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1.
J Environ Manage ; 329: 117119, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36566730

RESUMO

Along the Gulf of Mexico (GoM) coast, natural resource managers continually struggle with managing coastal uplands due to front-end costs, prolonged maintenance, and habitat-specific ecological needs. Prescribed fire, mechanical removal, and chemical treatments are common habitat management techniques used to remove invasive species, clear understory, and achieve other management goals. However, rapid development and changing climate exacerbate the difficulty in using these techniques. A potential alternative or complementary technique is using livestock for habitat management (i.e., targeted or controlled grazing). In other regions of the world, using livestock for conservation or restoration of managed lands has shown to be a less intrusive and more financially viable alternative. To better understand the research needs, logistical, and environmental concerns related to using livestock for habitat management in the coastal uplands of the GoM, we developed and distributed a survey to three groups of land users, including natural resource managers, researchers, and livestock producers in the region. Survey results show that over 96% of respondents are interested in using livestock for habitat management, but less than 10% of respondents were aware of any information that could be used to inform grazing practices for coastal upland habitat management along the Gulf of Mexico coast. There were differences among surveyed groups, but generally small-sized cattle breeds and goats were identified as the livestock with the most potential for environmental benefit and ease of containment. General concerns and areas for further investigation were implementation (e.g., which livestock type to use and grazing intensity), logistical considerations (e.g., fencing and rotational frequency), impacts of grazing on water quality, wildlife, vegetation, and livestock nutrition. Survey respondents overwhelmingly (at least 75% of each group) indicated that livestock grazing ideally would not be a standalone management practice and should be used in conjunction with other habitat management techniques such as prescribed burns, mechanical clearing, or chemical treatments. The results of the survey could be used to develop applied research projects and guidance documents that directly address informational needs related to using livestock for habitat management of coastal uplands along the Gulf of Mexico coast.


Assuntos
Conservação dos Recursos Naturais , Gado , Animais , Bovinos , Conservação dos Recursos Naturais/métodos , Ecossistema , Animais Selvagens , Clima
2.
J Geophys Res Planets ; 127(2): e2021JE006848, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35859923

RESUMO

Aeolis Mons (informally, Mount Sharp) exhibits a number of canyons, including Gediz and Sakarya Valles. Poorly sorted debris deposits are evident on both canyon floors and connect with debris extending down the walls for canyon segments that cut through sulphate-bearing strata. On the floor of Gediz Vallis, debris overfills a central channel and merges with a massive debris ridge located at the canyon terminus. One wall-based debris ridge is evident. In comparison, the floor of Sakarya Vallis exhibits a complex array of debris deposits. Debris deposits on wall segments within Sakarya Vallis are mainly contained within chutes that extend downhill from scarps. Lateral debris ridges are also evident on chute margins. We interpret the debris deposits in the two canyons to be a consequence of one or more late-stage hydrogeomorphic events that increased the probability of landslides, assembled and channelized debris on the canyon floors, and moved materials down-canyon. The highly soluble nature of the sulphate-bearing rocks likely contributed to enhanced debris generation by concurrent aqueous weathering to produce blocky regolith for transport downslope by fluvial activity and landslides, including some landslides that became debris flows. Subsequent wind erosion in Gediz Vallis removed most of the debris deposits within that canyon and partially eroded the deposits within Sakarya Vallis. The enhanced wind erosion within Gediz Vallis was a consequence of the canyon's alignment with prevailing slope winds.

