Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 45
Filtrar
1.
Asian Nurs Res (Korean Soc Nurs Sci) ; 18(2): 188-202, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38692407

RESUMO

PURPOSE: Although the importance of health promotion for nurses is increasing, there is a lack of meta-analyses targeting nurses in the world. This study aimed to identify the effect sizes between the health-promoting behaviors and related variables of nurses working in Korea. METHODS: Systematic review and meta-analysis were conducted according to the PRISMA and MOOSE guidelines. The literature included in this meta-analysis was published between 1994 and 2022 in core databases such as KMbase, KISS, KoreaMed, ScienceON, DBpia, NAL, RISS, CINAHL, CENTRAL, WoS, PubMed, and hand searched. In this study, the PICO-SD framework was applied with Participants being nurses actively working in various healthcare settings across Korea, and for a more comprehensive search, intervention and comparisons were not set. The outcomes measured were nurses' health-promoting behaviors, assessed using structured tools. The study design included observational studies. The Comprehensive Meta-Analysis and the R software program were used for meta-analysis. RESULTS: In total, 50 articles were selected for the systematic review and meta-analysis. The total effect size of the 50 articles was moderate (correlation effect size [ESr] = 0.30). The individual variables presented in the 50 articles were classified into nine sub-categories according to Pender's Health Promotion Model (HPM). Among them, situational influences demonstrated the largest effect size (ESr = 0.44, number of studies [k] = 2), followed by perceived self-efficacy (ESr = 0.39, k = 10) and activity-related affect (ESr = 0.32, k = 12). CONCLUSIONS: To achieve the optimal health status of nurses through health promotion intervention programs, these effective variables - situational influences, perceived self-efficacy, and activity-related affect - should be considered when developing the intervention program for nurses. REGISTRATION: CRD42022299907.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde , Humanos , Promoção da Saúde/métodos , República da Coreia , Enfermeiras e Enfermeiros/psicologia , Feminino , Adulto , Masculino
2.
BMC Nephrol ; 23(1): 98, 2022 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-35260104

RESUMO

BACKGROUND: Chronic stimulation of the mineralocorticoid receptor has been suggested as one of the potential causes of cardiovascular events and death in patients with end-stage renal disease. This observational cohort study was performed to demonstrate that serum cortisol might be a predictive marker for patient mortality and to evaluate its association with oxidized low-density lipoprotein (oxLDL) in hemodialysis (HD) patients. METHODS: Patients receiving HD three times a week were screened for enrollment at two institutions. Baseline cortisol levels were measured before each HD session, and the patients were divided into two groups according to the median value of serum cortisol before analysis. The baseline characteristics and laboratory values of the high and low cortisol groups were compared. Serum cortisol, adrenocorticotropic hormone, renin, aldosterone, and oxLDL were measured in 52 patients to evaluate the effect of oxidative stress on serum cortisol levels. RESULTS: A total of 133 HD patients were enrolled in this cohort study. Compared to the patients with low serum cortisol levels, the patients with high serum cortisol levels (baseline cortisol ≥ 10 µg/dL) showed higher rates of cardiovascular disease (59.7% vs. 39.4%, P=0.019) and left ventricular systolic dysfunction (LVSD) (25.9% vs. 8.0%, P=0.016). The patients in the high cortisol group demonstrated higher all-cause mortality than those in the low cortisol group. The serum cortisol level was an independent risk factor for patient mortality (hazard ratio 1.234, 95% confidence interval 1.022-1.49, P=0.029). Among the 52 patients with oxLDL measurements, oxLDL was an independent risk factor for elevated serum cortisol levels (Exp(B) 1.114, P=0.013) and LVSD (Exp(B) 12.308, P=0.045). However, plasma aldosterone levels did not affect serum cortisol levels. CONCLUSIONS: Serum cortisol is a useful predictive marker for all-cause death among patients receiving HD. OxLDL is an independent marker for elevated serum cortisol among HD patients.


