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1.
Int J Dent Hyg ; 21(1): 211-218, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35943370

RESUMO

BACKGROUND: In daily dental practice, plaque-induced gingivitis is one of the most common periodontal diseases that is frequently encountered. Accumulation of microbial biofilms on surfaces of teeth and poor or inadequate oral hygiene is the chief predisposing factor for this condition. In such a state, antimicrobial mouthwash as an adjunct to mechanical plaque control helps in maintaining good oral hygiene. Among the many conditions, fixed orthodontic treatment is one of the conditions where plaque control becomes challenging to the patient as well as the dentist. In such a situation, antimicrobial mouthwash as an adjunct to mechanical plaque control is highly recommended. Dentistry has recently evidenced a shift of approach for treating many inflammatory oral diseases by using herbal treatment modalities. Aloe vera is one such product exhibiting multiple benefits and has gained considerable importance in clinical research recently. The present study aimed to evaluate efficacy of aloe vera mouth rinse on the dental plaque and gingivitis in patients who were undergoing fixed orthodontic treatment in comparison with 0.2% chlorhexidine mouthwash. MATERIAL AND METHOD: This randomized controlled trial was conducted on 30 subjects with fixed orthodontic treatment. The subjects were grouped in the test group (15 subjects with 10 ml aloe vera mouthwash (99.6% [w/v])) and the control group (15 subjects with 0.2% 10 ml chlorhexidine mouthwash). Plaque index, gingival index and bleeding on probing were recorded for each participant at baseline, 21 days from baseline and 35 days from baseline. The findings were then statistically analysed using student paired and unpaired t-test. RESULTS: Gingival index showed a statistically significant difference from baseline to 21 days and 35 days visit in both the groups. Plaque index and bleeding on probing were statistically significant among both groups when compared baseline to 21 days and 35 days visit, but the difference was not significant between visit 2 and visit 3. CONCLUSIONS: Although chlorhexidine is still the gold standard mouthwash, aloe vera exhibits promising results in reducing plaque and gingivitis scores, without any reported adverse effects. Larger multi-centric trials are needed to prove its effectiveness on dental plaque-induced gingivitis.


Assuntos
Aloe , Placa Dentária , Gengivite , Humanos , Clorexidina/uso terapêutico , Antissépticos Bucais/uso terapêutico , Placa Dentária/prevenção & controle , Placa Dentária/tratamento farmacológico , Gengivite/prevenção & controle , Gengivite/tratamento farmacológico
2.
Vaccine ; 40(41): 5843-5855, 2022 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-36008233

RESUMO

The World Health Organization (WHO) global strategy to eliminate cervical cancer (CxCa) could result in >62 million lives saved by 2120 if strategy targets are reached and maintained: 90% of adolescent girls receiving prophylactic human papillomavirus (HPV) vaccine, 70% of women receiving twice-lifetime cervical cancer screening, and 90% of cervical pre-cancer lesions and invasive CxCa treated. However, the cost and complexity of CxCa screening and treatment approaches has hampered scale-up, particularly in low- and middle-income countries (LMICs), and new approaches are needed. Therapeutic HPV vaccines (TxV), which could clear persistent high-risk HPV infection and/or cause regression of pre-cancerous lesions, are in early clinical development and might offer one such approach. During October 2021 to March 2022, WHO, in collaboration with the Bill and Melinda Gates Foundation, convened a series of global expert consultations to lay the groundwork for understanding the potential value of TxV in the context of current CxCa prevention efforts and for defining WHO preferred product characteristics (PPCs) for TxV. WHO PPCs describe preferences for vaccine attributes that would help optimize vaccine value and use in meeting the global public health need. This paper reports on the main discussion points and findings from the expert consultations. Experts identified several ways in which TxV might address challenges in current CxCa prevention programmes, but emphasized that the potential value of TxV will depend on their degree of efficacy and how quickly they can be developed and implemented relative to ongoing scale-up of existing interventions. Consultation participants also discussed potential use-cases for TxV, important PPC considerations (e.g., vaccine indications, target populations, and delivery strategies), and critical modelling needs for predicting TxV impact and cost-effectiveness.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Adolescente , Detecção Precoce de Câncer , Feminino , Humanos , Papillomaviridae , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Saúde Pública , Encaminhamento e Consulta , Neoplasias do Colo do Útero/diagnóstico , Organização Mundial da Saúde
3.
PLoS One ; 17(5): e0268022, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35584148