3.
BMC Public Health ; 21(1): 784, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33892700

RESUMO

BACKGROUND: Public health organizations have been alerted to the high levels of sedentary behaviour (SB) among adolescents as well as to the health and social consequences of excess sedentary time. However, SB changes of the European Union (EU) adolescents over time have not been reported yet. This study aimed to identify SB of the EU adolescents (15-17 years) in four-time points (2002, 2005, 2013 and 2017) and to analyse the prevalence of SB according to the sex. METHODS: SB of 2542 adolescents (1335 boys and 1207 girls) as a whole sample and country-by-country was analysed in 2002, 2005, 2013, and 2017 using the Sport and Physical Activity EU Special Eurobarometers' data. SB was measured using the sitting time question from the short version of the International Physical Activity Questionnaire (IPAQ), such that 4h30min of daily sitting time was the delineating point to determine excess SB behaviour (≥4h30min of sitting time) or not (≤4h30min of sitting time). A χ2 test was used to compare the prevalence of SB between survey years. Furthermore, SB prevalence between sexes was analysed using a Z-Score test for two population proportions. RESULTS: The prevalence of SB among EU adolescents across each of the four survey years ranged from 74.2 and 76.8%, rates that are considered high. High levels of SB were also displayed by both sexes (girls: 76.8 to 81.2%; boys: 71.7 to 76.7%). No significant differences in the prevalence of SB among years (p > 0.05) were found for the whole sample, and for either girls or boys. Also, no significant differences in the prevalence of SB between girls and boys were found. CONCLUSION: The SB prevalence in European adolescents is extremely high (76.8% in 2017) with no differences between girls and boys. No significant improvements have been seen between 2002 and 2017. Eurobarometer should increase the adolescents' sample to make possible benchmarking comparisons among the EU countries and extend the survey to the younger children population.


Assuntos
Comportamento Sedentário , Esportes , Adolescente , Criança , Estudos Transversais , Europa (Continente) , Exercício Físico , Feminino , Humanos , Masculino , Saúde Pública
4.
BMC Public Health ; 20(1): 1206, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32843022

RESUMO

BACKGROUND: Sedentary behaviour (SB) has been identified as an important mortality risk factor. Health organizations have recognised SB as a public health challenge with major health, social, and economic consequences. Researchers have alerted the need to develop specific strategies, to monitor, prevent, and reduce SB. However, there is no systematic analysis of the SB changes in European Union adults. We aimed to examine SB changes between 2002 and 2017 in the European Union (EU) adult population. METHODS: SB prevalence (>4h30mins of sitting time/day) of 96,004 adults as a whole sample and country-by-country was analysed in 2002, 2005, 2013, and 2017 of the Sport and Physical Activity EU Special Eurobarometers' data. The SB question of a modified version of the International Physical Activity Questionnaire was considered. SB prevalence between countries and within years was analysed with a χ2 test, and SB between genders was analysed with the Z-Score test for two population proportions. RESULTS: An association between the SB prevalence and the years was found (p < 0.001), with increases for the whole sample (2002: 49.3%, 48.5-50.0 95% confidence interval (CI); 2017: 54.5%, 53.9-55.0 95% CI) and men (2002: 51.2%, 50.0-52.4 95% CI; 2017: 55.8%, 55.0-56.7 95% CI) and women (2002: 47.6%, 46.6-48.7 95% CI; 2017: 53.4%, 52.6-54.1 95% CI) separately. The adjusted standardised residuals showed an increase in the observed prevalence versus the expected during 2013 and 2017 for the whole sample and women and during 2017 for men. For all years, differences were observed in the SB prevalence between countries for the whole sample, and men and women separately (p < 0.001). Besides, the SB prevalence was always higher in men versus women in the overall EU sample (p < 0.001). CONCLUSIONS: SB prevalence increased between 2002 and 2017 for the EU as a whole and for both sexes separately. Additionally, differences in SB prevalence were observed for all years between EU countries in the whole sample and both sexes separately. Lastly, SB was consistently higher in men than women. These findings reveal a limited impact of current policies and interventions to tackle SB at the EU population level.


Assuntos
Atitude Frente a Saúde , Exercício Físico/psicologia , Promoção da Saúde/estatística & dados numéricos , Promoção da Saúde/tendências , Estilo de Vida Saudável , Saúde Pública/estatística & dados numéricos , Comportamento Sedentário , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Características Culturais , União Europeia , Feminino , Previsões , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
5.
Obes Sci Pract ; 5(5): 449-458, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31687169

