Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.964
Filtrar
1.
J Refract Surg ; 40(7): e480-e489, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39007817

RESUMO

PURPOSE: To evaluate the effectiveness, safety, and stability of a modified PRESBYOND Laser Blended Vision protocol (Carl Zeiss Meditec AG) for correcting hyperopic astigmatism and presbyopia, using Custom Refractive Software Master (CRSM) targeting over a 6-month period. METHODS: A total of 636 eyes of 318 patients with a mean age of 51.05 ± 4.71 years (range: 40 to 60 years) met the inclusion and exclusion criteria. All patients completed a 6-month follow-up. CRSM software was used to generate ablation profiles for the MEL90 excimer laser (Carl Zeiss Meditec AG). The target refraction was emmetropic for the dominant eyes and between -0.75 and -1.12 diopters (D) for the near eyes. RESULTS: Visual and refractive results were studied separately by the dominant and non-dominant eyes. The mean attempt to correct for spherical equivalent refraction was +2.17 ± 1.16 D (range: -1.00 to +5.37 D). The mean attempted cylinder was -0.60 ± 0.75 D (range: -4.00 to 0.00 D). All eyes monocularly achieved uncorrected distance visual acuity (UDVA) of 20/25 or better after refractive treatment and 88% achieved 20/20. Binocularly all eyes achieved UDVA of 20/25 or better and 96.54% achieved 20/20. Ninety-eight percent of the patients maintained their corrected distance visual acuity before surgery and UDVA 6 months after surgery. CONCLUSIONS: This hyperopic micro-anisometropia protocol with PRESBYOND Laser Blended Vision was an effective, safe, and well-tolerated refractive treatment. It was an effective procedure with excellent results for UDVA and uncorrected near visual acuity and demonstrates that binocular summation exists. [ J Refract Surg. 2024;40(7):e480-e489.].


Assuntos
Astigmatismo , Hiperopia , Ceratomileuse Assistida por Excimer Laser In Situ , Lasers de Excimer , Presbiopia , Refração Ocular , Software , Acuidade Visual , Humanos , Presbiopia/cirurgia , Presbiopia/fisiopatologia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Acuidade Visual/fisiologia , Refração Ocular/fisiologia , Lasers de Excimer/uso terapêutico , Masculino , Hiperopia/fisiopatologia , Hiperopia/cirurgia , Pessoa de Meia-Idade , Feminino , Adulto , Astigmatismo/fisiopatologia , Astigmatismo/cirurgia , Resultado do Tratamento , Anisometropia/fisiopatologia , Anisometropia/cirurgia , Topografia da Córnea , Seguimentos , Estudos Prospectivos , Córnea/fisiopatologia , Córnea/cirurgia
2.
Artigo em Inglês | MEDLINE | ID: mdl-39021197

RESUMO

The cubic α-CsPbI3 phase stands out as one of the most promising perovskite compounds for solar cell applications due to its suitable electronic band gap of 1.7 eV. However, it exhibits structural instability under operational conditions, often transforming into the hexagonal non-perovskite δ-CsPbI3 phase, which is unsuitable for solar cell applications because of the large band gap (e.g., ∼2.9 eV). Thus, there is growing interest in identifying possible mechanisms for increasing the stability of the cubic α-CsPbI3 phase. Here, we report a theoretical investigation, based on density functional theory calculations, of the surface passivation of the α-, γ-, and δ-CsPbI3(100) surfaces using the C6H4(NH3)2 [p-phenylenediamine (PPD)] and Cs species as passivation agents. Our calculations and analyses corroborate recent experimental findings, showing that PPD passivation effectively stabilizes the cubic α-CsPbI3 perovskite against the cubic-to-hexagonal phase transition. The PPD molecule exhibits covalent-dominating bonds with the substrate, which makes it more resistant to distortion than the ionic bonds dominant in perovskite bulks. By contrasting these results with the natural Cs passivation, we highlight the superior stability of the PPD passivation, as evidenced by the negative surface formation energies, unlike the positive values observed for the Cs passivation. This disparity is due to the covalent characteristics of the molecule/surface interaction of PPD, as opposed to the purely ionic interaction seen with the Cs passivation. Notably, the PPD passivation maintains the optoelectronic properties of the perovskites because the electronic states derived from the PPD molecules are localized far from the band gap region, which is crucial for optoelectronic applications.

