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1.
ACS Omega ; 8(49): 46816-46829, 2023 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-38107974

RESUMO

Alzheimer's disease (AD) is a neurological disease that disturbs the memory, thinking skills, and behavior of the affected person. AD is a complex disease caused by the breakdown of acetylcholine via acetylcholinesterase (AChE). The present study aimed to assess the synthetic inhibitors of AChE that could be used to treat AD. For this purpose, synthetic compounds of oxadiazole derivatives (15-35) were evaluated and identified as promising inhibitors of AChE, exhibiting IC50 varying between 41.87 ± 0.67 and 1580.25 ± 0.7 µM. The kinetic parameters indicated that all the studied compounds bind to the allosteric site and decrease the efficiency of the AChE enzyme. In silico docking analysis showed that the majority of the compounds interact with the anionic subsite and Per-Arnt-Sim domain of AChE and are stabilized by various bonds including π-π and hydrogen bonding. The stability of the most potent compounds 16 and 17 with AChE interaction was confirmed by molecular dynamics simulations. Moreover, all compounds exhibited concentration-dependent calcium (Ca2+) antagonistic and spasmolytic activities. Among the whole series of oxadiazole derivatives, compounds 16 and 17 displayed the highest activities on spontaneous and potassium (K+)-induced contraction. Therefore, the AChE inhibitory potential, cytotoxicity safe profile, and Ca2+ antagonistic ability of these compounds make them potential therapeutic agents against AD and its associated problems in the future.

2.
J Coll Physicians Surg Pak ; 33(10): 1176-1180, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37804026

RESUMO

OBJECTIVE: To explore the fresh medical graduates' perspectives regarding online teaching of clinical subjects in the final year MBBS program during the COVID-19 pandemic. STUDY DESIGN: Qualitative research with exploratory study design. Place and Duration of the Study: Punjab Medical College (PMC), Faisalabad Medical University (FMU), Faisalabad, from January to June 2022. METHODOLOGY: Semi-structured, open-ended, in-depth interviews were used to collect data from fresh medical graduates of PMC, FMU, who had experienced online teaching from March 2020 to May 2021, during their final year of undergraduate medical degree. Fourteen graduates, selected on the basis of non-probability purposive sampling, were interviewed. The interviews were audio recorded and transcribed verbatim. An iterative process was employed in data collection and analysis. Thematic analysis was used to interpret data. Manual coding was done inductively and the codes were synthesised into categories and themes with consensus. RESULTS: Four themes emerged including advantages, disadvantages, challenges, and suggestions for improvement. Comfort, efficient learning, self-directed learning, and flexibility were the categories of advantages. The disadvantages theme had three categories including deficient clinical skills, demotivation, and unprofessional behaviour. Infrastructure limitations, distractions, and digital illiteracy came up as the main challenges. The students suggested the use of a hybrid model and simulated patients for improvement of the online teaching experience. CONCLUSION: Fresh medical graduates consider online teaching a convenient and efficient method of learning theoretical concepts in clinical subjects, during their final year. However, the lack of contact with patients results in deficient clinical skills in their opinion. KEY WORDS: Coronavirus infection, Medical students, Undergraduate medical education, Teaching, Distance learning.


Assuntos
COVID-19 , Estudantes de Medicina , Humanos , COVID-19/epidemiologia , Pandemias , Aprendizagem , Pesquisa Qualitativa , Ensino
3.
Sensors (Basel) ; 23(19)2023 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-37836907

RESUMO

In smart cities, unmanned aerial vehicles (UAVS) play a vital role in surveillance, monitoring, and data collection. However, the widespread integration of UAVs brings forth a pressing concern: security and privacy vulnerabilities. This study introduces the SP-IoUAV (Secure and Privacy Preserving Intrusion Detection and Prevention for UAVS) model, tailored specifically for the Internet of UAVs ecosystem. The challenge lies in safeguarding UAV operations and ensuring data confidentiality. Our model employs cutting-edge techniques, including federated learning, differential privacy, and secure multi-party computation. These fortify data confidentiality and enhance intrusion detection accuracy. Central to our approach is the integration of deep neural networks (DNNs) like the convolutional neural network-long short-term memory (CNN-LSTM) network, enabling real-time anomaly detection and precise threat identification. This empowers UAVs to make immediate decisions in dynamic environments. To proactively counteract security breaches, we have implemented a real-time decision mechanism triggering alerts and initiating automatic blacklisting. Furthermore, multi-factor authentication (MFA) strengthens access security for the intrusion detection system (IDS) database. The SP-IoUAV model not only establishes a comprehensive machine framework for safeguarding UAV operations but also advocates for secure and privacy-preserving machine learning in UAVS. Our model's effectiveness is validated using the CIC-IDS2017 dataset, and the comparative analysis showcases its superiority over previous approaches like FCL-SBL, RF-RSCV, and RBFNNs, boasting exceptional levels of accuracy (99.98%), precision (99.93%), recall (99.92%), and F-Score (99.92%).