RESUMO

BACKGROUND: Body mass index (BMI) is often used to diagnose obesity in childhood and adolescence but has limitations as an index of obesity-related morbidity. The Edmonton Obesity Staging System for Pediatrics (EOSS-P) is a clinical staging system that uses weight-related comorbidities to determine health risk in paediatric populations. The purpose of this study was to investigate the associations of EOSS-P and BMI percentile with quality of life (QOL), cardiorespiratory fitness (CRF) and muscular strength in adolescents with obesity. METHODS: Participants were enrolled at baseline in the Healthy Eating, Aerobic and Resistance Training in Youth trial (BMI = 34.6 ± 4.5 kg m-2, age = 15.6 ± 1.4 years, N = 299). QOL, CRF (peak oxygen uptake, VO2peak) and muscular strength were assessed by the Pediatric QOL Inventory (PedsQL), indirect calorimetry during a maximal treadmill test and eight-repetition maximum bench and leg press tests, respectively. Participants were staged from 0 to 3 (absent to severe health risk) according to EOSS-P. Associations were assessed using age-adjusted and sex-adjusted general linear models. RESULTS: Quality of life decreased with increasing EOSS-P stages (p < 0.001). QOL was 75.7 ± 11.4 in stage 0/1, 69.1 ± 13.1 in stage 2 and 55.4 ± 13.0 in stage 3. BMI percentile was associated with VO2peak (ß = -0.044 mlO2 kg-1 min-1 per unit increase in BMI percentile, p < 0.001), bench press (ß = 0.832 kg per unit increase in BMI percentile, p = 0.029) and leg press (ß = 3.992 kg, p = 0.003). There were no significant differences in treadmill time or VO2peak between EOSS-P stages (p > 0.05). CONCLUSION: As EOSS-P stages increase, QOL decreases. BMI percentile was negatively associated with CRF and positively associated with muscular strength.

6.
Science ; 360(6389): 649-651, 2018 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-29674430

RESUMO

Earth's most severe climate changes occurred during global-scale "snowball Earth" glaciations, which profoundly altered the planet's atmosphere, oceans, and biosphere. Extreme rates of glacioeustatic sea level rise are predicted by the snowball Earth hypothesis, but supporting geologic evidence has been lacking. We use paleohydraulic analysis of wave ripples and tidal laminae in the Elatina Formation, Australia-deposited after the Marinoan glaciation ~635 million years ago-to show that water depths of 9 to 16 meters remained nearly constant for ~100 years throughout 27 meters of sediment accumulation. This accumulation rate was too great to have been accommodated by subsidence and instead indicates an extraordinarily rapid rate of sea level rise (0.2 to 0.27 meters per year). Our results substantiate a fundamental prediction of snowball Earth models of rapid deglaciation during the early transition to a supergreenhouse climate.

7.
Top Catal ; 61(3): 213-224, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30956506

RESUMO

Sequential treatment of a previously-calcined solid oxide support (i.e. SiO2, γ-Al2O3, or mixed SiO2-Al2O3) with solutions of Cr{N(SiMe3)2}3 (0.71 wt% Cr) and a Lewis acidic alkyl aluminium-based co-catalyst (15 molar equivalents) affords initiator systems active for the oligomerisation and/or polymerisation of ethylene. The influence of the oxide support, calcination temperature, co-catalyst, and reaction diluent on both the productivity and selectivity of the immobilised chromium initiator systems have been investigated, with the best performing combination (SiO2-600, modified methyl aluminoxane-12 {MMAO-12}, heptane) producing a mixture of hexenes (61 wt%; 79% 1-hexene), and polyethylene (16 wt%) with an activity of 2403 g gCr -1 h-1. The observed product distribution is rationalised by two competing processes: trimerisation via a supported metallacycle-based mechanism and polymerisation through a classical Cossee-Arlman chain-growth pathway. This is supported by the indirect observation of two distinct chromium environments at the surface of the oxide support by a solid-state 29Si NMR spectroscopic study of the Cr{N(SiMe3)2}x/SiO2-600 pro-initiator.

