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1.
Front Neurorobot ; 18: 1401931, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39021504

RESUMO

Neurological diseases are observed in approximately 1 billion people worldwide. A further increase is foreseen at the global level as a result of population growth and aging. Individuals with neurological disorders often experience cognitive, motor, sensory, and lower extremity dysfunctions. Thus, the possibility of falling and balance problems arise due to the postural control deficiencies that occur as a result of the deterioration in the integration of multi-sensory information. We propose a novel rehabilitation framework, Integrated Balance Rehabilitation (I-BaR), to improve the effectiveness of the rehabilitation with objective assessment, individualized therapy, convenience with different disability levels and adoption of assist-as-needed paradigm and, with integrated rehabilitation process as whole, that is, ankle-foot preparation, balance, and stepping phases, respectively. Integrated Balance Rehabilitation allows patients to improve their balance ability by providing multi-modal feedback: visual via utilization of virtual reality; vestibular via anteroposterior and mediolateral perturbations with the robotic platform; proprioceptive via haptic feedback.

2.
J Chemother ; : 1-9, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38698711

RESUMO

The main aim of this study was to compare and analyze the effectiveness of treatment regimens using ceftazidime/avibactam (CAZ/AVI) versus fosfomycin plus meropenem (FOS/MER) for managing bloodstream infections (BSI) or ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) in critically ill patients. Between 4 January 2019, and 16 July 2023, adult patients (≥18 years old) diagnosed with BSI or VAP due to culture confirmed CRKP in ICU of a tertiary care hospital were investigated retrospectively. A total of 71 patients were categorized into two groups: 30 patients in CAZ/AVI-based, and 41 patients in FOS/MER-based group. No substantial disparities were found in the total duration of ICU hospitalization, as well as the 14- and 30-day mortality rates, between patients treated with CAZ/AVI-based and FOS/MER-based therapeutic regimens. We consider that our study provides for the first time a comprehensive understanding of treatment outcomes and associated risk factors among patients with CRKP-related infections.

3.
J Man Manip Ther ; 32(2): 131-140, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37272310

RESUMO

OBJECTIVES: The use of instrument-assisted soft tissue mobilization (IASTM) has been documented to be effective for improving pain and function, but it is unclear whether it helps improve muscle performance in musculoskeletal diseases. This study investigated the effects of IASTM combined with exercise therapy on muscle endurance and pain intensity in patients with chronic neck pain. METHODS: Forty-eight individuals with chronic neck pain were randomly divided into exercise therapy (ET, n = 24) and combined therapy (CT, n = 24) groups. For 4 weeks, each group underwent exercise therapy 3 days a week for a total of 12 sessions. The ET group received exercise therapy only. The CT group received IASTM combined with exercise therapy twice per week for a total of 8 sessions. The muscle endurance of the participants was assessed with the Deep Neck Flexor Muscle Endurance (DNFE) test and pain intensity with Visual Analogue Scale (VAS) at baseline and post-treatment. RESULTS: While both groups showed significant improvement in pain intensity (p < 0.05), the CT group showed a greater effect size for pain (CT group: Cohen's d = 3.28; ET group: Cohen's d = 2.12). The CT group showed significant improvement for muscle endurance (p < 0.05), whereas the ET group did not (p > 0.05). CONCLUSION: In the current study, the IASTM intervention combined with ET improved pain and muscular endurance in participants with chronic neck pain compared to exercise therapy alone. As an alternative method, IASTM intervention before exercise seems to increase the short-term recovery effect in chronic neck pain conditions.


Assuntos
Dor Crônica , Doenças Musculoesqueléticas , Humanos , Cervicalgia/terapia , Terapia por Exercício/métodos , Dor Crônica/terapia , Músculos
4.
Wound Manag Prev ; 69(4): 4-9, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38090950