RESUMO

BACKGROUND: Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown. OBJECTIVE: To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID). METHODS: Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day mortality across racial/ethnic groups. RESULTS: A total of 2153 patients were included (994 [46.2%] Hispanic and 1159 [53.8%] non-Hispanic White). The median (IQR) age was 62 (51-71) years (non-Hispanic White, 66 [57-74] years; Hispanic, 56 [46-67] years), and 1462 (67.9%) were men. Compared with non-Hispanic White patients, Hispanic patients were younger; were less likely to have hypertension, chronic obstructive pulmonary disease, coronary artery disease, or heart failure; and had longer duration of symptoms prior to ICU admission. During median (IQR) follow-up of 14 (7-24) days, 785 patients (36.5%) died. In analyses adjusted for age, sex, clinical characteristics, and hospital size, Hispanic patients had higher odds of death compared with non-Hispanic White patients (OR, 1.44; 95% CI, 1.12-1.84). CONCLUSIONS: Among critically ill adults with COVID-19, Hispanic patients were more likely to die than non-Hispanic White patients, even though they were younger and had lower comorbidity burden. This finding highlights the need to provide earlier access to care to Hispanic individuals with COVID-19, especially given our finding of longer duration of symptoms prior to ICU admission among Hispanic patients. In addition, there is a critical need to address ongoing disparities in post hospital discharge care for patients with COVID-19.


Assuntos
COVID-19 , Adulto , Idoso , Estudos de Coortes , Estado Terminal , Etnicidade , Feminino , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Estados Unidos/epidemiologia
4.
Blood Adv ; 4(16): 3804-3813, 2020 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-32785684

RESUMO

Sickle cell disease (SCD) is the most common inherited blood disorder in the United States. It is a medically and socially complex, multisystem illness that affects individuals throughout the lifespan. Given improvements in care, most children with SCD survive into adulthood. However, access to adult sickle cell care is poor in many parts of the United States, resulting in increased acute care utilization, disjointed care delivery, and early mortality for patients. A dearth of nonmalignant hematology providers, the lack of a national SCD registry, and the absence of a centralized infrastructure to facilitate comparative quality assessment compounds these issues. As part of a workshop designed to train health care professionals in the skills necessary to establish clinical centers focused on the management of adults living with SCD, we defined an SCD center, elucidated required elements of a comprehensive adult SCD center, and discussed different models of care. There are also important economic impacts of these centers at an institutional and health system level. As more clinicians are trained in providing adult-focused SCD care, center designation will enhance the ability to undertake quality improvement and compare outcomes between SCD centers. Activities will include an assessment of the clinical effectiveness of expanded access to care, the implementation of SCD guidelines, and the efficacy of newly approved targeted medications. Details of this effort are provided.


Assuntos
Anemia Falciforme , Doenças Hematológicas , Adulto , Anemia Falciforme/terapia , Criança , Acessibilidade aos Serviços de Saúde , Humanos , Estados Unidos
5.
J Aging Phys Act ; 28(1): 149-154, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31629356

RESUMO

The authors compared the linear and nonlinear heart rate variability dynamics from rest through maximal exercise in postmenopausal women who trained at either moderate or high intensities. The outcome variables included the RR triangular index, TINN, SD1, SD2, SD1/SD2, DFA α1, DFA α2, and α1/α2. Maximal exercise reduced SD1, SD2, DFA α1, DFA α2, α1/α2, RRTri, and TINN in both groups and increased SD1/SD2 (p < .05). Two minutes of active recovery produced significant increases in SD1, SD2, DFA α1, and TINN, compared with exercise in both groups (p < .0001). There was also a significant main effect between groups for RRTri during exercise recovery, with the moderate group achieving higher levels (p < .04). The authors have shown that both moderate and vigorous exercise training can lead to a healthy response to maximal exercise and recovery, with the moderate group having a slightly improved recovery in the triangular index.