Assuntos
Hidrocortisona , Falência Renal Crônica , Aldosterona , Biomarcadores , Estudos de Coortes , Feminino , Humanos , Falência Renal Crônica/complicações , Masculino , Estresse Oxidativo , Diálise Renal
3.
Sci Rep ; 9(1): 9976, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31292469

RESUMO

This paper presents very large complete band gaps at low audible frequency ranges tailored by gradient-based design optimizations of periodic two- and three-dimensional lattices. From the given various lattice topologies, we proceed to create and enlarge band gap properties through controlling neutral axis configuration and cross-section thickness of beam structures, while retaining the periodicity and size of the unit cell. Beam neutral axis configuration and cross-section thickness are parameterized by higher order B-spline basis functions within the isogeometric analysis framework, and controlled by an optimization algorithm using adjoint sensitivity. Our optimal curved designs show much more enhanced wave attenuation properties at audible low frequency region than previously reported straight or simple undulated geometries. Results of harmonic response analyses of beam structures consisting of a number of unit cells demonstrate the validity of the optimal designs. A plane wave propagation in infinite periodic lattice is analyzed within a unit cell using the Bloch periodic boundary condition.

4.
PLoS One ; 14(5): e0216415, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31048884

RESUMO

BACKGROUND AND AIMS: Malnutrition and inflammation are closely linked to vascular calcification (VC), the severity of which correlate with adverse outcome. However, there were few studies on the interplay between malnutrition, inflammation and VC progression, rather than VC presence per se. We aimed to determine the relationship of malnutrition, inflammation, abdominal aortic calcification (AAC) progression with survival in hemodialysis (HD) patients. METHODS: Malnutrition and inflammation were defined as low serum albumin (< 40 g/L) and high hs-CRP (≥ 28.57 nmol/L), respectively. We defined AAC progression as an increase in AAC score using lateral lumbar radiography at both baseline and one year later. Patients were followed up to investigate the impact of AAC progression on all-cause and cardiovascular mortality. RESULTS: AAC progressed in 54.6% of 97 patients (mean age 58.2±11.7 years, 41.2% men) at 1-year follow-up. Hypoalbuminemia (Odds ratio 3.296; 95% confidence interval 1.178-9.222), hs-CRP (1.561; 1.038-2.348), low LDL-cholesterol (0.976; 0.955-0.996), and the presence of baseline AAC (10.136; 3.173-32.386) were significant risk factors for AAC progression. During the mean follow-up period of 5.9 years, 38(39.2%) patients died and 27(71.0%) of them died of cardiovascular disease. Multivariate Cox regression analysis adjusted for old age, diabetes, cardiovascular history, and hypoalbuminemia determined that AAC progression was an independent predictor of all-cause mortality (2.294; 1.054-4.994). CONCLUSIONS: Malnutrition and inflammation were significantly associated with AAC progression. AAC progression is more informative than AAC presence at a given time-point as a predictor of all-cause mortality in patients on maintenance HD.


Assuntos
Aorta Abdominal/diagnóstico por imagem , Desnutrição , Diálise Renal , Calcificação Vascular , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Inflamação/diagnóstico por imagem , Inflamação/mortalidade , Inflamação/terapia , Masculino , Desnutrição/complicações , Desnutrição/diagnóstico por imagem , Desnutrição/mortalidade , Desnutrição/terapia , Pessoa de Meia-Idade , Estudos Prospectivos , Taxa de Sobrevida , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/etiologia , Calcificação Vascular/mortalidade , Calcificação Vascular/terapia
5.
Korean J Intern Med ; 34(6): 1297-1303, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29466851

RESUMO

BACKGROUND/AIMS: Hepatitis A virus (HAV) is a self-limiting infectious disease, but 1% of subjects develop fulminant hepatitis. The prevalence of the anti-HAV immunoglobulin G (IgG) antibody in hemodialysis subjects in Korea remains unknown. The purpose of this study was to describe and compare the seropositive rate of anti-HAV antibody among hemodialysis subjects in two hospitals according to age group. METHODS: A total of 170 hemodialysis subjects were evaluated for the seropositive rate of the anti-HAV IgG antibody and its titer. RESULTS: Of the 170 maintenance hemodialysis subjects in two hospitals (Kangnam 92 vs. Chuncheon 78), 79 (46.5%) were male. The mean age was 53.2 years old, and 94.1% of the subjects were over 40 years old. The median vintage of hemodialysis was 29.0 months. Anti-HAV antibody was found in 163 subjects (95.9%), with no significant difference between the two areas (Kangnam 97.8% [n = 90] vs. Chuncheon 93.6% [n = 73]). Subjects younger than 40 years old showed a seropositive rate of 50%, while the seropositive rate increased with age for subjects aged 40 or older (p for trend < 0.001). Seropositive subjects from Kangnam showed a higher anti-HAV antibody titer than those from Chuncheon (median: Kangnam 14.2 vs. Chuncheon 11.7). Only age influenced seropositivity. The only factor that influenced the antibody level was the location of hospital (p < 0.001). CONCLUSION: The seropositive rate of the anti-HAV antibody in hemodialysis subjects was 95%, which is similar to findings in the general population. Active immunization against hepatitis A is strongly recommended for hemodialysis subjects under 40 years of age after anti-HAV testing.