3.
PLoS One ; 19(7): e0306999, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39012871

RESUMO

Multiple sclerosis (MS) is a multifaceted neurological condition characterized by challenges in timely diagnosis and personalized patient management. The application of Artificial Intelligence (AI) to MS holds promises for early detection, accurate diagnosis, and predictive modeling. The objectives of this study are: 1) to propose new MS trajectory descriptors that could be employed in Machine Learning (ML) regressors and classifiers to predict patient evolution; 2) to explore the contribution of ML models in discerning MS trajectory descriptors using only baseline Magnetic Resonance Imaging (MRI) studies. This study involved 446 MS patients who had a baseline MRI, at least two measurements of Expanded Disability Status Scale (EDSS), and a 1-year follow-up. Patients were divided into two groups: 1) for model development and 2) for evaluation. Three descriptors: ß1, ß2, and EDSS(t), were related to baseline MRI parameters using regression and classification XGBoost models. Shapley Additive Explanations (SHAP) analysis enhanced model transparency by identifying influential features. The results of this study demonstrate the potential of AI in predicting MS progression using the proposed patient trajectories and baseline MRI scans, outperforming classic Multiple Linear Regression (MLR) methods. In conclusion, MS trajectory descriptors are crucial; incorporating AI analysis into MRI assessments presents promising opportunities to advance predictive capabilities. SHAP analysis enhances model interpretation, revealing feature importance for clinical decisions.


Assuntos
Progressão da Doença , Aprendizado de Máquina , Imageamento por Ressonância Magnética , Esclerose Múltipla , Humanos , Imageamento por Ressonância Magnética/métodos , Esclerose Múltipla/diagnóstico por imagem , Feminino , Masculino , Adulto , Pessoa de Meia-Idade
4.
Death Stud ; : 1-10, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38990603

RESUMO

This article deals with the opinions and attitudes of the adolescent population toward death and its possible treatment in formal education at a public secondary school in Spain. To do so, we use a mixed methodology - DEA-S scale (n = 366) and three focus groups (n = 23), using descriptive statistical analysis, cluster analysis and qualitative thematic analysis. As in other studies, these students show moderately positive attitudes toward the inclusion of death education at their school, but their position is not unanimous, and above all, they admit its inclusion with certain reservations and conditions that reveal a limited conception of the educational potential of death education: they do not consider it appropriate at all educational stages and are critical of the way in which similar topics are usually dealt with at school. The analysis provides important didactic guidelines for the promotion of death awareness in secondary education.

5.
Cancers (Basel) ; 16(13)2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-39001552

RESUMO

Lung adenocarcinoma is the most prevalent form of lung cancer, and drug resistance poses a significant obstacle in its treatment. This study aimed to investigate the overexpression of long non-coding RNAs (lncRNAs) as a mechanism that promotes intrinsic resistance in tumor cells from the onset of treatment. Drug-tolerant persister (DTP) cells are a subset of cancer cells that survive and proliferate after exposure to therapeutic drugs, making them an essential object of study in cancer treatment. The molecular mechanisms underlying DTP cell survival are not fully understood; however, long non-coding RNAs (lncRNAs) have been proposed to play a crucial role. DTP cells from lung adenocarcinoma cell lines were obtained after single exposure to tyrosine kinase inhibitors (TKIs; erlotinib or osimertinib). After establishing DTP cells, RNA sequencing was performed to investigate the differential expression of the lncRNAs. Some lncRNAs and one mRNA were overexpressed in DTP cells. The clinical relevance of lncRNAs was evaluated in a cohort of patients with lung adenocarcinoma from The Cancer Genome Atlas (TCGA). RT-qPCR validated the overexpression of lncRNAs and mRNA in the residual DTP cells and LUAD biopsies. Knockdown of these lncRNAs increases the sensitivity of DTP cells to therapeutic drugs. This study provides an opportunity to investigate the involvement of lncRNAs in the genetic and epigenetic mechanisms that underlie intrinsic resistance. The identified lncRNAs and CD74 mRNA may serve as potential prognostic markers or therapeutic targets to improve the overall survival (OS) of patients with lung cancer.