Assuntos
Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Menopausa/fisiologia , Feminino , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Descanso
6.
Water Sci Technol ; 79(5): 1017-1028, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31025982

RESUMO

To mitigate the toxicity of ammonia in aquaculture systems, marine and brackish water ammonia-oxidizing bacterial consortia have been developed and are used for activation of nitrifying bioreactors integrated to recirculating aquaculture systems. To shed more light on to these biological entities, diversity of both the consortia were analyzed based on random cloning of 16S rRNA gene and ammonia-oxidizing bacterial specific amoA gene sequences. The dendrograms of representative clones on the basis of amplified ribosomal DNA restriction analysis generated 22 and 19 clusters for marine and brackish water nitrifying consortia, respectively. Phylogenetic analysis demonstrated the presence of various autotrophic nitrifiers belonging to α-, ß- and γ-Proteobacteria, anaerobic ammonia oxidizers, heterotrophic denitrifiers, Bacteroidetes, and Actinobacteria. Distribution patterns of the organisms within the two consortia were determined using the software Geneious and diversity indices were investigated using Mega 5.0, VITCOMIC and Primer 7. The abundance of ammonia oxidizers was found in the order of 2.21 ± 0.25 × 109 copies/g wet weight of marine consortium and 6.20 ± 0.23 × 107 copies/g of brackish water consortium. Besides, marine ammonia-oxidizing consortium exhibited higher mean population diversity and Shannon Wiener diversity than the brackish water counterparts.


Assuntos
Amônia/metabolismo , Aquicultura , Consórcios Microbianos , Microbiota , Microbiologia da Água , Poluentes da Água/metabolismo , Biodegradação Ambiental , Oxirredução , Filogenia , RNA Ribossômico 16S , Água do Mar/microbiologia
7.
3 Biotech ; 8(12): 493, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30498666

RESUMO

The present work is an attempt to integrate the molecular simulation studies with in vitro cytotoxicity of cytarabine-loaded chitosan nanoparticles and exploring the potential of this formulation as therapeutics for treating solid tumours. The molecular simulation was performed using GROMACS v5.4 in which, chitosan polymer (CHT; six molecules) was used to study the encapsulation and release of a single molecule of cytarabine. Root Mean Square Deviation (RMSD) of the Cα atom of cytarabine (CBR) molecule shows that CBR starts to diffuse out of the CHT polymer binding pocket around 10.2 ns, indicated by increased fluctuation of RMSD at pH 6.4, while the drug diffusion is delayed at pH 7.4 and starts diffusing around 17.5 ns. Cytarabine-loaded chitosan nanoparticles (CCNP), prepared by ionic gelation method were characterized for encapsulation efficiency, particle size and morphology, zeta potential, crystallinity and drug release profile at pH 6.4 and 7.4. CCNPs showed 64% encapsulation efficiency with an average diameter of 100 nm and zeta potential of + 53.9 mV. It was found that cytarabine existed in amorphous state in nanoformulation. In vitro release studies showed 70% cytarabine was released from the chitosan-based nanoformulation release at pH 6.4, which coincides with the pH of tumour microenvironment. Cytotoxicity against breast cancer cell line (MCF 7) was higher for nanoformulation compared to free cytarabine. Haemocompatibility studies showed that chitosan-based nanoformulation is safe, biocompatible and nonhaemolytic in nature; hence, can be used as a safe drug delivery system. Taken together, our study suggests that chitosan nanoformulation would be an effective strategy for the pH-dependent release of cytarabine against solid tumours and might impart better therapeutic efficiency.