4.
J Biomol Struct Dyn ; : 1-15, 2023 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-37551015

RESUMO

During last decades, 3,5-disubstituted-tetrahydro-2H-thiadiazine-2-thione scaffold remains the center of interest due to their ease of preparation, diverse range substituents at N-3 and N-5 positions, and profound biological activities. In the current study, a series of 3,5-disubstituted-tetrahydro-2H-thiadiazine-2-thiones were synthesized in good to excellent yield, and the structure of the compounds were confirmed by various spectroscopic techniques such as FTIR, 1H-NMR, 13C-NMR and Mass spectrometry, and finally evaluated against Leishmania major. Whereas, all the evaluated compounds (1-33), demonstrate potential leishmanicidal activities with IC50 values in the range of (1.30- 149.98 uM). Among the evaluated compounds such as 3, 4, 6, and 10 exhibited excellent leishmanicidal activities with IC50 values of (2.17 µM), (2.39 µM), (2.00 µM), and (1.39 µM), respectively even better than the standard amphotericin B (IC50 = 0.50) and pentamidine (IC50 = 7.52). In order to investigate binding interaction of the most active compounds, molecular docking study was conducted with Leishmania major. Further molecular dynamic simulation study was also carried out to assess the stability and correct binding of the most active compound 10, within active site of the Leishamania major. Likewise, the physiochemical properties, drug likeness, and ADMET of the most active compounds were investigated, it was found that none of the compounds violate Lipiniski's rule of five, which show that this class of compounds had enough potential to be used as drug candidate in near future.Communicated by Ramaswamy H. Sarma.

5.
Opt Lett ; 48(5): 1088-1091, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36857220

RESUMO

Fiber optic bundles are used in narrow-diameter medical and industrial instruments for acquiring images from confined locations. Images transmitted through these bundles contain only one pixel of information per fiber core and fail to capture information from the cladding region between cores. Both factors limit the spatial resolution attainable with fiber bundles. We show here that computational imaging (CI) can be combined with spectral coding to overcome these two fundamental limitations and improve spatial resolution in fiber bundle imaging. By acquiring multiple images of a scene with a high-resolution mask pattern imposed, up to 17 pixels of information can be recovered from each fiber core. A dispersive element at the distal end of the bundle imparts a wavelength-dependent lateral shift on light from the object. This enables light that would otherwise be lost at the inter-fiber cladding to be transmitted through adjacent fiber cores. We experimentally demonstrate this approach using synthetic and real objects. Using CI with spectral coding, object features 5× smaller than individual fiber cores were resolved, whereas conventional imaging could only resolve features at least 1.5× larger than each core. In summary, CI combined with spectral coding provides an approach for overcoming the two fundamental limitations of fiber optic bundle imaging.

6.
Int J Biol Macromol ; 228: 659-670, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36584776

RESUMO

A novel series of twenty two flurbiprofen amides (1-22) were designed and synthesized in good to excellent yields by reacting flurbiprofen acid with various aromatic/aliphatic primary amines in the presence of 1,1­carbonyldiimidazole (CDI) in basic medium using acetonitrile as solvent. Structures of the synthesized derivatives were elucidated with the help of HR-ESI-MS, 1H-, and 13C NMR spectroscopy and finally screened them for their in-vivo anti-inflammatory potential using carrageenan induced mice paw oedema assay. Among the series, four compounds (8, 14, 15, and 20) displayed excellent activity ranging from 59.0 to 77.7 % decrease, while eight compounds (1, 3, 7, 10, 12, 13, 17, and 18) exhibited good activity in the decrease range of 37.0-50.0 %. Additionally, four compounds (2, 6, 16, and 22) attributed less activity, while the remaining six compounds (4, 5, 9, 11, 19, and 21) were found to be inactive. Furthermore, the In-silico studies were executed on the synthesized derivatives in order to explain the binding interface of compounds with the active sites of prostaglandin endoperoxide-synthase II enzyme.