6.
JPRAS Open ; 41: 98-103, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38984325

RESUMO

One of the risks of distraction osteogenesis-based techniques is the development of vascular complications, such as pseudoaneurysms associated with the osteotomies performed or the fixation elements of the external fixator used in the procedure. Pseudoaneurysm are formed when the tunica adventitia of the artery is injured, resulting in a gradual and persistent blood extravasation into the surrounding tissues that is encapsulated and connected to the arterial lumen. This report describes a rare case of a late-presentation pseudoaneurysm in the anterior tibial artery resulting from a tibial lengthening procedure aimed at addressing a leg length discrepancy in a 57-year-old female with severe peripheral neuropathy resulting from long-standing poorly controlled diabetes mellitus. We describe the diagnostic process, the treatment options and confirm how the shape of the bony callus can be a reliable indicator of this pathology, as has already been described in the literature.

7.
Artigo em Inglês | MEDLINE | ID: mdl-38985538

RESUMO

BACKGROUND: The COVID-19 pandemic has resulted in great incertitude and overwhelming changes in healthcare that have had a direct impact on antibiotic prescription. However, the influence of this pandemic on antibiotic consumption in patients undergoing surgery has not yet been analysed. The goal of this study was to analyse antimicrobial consumption and prescription in the same period of 2019 (pre-COVID-19), 2020 (beginning of the COVID-19 pandemic) and 2021 (established COVID-19) according to the DDD system in surgical patients at a tertiary-level hospital. METHODS: A prospectively maintained database was analysed. All patients who underwent elective or emergency gastrointestinal surgery during the same period (2019, 2020 and 2021) were included. Those who received at least 1 of the 10 most frequently prescribed antimicrobials during those periods were analysed. RESULTS: A total of 2975 patients were included in this study. In 2020, the number of procedures performed decreased significantly (653 versus 1154 and 1168 in 2020 versus 2019 and 2021, respectively; P = 0.005). Of all patients who underwent surgery during these periods, 45.08% received at least one of the antimicrobials studied (45.8% in 2020 versus 22.9% and 22.97% in 2019 and 2021, respectively; P = 0.005). Of these, 22.97% of the patients received a combination of these antimicrobials, with ceftriaxone/metronidazole being the most frequent. Hepato-Pancreato-Biliary and Liver Transplant, Emergency Surgery and Colorectal Surgery units had higher antibiotic consumption. CONCLUSIONS: The COVID-19 pandemic has resulted in a significant decrease in surgical activity and higher post-operative antimicrobial prescription compared with previous and subsequent years.

8.
Arch Bronconeumol ; 2024 Jun 26.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38987114

RESUMO

Alveolar-pleural fistulas (APF) are a clinical entity that represents a diagnostic and therapeutic challenge. OBJECTIVE: The objective of this work is to design a diagnostic algorithm for the anatomical detection of APF in patients who are not candidates for surgical treatment. METHOD: Prospective non-randomized study of 47 patients. Diagnostic procedures were performed: (a) prior to bronchoscopy: computed axial tomography (CT) and implantation of electronic pleural drainage system (EPD) and (b) endoscopic: endobronchial occlusion (EO) by balloon, selective endobronchial oxygen insufflation (OI) (2l) and selective bronchography (BS) (instillation of iodinated radiological contrast using continuous fluoroscopy). RESULTS: The sample was predominantly male (81%). The diagnostic methods revealed: (a) Determination of the anatomical location of APF by CT in 15/46 patients (31.9% of sample), and variations in the pattern (intermittent or continuous air leak) and quantification after drug administration sedatives using EPD, (b) endoscopic: anatomical determination of APF was achieved in 57.1, 81 and 63.4% respectively using EO, OI and BS. The combination of the diagnostic tests allowed us to determine the anatomical location of the APF in 91.5% of the sample. No complications were recorded in 85.1% of cases. CONCLUSIONS: The diagnosis of APF by flexible bronchoscopy is a useful method, with an adequate safety and efficacy profile. The proposed diagnostic algorithm includes the use of EPD and performing a CT scan. Regarding endoscopic diagnosis: in case of continuous air leak, the first option is OE; and if the leak is intermittent, we recommend endobronchial OI, with BS as a secondary option (respective sensitivity 81% vs 63.4% and complications 8.1% vs 7.3%).