Assuntos
Anticorpos Anti-Hepatite A/sangue , Hepatite A/sangue , Imunoglobulina G/sangue , Nefropatias/terapia , Diálise Renal , Adulto , Fatores Etários , Idoso , Biomarcadores/sangue , Feminino , Hepatite A/diagnóstico , Hepatite A/epidemiologia , Hepatite A/virologia , Humanos , Nefropatias/sangue , Nefropatias/diagnóstico , Nefropatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Diálise Renal/efeitos adversos , República da Coreia/epidemiologia , Medição de Risco , Estudos Soroepidemiológicos , Resultado do Tratamento
6.
Korean J Intern Med ; 34(6): 1304-1312, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30025441

RESUMO

BACKGROUND/AIMS: Maintaining the patency of vascular access (VA) in hemodialysis (HD) patients is important and can be life-saving. We investigated the effects of aspirin resistance and mean platelet volume (MPV) on VA failure in HD patients. METHODS: We enrolled 163 patients on maintenance HD. VA failure was defined as thrombosis or a decrease of > 50% of the normal vessel diameter, as revealed by angiography. RESULTS: Aspirin resistance was observed in 17 of 109 patients in whom this parameter was measured, and was not significantly associated with VA failure (p = 0.051). The mean MPV was 9.15 ± 0.05 fL. The 163 patients were grouped by the median MPV value (9.08 fL) at baseline; patients with higher MPVs (n = 82) had lower platelet counts (p = 0.002) and albumin levels (p = 0.009). During 34 months of follow-up, 65 VA failures (39.9%) occurred. The Kaplan-Meier curve revealed significant differences between the two groups in terms of cumulative VA failure (54.1% vs. 35.3%, p = 0.018). On multivariate analysis, the MPV (hazard ratio [HR], 1.794; 95% confidence interval [CI], 1.066 to 3.020; p = 0.028), platelet count (HR, 1.003; 95% CI, 1.001 to 1.006; p = 0.01), and smoking status (HR, 1.894; 95% CI, 1.019 to 3.519; p = 0.043) independently predicted VA failure. CONCLUSION: A high MPV was associated with an increased risk of VA failure, whereas aspirin resistance showed only a weak association. The MPV may predict VA survival in HD patients.


Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Aspirina/uso terapêutico , Implante de Prótese Vascular/efeitos adversos , Resistência a Medicamentos , Oclusão de Enxerto Vascular/etiologia , Falência Renal Crônica/terapia , Volume Plaquetário Médio , Inibidores da Agregação Plaquetária/uso terapêutico , Agregação Plaquetária/efeitos dos fármacos , Diálise Renal , Grau de Desobstrução Vascular , Idoso , Aspirina/efeitos adversos , Feminino , Oclusão de Enxerto Vascular/sangue , Oclusão de Enxerto Vascular/diagnóstico , Oclusão de Enxerto Vascular/fisiopatologia , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/diagnóstico , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/efeitos adversos , Valor Preditivo dos Testes , Medição de Risco , Fatores de Risco , Falha de Tratamento
7.
Artif Cells Nanomed Biotechnol ; 46(sup2): 1127-1136, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30047294

RESUMO

Due to its tentacle poison and huge body, giant jellyfish (Nemopilema nomurai) poses challenging issues to the environment and ecosystems. Here we developed, upcycling a giant jellyfish extract as a reducing agent, a green synthetic method of gold nanoparticles (JF-AuNPs) which possess biological activities. The colloidal solutions of JF-AuNPs were blue, violet, purple and pink depending on the extract concentration. UV-visible spectra exhibited two surface plasmon resonance bands at 5 4 0 ∼ 550 nm and 810 nm. Spherical shapes with an average size of 35.2 ± 8.7 nm and triangular nanoplates with an average height of 70.5 ± 30.3 nm were observed. A face-centered cubic structure was confirmed by high-resolution X-ray diffraction. JF-AuNPs exhibited significant cytotoxic effect against HeLa cancer cells but not against normal cells such as NIH-3T3 and Raw 264.7 cells. In HeLa cells, JF-AuNPs decreased the phosphorylation of AKT and ERK, which are crucial for cell proliferation. Also, JF-AuNPs decreased NO secretion and iNOS expression levels, resulting in anti-inflammatory effects in LPS-inflamed macrophages. Collectively, we established a green synthesis of anti-tumorigenic and anti-inflammatory JF-AuNPs using the extract of jellyfish sea wastes. Thus, beneficial effects of JF-AgNPs must be weighed in further studies in vivo and it can be potent nanomedicine for future applications.