8.
J Biomech ; 78: 87-93, 2018 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-30060922

RESUMO

Lumbar intervertebral body fusion devices (L-IBFDs) are intended to provide stability to promote fusion in patients with a variety of lumbar pathologies. Different L-IBFD designs have been developed to accommodate various surgical approaches for lumbar interbody fusion procedures including anterior, lateral, posterior, and transforaminal lumbar interbody fusions (ALIF, LLIF, PLIF, and TLIF, respectively). Due to design differences, there is a potential for mechanical performance differences between ALIF, LLIF, PLIF, and TLIF devices. To evaluate this, mechanical performance and device dimension data were collected from 124 Traditional 510(k) submissions to the FDA for L-IBFDs cleared for marketing from 2007 through 2016. From these submissions, mechanical test results were aggregated for seven commonly performed tests: static and dynamic axial compression, compression-shear, and torsion testing per ASTM F2077, and subsidence testing per ASTM F2267. The Kruskal-Wallis test and Wilcoxon signed-rank test were used to determine if device type (ALIF, LLIF, PLIF, TLIF) had a significant effect on mechanical performance parameters (static testing: stiffness and yield strength; dynamic testing: runout load; subsidence testing: stiffness [Kp]). Generally, ALIFs and LLIFs were found to be stiffer, stronger, and had higher subsidence resistance than PLIF and TLIF designs. These results are likely due to the larger footprints of the ALIF and LLIF devices. The relative mechanical performance and subsidence resistance can be considered when determining the appropriate surgical approach and implant for a given patient. Overall, the mechanical performance data presented here can be utilized for future L-IBFD development and design verification.


Assuntos
Vértebras Lombares/cirurgia , Fenômenos Mecânicos , Projetos de Pesquisa , Fusão Vertebral/instrumentação , United States Food and Drug Administration , Feminino , Humanos , Teste de Materiais , Pressão , Estados Unidos
9.
Appl Clin Inform ; 9(3): 667-682, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30157499

RESUMO

BACKGROUND: Defining clinical conditions from electronic health record (EHR) data underpins population health activities, clinical decision support, and analytics. In an EHR, defining a condition commonly employs a diagnosis value set or "grouper." For constructing value sets, Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) offers high clinical fidelity, a hierarchical ontology, and wide implementation in EHRs as the standard interoperability vocabulary for problems. OBJECTIVE: This article demonstrates a practical approach to defining conditions with combinations of SNOMED CT concept hierarchies, and evaluates sharing of definitions for clinical and analytic uses. METHODS: We constructed diagnosis value sets for EHR patient registries using SNOMED CT concept hierarchies combined with Boolean logic, and shared them for clinical decision support, reporting, and analytic purposes. RESULTS: A total of 125 condition-defining "standard" SNOMED CT diagnosis value sets were created within our EHR. The median number of SNOMED CT concept hierarchies needed was only 2 (25th-75th percentiles: 1-5). Each value set, when compiled as an EHR diagnosis grouper, was associated with a median of 22 International Classification of Diseases (ICD)-9 and ICD-10 codes (25th-75th percentiles: 8-85) and yielded a median of 155 clinical terms available for selection by clinicians in the EHR (25th-75th percentiles: 63-976). Sharing of standard groupers for population health, clinical decision support, and analytic uses was high, including 57 patient registries (with 362 uses of standard groupers), 132 clinical decision support records, 190 rules, 124 EHR reports, 125 diagnosis dimension slicers for self-service analytics, and 111 clinical quality measure calculations. Identical SNOMED CT definitions were created in an EHR-agnostic tool enabling application across disparate organizations and EHRs. CONCLUSION: SNOMED CT-based diagnosis value sets are simple to develop, concise, understandable to clinicians, useful in the EHR and for analytics, and shareable. Developing curated SNOMED CT hierarchy-based condition definitions for public use could accelerate cross-organizational population health efforts, "smarter" EHR feature configuration, and clinical-translational research employing EHR-derived data.


Assuntos
Registros Eletrônicos de Saúde , Systematized Nomenclature of Medicine , Sistemas de Apoio a Decisões Clínicas , Humanos , Software , Pesquisa Translacional Biomédica
10.
Methods Inf Med ; 56(99): e74-e83, 2017 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-28930362