RESUMO

BACKGROUND: Critically-ill patients (CIPs) with pressure injuries (PIs) may develop bloodstream infections (BSIs). PURPOSE: To identify predisposing factors and discuss diagnosis and management of sepsis-related PIs in CIPs. METHODS: The records of CIPs in the intensive care unit (ICU) between January 1, 2014, and January 1, 2020, with PI with sepsis-diagnoses and with different site cultures that were positive concurrent with bloodstream-cultures were retrospectively reviewed. RESULTS: Ninety-one sepsis episodes were included in the study. Low albumin level (U = 382.00, P = .006), renal failure (odds ratio [OR], 0.108 [95% CI, 0.015-0.783]; P = .025), and length of ICU stay (U = 130.00, P < .001) were identified as risk factors of BSIs due to PIs. The probability of BSI during a sepsis episode was lower in CIPs with PIs with higher C-reactive protein levels (U = 233.00, P < .001) and whose injury resulted from trauma or surgery (OR, 0.101 [95% CI, 0.016-0.626]; P = .014). The mortality was higher in CIPs with PI-induced BSIs (OR, 0.051 [95% CI, 0.008-0.309]; P = .001). CONCLUSIONS: Pressure injury-induced sepsis was associated with a high risk of 28-day mortality. The findings suggest that CIPs with PI are at increased risk of BSIs if they have low albumin levels, renal-failure, and prolonged ICU stay during sepsis episodes.


Assuntos
Úlcera por Pressão , Sepse , Humanos , Estudos Retrospectivos , Estado Terminal , Úlcera por Pressão/etiologia , Úlcera por Pressão/complicações , Sepse/complicações , Albuminas
5.
Cureus ; 15(10): e46780, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37822692

RESUMO

Objective In this study, we aimed to describe the outcomes in ICU patients with bloodstream infection (BSI) or ventilatory-associated pneumonia (VAP) due to carbapenem-resistant Klebsiella pneumoniae (CRKP) who received ceftazidime-avibactam treatment at a tertiary care university hospital. Methods Patients aged 18 years or older who were admitted to the Anesthesiology and Reanimation ICU at Bursa Uludag University Faculty of Medicine Hospital between June 13, 2021, and July 16, 2023, and diagnosed with BSI or VAP due to CRKP were included in this study. Results A total of 42 patients treated with ceftazidime-avibactam were included. Total crude mortality rates were 33.3% on day 14 and 54.8% on day 30. Mortality rates on the 14th and 30th days were 37.5% and 62.5% in patients with BSI and 27.8% and 44.4% in patients with VAP, respectively. There was no statistically significant difference between monotherapy and combination therapy in terms of mortality rates on days 14 and 30, respectively (3/11 vs. 11/31, p=0.620; 5/11 vs. 18/31, p=0.470). Immunosuppression (10/11 vs. 13/31, p=0.005), the Sequential Organ Failure Assessment (SOFA) score ≥8 (at the initiation of treatment; 19/25 vs. 4/17, p<0.001), INCREMENT-CPE score ≥10 (12/16 vs. 3/10, p=0.024) and longer duration (in days) from culture collection to treatment initiation (5.0 ± 0.61 vs. 3.11 ± 0.48, p=0.024) were found to have a statistically significant effect on 30-day mortality. In multivariate analysis, a SOFA score ≥8 at the initiation of treatment (p=0.037, OR: 17.442, 95% CI: 1.187-256.280) was found to be a significant risk factor affecting mortality (30-day). Conclusion The mortality rates of patients with CRKP infection who were followed up in the ICU were found to be high, and it was observed that whether ceftazidime-avibactam treatment was given as a combination or monotherapy did not affect mortality. Further multicentre studies with a larger number of patients are needed to gain a comprehensive understanding of the topic, given that this treatment is typically reserved for documented infections.

6.
Rev Assoc Med Bras (1992) ; 69(11): e20230727, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37820167

RESUMO

OBJECTIVE: The aim of this study was to evaluate the combination treatments with intravenous fosfomycin for carbapenem-resistant Klebsiella pneumoniae infections in a tertiary-care center. METHODS: Between December 24, 2018 and November 21, 2022, adult patients diagnosed with bloodstream infection or ventilator-associated pneumonia due to culture-confirmed carbapenem-resistant Klebsiella pneumoniae in the anesthesiology and reanimation intensive care units were investigated retrospectively. RESULTS: There were a total of 62 patients fulfilling the study inclusion criteria. No significant difference was recorded in 14- and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations. Hypokalemia (OR:5.651, 95%CI 1.019-31.330, p=0.048) was found to be a significant risk factor for 14-day mortality, whereas SOFA score at the time of diagnosis (OR:1.497, 95%CI 1.103-2.032, p=0.010) and CVVHF treatment (OR:6.409, 95%CI 1.395-29.433, p=0.017) were associated with 30-day mortality in multivariate analysis. CONCLUSION: In our study, high mortality rates were found in patients with bloodstream infection or ventilator-associated pneumonia due to carbapenem-resistant Klebsiella pneumoniae, and no significant difference was recorded in 14- and 30-day mortality among different types of combination regimens such as fosfomycin plus one or two antibiotic combinations.