Assuntos
Ouro/química , Ouro/farmacologia , Nanopartículas Metálicas/química , Substâncias Redutoras/química , Cifozoários/química , Resíduos , Animais , Anti-Inflamatórios não Esteroides/síntese química , Anti-Inflamatórios não Esteroides/química , Anti-Inflamatórios não Esteroides/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/química , Antineoplásicos/farmacologia , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Ativação Enzimática/efeitos dos fármacos , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Química Verde , Humanos , Camundongos , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo
8.
PLoS One ; 12(10): e0185846, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29049308

RESUMO

BACKGROUND: Vascular calcification is associated with structural and functional abnormality of the heart and blood vessels. We investigated the relationship between intradialytic hypotension (IDH) and vascular calcification in hemodialysis (HD) patients, and their impacts on cardiovascular events (CVEs). METHOD: We enrolled 191 maintenance HD patients who underwent plain abdomen radiography for abdominal aortic calcification score (AACS). A nadir systolic blood pressure (BP) < 90 mm Hg or the requirement of bolus fluid administration was required to quantify the hypotension diagnosis. IDH was defined as > 2 hypotension episodes during 10 HD treatments. RESULTS: Among the 191 patients, IDH occurred in 32. AACS was higher in the IDH group compared with the no-IDH group (8.4 ± 6.0 vs. 4.9 ± 5.2, respectively; P = 0.001). High AACS was an independent risk factor after adjustment for age, diabetes mellitus, ultrafiltration, diastolic BP, and calcium level (odds ratio (OR) = 1.09, 95% CI = 1.01-1.18; P = 0.03). Patients with both IDH and AACS ≧ 4 had the highest cumulative CVE rate (27.9%, P = 0.008) compared with 11.2%, 12.5%, and 6% for those with AACS ≧ 4 only, with IDH only, and neither, respectively. In multivariate analysis, the presence of both IDH and AACS ≧ 4 was a significant predictor of CVE (hazard ratio (HR) = 2.84, 95% CI = 1.04-7.74, P = 0.04). CONCLUSION: IDH is associated with abdominal aortic calcification and is an independent risk factor for IDH. Both IDH and high AACS were significant predictors of CVE.


Assuntos
Hipotensão/complicações , Diálise Renal , Calcificação Vascular/complicações , Idoso , Aorta/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
PLoS One ; 12(9): e0185296, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28953969

RESUMO

BACKGROUND: Vascular calcification is common and may affect cardiac function in patients with end-stage renal disease (ESRD). However, little is known about the effect of residual renal function on vascular calcification and cardiac function in patients on hemodialysis. METHODS: This study was conducted between January 2014 and January 2017. One hundred six patients with residual renal function on maintenance hemodialysis for 3 months were recruited. We used residual renal urea clearance (KRU) to measure residual renal function. First, abdominal aortic calcification score (AACS) and brachial-ankle pulse wave velocity (baPWV) were measured in patients on hemodialysis. Second, we performed echocardiography and investigated new cardiovascular events after study enrollment. RESULTS: The median KRU was 0.9 (0.3-2.5) mL/min/1.73m2. AACS (4.0 [1.0-10.0] vs. 3.0 [0.0-8.0], p = 0.05) and baPWV (1836.1 ± 250.4 vs. 1676.8 ± 311.0 cm/s, p = 0.01) were significantly higher in patients with a KRU < 0.9 mL/min/1.73m2 than a KRU ≥ 0.9 mL/min/1.73m2. Log-KRU significantly negatively correlated with log-AACS (ß = -0.29, p = 0.002) and baPWV (ß = -0.19, P = 0.05) after factor adjustment. The proportion of left ventricular diastolic dysfunction was significantly higher in patients with a KRU < 0.9 mL/min/1.73m2 than with a KRU ≥ 0.9 mL/min/1.73m2 (67.9% vs. 49.1%, p = 0.05). Patients with a KRU < 0.9 mL/min/1.73m2 showed a higher tendency of cumulative cardiovascular events compared to those with a KRU ≥ 0.9 ml/min/1.73m2 (P = 0.08). CONCLUSIONS: Residual renal function was significantly associated with vascular calcification and left ventricular diastolic dysfunction in patients on hemodialysis.