RESUMO

BACKGROUND: Creation of a new electronic health record (EHR)-based registry often can be a "one-off" complex endeavor: first developing new EHR data collection and clinical decision support tools, followed by developing registry-specific data extractions from the EHR for analysis. Each development phase typically has its own long development and testing time, leading to a prolonged overall cycle time for delivering one functioning registry with companion reporting into production. The next registry request then starts from scratch. Such an approach will not scale to meet the emerging demand for specialty registries to support population health and value-based care. OBJECTIVE: To determine if the creation of EHR-based specialty registries could be markedly accelerated by employing (a) a finite core set of EHR data collection principles and methods, (b) concurrent engineering of data extraction and data warehouse design using a common dimensional data model for all registries, and (c) agile development methods commonly employed in new product development. METHODS: We adopted as guiding principles to (a) capture data as a byproduct of care of the patient, (b) reinforce optimal EHR use by clinicians, (c) employ a finite but robust set of EHR data capture tool types, and (d) leverage our existing technology toolkit. Registries were defined by a shared condition (recorded on the Problem List) or a shared exposure to a procedure (recorded on the Surgical History) or to a medication (recorded on the Medication List). Any EHR fields needed - either to determine registry membership or to calculate a registry-associated clinical quality measure (CQM) - were included in the enterprise data warehouse (EDW) shared dimensional data model. Extract-transform-load (ETL) code was written to pull data at defined "grains" from the EHR into the EDW model. All calculated CQM values were stored in a single Fact table in the EDW crossing all registries. Registry-specific dashboards were created in the EHR to display both (a) real-time patient lists of registry patients and (b) EDW-generated CQM data. Agile project management methods were employed, including co-development, lightweight requirements documentation with User Stories and acceptance criteria, and time-boxed iterative development of EHR features in 2-week "sprints" for rapid-cycle feedback and refinement. RESULTS: Using this approach, in calendar year 2015 we developed a total of 43 specialty chronic disease registries, with 111 new EHR data collection and clinical decision support tools, 163 new clinical quality measures, and 30 clinic-specific dashboards reporting on both real-time patient care gaps and summarized and vetted CQM measure performance trends. CONCLUSIONS: This study suggests concurrent design of EHR data collection tools and reporting can quickly yield useful EHR structured data for chronic disease registries, and bodes well for efforts to migrate away from manual abstraction. This work also supports the view that in new EHR-based registry development, as in new product development, adopting agile principles and practices can help deliver valued, high-quality features early and often.


Assuntos
Registros Eletrônicos de Saúde/normas , Sistema de Registros/normas , Coleta de Dados , Documentação , Humanos , Software
11.
Ann Card Anaesth ; 20(2): 163-168, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28393775

RESUMO

CONTEXT: Analgesia and sedation are required for the comfort of patient and the cardiologist during balloon mitral valvotomy. AIMS: In this study, efficacy of analgesia, sedation, and patient satisfaction with sufentanil was compared with fentanyl. SETTINGS AND DESIGN: Single-centered, prospective single-blind study of sixty patients. MATERIALS AND METHODS: Patients between 15 and 45 years of rheumatic mitral stenosis with valve area of 0.8-1 cm2 undergoing elective balloon mitral valvotomy, randomly divided to receive bolus injection fentanyl 1 mcg/kg (Group 1, n = 30) followed by infusion at 1 mcg/kg/h or bolus of injection sufentanil 0.1 mcg/kg (Group 2, n = 30) followed by continuous infusion at 0.1 mcg/h. Both the groups received injection midazolam bolus 0.02 mg/kg followed by infusion at 15 mcg/kg/h. Pain intensity (by visual analog score [VAS]), level of sedation (by Ramsay sedation scale), overall patient and operator's satisfaction, effect on cardiorespiratory parameters, and discharge score (by modified Aldrete score) were assessed. STATISTICAL ANALYSIS USED: Statistical analysis used Student's unpaired t-test and Chi-square test. P < 0.05 was considered statistically significant. RESULTS: Mean number of bolus doses in fentanyl group was 0.9 versus 0.13 in sufentanil group (P < 0.01). The mean value of mean blood pressure in fentanyl group was 83.52 mmHg versus 88 mmHg in sufentanil group (P < 0.05), but the value was within normal range in both the groups. The mean VAS - patient's opinion in fentanyl group was 8.97 versus 9.53 in sufentanil group (P < 0.05). Mean discharge score in fentanyl group was 17.87 versus 18.23 in sufentanil group (P < 0.05). No statistically significant difference was found with respect to heart rate, respiratory rate, oxygen saturation, PaCO2values, and anxiety scores. CONCLUSION: Sufentanil was found to be better with respect to analgesia, patient satisfaction, and recovery however not cost-effective for continuous infusion technique.