Assuntos
Fosfomicina , Infecções por Klebsiella , Pneumonia Associada à Ventilação Mecânica , Sepse , Adulto , Humanos , Fosfomicina/uso terapêutico , Klebsiella pneumoniae , Carbapenêmicos/uso terapêutico , Estudos Retrospectivos , Infecções por Klebsiella/tratamento farmacológico , Antibacterianos/uso terapêutico
7.
BMC Nephrol ; 24(1): 302, 2023 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-37833622

RESUMO

BACKGROUND: We aimed to determine the risk factors that may be associated with colistin-induced acute kidney injury (AKI) to promote the safer use of colistin in the treatment of nosocomial infections caused by multidrug-resistant Gram-negative bacteria in intensive care units. MATERIALS AND METHODS: This retrospective observational study was conducted among adult patients who received a minimum of 48 h of intravenous colistin from January 2020 to December 2020 at the intensive care unit of a tertiary care hospital. AKI diagnosis and staging were made based on the Kidney Disease Improving Global Outcome Criteria. RESULTS: Of 148 patients who received intravenous colistin at a daily dose of 9 million IU, 54 (36%) developed AKI. In the univariate analysis, age, Charlson comorbidity index, APACHE II score, duration of colistin treatment, basal creatinine level, use of vasopressors, and vancomycin were significantly associated with AKI (p < 0.05). The multivariate analysis revealed that the independent predictor of AKI was the use of vasopressors (OR: 3.14; 95% confidence interval: 1.39-97.07; p = 0.06). CONCLUSION: The use of vasopressors in critically ill patients was independently associated with AKI developing during colistin treatment.


Assuntos
Injúria Renal Aguda , Colistina , Adulto , Humanos , Colistina/efeitos adversos , Antibacterianos/efeitos adversos , Vancomicina/efeitos adversos , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/tratamento farmacológico , Estudos Retrospectivos , Fatores de Risco , Unidades de Terapia Intensiva , Estado Terminal/terapia
10.
Int Ophthalmol ; 43(10): 3823-3829, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37498447

RESUMO

PURPOSE: To investigate the relationship between digital screen time and the development and progression of myopia during the 2019 coronavirus disease (COVID-19) pandemic. METHODS: Children aged 7-18 years who had regular refractive measurement follow-ups before and after the COVID-19 pandemic were included in the study. They were divided into two groups according to their initial refractive status, emmetropic and myopic. The relationship between spherical equivalent refraction (SER) changes and digital screen time before and after the pandemic was analyzed. RESULTS: A total of 255 children were included in the study. During the pandemic in the emmetropic group, digital screen time increased by 5.98 ± 2.13 h/day, and the mean SER decreased from - 0.02 to - 0.55 D (p < 0.001). During the pandemic in the myopic group, the digital screen time increased by 6.25 ± 2.36 h, and the mean SER decreased from - 1.82 to - 2.72 D (p < 0.001). A significant correlation was found between the increase in digital screen time and the change in SER in the emmetropic and myopic groups (r = - 0.261, p = 0.015, r = - 0.269, p = 0.001, respectively). CONCLUSION: Increased digital screen time during the COVID-19 pandemic is associated with a myopic shift in emmetropic children and myopic progression in myopic children. As a result of COVID-19, increasing cases of myopia should be addressed as a public health concern.