Assuntos
Testes de Função Cardíaca , Testes de Função Renal , Rim/fisiopatologia , Diálise Renal , Micção/fisiologia , Calcificação Vascular/fisiopatologia , Índice Tornozelo-Braço , Aorta Abdominal/patologia , Aorta Abdominal/fisiopatologia , Demografia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Ureia/metabolismo , Calcificação Vascular/diagnóstico por imagem
10.
PLoS One ; 12(1): e0170272, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28099511

RESUMO

BACKGROUND: In hemodialysis patients, fluid overload and malnutrition are accompanied by extracellular fluid (ECF) expansion and intracellular fluid (ICF) depletion, respectively. We investigated the relationship between ECF/ICF ratio (as an integrated marker reflecting both fluid overload and malnutrition) and survival and cardiovascular disease (CVD) in the context of malnutrition-inflammation-arteriosclerosis (MIA) complex. METHODS: Seventy-seven patients from a single hemodialysis unit were prospectively enrolled. The ECF/ICF volume was measured by segmental multi-frequency bioimpedance analysis. MIA and volume status were measured by serum albumin, C-reactive protein (CRP), pulse wave velocity (PWV) and plasma B-type natriuretic peptide (BNP), respectively. RESULTS: The mean ECF/ICF ratio was 0.56±0.06 and the cut-off value for maximum discrimination of survival was 0.57. Compared with the low ECF/ICF group, the high ECF/ICF group (ratio≥0.57, 42%) had higher all-cause mortality, CVD, CRP, PWV, and BNP, but lower serum albumin. During the 5-year follow-up, 24 all-cause mortality and 38 CVD occurred (18 and 24, respectively, in the high ECF/ICF group versus 6 and 14 respectively in the low ECF/ICF group, P<0.001). In the adjusted Cox analysis, the ECF/ICF ratio nullifies the effects of the MIA and volume status on survival and CVD and was an independent predictor of all-cause mortality and CVD: hazard ratio (95% confidence interval); 1.12 (1.01-1.25) and 1.09 (1.01-1.18) for a 0.01 increase in the ECF/ICF ratio. The degree of malnutrition (albumin), inflammation (CRP), arteriosclerosis (PWV), and fluid overload (BNP) were correlated well with the ECF/ICF ratio. CONCLUSIONS: Hemodialysis patients with high ECF/ICF ratio are not only fluid overloaded, but malnourished and have stiff artery with more inflammation. The ECF/ICF ratio is highly related to the MIA complex, and is a major risk indicator for all-cause mortality and CVD.


Assuntos
Arteriosclerose/patologia , Líquido Extracelular/metabolismo , Inflamação/patologia , Líquido Intracelular/metabolismo , Desnutrição/patologia , Diálise Renal/mortalidade , Proteína C-Reativa/análise , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Estudos Prospectivos , Análise de Onda de Pulso , Fatores de Risco , Albumina Sérica/análise
11.
J Cell Physiol ; 232(11): 3146-3157, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28063235

RESUMO

Adiponectin is one of the adipokines in the collagen superfamily. It is secreted primarily by white adipocytes and influences reproductive processes including ovarian and uterine functions. Adiponectin regulates energy homeostasis, insulin sensitivity, and is anti-inflammatory in various tissues. Its receptors (ADIPOR1 and ADIPOR2) are widely expressed in mammalian tissues, including porcine conceptuses and endometrial during the estrous cycle and peri-implantation period of pregnancy. However, regulatory effects of adiponectin on endometrial epithelial cells are unknown. Therefore, we investigated the effects of parity on expression of ADIPOR1 and ADIPOR2 and the effects of adiponectin in the porcine endometrium during early pregnancy. Results of this study revealed robust expression of ADIPOR1 and ADIPOR2 in uterine luminal (LE) and glandular (GE) epithelia during early pregnancy and expression decreased as with increasing parity. For porcine luminal epithelial (pLE) cells, adiponectin enhanced proliferation, and increased phosphorylation of AKT, P70S6K, S6, ERK1/2, JNK, P38, and P90RSK in a time-dependent manner. Moreover, the abundance of adiponectin-activated signaling molecules were suppressed by pharmacological inhibitors including wortmannin, U0126, SP600125, and SB203580, respectively, in pLE cells. Furthermore, inhibition of each targeted signal transduction molecule influenced proliferation of adiponectin-stimulated pLE cells. In addition, adiponectin inhibited tunicamycin-induced endoplasmic reticulum (ER)-stress through effects on ER stress regulated proteins in pLE cells. Collectively, these results suggest that adiponectin affects development of porcine uterine epithelia and reproductive performance through modulation of PI3K/AKT and MAPK cell signaling pathways.