Assuntos
Anestésicos Intravenosos/administração & dosagem , Valvuloplastia com Balão/métodos , Sedação Consciente/métodos , Fentanila/administração & dosagem , Estenose da Valva Mitral/terapia , Sufentanil/administração & dosagem , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral , Estenose da Valva Mitral/etiologia , Satisfação do Paciente , Estudos Prospectivos , Doenças Reumáticas/complicações , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
12.
J Biomech ; 54: 26-32, 2017 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-28256243

RESUMO

Cervical intervertebral body fusion devices (IBFDs) are utilized to provide stability while fusion occurs in patients with cervical pathology. For a manufacturer to market a new cervical IBFD in the United States, substantial equivalence to a cervical IBFD previously cleared by FDA must be established through the 510(k) regulatory pathway. Mechanical performance data are typically provided as part of the 510(k) process for IBFDs. We reviewed all Traditional 510(k) submissions for cervical IBFDs deemed substantially equivalent and cleared for marketing from 2007 through 2014. To reduce sources of variability in test methods and results, analysis was restricted to cervical IBFD designs without integrated fixation, coatings, or expandable features. Mechanical testing reports were analyzed and results were aggregated for seven commonly performed tests (static and dynamic axial compression, compression-shear, and torsion testing per ASTM F2077, and subsidence testing per ASTM F2267), and percentile distributions of performance measurements were calculated. Eighty-three (83) submissions met the criteria for inclusion in this analysis. The median device yield strength was 10,117N for static axial compression, 3680N for static compression-shear, and 8.6Nm for static torsion. Median runout load was 2600N for dynamic axial compression, 1400N for dynamic compression-shear, and ±1.5Nm for dynamic torsion. In subsidence testing, median block stiffness (Kp) was 424N/mm. The mechanical performance data presented here will aid in the development of future cervical IBFDs by providing a means for comparison for design verification purposes.


Assuntos
Vértebras Cervicais/fisiologia , Próteses e Implantes , Fusão Vertebral/instrumentação , Humanos , Teste de Materiais , Desenho de Prótese , Fusão Vertebral/métodos , Estados Unidos , United States Food and Drug Administration
13.
Sports Med Int Open ; 1(5): E166-E171, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30539103

RESUMO

Postmenopausal women have an increased risk for cardiovascular disease through many factors, such as a sedentary lifestyle and reduced heart rate variability (HRV). Endurance training improves coronary risk but the role of exercise intensity is unclear. The purpose of this observational study was to evaluate the effects of moderate versus vigorous exercise on cardiovascular disease risk in postmenopausal women. Thirty-six postmenopausal women who self-reported training at moderate (3-5.9 METS; n=18; age 58.9±4.4yr) or vigorous intensities (>6 METS; n=18; age 59.7±5.2yr) participated. C-reactive protein (CRP), HRV, VO 2 max, and stress (Perceived Stress Survey, Menopause Rating Scale) were measured. Groups were compared using independent samples t- tests, and associations of exercise intensities with CRP and HRV were assessed using multiple regression. CRP, HRV, and VO 2 max were similar ( p >0.05). Vigorous exercise had lower stress subscale scores ( p <0.01) and higher counter-stress subscale scores compared to moderate ( p <0.05). There was a positive association between time spent in vigorous exercise and HRV ( p <0.05).Vigorous exercise may not confer additional benefits in CRP and HRV over moderate, except for stress reduction. However, more time spent in vigorous exercise was associated with higher HRV. Therefore, increased parasympathetic tone may provide cardioprotection after menopause.