8.
Hum Reprod ; 33(1): 101-108, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29145594

RESUMO

STUDY QUESTION: Are there differences in levels of parental wellbeing (parental stress, psychological adjustment and partner relationship satisfaction) between gay-father families with infants born through surrogacy, lesbian-mother families with infants born through donor insemination, and heterosexual-parent families with infants born through IVF? SUMMARY ANSWER: There were no differences in parental wellbeing. WHAT IS KNOWN ALREADY: The only other study of parental wellbeing in gay-father families formed through surrogacy (mean age children: 4 years old) found no difference in couple relationship satisfaction between these families and lesbian-mother families formed through donor insemination and heterosexual-parent families formed without assisted reproductive technologies. STUDY DESIGN, SIZE, DURATION: This cross-sectional study is part of an international research project involving 38 gay-father families, 61 lesbian-mother families and 41 heterosexual-parent families with 4-month-olds. In each country (the UK, the Netherlands and France), participants were recruited through several sources, such as specialist lawyers with expertise in surrogacy (for the recruitment of gay fathers), lesbian and gay parenting support groups, fertility clinics (for the recruitment of lesbian and heterosexual parents), and/or online forums and magazines. PARTICIPANTS/MATERIALS, SETTING, METHODS: During a home visit when their infants were between 3.5 and 4.5 months old, participants completed standardized measures of parental stress, parental psychological adjustment (anxiety and depression) and partner relationship satisfaction. MAIN RESULTS AND THE ROLE OF CHANCE: All parents reported relatively low levels of parental stress, anxiety and depression, and were all relatively satisfied with their intimate relationships. After controlling for caregiver role (primary or secondary caregiver role), there were no significant family type differences in parental stress, P = 0.949, depression, P = 0.089, anxiety, P = 0.117, or relationship satisfaction, P = 0.354. LIMITATIONS, REASONS FOR CAUTION: The findings cannot be generalized to all first-time ART parents with infants because only families from relatively privileged backgrounds participated. WIDER IMPLICATIONS OF THE FINDINGS: Our findings may have implications for the development of policy and legislation in relation to these new family forms, as well as the regulation of surrogacy in the Netherlands and France. In addition, our findings might encourage professional organizations of obstetricians and gynecologists in these countries to recommend that requests for assisted reproduction should be considered regardless of the applicants' sexual orientation. STUDY FUNDING/COMPETING INTEREST(S): This research was supported, under the auspices of the Open Research Area (Application BO 3973/1-1; Principal Investigator, Michael E Lamb), by grants from the UK Economic and Social Research Council (ESRC; Grant ES/K006150/1; Principal Investigator, Michael E. Lamb), The Netherlands Organisation for Scientific Research (NWO; Grant NWO 464-11-001, Principal Investigator, Henny W.M. Bos) and the French Agence Nationale de Recherche (ANR; Grant ANR-12-ORAR-00005-01, Principal Investigator, Olivier Vecho) whose support is gratefully acknowledged. There were no competing interests.


Assuntos
Pai/psicologia , Homossexualidade Masculina/psicologia , Mães/psicologia , Poder Familiar/psicologia , Minorias Sexuais e de Gênero/psicologia , Adulto , Estudos Transversais , Feminino , Fertilização in vitro/psicologia , França , Heterossexualidade/psicologia , Homossexualidade Feminina/psicologia , Humanos , Lactente , Masculino , Países Baixos , Gravidez , Estresse Psicológico , Mães Substitutas
9.
J Geophys Res Planets ; 122(12): 2544-2573, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29497590

RESUMO

The Mars Science Laboratory rover Curiosity visited two active wind-blown sand dunes within Gale crater, Mars, which provided the first ground-based opportunity to compare Martian and terrestrial eolian dune sedimentary processes and study a modern analog for the Martian eolian rock record. Orbital and rover images of these dunes reveal terrestrial-like and uniquely Martian processes. The presence of grainfall, grainflow, and impact ripples resembled terrestrial dunes. Impact ripples were present on all dune slopes and had a size and shape similar to their terrestrial counterpart. Grainfall and grainflow occurred on dune and large-ripple lee slopes. Lee slopes were ~29° where grainflows were present and ~33° where grainfall was present. These slopes are interpreted as the dynamic and static angles of repose, respectively. Grain size measured on an undisturbed impact ripple ranges between 50 µm and 350 µm with an intermediate axis mean size of 113 µm (median: 103 µm). Dissimilar to dune eolian processes on Earth, large, meter-scale ripples were present on all dune slopes. Large ripples had nearly symmetric to strongly asymmetric topographic profiles and heights ranging between 12 cm and 28 cm. The composite observations of the modern sedimentary processes highlight that the Martian eolian rock record is likely different from its terrestrial counterpart because of the large ripples, which are expected to engender a unique scale of cross stratification. More broadly, however, in the Bagnold Dune Field as on Earth, dune-field pattern dynamics and basin-scale boundary conditions will dictate the style and distribution of sedimentary processes.