Assuntos
COVID-19 , Miopia , Criança , Humanos , COVID-19/epidemiologia , Progressão da Doença , Miopia/epidemiologia , Pandemias , Refração Ocular , Turquia/epidemiologia , Adolescente
11.
Ocul Immunol Inflamm ; 31(8): 1700-1706, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37068199

RESUMO

PURPOSE: To evaluate the coexistence of optic disc drusen (ODD) in eyes with uveitis. METHODS: In this retrospective, observational study, patients followed up in a uvea clinic with all types of uveitis were evaluated. ODD were confirmed by ocular ultrasonography, optic nerve head enhanced-depth imaging optical coherence tomography, fundus autofluorescence, and fundus photography. RESULTS: ODD were detected in 17 of 545 (3.1%) uveitis patients. The mean age was 18.9 ± 10.4 years, and 76.5% were female. 45.5% were anterior, 42.4% were panuveitis, 6.1% were intermediate, and 6.1% were posterior uveitis. ODD were found bilaterally in all 17 patients; uveitis was unilateral in one patient. 58.8% were under the age of 18, and in this group, the rate of buried ODD was 78.9% (p = 0.039). In adults (seven patients), ODD were buried in 42.9%. CONCLUSION: ODD can be detected in eyes with uveitis and may clinically mimic optic disc edema, lead to misdiagnosis and/or overtreatment.


Assuntos
Drusas do Disco Óptico , Disco Óptico , Papiledema , Uveíte , Adulto , Humanos , Feminino , Criança , Adolescente , Adulto Jovem , Masculino , Drusas do Disco Óptico/complicações , Drusas do Disco Óptico/diagnóstico , Estudos Retrospectivos , Papiledema/diagnóstico , Papiledema/etiologia , Tomografia de Coerência Óptica/métodos , Uveíte/complicações , Uveíte/diagnóstico
12.
Ocul Immunol Inflamm ; 31(7): 1315-1319, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36735755

RESUMO

PURPOSE: To report clinical features and follow-up of a case with subretinal hypopyon due to syphilis infection. CASE PRESENTATION: We present a case of syphilis admitted with optic neuritis and treated with intravenous pulse steroids without antibiotics. The patient was referred to the uvea clinic in the follow-up because of decreased vision and the onset of multiple retinitis foci. We determined subretinal hypopyon in the left eye and a positive TPHA test. A significant regression was observed in retinitis and hypopyon with antibiotic therapy. CONCLUSION: Before starting a steroid treatment, infective etiologies should be considered in patients with optic neuritis. Treating with a high dosage of steroids without antibiotics in syphilis would worsen the clinical features and prognosis.


Assuntos
Iridociclite , Neurite Óptica , Retinite , Sífilis , Humanos , Sífilis/tratamento farmacológico , Iridociclite/complicações , Antibacterianos/uso terapêutico , Neurite Óptica/etiologia , Retinite/tratamento farmacológico , Esteroides/uso terapêutico
13.
Ocul Immunol Inflamm ; 31(8): 1738-1739, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36800559

RESUMO

An aggressive treatment, including immunomodulatory therapy, is very important in preventing the development of the chronic recurrent stage in Vogt-Koyanagi-Harada (VKH) disease. However, the way of treatment is not the only factor determining the prognosis, and there are other factors that affect the outcome.


Assuntos
Síndrome Uveomeningoencefálica , Humanos , Síndrome Uveomeningoencefálica/diagnóstico , Síndrome Uveomeningoencefálica/tratamento farmacológico , Prognóstico
14.
Ocul Immunol Inflamm ; 31(8): 1687-1693, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36628436

RESUMO

PURPOSE: To identify the prognostic factors in Vogt-Koyanagi-Harada (VKH) disease. METHODS: This study included 23 patients (46 eyes) with acute-phase VKHdivided into two subgroups: Group 1; acute-resolved (10 patients), group 2; chronic-recurrent (13 patients). RESULTS: Mean age were 29.5 ± 10.2 years in group 1, 35.8 ± 12.2 years group 2 (p = .033). Best-corrected visual acuity with logMAR at admission was 0.91 ± 0.65 in group 1, 0.88 ± 0.62 in group 2 (p = .798), and improved to 0.08 ± 0.24, 0.18 ± 0.6, respectively (p = .557). Extraocular findings were detected in 30% in group 1, and 53.8% in group 2 at the time of admission (p = .108). All patients were treated with 1 g/day 3-5 days intravenous steroid, and 10 patients had immunomodulatory treatment. Initiation of immunomodulatory therapy did not affect the prognosis (p = .676). CONCLUSION: Older patients and/or who developed extraocular findings at the presentation were more prone to show recurrences.