14.
Acad Emerg Med ; 23(8): 932-40, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27155438

RESUMO

OBJECTIVES: The objective was to determine the test performance characteristics for point-of-care lung ultrasonography (LUS) performed by pediatric emergency medicine (PEM) physicians compared with radiographic diagnosis of acute chest syndrome (ACS) in patients with sickle cell disease (SCD) and fever. METHODS: This was a prospective study of patients up to 21 years with SCD and fever requiring chest X-ray (CXR) evaluation for ACS. Before obtaining CXR, a blinded PEM physician performed LUS using a standardized scanning protocol. Positive LUS for ACS was defined as lung consolidation. All patients received CXR and follow-up. The criterion standard for ACS was consolidation on CXR as determined by a blinded radiologist. LUS clips were reviewed by a blinded expert PEM sonologist. RESULTS: A total of 116 febrile events from 91 patients with a median age of 5.7 years were enrolled by 15 PEM sonologists. CXR was positive for ACS in 15 (13%) patients, and LUS was positive for ACS in 19 (16%) patients. Positive LUS had a sensitivity of 87% (95% confidence interval [CI] = 62% to 96%), specificity of 94% (95% CI = 88% to 97%), positive likelihood ratio of 14.6 (95% CI = 6.5 to 32.5), and negative likelihood ratio of 0.14 (95% CI = 0.04 to 0.52) for ACS. The interobserver agreement (kappa) was 0.77. There were two missed cases of ACS on LUS. CONCLUSIONS: LUS may be sensitive and specific for diagnosis of ACS in pediatric patients with SCD and fever. LUS may reduce the need for routine CXR and associated ionizing radiation exposure in this population.


Assuntos
Síndrome Torácica Aguda/diagnóstico por imagem , Anemia Falciforme , Pulmão/fisiopatologia , Sistemas Automatizados de Assistência Junto ao Leito , Ultrassonografia/normas , Criança , Pré-Escolar , Feminino , Febre , Humanos , Masculino , Pneumonia , Estudos Prospectivos , Radiografia Torácica , Sensibilidade e Especificidade
15.
Int Endod J ; 49(5): 413-21, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26059708

RESUMO

AIM: To evaluate the outcome of root canal treatment in primary teeth using three root canal filling materials - RC Fill, Vitapex and Pulpdent root canal sealer. METHODOLOGY: The study was a single-centre, double-blind, randomized controlled trial carried out on 129 primary mandibular molars with necrotic pulps or irreversible pulpitis in 4- to 9-year-old children. Participants were selected based on specific inclusion and exclusion criteria and were randomly allocated into 3 groups: Group I - RC Fill [zinc oxide-eugenol (ZOE) with iodoform]; Group II - Vitapex (calcium hydroxide with iodoform); and Group III - Pulpdent root canal sealer (ZOE). The outcome measures were evaluated both clinically and radiographically at 6, 12 and 30 months according to modified American Association of Endodontists (AAE) criteria. The radiographic outcomes were assessed by two blinded and calibrated evaluators. Pearson's chi-square analysis was performed for both intention-to-treat (ITT) and per-protocol population. RESULT: The success rates of RC Fill, Vitapex and Pulpdent were 94%, 90% and 97%, respectively, at 30 months and the differences were not significant (P = 0.137). CONCLUSION: All three materials were found to be equally effective root filling materials for primary molars with necrotic pulps and irreversible pulpitis at 30 months. However, long-term follow-up until the eruption of the permanent successor teeth is needed for more definitive assessments.


Assuntos
Pulpectomia , Materiais Restauradores do Canal Radicular , Método Duplo-Cego , Humanos , Dente Molar , Tratamento do Canal Radicular , Raiz Dentária , Dente Decíduo , Cimento de Óxido de Zinco e Eugenol
16.
Chemphyschem ; 16(4): 825-32, 2015 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-25640413

RESUMO

Dielectric spectroscopy is used to investigate the structure, molecular dynamics, and relaxation phenomena in electric-field-induced switchable dark conglomerate (DC) phases in a bent-core liquid crystal. The DC phases are obtained by applying a high-frequency ac electric field in the B1rev phase or by cooling under a dc or an ac field from the isotropic phase. Although the DC phases exhibit good electro-optic switching properties, the dielectric parameters are different from those observed in typical lamellar SmCP phases and similar to those obtained in a non-switchable DC phase. We therefore propose that the dielectric response and reduced intensity of the relaxation modes may be a general feature in DC phases and may owe its origin to the deformed layer structure in which certain molecular motions are impeded. Further, we find that in the field-induced DC phases derived from the isotropic phase, the dielectric modes are affected by chiral segregation promoted by the applied field.