Assuntos
Adiponectina/metabolismo , Proliferação de Células , Implantação do Embrião , Endométrio/metabolismo , Células Epiteliais/metabolismo , Placentação , Animais , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Implantação do Embrião/efeitos dos fármacos , Endométrio/citologia , Endométrio/efeitos dos fármacos , Estresse do Retículo Endoplasmático , Ativação Enzimática , Células Epiteliais/efeitos dos fármacos , Ciclo Estral/metabolismo , Feminino , Proteínas Quinases Ativadas por Mitógeno/antagonistas & inibidores , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Paridade , Fosfatidilinositol 3-Quinase/metabolismo , Inibidores de Fosfoinositídeo-3 Quinase , Fosforilação , Placentação/efeitos dos fármacos , Gravidez , Inibidores de Proteínas Quinases/farmacologia , Proteínas Proto-Oncogênicas c-akt/antagonistas & inibidores , Proteínas Proto-Oncogênicas c-akt/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptores de Adiponectina/genética , Receptores de Adiponectina/metabolismo , Transdução de Sinais , Sus scrofa , Fatores de Tempo
12.
Ann Thorac Surg ; 103(4): 1246-1253, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27743640

RESUMO

BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) for patients with septic shock is controversial. The outcomes are favorable in children but heterogeneous in adults. The present study aimed to analyze the outcomes of adult patients who underwent ECMO for septic shock, and to determine the factors associated with prognosis. METHODS: We respectively reviewed the medical records of patients who underwent ECMO for septic shock between January 2007 and December 2013. Patients were divided into survivor and nonsurvivor groups based on survival to hospital discharge. The patient characteristics before and during ECMO were compared between the groups. Independent risk factors for mortality were evaluated using multivariate logistic regression, receiver-operating characteristic curves, and Kaplan-Meier analysis. RESULTS: Twenty-eight patients were treated with venoarterial (n = 21), venovenous (n = 4), or venoarteriovenous (n = 3) mode ECMO. The overall survival rate to hospital discharge was 35.7%. The Simplified Acute Physiology Score II (SAPS II) and prealbumin were predictors of survival to hospital discharge. The optimal cutoff value for SAPS II was 80 (area under the curve 0.80, p = 0.010). Kaplan-Meier survival curves showed that the cumulative survival rate at hospital discharge and at 54-month follow-up was significantly higher among patients with SAPS II of 80 or less compared with patients with SAPS II greater than 80 (66.7% versus 12.5% and 58.3% versus 12.5%, respectively; p = 0.001). CONCLUSIONS: It is still difficult to conclude whether ECMO should be recommended as therapy for adult patients with septic shock. However, a SAPS II score of 80 or less may be an indicator of favorable outcomes with the use of ECMO.


Assuntos
Oxigenação por Membrana Extracorpórea , Choque Séptico/mortalidade , Choque Séptico/terapia , Escore Fisiológico Agudo Simplificado , Adulto , Idoso , Feminino , Mortalidade Hospitalar , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Choque Séptico/etiologia , Taxa de Sobrevida , Adulto Jovem
13.
J Biomed Mater Res B Appl Biomater ; 105(7): 2136-2144, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-27417290

RESUMO

During the last decade, there has been a great advance in the kidney dialysis system by wearable artificial kidney (WAK) system for end-stage renal disease patients. Uremic solute removal and water regeneration system are the most prerequisite for WAK to work properly. In this study, we designed a filtering membrane system by using immobilized urease silk fibroin filter and evaluated its comparative effectiveness with a PVDF filtering system in peritoneal dialysate regeneration system by urea removal efficacy. We evaluated this membrane's characteristic and performances by conducting SEM-EDX analyze, water-binding abilities and porosity test, removal abilities of urea, cytotoxicity assay and enzyme activity assay. Under the condition for optimization of urease, the percentage removal of urea was about 40% and 60% in 50 mg/dL urea solution by urease immobilized PVDF and silk fibroin scaffolds, respectively. The batch experimental result showed that immobilized filter removed more than 50% of urea in 50 mg/dL urea solution. In addition silk fibroin with urease filter removed 90 percent of urea in the peritoneal dialysate after 24 h filtration. We suggest that silk fibroin with urease fixation filter can be used more effectively for peritoneal dialysate regeneration system, which have hydrophilic property and prolonged enzyme activity. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2136-2144, 2017.