9.
Artigo em Inglês | MEDLINE | ID: mdl-38972388

RESUMO

A 36-year-old male presented to the Emergency Department with clinical symptoms of blurred vision of progressive onset of two years of evolution. The ophthalmological examination revealed the existence of bilateral papilledema. Using cranial computed tomography and magnetic resonance imaging, the presence of a right occipital pial arteriovenous malformation was certified. Arteriographically, pial arterial contributions dependent on the right middle cerebral artery and the right posterior cerebral artery were identified. Venous drainage was located at the level of the superior sagittal sinus. An associated right transverse sinus stenosis was also identified. The existence of secondary intracranial hypertension was corroborated by monitoring with an intracranial pressure sensor. An interventional procedure was carried out consisting of embolization of the arterial supplies of the lesion using Onyx®. The clinical-radiological findings after the procedure were favorable: the papilledema disappeared and complete exclusion of the malformation was achieved. A new intracranial pressure measurement showed resolution of intracranial hypertension. Subsequent regulated radiological controls showed complete exclusion of the malformation up to 5 years later.

10.
11.
Chemistry ; : e202401307, 2024 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-39037368

RESUMO

Sulfur(VI)-based functional groups are popular scaffolds in a wide variety of research fields including synthetic and medicinal chemistry, as well as chemical biology. The growing interest in sulfur(VI)-containing molecules has motivated the scientific community to explore new methods to synthesize and modify them. Here, photocatalysis plays a key role granting access to new types of reactivity under mild reaction conditions. In this Perspective, we present a selection of works reported in the last six years focused on the photocatalytic assembly and reactivity of sulfones, sulfonamides, and sulfoximines. We addressed the key synthetic intermediates for each transformation, while discussing limitations and strength points of the protocols. Future directions of the field are finally presented.

12.
J Infect Chemother ; 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38969100

RESUMO

We present the case of a 53-year-old Caucasian man with a history of intravenous drug use who presented with fever and multiple pustules predominantly affecting hairy areas of the body, with no clinical improvement despite previous antibiotic treatment. Culture of the pustules confirmed Candida albicans infection and histological examination of skin biopsies revealed suppurative granulomas compatible with candidomycetic folliculitis. The patient was successfully treated with systemic antifungals and discharged with resolution of symptoms. Candidomycetic folliculitis is a condition typically associated with brown heroin consumption due to the use of acidic solvent that promotes Candida growth. Clinical manifestations include fever followed by skin lesions, with possible systemic involvement if untreated. Extensive folliculitis with associated fever in an IVDU should raise suspicion of this pathology since early diagnosis and appropriate treatment are crucial to prevent complications.

13.
Environ Microbiol Rep ; 16(4): e13300, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38979873

RESUMO

Desert plants, such as Agave tequilana, A. salmiana and Myrtillocactus geometrizans, can survive harsh environmental conditions partly due to their symbiotic relationships with microorganisms, including arbuscular mycorrhizal fungi (AMF). Interestingly, some of these fungi also harbour endosymbiotic bacteria. Our research focused on investigating the diversity of these AMFs and their associated bacteria in these plants growing in arid soil. We found that agaves have a threefold higher AMF colonization than M. geometrizans. Metabarcoding techniques revealed that the composition of AMF communities was primarily influenced by the plant host, while the bacterial communities were more affected by the specific plant compartment or niche they inhabited. We identified both known and novel endofungal bacterial taxa, including Burkholderiales, and confirmed their presence within AMF spores using multiphoton microscopy. Our study also explored the effects of drought on the symbiosis between A. tequilana and AMF. We discovered that the severity of drought conditions could modulate the strength of this symbiosis and its outcomes for the plant holobiont. Severe drought conditions prevented the formation of this symbiosis, while moderate drought conditions promoted it, thereby conferring drought tolerance in A. tequilana. This research sheds light on the diversity of AMF and associated bacteria in Crassulacean Acid Metabolism (CAM) plants and underscores the crucial role of drought as a factor modulating the symbiosis between A. tequilana and AMF. Further research is needed to understand the role of endofungal bacteria in this response.