Assuntos
Síndrome Uveomeningoencefálica , Humanos , Adulto Jovem , Adulto , Síndrome Uveomeningoencefálica/diagnóstico , Síndrome Uveomeningoencefálica/tratamento farmacológico , Prognóstico , Quimioterapia Combinada , Acuidade Visual , Estudos Retrospectivos
15.
Ocul Immunol Inflamm ; 31(8): 1694-1699, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36701791

RESUMO

PURPOSE: To investigate the vitreo-lenticular interface (Berger space) in Fuchs uveitis (FU). METHODS: This cross-sectional study included 20 FU patients (Group 1), the fellow eyes of patients (Group 2) and 20 healthy individuals (Group 3). RESULTS: Berger space was detected in all, and hyperreflective spots were identified in Berger spaces in 65% of FU eyes through optical coherence tomography (OCT). The measurements of Berger space the distance in central, nasal, and temporal 2 mm were 715 ± 101µ, 620 ± 66µ, and 676 ± 76µ in group 1; 370 ± 40µ, 321 ± 41µ, 297 ± 39µ in group 2 and 290 ± 37µ, 267 ± 32µ, 227 ± 28µ in group 3. There was a statistical difference between groups 1, 2nd, and 3rd in all the values. CONCLUSION: The detection of the Berger space is the crucial finding of this study. Visualizing the vitreolenticular area may reveal new insights for pathology and OCT-guided investigations.


Assuntos
Cristalino , Uveíte , Humanos , Estudos Transversais , Uveíte/diagnóstico , Uveíte/patologia , Cristalino/patologia , Tomografia de Coerência Óptica/métodos
16.
Nutr Neurosci ; 26(3): 228-234, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35143375

RESUMO

OBJECTIVE: Nutrition modulation can reduce multiple sclerosis (MS) related symptoms and fatigue severity. Mediterranean diet may be beneficial regarding anti-inflammatory components. However, previous studies are limited. This study aims to investigate the relationship between Mediterranean diet adherence and MS-related symptoms and fatigue severity. METHODS: One hundred and two adult MS patients were enrolled in this cross-sectional study. Dietary adherence was assessed using the Mediterranean diet assessment tool (MEDAS). MS-related symptoms were determined using the MS-related symptom checklist (MS-RS), and the fatigue severity scale (FSS) was applied. Linear regression models were established to assess predicted factors of MS-RS and FSS. RESULTS: The mean age of the participants was 33.1 ± 9.81 years. Being female and having higher education degree was 71.6% and 60.8%, respectively. In the linear regression model, MEDAS were not associated with MS-RS but negatively associated with FSS scores. MS-RS scores were significantly higher among participants who consumed more than one serving of red meat or products per day. Those who consumed less than one serving of butter, margarine, or cream per day reported lower FSS scores. Some trend significances were shown to consume limited sweet and lower FSS scores. Likewise, MS-RS scores were lower in those ≥three serving/week intake of fish. CONCLUSION: Following a Mediterranean-style diet should be encouraged to improve fatigue severity. Components, such as reduced consumption of red meat, saturated fatty acids, sweets and increased fish consumption, could be promising to reduce MS symptoms or fatigue severity. These findings should be proven with further intervention studies.


Assuntos
Dieta Mediterrânea , Esclerose Múltipla , Feminino , Masculino , Humanos , Esclerose Múltipla/complicações , Estudos Transversais , Estado Nutricional , Fadiga/complicações
17.
Turk J Med Sci ; 53(5): 1155-1165, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38813018

RESUMO

Background/aim: Multiple sclerosis (MS) may cause modifications in body composition, particularly for body fat associated with obesity and some biochemical parameters such as lipid profiles. We investigated whether there is a link between the inflammatory contents of diets and body composition and lipid profiles in patients with MS. Materials and methods: This was a cross-sectional study that included 85 MS patients. The study data of the patients were collected in the Neurology Clinic of Ondokuz Mayis University's Health Practice and Research Center. The data included demographic characteristics; anthropometric measurements such as body weight, height, body mass index, waist circumference, hip circumference, body fat mass, body fat-free mass, and waist-hip ratio; and biochemical parameters such as high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol, triglyceride, and total cholesterol. Results: The body fat percentages of the patients were higher among those with proinflammatory diets (p < 0.05). Body fat percentage had a positive and very weak correlation with the Dietary Inflammatory Index (DII) score (rho = 0.206 and rho = 0.217, respectively; p < 0.05). HDL-c levels were higher in the group with high DII scores and there was a positive and weak correlation between HDL-c and DII scores (rho = 0.307, p < 0.05). Crude and adjusted linear regression models showed that the effect of HDL-c on DII scores was significant (p < 0.05). Conclusion: We showed that DII scores, associated with the inflammatory potential of the diet and proinflammatory diets, may be associated with adiposity in MS patients and can be used from a clinical point of view for assessment.