Assuntos
Enzimas Imobilizadas/química , Fibroínas/química , Teste de Materiais , Diálise Peritoneal/instrumentação , Urease/química , Animais , Camundongos , Células NIH 3T3
14.
J Microbiol Biotechnol ; 26(9): 1620-8, 2016 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-27238937

RESUMO

In this study, we investigated colistin resistance mechanisms associated with the regulation of the pbgP operon in Klebsiella pneumoniae, using four isogenic pairs of colistin-susceptible strains and their colistin-resistant derivatives and two colistin-resistant clinical isolates. Amino acid sequence alterations of PhoPQ, PmrAB, and MgrB were investigated, and mRNA expression levels of phoQ, pmrB, pmrD, and pbgP were measured using quantitative real-time PCR. The phoQ and pmrB genes were deleted from two colistin-resistant derivatives, 134R and 063R. We found that phoQ, pmrD, and pbgP were significantly upregulated in all colistin-resistant derivatives. However, pmrB was significantly upregulated in only two colistin-resistant derivatives and one clinical strain. pmrB was not overexpressed in the other strains. The minimum inhibitory concentration of colistin was drastically lower in both phoQ- and pmrB-deleted mutants from a colistin-resistant derivative (134R) that was overexpressing phoQ and pmrB. However, colistin susceptibility was restored only in a phoQ-deleted mutant from a colistin-resistant derivative (063R) without overexpression of pmrB. In conclusion, two different regulations of the pbgP operon may associate with the development of colistin-resisant K. pneumoniae.


Assuntos
Colistina/farmacologia , Farmacorresistência Bacteriana/genética , Regulação Bacteriana da Expressão Gênica , Genes Bacterianos/genética , Klebsiella pneumoniae , Sequência de Aminoácidos , Antibacterianos/farmacologia , Proteínas de Bactérias/genética , Deleção de Genes , Regulação Bacteriana da Expressão Gênica/efeitos dos fármacos , Regulação Bacteriana da Expressão Gênica/genética , Humanos , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/genética , Testes de Sensibilidade Microbiana , Óperon/genética
15.
Antimicrob Agents Chemother ; 60(1): 609-12, 2016 01.
Artigo em Inglês | MEDLINE | ID: mdl-26459897

RESUMO

Colistin-resistant mutants were obtained from 17 colistin-susceptible strains of Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli. The stability of colistin resistance in these mutants was investigated. Three of four colistin-resistant P. aeruginosa mutants recovered colistin susceptibility in colistin-free medium; however, colistin-susceptible revertants were obtained from only one strain each of A. baumannii and E. coli. No susceptible revertants were obtained from K. pneumoniae mutants.


Assuntos
Acinetobacter baumannii/efeitos dos fármacos , Antibacterianos/farmacologia , Colistina/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Klebsiella pneumoniae/efeitos dos fármacos , Pseudomonas aeruginosa/efeitos dos fármacos , Acinetobacter baumannii/genética , Acinetobacter baumannii/metabolismo , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Farmacorresistência Bacteriana/genética , Escherichia coli/genética , Escherichia coli/metabolismo , Expressão Gênica , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/metabolismo , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Testes de Sensibilidade Microbiana , Taxa de Mutação , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo
16.
Antimicrob Agents Chemother ; 59(11): 6763-73, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26282408