Assuntos
Bactérias , Clima Desértico , Secas , Micorrizas , Microbiologia do Solo , Simbiose , Micorrizas/fisiologia , Micorrizas/classificação , Micorrizas/genética , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Bactérias/metabolismo , Agave/microbiologia , Biodiversidade , Raízes de Plantas/microbiologia
14.
J Gen Intern Med ; 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39023662

RESUMO

BACKGROUND: Most patients with mild or moderate COVID infection did not require hospital admission, but depending on their personal history, they needed medical supervision. In monitoring these patients in primary care, the design of specific surveillance programs was of great help. Between February 2021 and March 2022, EDCO program was designed in Tenerife, Spain, to telemonitor patients with COVID infection who had at least one vulnerability factor to reduce hospital admissions and mortality. OBJECTIVE: The aim of this study is to describe the clinical course of patients included in the EDCO program and to analyze which factors were associated with a higher probability of hospital admission and mortality. DESIGN: Retrospective cohort study. PATIENTS: We included 3848 patients with a COVID-19 infection age over 60 years old or age over 18 years and at least one vulnerability factor previously reported in medical history. MAIN MEASURES: Primary outcome was to assess risk of admission or mortality. KEY RESULTS: 278 (7.2%) patients required hospital admission. Relative risks (RR) of hospital admission were oxygen saturation ≤ 92% (RR: 90.91 (58.82-142.86)), respiratory rate ≥ 22 breaths per minute (RR: 20.41 (1.19-34.48), obesity (RR: 1.53 (1.12-2.10), chronic kidney disease (RR:2.31 (1.23-4.35), ≥ 60 years of age (RR: 1.44 (1.04-1.99). Mortality rate was 0.7% (27 patients). Relative risks of mortality were respiratory rate ≥ 22 breaths per minute (RR: 24.85 (11.15-55.38), patients with three or more vulnerability factors (RR: 4.10 (1.62-10.38), oxygen saturation ≤ 92% (RR: 4.69 (1.70-15.15), chronic respiratory disease (RR: 3.32 (1.43-7.69) and active malignancy (RR: 4.00 (1.42-11.23). CONCLUSIONS: Vulnerable patients followed by a primary care programme had admission rates of 7.2% and mortality rates of 0.7%. Supervision of vulnerable patients by a Primary Care team was effective in the follow-up of these patients with complete resolution of symptoms in 91.7% of the cases.

15.
Eur. j. psychiatry ; 38(2): [100234], Apr.-Jun. 2024.
Artigo em Inglês | IBECS | ID: ibc-231862

RESUMO

Background and objectives Almost half of the individuals with a first-episode of psychosis who initially meet criteria for acute and transient psychotic disorder (ATPD) will have had a diagnostic revision during their follow-up, mostly toward schizophrenia. This study aimed to determine the proportion of diagnostic transitions to schizophrenia and other long-lasting non-affective psychoses in patients with first-episode ATPD, and to examine the validity of the existing predictors for diagnostic shift in this population. Methods We designed a prospective two-year follow-up study for subjects with first-episode ATPD. A multivariate logistic regression analysis was performed to identify independent variables associated with diagnostic transition to persistent non-affective psychoses. This prediction model was built by selecting variables on the basis of clinical knowledge. Results Sixty-eight patients with a first-episode ATPD completed the study and a diagnostic revision was necessary in 30 subjects at the end of follow-up, of whom 46.7% transited to long-lasting non-affective psychotic disorders. Poor premorbid adjustment and the presence of schizophreniform symptoms at onset of psychosis were the only variables independently significantly associated with diagnostic transition to persistent non-affective psychoses. Conclusion Our findings would enable early identification of those inidividuals with ATPD at most risk for developing long-lasting non-affective psychotic disorders, and who therefore should be targeted for intensive preventive interventions. (AU)