Assuntos
Tecido Adiposo , Índice de Massa Corporal , Inflamação , Esclerose Múltipla , Humanos , Masculino , Feminino , Estudos Transversais , Adulto , Esclerose Múltipla/sangue , Inflamação/sangue , Pessoa de Meia-Idade , Lipídeos/sangue , Dieta , HDL-Colesterol/sangue , Composição Corporal/fisiologia
18.
Nutr Hosp ; 39(5): 1058-1063, 2022 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-36094063

RESUMO

Introduction: Background: intermittent fasting diets that reduce or completely restrict food intake for specific periods have become more popular in recent years. Fasting in Ramadan is also an example of these intermittent fasting practices. In fasting practices focusing on the duration of nutrition, less emphasis was placed on the information on the dietary pattern. Objective: this study aims to evaluate the Healthy Eating Index (HEI) and diet quality in fasting individuals in Ramadan. Material and methods: this study was a cross-sectional study, conducted with adults aged 18-65 years. Food consumption record was taken with a 24-h-record with food consumption form. Diet quality and adequacy were assessed with the HEI, Nutrient Adequacy Ratio (NAR), and Average Adequacy Ratio (MAR) from food consumption records. Results: according to study results, HEI and NAR Ca scores were statistically significantly lower in the fasting group than in the non-fasting group (p < 0.05). In the non-fasting group, HEI scores showed a negative correlation with body mass index (BMI) (kg/m2) and waist-hip ratio (r = -0.023, r = -0.148, p < 0.05). Conclusion: this study claimed that fasting might be associated with low scores of HEI. These results suggest that specific nutritional recommendations should be developed for fasting individuals.


Introducción: Introducción: las dietas de ayuno intermitente que reducen o restringen por completo la ingesta de alimentos durante periodos específicos se han vuelto más populares en los últimos años. El ayuno en Ramadán también es un ejemplo de estas prácticas de ayuno intermitente. En las prácticas de ayuno centradas en la duración de la nutrición, se ha puesto menos énfasis en la información sobre el patrón dietético. Objetivo: este estudio tiene como objetivo evaluar el índice de alimentación saludable (IAS) y la calidad de la dieta en personas en ayunas en Ramadán. Material y métodos: se trata de un estudio transversal, realizado con adultos de 18 a 65 años. El registro de consumo de alimentos se tomó con un registro de 24 horas con formulario de consumo de alimentos. La calidad y la adecuación de la dieta se evaluaron con el IAS, el índice de adecuación de nutrientes (NAR) y la ratio de adecuación promedio (MAR) de los registros de consumo de alimentos. Resultados: de acuerdo con los resultados del estudio, las puntuaciones de HEI y NAR Ca fueron estadísticamente significativamente más bajas en el grupo que hace ayuno que en el grupo sin ayuno (p < 0,05). En el grupo sin ayuno, las puntuaciones HEI mostraron una correlación negativa con el índice de masa corporal (IMC) (kg/m2) y la relación cintura-cadera (r = -0,023, r = -0,148, p < 0,05). Conclusión: este estudio afirmó que el ayuno podría estar asociado con puntuaciones bajas de IAS. Dichos resultados sugieren que se deben desarrollar recomendaciones nutricionales específicas para las personas que hacen ayuno.


Assuntos
Dieta Saudável , Jejum , Adulto , Estudos Transversais , Dieta , Inquéritos sobre Dietas , Ingestão de Alimentos , Humanos
19.
Am J Otolaryngol ; 43(3): 103401, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35210114

