test. RESULTS: The greatest mean for push-out bond strength (138.48 ± 11.43 MPa) was observed for the nano-modification of WMTA. The values decreased to 110.73 ± 11.19 and 25.64 ± 5.27 MPa for Angelus WMTA and Bioaggregate, respectively. There were significant differences between the groups (P < 0.001). Inspection of the samples revealed the bond failure to be predominantly adhesive type except for the nano-modification group, as some samples also exhibited cohesive failures. CONCLUSIONS: It is concluded that the force needed for the displacement of the nano-modification of WMTA (NWMTA) was significantly higher than for Angelus WMTA and Bioaggregate.


Assuntos
Compostos de Alumínio/química , Compostos de Cálcio/química , Hidróxido de Cálcio/química , Adesivos Dentinários/química , Dentina/química , Hidroxiapatitas/química , Nanoestruturas/química , Óxidos/química , Materiais Restauradores do Canal Radicular/química , Silicatos/química , Raiz Dentária/química , Análise do Estresse Dentário , Combinação de Medicamentos , Análise de Falha de Equipamento , Humanos , Microscopia Eletrônica de Varredura
14.
Photomed Laser Surg ; 30(10): 587-91, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22897674

RESUMO

OBJECTIVE: The aim of this in vitro study was to evaluate the effects of diode laser, MTAD(™) and laser plus MTAD on the push-out bond strength of mineral trioxide aggregate (MTA)-dentin. BACKGROUND DATA: MTA has been used widely, especially in root canal therapies (RCT); however, the effect of different final treatments during RCT has been questioned regarding the retention characteristic of this cement-based material. MATERIALS AND METHODS: Forty single-rooted human teeth were prepared into dentin slices and drilled to form canal spaces. Samples were divided into four groups of 10 in each (n=10). In groups A and B, diode laser irradiations were performed, and then MTA was placed inside the canal spaces and incubated at 37 °C for 7 days. After incubation, dentin slices in groups B and C were immersed in Biopure MTAD, and the last group served as control without any treatment. The push-out bond strengths were then measured by using a universal testing machine. RESULTS: The means±standard deviations of push-out bond strength were 6.74±0.48, 5.95±0.40, 6.86±0.66, and 7.88±0.37 for groups A (laser), B (laser plus MTAD), C (MTAD) and D (control), respectively. One-way analysis of variance (ANOVA) test revealed significant differences among the groups (p<0.0001). Tukey's test did not show any significant difference between groups A and C (p=0.93). However, these differences were significant between groups A and B (p=0.006) and between groups B and C (p=0.001). CONCLUSIONS: The results of this study indicated that either diode laser or MTAD can lower the bond strength of MTA-dentin, and that diode laser irradiations plus MTAD might affect MTA bond to dentin negatively.


Assuntos
Compostos de Alumínio/efeitos da radiação , Compostos de Cálcio/efeitos da radiação , Colagem Dentária/métodos , Dentina/efeitos da radiação , Lasers Semicondutores/uso terapêutico , Óxidos/efeitos da radiação , Materiais Restauradores do Canal Radicular/efeitos da radiação , Silicatos/efeitos da radiação , Compostos de Alumínio/química , Análise de Variância , Compostos de Cálcio/química , Força Compressiva , Análise do Estresse Dentário , Combinação de Medicamentos , Humanos , Técnicas In Vitro , Óxidos/química , Materiais Restauradores do Canal Radicular/química , Preparo de Canal Radicular/métodos , Silicatos/química
15.
Adv Ther ; 25(7): 681-702, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18636232

RESUMO

INTRODUCTION: Recent investigations have revealed that control of hyperglycaemia with insulin improves outcomes. The cornerstone of hyperglycaemia in critically ill patients is insulin resistance and it remains refractory to intensive insulin protocols. We designed this study to evaluate the efficacy and safety of a new intensive insulin therapy (IIT) protocol combined with metformin. METHODS: Twenty-one patients with systemic inflammatory response syndrome and a blood glucose level of >120 mg/dl admitted to an intensive care unit (ICU) were randomised to receive either intravenous infusion of IIT alone (n=11) or combined with metformin (IIT+MET; n=10) to maintain a blood glucose level (BGL) of 80-120 mg/dl. Blood samples were obtained at baseline and at 48 hours, 96 hours and 7 days after initiation of the study. Samples were analysed for interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-alpha) and nitric oxide (NO) as inflammatory mediators; plasminogen activation inhibitor-1 (PAI-1) as a coagulation mediator; and thiobarbituric reactive substances (TBARS), total antioxidant power (TAP) and total thiol molecules (TTM) as oxidative stress parameters. RESULTS: The addition of metformin to the IIT protocol decreased insulin requirement and concentration of insulin and C-peptide. With both treatments at most time points, the mean plasma levels of IL-6, TNF-alpha, NO, PAI-1 and TBARS were found to be significantly lower compared with baseline. Antioxidant activity was increased in both arms with increasing TAP and TTM (P<0.05). There was no significant difference between the two groups regarding reported beneficial effects on these parameters. Therapeutic Intervention Scoring System-28 (TISS-28) score, an index of nursing workload and number of therapeutic interventions, decreased in the IIT+MET group (P<0.01). We did not observe any occurrence of hyperlactataemia or acidosis in the IIT+MET group. CONCLUSION: Metformin plus insulin appears to lower the incidence of insulin resistance, lower insulin requirement while maintaining blood glucose level control, and consequently lower the incidence of adverse effects related to high-dose insulin therapy, particularly hypoglycaemia, and also declined nursing workload. Both treatment protocols showed improvements in inflammatory cytokine levels. Further studies with larger sample sizes are warranted to determine the undiscovered facts of insulin-sensitising agents in critically ill patients.


Assuntos
Glicemia/análise , Citocinas/metabolismo , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Metformina/uso terapêutico , Estresse Oxidativo , Adulto , Idoso , Peptídeo C/metabolismo , Protocolos Clínicos , Quimioterapia Combinada , Humanos , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Unidades de Terapia Intensiva , Metformina/administração & dosagem , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Síndrome de Resposta Inflamatória Sistêmica/tratamento farmacológico , Adulto Jovem
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