Assuntos
Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Valor Preditivo dos Testes , Previsões , Esquizofrenia/prevenção & controle , Transtornos Psicóticos/prevenção & controle , Espanha , Análise Multivariada , Modelos Logísticos
16.
Artigo em Inglês | MEDLINE | ID: mdl-38842073

RESUMO

BACKGROUND: Mastoid pneumatization is subject to numerous influencing factors including race, sex, and surrounding structures of the middle ear. This study aims to determine the mastoid air cell system (MACS) volume and its relationship with middle ear structures, and the influence of sex. MATERIALS AND METHODS: A cross-sectional study was performed analyzing computed tomography (CT) scans in which MACS volume and the Estachian tube length (ETL) were visible. MACS volume, ETL, and width and height of the aditus ad antrum were obtained. RESULTS: A total of 100 CT were included with a mean age of 38.5 ± 15.3 years, of which 56 were women and 44 were men. The mean right and left MACS volume were 5.43 ± 3.15 cm³ and 5.54 ± 3.43 cm3 respectively , with a ETL of 24.55 ± 3.07 mm in right side and 24.24 ± 2.60 mm on left side. A aditus ad antrum width of 2.98 ± 0.65 in right and 2.98 ± 0.58 on the left and height of 4.51 ± 1.05 and 4.32 ± 0.85, on right and left side respectively. There were statistical differences between sexes in left ETL, and in MACS volume bilaterally. A low positive correlation between aditus ad antrum height and MACS volume was identified. CONCLUSIONS: Mastoid pneumatization was bigger in men than women. There was a low positive correlation between mastoid volume and ETL on both sides, and a significant correlation between right mastoid volume and aditus ad antrum height. This could lead us to believe that the length of ETL does not affect the pneumatization of MACS.

17.
Clin Exp Dermatol ; 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38833603

RESUMO

INTRODUCTION: Five to twelve percent of melanomas show aggregation of melanomas or other related tumors within the same family or individual. Genes such as CDKN2A, or BAP1, among others, have been involved in this condition. MATERIAL AND METHODS: Retrospective descriptive study that includes patients from Cruces University Hospital (2016-2023) who met any of the following criteria: presence of two or more melanomas (1), or a melanoma and a pancreatic cancer (2) in the same individual; presence of a melanoma in an individual and one or more first- or second-degree relatives with melanoma or pancreatic cancer (3); first- or second-degree relationship with an individual with a known deleterious variant in genes related to melanoma predisposition (4); or incidental discovery of deleterious variants in genes related to predisposition to melanoma, within hereditary cancer panels carried out for reasons other than melanoma (5). RESULTS: 59 families were included (69 patients; 63.8% women), of which 8.5% (13% of patients) presented pathogenic/likely pathogenic variants (PV/LPV) in CDKN2A (6% of families and patients, excluding criteria 4 and 5), and 1.7% of families (1.4% of patients) presented PV/LPV in BAP1, BRCA2 and TERF2IP. DISCUSSION AND CONCLUSIONS: The frequencies of PV/LPV in CDKN2A are similar to those previously described. This study could contribute to the knowledge of the characteristics of patients who meet genetic study criteria for hereditary melanoma, in a setting of real clinical practice.

18.
Dent J (Basel) ; 12(6)2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38920866

RESUMO

Dental treatment anxiety is highly prevalent worldwide. This is particularly important in the field of implantology since, in daily clinical practice, it translates into an increase in the difficulty of treatments, extending surgical times and having repercussions in the postoperative period. The aim of this multicentre, cross-sectional, epidemiological study was to determine the influence of anxiety levels in the postoperative period of an implant treatment on patients treated at two dental departments in Extremadura (Spain). To analyse anxiety levels, the modified Corah's Dental Anxiety Scale questionnaire was administered before surgical treatment. To analyse the postoperative period, another questionnaire was provided 7 days after surgery. The study was conducted on a total of 102 patients (55 men and 47 women), with a mean age of 47.99 years. The results indicated that patients with a high and severe degree of anxiety had a poorer quality of life in general. Patients with a higher degree of anxiety perceived greater swelling at 24, 48, 72 h and one week after surgery.