10.
Eur J Clin Nutr ; 71(1): 115-121, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27759070

RESUMO

BACKGROUND/OBJECTIVES: The cardiovascular benefit of increasing fruit and vegetable (F&V) intake following diagnosis of diabetes remains unknown. We aimed to describe how quantity and variety of F&V intake, and plasma vitamin C, change after diagnosis of type 2 diabetes and examine whether these changes are associated with improvements in cardiovascular risk factors. SUBJECTS/METHODS: A total of 401 individuals with screen-detected diabetes from the ADDITION-Cambridge study were followed up over 5 years. F&V intake was assessed by food frequency questionnaire and plasma vitamin C at baseline, at 1 year and at 5 years. Linear mixed models were used to estimate associations of changes in quantity and variety of F&V intake, and plasma vitamin C, with cardiovascular risk factors and a clustered cardiometabolic risk score (CCMR), where a higher score indicates higher risk. RESULTS: F&V intake increased in year 1 but decreased by year 5, whereas variety remained unchanged. Plasma vitamin C increased at 1 year and at 5 years. Each s.d. increase (250g between baseline and 1 year and 270g between 1 and 5 years) in F&V intake was associated with lower waist circumference (-0.92 (95% CI: -1.57, -0.27) cm), HbA1c (-0.11 (-0.20, -0.03) %) and CCMR (-0.04 (-0.08, -0.01)) at 1 year and higher high-density lipoprotein (HDL)-cholesterol (0.04 (0.01, 0.06) mmol/l) at 5 years. Increased plasma vitamin C (per s.d., 22.5 µmol/l) was associated with higher HDL-cholesterol (0.04 (0.01, 0.06) mmol/l) and lower CCMR (-0.07 (-0.12, -0.03)) between 1 and 5 years. CONCLUSIONS: Increases in F&V quantity following diagnosis of diabetes are associated with lower cardiovascular risk factors. Health promotion interventions might highlight the importance of increasing, and maintaining increases in, F&V intake for improved cardiometabolic health in patients with diabetes.


Assuntos
Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/complicações , Dieta/efeitos adversos , Frutas , Verduras , Adulto , Idoso , Ácido Ascórbico/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/fisiopatologia , Dieta/métodos , Inquéritos sobre Dietas , Ingestão de Alimentos/fisiologia , Feminino , Seguimentos , Hemoglobinas Glicadas/análise , Humanos , Modelos Lineares , Lipoproteínas HDL/sangue , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Fatores de Risco , Reino Unido , Circunferência da Cintura
11.
Science ; 353(6294): 55-8, 2016 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-27365444

RESUMO

Wind blowing over sand on Earth produces decimeter-wavelength ripples and hundred-meter- to kilometer-wavelength dunes: bedforms of two distinct size modes. Observations from the Mars Science Laboratory Curiosity rover and the Mars Reconnaissance Orbiter reveal that Mars hosts a third stable wind-driven bedform, with meter-scale wavelengths. These bedforms are spatially uniform in size and typically have asymmetric profiles with angle-of-repose lee slopes and sinuous crest lines, making them unlike terrestrial wind ripples. Rather, these structures resemble fluid-drag ripples, which on Earth include water-worked current ripples, but on Mars instead form by wind because of the higher kinematic viscosity of the low-density atmosphere. A reevaluation of the wind-deposited strata in the Burns formation (about 3.7 billion years old or younger) identifies potential wind-drag ripple stratification formed under a thin atmosphere.

12.
Science ; 350(6257): aac7575, 2015 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-26450214

RESUMO

The landforms of northern Gale crater on Mars expose thick sequences of sedimentary rocks. Based on images obtained by the Curiosity rover, we interpret these outcrops as evidence for past fluvial, deltaic, and lacustrine environments. Degradation of the crater wall and rim probably supplied these sediments, which advanced inward from the wall, infilling both the crater and an internal lake basin to a thickness of at least 75 meters. This intracrater lake system probably existed intermittently for thousands to millions of years, implying a relatively wet climate that supplied moisture to the crater rim and transported sediment via streams into the lake basin. The deposits in Gale crater were then exhumed, probably by wind-driven erosion, creating Aeolis Mons (Mount Sharp).


Assuntos
Lagos , Marte , Clima , Exumação , Paleontologia
13.
Diabet Med ; 32(8): 1036-50, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25510978