Assuntos
Flurbiprofeno , Camundongos , Animais , Flurbiprofeno/farmacologia , Inibidores de Ciclo-Oxigenase/farmacologia , Inibidores de Ciclo-Oxigenase/uso terapêutico , Simulação de Acoplamento Molecular , Anti-Inflamatórios/uso terapêutico , Ciclo-Oxigenase 2 , Relação Estrutura-Atividade , Anti-Inflamatórios não Esteroides/química , Estrutura Molecular , Edema/induzido quimicamente , Edema/tratamento farmacológico , Carragenina
7.
Cureus ; 14(11): e31575, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36540487

RESUMO

Persistent sciatic artery (PSA) aneurysms are a rare cause of gluteal or lower extremity pain. The persistent sciatic artery is an uncommon congenital vasculature anomaly that presents with variable clinical presentation and is prone to cause an aneurysm, thrombosis, rupture, and possible amputation. Thus, early diagnosis is imperative to prevent further complications. We present the case of a 75-year-old female who was diagnosed with a persistent sciatic artery aneurysm after presenting with gluteal and lower extremity pain initially thought to be sciatica. Our patient underwent a successful hybrid open and endovascular approach with a femoral to below-knee popliteal artery bypass and the placement of coils at the proximal and distal ends of the aneurysmal segment.

8.
Front Pharmacol ; 13: 946134, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36059999

RESUMO

Alzheimer's is a type of dementia that affects the affected person's thinking, memory, and behavior. It is a multifactorial disease, developed by the breakdown of the neurotransmitter acetylcholine via acetylcholinesterase (AChE). The present study was designed to evaluate potential inhibitors of acetylcholinesterase that could be used as a therapeutic agent against Alzheimer's disease (AD). For this course, synthetic compounds of the Schiff bases class of 2-mercaptobenzimidazole hydrazone derivatives (9-14) were determined to be potent acetylcholinesterase inhibitors with IC50 values varying between 37.64 ± 0.2 and 74.76 ± 0.3 µM. The kinetic studies showed that these are non-competitive inhibitors of AChE. Molecular docking studies revealed that all compounds accommodate well in the active site and are stabilized by hydrophobic interactions and hydrogen bonding. Molecular dynamics (MD) simulations of selected potent inhibitors confirm their stability in the active site of the enzyme. Moreover, all compounds showed antispasmodic and Ca2+ antagonistic activities. Among the selected compounds of 2-mercaptobenzimidazole hydrazone derivatives, compound 11 exhibited the highest activity on spontaneous and K+-induced contractions, followed by compound 13. Therefore, the Ca2+ antagonistic, AChE inhibition potential, and safety profile of these compounds in the human neutrophil viability assay make them potential drug candidates against AD in the future.

9.
Environ Sci Pollut Res Int ; 29(31): 47267-47285, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35179685

RESUMO

Since industrialization, the world has been under great strain from rising temperatures. Economies work hard to boost economic growth by sacrificing natural surroundings that are degrading owing to increased carbon emissions from unsustainable production and consumption. The race-to-the-bottom strategy is seen in different parts of the globalized world, corroborating the pollution haven concept and energy-related emissions. The study assumed that once affluent nations reached a particular economic level, they would concentrate on environmental reforms to safeguard environmental and natural resources. The study built a model of the emissions-growth nexus by controlling inward FDI, information and communication technology, research and development expenditures, and renewable energy using aggregated data from high-income nations from 1976 to 2019. The study verified the N-shaped environmental Kuznets curve using a three-degree polynomial factor of per capita income. On the other hand, inward FDI was assessed as having the potential to support the pollution haven hypothesis (PHH) by increasing carbon emissions. The data show that the square and cubic forms of per capita income have a significant negative and positive effect on carbon emissions in the long run, corroborating the short-peak V-shaped EKC hypothesis. However, the N-shaped EKC hypothesis between income and emissions is verified in the short run. The PHH confirmed that more inward FDI is associated with higher long-term carbon emissions. For decreasing global carbon emissions and unclean production, stringent and incentive-based regulations are preferable.