RESUMO

In this study, we investigated the effects of colistin resistance on virulence and fitness in hypermucoviscous (HV) Klebsiella pneumoniae sequence type 23 (ST23) strains. Colistin-resistant mutants were developed from three colistin-susceptible HV K. pneumoniae ST23 strains. The lipid A structures of strains were analyzed by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. Changes in HV were investigated using the string test, and extracellular polysaccharide production was quantified. The expression levels of the phoQ, pmrD, pmrB, pbgP, magA, and p-rmpA2 genes, serum resistance, and biofilm-forming activity were determined. The fitness of colistin-resistant mutants compared to that of the parental strains was examined by determining the competitive index (CI). The colistin-resistant mutants exhibited reduced HV, which was accompanied by decreased formation of capsular polysaccharides (CPS) and reduced expression of genes (magA and p-rmpA2). While there was enhanced expression of pmrD and pbgP in all colistin-resistant derivatives, there were differences in the expression levels of phoQ and pmrB between strains. MALDI-TOF analysis detected the addition of aminoarabinose or palmitate to the lipid A moiety of lipopolysaccharide in the colistin-resistant derivatives. In addition, survival rates in the presence of normal human serum were decreased in the mutant strains, and CI values (0.01 to 0.19) indicated significant fitness defects in the colistin-resistant derivatives compared to the respective parental strains. In hypervirulent HV K. pneumoniae strains, the acquisition of colistin resistance was accompanied by reduced CPS production, impaired virulence, and a significant fitness cost.


Assuntos
Antibacterianos/farmacologia , Colistina/farmacologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/metabolismo , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Biofilmes/efeitos dos fármacos , Farmacorresistência Bacteriana/genética , Regulação Bacteriana da Expressão Gênica , Polissacarídeos Bacterianos/metabolismo , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
17.
PLoS One ; 10(8): e0132944, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26241496

RESUMO

In this paper, we present a method for predicting the value of virtual currencies used in virtual gaming environments that support multiple users, such as massively multiplayer online role-playing games (MMORPGs). Predicting virtual currency values in a virtual gaming environment has rarely been explored; it is difficult to apply real-world methods for predicting fluctuating currency values or shares to the virtual gaming world on account of differences in domains between the two worlds. To address this issue, we herein predict virtual currency value fluctuations by collecting user opinion data from a virtual community and analyzing user sentiments or emotions from the opinion data. The proposed method is straightforward and applicable to predicting virtual currencies as well as to gaming environments, including MMORPGs. We test the proposed method using large-scale MMORPGs and demonstrate that virtual currencies can be effectively and efficiently predicted with it.


Assuntos
Economia , Emoções , Jogos Recreativos/psicologia , Atitude , Comércio , Humanos , Aprendizado de Máquina , Modelos Econométricos , Apoio Social , Inquéritos e Questionários
20.
Int J Cardiol ; 176(3): 941-5, 2014 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-25200848

RESUMO

BACKGROUND: Periprocedural (6 h pre- and 24 h post-angiography) hemofiltration appears to effectively prevent contrast-induced nephropathy (CIN) in chronic kidney disease (CKD) patients undergoing coronary angiography. However, this procedure over-uses medical resources, and the cessation of hemofiltration during coronary angiography results in persistent renal injury. In comparison, simultaneous hemofiltration performed only during coronary angiography requires fewer medical resources and can provide instantaneous protection against CIN. METHODS: Sixty-eight CKD patients (serum creatinine, 2.51±1.15 mg/dL) undergoing coronary angiography were randomized in a 1:2 ratio to receive either periprocedural (n=23) or simultaneous (n=45) hemofiltration. The expected CIN rate was similar for the two groups (41.3% versus 40.0%, p=0.769). RESULTS: On day 3 after contrast exposure, four and seven patients in the periprocedural and simultaneous groups, respectively experienced CIN (17.4% versus 15.6%, p=0.846). On days 5-30, seven and three patients in the periprocedural and simultaneous groups, respectively experienced CIN (30.4% versus 6.7%, p=0.009). The serum creatinine levels of patients in the periprocedural group transiently decreased on day 1 and persistently increased during days 5-30 compared with the simultaneous group. This difference between the two groups in terms of creatinine levels over time was statistically significant (F statistic=6.830; p=0.001, by ANCOVA). The cost of hemofiltration was doubled in the periprocedural group ($1066±83 versus $504±40, p<0.001). CONCLUSIONS: Simultaneous hemofiltration provide equal early (day 3) and better late-stage (days 5-30) renal protection against CIN at a significantly lower cost compared with periprocedural hemofiltration.


Assuntos
Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/prevenção & controle , Meios de Contraste/efeitos adversos , Angiografia Coronária/efeitos adversos , Hemofiltração/métodos , Insuficiência Renal Crônica/diagnóstico por imagem , Injúria Renal Aguda/epidemiologia , Idoso , Angiografia Coronária/métodos , Creatinina/sangue , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Assistência Perioperatória/métodos , Projetos Piloto , Estudos Prospectivos , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/complicações , Ácidos Tri-Iodobenzoicos/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...