RESUMO

AIMS: Improving glycaemic control in people with Type 1 diabetes is known to reduce complications. Our aim was to compare glycaemic control among people with Type 1 diabetes using data gathered in regional or national registries. METHODS: Data were obtained for children and/or adults with Type 1 diabetes from the following countries (or regions): Western Australia, Austria, Denmark, England, Champagne-Ardenne (France), Germany, Epirus, Thessaly and Thessaloniki (Greece), Galway (Ireland), several Italian regions, Latvia, Rotterdam (The Netherlands), Otago (New Zealand), Norway, Northern Ireland, Scotland, Sweden, Volyn (Ukraine), USA and Wales) from population or clinic-based registries. The sample size with available data varied from 355 to 173 880. Proportions with HbA1c < 58 mmol/mol (< 7.5%) and ≥ 75 mmol/mol (≥ 9.0%) were compared by age and sex. RESULTS: Data were available for 324 501 people. The proportions with HbA1c 58 mmol/mol (< 7.5%) varied from 15.7% to 46.4% among 44 058 people aged < 15 years, from 8.9% to 49.5% among 50 766 people aged 15-24 years and from 20.5% to 53.6% among 229 677 people aged ≥ 25 years. Sex differences in glycaemic control were small. Proportions of people using insulin pumps varied between the 12 sources with data available. CONCLUSION: These results suggest that there are substantial variations in glycaemic control among people with Type 1 diabetes between the data sources and that there is room for improvement in all populations, especially in young adults.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Hemoglobinas Glicadas/metabolismo , Hipoglicemiantes/uso terapêutico , Sistemas de Infusão de Insulina/estatística & dados numéricos , Insulina/uso terapêutico , Sistema de Registros , Adolescente , Adulto , Áustria , Dinamarca , Diabetes Mellitus Tipo 1/metabolismo , Inglaterra , Feminino , França , Alemanha , Grécia , Fidelidade a Diretrizes , Humanos , Irlanda , Itália , Letônia , Masculino , Países Baixos , Nova Zelândia , Irlanda do Norte , Noruega , Guias de Prática Clínica como Assunto , Escócia , Suécia , Ucrânia , Estados Unidos , País de Gales , Austrália Ocidental , Adulto Jovem
14.
Dis Colon Rectum ; 57(12): 1430-40, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25380010

RESUMO

BACKGROUND: Initial management of diverticulitis with abscess formation has progressed from a surgical emergency to nonoperative management with antibiotics and percutaneous drainage followed by delayed resection. Controversy has arisen regarding the necessity of elective surgery, when nonoperative management has successfully resolved the index attack. OBJECTIVE: The aim of this systematic review was to analyze the literature to determine the recurrence rate in those patients who were successfully managed nonoperatively and determine the role of elective surgical resection. DATA SOURCES: An electronic literature search of PubMed, MEDLINE, EMBASE, and the Cochrane Database of Collected Reviews performed from 1986 to 2014. The search terms used were as follows: "diverticulitis," "abscess," "diverticular abscess," "percutaneous drainage," and "surgery." STUDY SELECTION: Studies included for review evaluated the management of diverticular abscesses and the subsequent role of delayed elective resection. INTERVENTIONS: All of the studies were systematically reviewed and underwent a meta-analysis. MAIN OUTCOME MEASURES: End points were the need for surgery and recurrent attacks without surgery. RESULTS: Twenty-two studies reporting a total of 1051 patients with acute diverticulitis with abscess formation (modified Hinchey grades IB and II) were included in the review. Percutaneous drainage was successful in 49% patients (diameter, >3 cm) and antibiotic therapy in 14% patients. Urgent surgery during the index hospitalization was performed in 30% of patients, elective resection in 36%, and no surgery in 35%. Recurrence rates were high, with 39% in patients awaiting elective resection and 18% in the nonsurgery group, with an overall recurrence rate of 28%. Of the whole cohort, only 28% had no surgery and no recurrence during follow-up. LIMITATIONS: Sample size, heterogeneity, selection and treatment bias, and limited follow-up of included studies were limitations to this study. CONCLUSIONS: The evidence from the literature is weak but still suggests that complicated diverticulitis with abscess formation is associated with a high probability of resective surgery, whereas conservative management may result in chronic or recurrent diverticular symptoms.