RESUMO

PURPOSE: This study aims to compare percutaneous tracheostomy (PCT) and surgical tracheostomy's aerosol and droplet scattering by using a particle counter. MATERIALS AND METHODS: This study was carried out with 35 patients between October 2020 and June 2021. All personal protective equipment was provided to protect healthcare workers. Measurements were made in the 5 s period before the tracheal incision and the 5 s period after the tracheal incision. RESULTS: The mean age of the 15 female and 20 male patients in this study was 68.88 ± 13.48 years old (range: 33-95 years old). Patients were intubated for an average of 22 days. Particle amounts were found to be significantly higher at 5 µm (p = 0.003) and 10 µm (p = 0.012) during PCT. In surgical tracheostomy, there was no significant increase in the number of particles. When the particle measurement values of both methods were compared with each other, there was a significantly more particle scattering in PCT than in surgical tracheotomy at 0.3 µm (p = 0.034), 5 µm (p = 0.001), and 10 µm (p = 0.003). CONCLUSION: According to the data in our study, a surgical tracheotomy was not identified as an aerosol-generating procedure. Considering the risk of airborne transmission may increase due to viral mutations, we have shown that surgical tracheostomy may be more appropriate in patients who need a tracheostomy. Of course, the use of personal protective equipment during these processes is very important.


Assuntos
COVID-19 , Traqueostomia , Adulto , Aerossóis , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipamento de Proteção Individual , Traqueostomia/métodos , Traqueotomia
20.
Rev. Nutr. (Online) ; 35: e220020, 2022. tab
Artigo em Inglês | LILACS | ID: biblio-1406929

RESUMO

ABSTRACT Objective This study was conducted to determine the frequency of vitamin D deficiency in patients with lumbar spinal stenosis and to define the relationship between vitamin D levels and obesity, depression, and pain intensity. Methods This study was conducted with 69 patients (Male = 32, Female = 37) diagnosed with lumbar spinal stenosis. The participants' 25(OH)D levels were measured by radioimmunoassay. In addition, bone metabolic status, including bone mineral density and bone turnover markers, was also evaluated. The Beck Depression Inventory was used to determine the depression statuses of the patients, while the McGill Melzack Pain Questionnaire was administered to measure pain intensity. The results were evaluated at a significance level of p<0.05. Results Vitamin D deficiency (<20 ng/mL) was found in 76.8% of the patients. Binary logistic regression analysis showed a significantly higher frequency of vitamin D deficiency in patients who: 1) had higher body mass indexes (OR 3.197, 95% CI 1.549-6.599); 2) fared higher in Beck's depression score (OR 1.817, 95% CI 1.027-3.217); and 3) were female rather than male (OR 1.700, 95% CI 0.931-3.224) (p<0.05). Conclusion In this study, vitamin D deficiency was prevalent in lumbar spinal stenosis patients. In addition, obese, depressed, and female individuals have higher risks of vitamin D deficiency.


RESUMO Objetivo Este estudo foi realizado para determinar a frequência de deficiência de vitamina D em pacientes com estenose espinhal lombar e para definir a relação entre os níveis de vitamina D e obesidade, depressão e intensidade da dor. Métodos Este estudo foi realizado com 69 pacientes (homens = 32, mulheres = 37) diagnosticados com estenose espinhal lombar. Os níveis de 25(OH)D dos participantes foram medidos por radioimunoensaio. Além disso, o estado metabólico ósseo, incluindo densidade mineral óssea e marcadores de remodelação óssea, também foi avaliado. O Inventário de Depressão de Beck foi usado para determinar os estados de depressão dos pacientes, enquanto o Questionário de Dor McGill Melzack foi aplicado para medir a intensidade da dor. Os resultados foram avaliados a um nível de significância de p<0,05. Resultados A deficiência de vitamina D (<20 ng/mL) foi encontrada em 76,8% dos pacientes. A análise de regressão logística binária mostrou uma frequência significativamente maior de deficiência de vitamina D nos seguintes pacientes: 1) com maior índice de massa corporal (OR 3,197, 95% IC 1,549-6,599); 2) com maior pontuação na escala de depressão de Beck (OR 1,817, 95% IC 1,027-3,217) e 3) do sexo feminino em vez de masculino (OR 1,700, 95% IC 0,931-3,224) (p<0,05). Conclusão Neste estudo, a deficiência de vitamina D foi prevalente em pacientes com estenose espinhal lombar. Além disso, pessoas obesas, deprimidas e mulheres correm maior risco de deficiência de vitamina D.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Estenose Espinal/etiologia , Deficiência de Vitamina D/complicações , Medição da Dor , Estudos Transversais , Depressão/etiologia , Obesidade/etiologia
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