19.
Artigo em Inglês | MEDLINE | ID: mdl-38851213

RESUMO

BACKGROUND: The removal of impacted lower third molars (ILTMs) is associated with bone defects in the distal area of second molars. Different methods have been described to minimize these defects. PURPOSE: The primary objective was to assess changes in probing depth (PD) over time (up to 36 months) between test (grafted) and control (ungrafted) groups; the graft was obtained from the extracted ILTM. STUDY DESIGN, SETTING, SAMPLE: This split-mouth randomized clinical trial was conducted at the Postgraduate Course in Oral Surgery of the Faculty of Dentistry of the Complutense University of Madrid. Adult patients requiring bilateral ILTM extraction with adjacent second molars were recruited, excluding pregnant/lactating women, patients in treatment with nonsteroidal anti-inflammatory drugs and patients with periodontal diseases. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: The predictor variable was the graft technique. The bone defect after ILTM removal was treated with autogenous tooth graft (ATG) in the test group, leaving the control group ungrafted. MAIN OUTCOME VARIABLE: PD on the distobuccal, distomedial, and distolingual surfaces was recorded in both groups and averaged at baseline (T0), 3 (T1), 6 (T2), and 36 months (T3) postoperatively. COVARIATES: Sex, age, surgical time, ILTM situation and position between groups were assessed. ANALYSES: ANOVA repeated measures for comparisons between groups and the Friedman test for comparisons within the groups over time were applied. Statistical significance was established with a confidence interval of 95% (P < .05). RESULTS: The sample comprised 22 patients (6 males, 16 females) with a mean age of 21.68 ± 2.19 years; 44 ILTM extractions were performed. Statistically significant differences in PD average were found between groups (P < .001, 95% confidence interval) at 3 (1.63 ± 0.29), 6 (1.76 ± 0.3), and 36 months (1.74 ± 0.36). Reductions from T0 to T3 of 2.74 ± 0.28 (P < .001) and 0.54 ± 0.3 (P = .43) were observed in test and control groups, respectively. CONCLUSION AND RELEVANCE: ATG placed on the distal surface of lower second molars and almost completely filling the extraction socket improved PD 3, 6 and 36 months after ILTM. Furthermore, no significant changes in PD were observed over time; no major complications occurred. ATG appears to be a viable alternative graft material for this procedure.

20.
Ther Drug Monit ; 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38858812

RESUMO

BACKGROUND: Following lung transplantation (LT), receiving immunosuppressive therapy is crucial. Tacrolimus is considered a drug with a narrow therapeutic range and its use requires constant monitoring. This study aimed to evaluate the correlation between tacrolimus levels obtained from central venous catheter and direct venipuncture in adult patients undergoing LT. METHODS: This prospective study included LT patients hospitalized in conventional ward carrying a central catheter through which no intravenous tacrolimus was administered. Trough samples were obtained through direct puncture and from the central catheter. Pearson correlation coefficient was calculated to quantify the mean difference between the 2 measures. RESULTS: A total of 54 sample pairs from 16 LT patients were obtained, mostly male (81.3%) and bilateral transplant recipients (93.8%); the transplant procedure was the primary reason for admission (81.3%). The difference in tacrolimus levels between both samples was 0.3 (0.1-0.6) mcg/L, with the measurement for the samples obtained through venipuncture being mostly higher than that for those obtained from the catheter. A strong correlation was observed between the tacrolimus levels in the samples obtained from the catheter and through venipuncture (Pearson correlation coefficient, 0.991; P < 0.001; R2 = 0.982). CONCLUSIONS: There is an excellent correlation between tacrolimus levels obtained from venipuncture and those obtained from central venous catheter in LT patients undergoing oral tacrolimus therapy.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...