Assuntos
Abscesso Abdominal , Antibacterianos/uso terapêutico , Colectomia , Doença Diverticular do Colo , Drenagem , Abscesso Abdominal/etiologia , Abscesso Abdominal/terapia , Colectomia/efeitos adversos , Colectomia/métodos , Gerenciamento Clínico , Doença Diverticular do Colo/complicações , Doença Diverticular do Colo/fisiopatologia , Doença Diverticular do Colo/terapia , Drenagem/efeitos adversos , Drenagem/métodos , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Procedimentos Cirúrgicos Eletivos/métodos , Humanos , Avaliação de Resultados em Cuidados de Saúde , Recidiva , Tempo para o Tratamento
15.
Transplant Proc ; 46(6): 1975-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25131086

RESUMO

INTRODUCTION: Chronic shortage of quality human cadaveric pancreata limits islet transplantation. Porcine islet xenotransplantation is being explored to increase the donor pool. For clinical-ready islets, centralized animal husbandry, Current Good Manufacturing Practice-regulated processing facilities, and organ transportation support are required. Amount of cold ischemia time (CIT) before isolation significantly affects transplantation. The goal of this study was to determine the maximum safe CIT of whole pancreata before islet isolation. MATERIALS AND METHODS: Pancreata were rapidly removed from Yorkshire pigs (age, 14-22 days) and stored in modified University of Wisconsin solution or in EuroCollins solution at 4(°)C. Pancreata were processed with <1 hour CIT (control) or stored for 4 or 12 hours before isolation. Islet yield and percent purity and viability were determined after 7 days of in vitro tissue culture and maturation. Samples from nonprocessed pancreata were collected and snap-frozen in liquid nitrogen at 0, 3, 6, 9, 12, 15, and 24 hours of preservation, then analyzed for adenosine diphosphate/adenosine triphosphate ratio as a measure of tissue energetics. RESULTS: Up to 12 hours in cold storage had no significant impact on overall islet yield after 7 days of in vitro culture compared with controls; islet yield at the end of the maturation process was 28,700 ± 500 islet equivalents per pancreas (mean ± SEM control yield, 30,300 ± 900 islet equivalents per pancreas); islet purity was 75 ± 5% compared with 74 ± 5% in controls. Islet viability was significantly reduced at 12 hours compared with controls (80 ± 6% vs 96 ± 5%; P < .05). The tissue adenosine diphosphate/adenosine triphosphate ratio was maintained within the first 6 hours (1.6 ± 0.1 to 1.8 ± 0.2; P = NS) but was markedly increased during the 24-hour study (3.3 ± 0.1 at 24 hours), indicating a progressive loss of adenosine triphosphate tissue stores. CONCLUSIONS: Young pig pancreata can be hypothermically stored for up to 12 hours without affecting islet yield and purity; however, islet viability is reduced. These data highlight the need for uniform shipping parameters to standardize islet quality, ideally with CIT <6 hours.


Assuntos
Isquemia Fria , Ilhotas Pancreáticas/fisiologia , Pâncreas/patologia , Sobrevivência de Tecidos/fisiologia , Adenosina , Difosfato de Adenosina/metabolismo , Trifosfato de Adenosina/metabolismo , Alopurinol , Animais , Glutationa , Soluções Hipertônicas , Insulina , Soluções para Preservação de Órgãos , Pâncreas/metabolismo , Pâncreas/cirurgia , Rafinose , Suínos , Fatores de Tempo , Técnicas de Cultura de Tecidos
16.
Vet Comp Oncol ; 12(1): 52-7, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22520498

RESUMO

A retrospective evaluation of 232 feline nasal biopsies initially diagnosed as either carcinoma or lymphoma was performed by two pathologists. One or both pathologists disagreed with the original diagnosis in 15 cases (7%), 14 of which had original diagnoses of carcinoma. Out of the 232 cases, 140, including the disputed ones, were subjected to immunohistochemical staining with epithelial and lymphoid markers. Immunohistochemical staining of the 15 disputed cases showed that the original diagnoses were incorrect in 67% (10/15), unverified in 13% (2/15) and correct in 20% (3/15). Among the consensual diagnoses, immunohistochemistry revealed that 3% (4/125) of diagnoses were unverified because they did not stain for any of the markers evaluated. This report demonstrates the importance of immunohistochemistry in establishing a correct histologic diagnosis for nasal neoplasms in cats.