17.
J Food Sci Technol ; 51(10): 2827-32, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25328233

RESUMO

Investigations were carried out to study the influence of vacuum packaging and long term storage on quality in red chilli. Chilli fruits were stored in vacuum packed and jute bags at two moisture levels (10 % and 12 %) in room and cold environments under both light and dark conditions for a period of 24 months. During storage period, average room and cool chamber temperatures were 25 ± 2 °C and 4 ± 1 °C, respectively. Changes of moisture (Halogen moisture analyzer), capsaicin (HPLC-UV), oleoresin and total extractable colour (spectrophotometer) were analyzed at 3 months interval up to 12 months and 6 months interval from 12 to 24 months. Statistical analysis (ANOVA) and Duncan's test were applied to the analytical data to evaluate the effect of treatments applied. It was observed that the vacuum packed chillies under cold storage were found to have the least per cent decline in various quality parameters. Chillies with 12 % moisture and stored in vacuum packaged bags recorded better quality parameters over 10 % moisture.

18.
Meat Sci ; 98(2): 240-6, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24973774

RESUMO

The meat quality characteristics of adult emus transported for 6h before slaughter were determined. Forty-two emus were used in two trials, undertaken under warm and cool weather conditions, respectively. Male emus had significantly higher fat yields than females (12.43kg vs 9.5kg, P=0.002). About 38.1% of the emus had no wounds or bruises, 40.5% had bruises, while 21.4% had small wounds after transport. Meat from injured emus had significantly higher pH45. In warm weather, emus experienced significantly higher loss in body weight than that under cool weather. Drip loss in meat after 24h of storage was higher in emus which had greater live weight loss after transport (r=0.66, P<0.0001), confirming the adverse effects of transport stress on meat quality. Nutrient supplementation did not significantly affect processing yield or meat quality characteristics. This study points to the need for optimizing transport conditions of emus to maintain meat quality.


Assuntos
Qualidade dos Alimentos , Carne/análise , Matadouros , Animais , Composição Corporal , Peso Corporal , Cor , Suplementos Nutricionais , Dromaiidae , Feminino , Concentração de Íons de Hidrogênio , Masculino , Músculo Esquelético/química , Estresse Fisiológico , Temperatura , Meios de Transporte
19.
Artigo em Inglês | MEDLINE | ID: mdl-24827266

RESUMO

Generating and controlling chiral symmetry breaking and enantiomeric excess is not only interesting from a fundamental perspective but can also lead to novel functional materials. In this work, we show how the dark conglomerate (DC) liquid crystalline phase characterized by macroscopic chiral domains offers such a possibility if formed under an electric field. In addition the chiral domains are electro-optically switchable. The chiral segregation in the DC phase can be tuned by using dc or ac fields at different frequencies. Consequently, the enantioselectivity, dielectric parameters and switching polarization in the DC phase become tunable. Another interesting aspect is that the nucleating conglomerate domains formed under ac fields exhibit frequency dependent shape transitions which have a striking resemblance to domain shape changes observed in two-dimensional monolayers. This can therefore be used as a model experimental system to get a physical insight into the effects of chiral and electrostatic interactions, under external fields, on domain growth and interface structures. The domain shape transitions can also be used to investigate the role of growth morphology in coarsening and scaling hypotheses. From a technological point of view this opens up the possibility of obtaining chiral thin films with preferential sense of chirality which can be useful in chiroptical and nonlinear optical applications.

20.
Saudi Dent J ; 26(1): 7-13, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24526823

RESUMO

Dental plaque is considered to be a major etiological factor in the development of periodontal disease. Accordingly, the elimination of supra- and sub-gingival plaque and calculus is the cornerstone of periodontal therapy. Dental calculus is mineralized plaque; because it is porous, it can absorb various toxic products that can damage the periodontal tissues. Hence, calculus should be accurately detected and thoroughly removed for adequate periodontal therapy. Many techniques have been used to identify and remove calculus deposits present on the root surface. The purpose of this review was to compile the various methods and their advantages for the detection and removal of calculus.

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