Assuntos
Carcinoma/veterinária , Doenças do Gato/diagnóstico , Imuno-Histoquímica/veterinária , Linfoma/veterinária , Neoplasias Nasais/veterinária , Animais , Biomarcadores Tumorais , Carcinoma/diagnóstico , Carcinoma/patologia , Doenças do Gato/patologia , Gatos , Imuno-Histoquímica/métodos , Linfoma/diagnóstico , Linfoma/patologia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/patologia , Estudos Retrospectivos
19.
Transplant Proc ; 43(9): 3265-6, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22099772

RESUMO

Islet encapsulation offers an immune system barrier for islet transplantation, and encapsulation within an alginate sheetlike structure offers the ability to be retrievable after transplanted. This study aims to show that human islets encapsulated into islet sheets remain functional and viable after 8 weeks in culture or when transplanted into the subcutaneous space of rats. Human islets were isolated from cadaveric organs. Dissociation and purification were done using enzymatic digestion and a continuous Ficoll-UWD gradient. Purified human islets were encapsulated in alginate sheets. Human Islet sheets were either kept in culture, at 37°C and 5% CO(2), or transplanted subcutaneously into Lewis rats. After 1, 2, 4, and 8 weeks, the human islet sheets were retrieved from the rats and assessed. The viability of the sheets was measured using fluorescein diacetate (FDA)/propidium iodide (PI), and function was measured through glucose-stimulated insulin release, in which the sheets were incubated for an hour in low-glucose concentration (2.8 mmol/L) and then high (28 mmol/L), then high (28 mmol/L) plus 3-isobutyl-1-methylxanthine (50 µm). Human islet sheets remained both viable, above 70%, and functional, with a stimulation index (insulin secretion in high glucose divided by insulin secretion in low glucose) above 1.5, over 8 weeks of culture or subcutaneous transplantation. Islet transplantation continues to make advances in the treatment of type 1 diabetes. These preliminary results suggest that encapsulated islets sheets can survive and maintain islet viability and function in vivo, within the subcutaneous region.


Assuntos
Alginatos/química , Transplante das Ilhotas Pancreáticas/instrumentação , Transplante das Ilhotas Pancreáticas/métodos , Ilhotas Pancreáticas/citologia , Animais , Cadáver , Sobrevivência Celular , Transplante de Células , Células Cultivadas , Ácido Glucurônico/química , Ácidos Hexurônicos/química , Humanos , Técnicas In Vitro , Masculino , Microscopia Confocal/métodos , Polímeros/química , Ratos , Ratos Endogâmicos Lew , Fatores de Tempo
20.
Dis Colon Rectum ; 54(5): 615-21, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21471764

RESUMO

BACKGROUND: When a patient is deciding between treatment options for localized prostate cancer, brachytherapy is commonly chosen for its perceived low complication profile. Brachytherapy can frequently be complicated by the development of fecal incontinence. The potential long-term impact of this dysfunction on a patient's life should be discussed. OBJECTIVE: This study aimed to assess the long-term impact of brachytherapy for localized prostate cancer on fecal incontinence and to determine the impact and severity of the incontinence on patients' ability to engage in activities of daily living. DESIGN: A retrospective observational study was performed. A questionnaire packet was mailed to patients who had received brachytherapy treatment for localized prostate cancer and were now more than 2 years out from initial seed implantation. Each packet contained the Colon and Ano-Rectal Impact Questionnaire (assessing quality of life), the Colon and Ano-Rectal Distress Inventory, and the Cleveland Clinic Fecal Incontinence Score (both measured existence and severity of fecal incontinence). SETTINGS: This study was conducted at Caritas Christi St. Elizabeth's Medical Center, a tertiary referral center in Boston, Massachusetts from January 1, 1998 to December 31, 2007. PATIENTS: One hundred forty-three of 568 patients (a 25% response rate) responded and were analyzed. INTERVENTIONS: No interventions were performed. MAIN OUTCOME MEASURES: The main outcome was impact of fecal incontinence on quality of life. RESULTS: : Of the responses to the Colon and Ano-Rectal Impact Questionnaire, 13.2% (19 patients) (P < .001) stated that fecal incontinence was impacting their ability to participate in their daily activities. Sixty-three percent (12 patients) (P < .001) of patients described the impact of the incontinence as slight, 21% (4 patients) (P < .001) described it as moderate, and 15.8% (3 patients) (P < .001) described it as severe. LIMITATIONS: There were no case-matched controls and the response rate to the surveys was low. CONCLUSIONS: Postbrachytherapy fecal incontinence leaves a long-term impact on patients' ability to engage in activities of daily living.


Assuntos
Braquiterapia/efeitos adversos , Incontinência Fecal/psicologia , Neoplasias da Próstata/radioterapia , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Incontinência Fecal/epidemiologia , Incontinência Fecal/etiologia , Seguimentos , Humanos , Incidência , Masculino , Massachusetts/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários
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