Assuntos
Dióxido de Carbono , Investimentos em Saúde , Carbono , Dióxido de Carbono/análise , Desenvolvimento Econômico , Poluição Ambiental/análise , Energia Renovável
10.
Antioxidants (Basel) ; 10(12)2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34942971

RESUMO

Different physical and chemical techniques are used for the decontamination of Cr+6 contaminated sites. The techniques are expensive, laborious, and time-consuming. However, remediation of Cr+6 by microbes is viable, efficient, and cost-effective. In this context, plant growth-promoting rhizobacteria Acinetobacter bouvetii P1 isolated from the industrial zone was tested for its role in relieving Cr+6 induced oxidative stress in sunflower. At the elevated Cr+6 levels and in the absence of P1, the growth of the sunflower plants was inhibited. In contrast, the selected strain P1 restored the sunflower growth under Cr+6 through plant growth-promoting interactions. Specifically, P1 biotransformed the Cr+6 into a stable and less toxic Cr+3 form, thus avoiding the possibility of phytotoxicity. On the one hand, the P1 strengthened the host antioxidant system by triggering higher production of enzymatic antioxidants, including catalases, ascorbate peroxidase, superoxide dismutase, and peroxidase. Similarly, P1 also promoted higher production of nonenzymatic antioxidants, such as flavonoids, phenolics, proline, and glutathione. Apart from the bioremediation, P1 solubilized phosphate and produced indole acetic acid, gibberellic acid, and salicylic acid. The production of phytohormones not only helped the host plant growth but also mitigated the harsh condition posed by the elevated levels of Cr+6. The findings mentioned above suggest that P1 may serve as an excellent phyto-stimulant and bio-remediator in a heavy metal-contaminated environment.

11.
Int J Clin Pract ; 75(11): e14566, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34165869

RESUMO

BACKGROUND: Aortic valve myxoma is the rarest location of the most common primary tumour of cardiac origin. Because of the paucity of data, there is little known about their clinical presentation, diagnosis and complications. METHODS: PUBMED, EMBASE, SCOPUS and WEB OF SCIENCE were systematically searched to identify all published cases of aortic valve myxoma through October 2020. Descriptive statistics were used to report the data. RESULTS: Aortic valve myxomas were more prevalent in young (mean age 41 years) male (75%) patients. It most commonly involved the right coronary cusp (50%). Cerebrovascular events (25%), dyspnoea (18.8%), and distal embolisation (18.8%) were found to be the most frequent complications. Echocardiography remains the diagnostic modality of choice in all cases, histopathology is used for confirmation. Most cases were treated with surgical excision (94%); concomitant aortic valve repair and mechanical aortic valve replacement were performed in 25% and 37.5% cases respectively. Sudden cardiac death was noted in one patient. CONCLUSION: Aortic valve myxomas are more often than not discovered in the context of embolic phenomenon or dyspnoea. The most feared complication is stroke, although mortality remains low in surgically managed cases.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Mixoma , Acidente Vascular Cerebral , Adulto , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Ecocardiografia , Humanos , Masculino , Mixoma/complicações , Mixoma/epidemiologia , Mixoma/cirurgia
12.
J Arrhythm ; 37(1): 121-127, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33664894

RESUMO

BACKGROUND: Tumor lysis syndrome (TLS) is a life-threatening oncologic emergency associated with fatal complications including arrhythmia. The epidemiology and mortality outcomes of arrhythmia in TLS are scarcely studied in the literature. METHODS: We used the National Inpatient Sample (NIS) to study the prevalence and outcome of arrhythmia in patients hospitalized with TLS (ICD-9 code 277.88) from 2009 to 2014. Baseline characteristics, burden of arrhythmia, and pertinent outcomes were analyzed. Multivariable regression analysis was performed to identify the impact of underlying malignancy in predicting TLS-related mortality. RESULTS: A total of 9034 cases of arrhythmia among 37 861 TLS patients were identified. More than half of the arrhythmia cases (67%) were found among white old (>65) males admitted to large bed size and urban teaching hospitals. Arrhythmic cohort showed higher frequency of comorbidities such as fluid-electrolyte disturbances, hypertension, congestive heart failure, renal failure, dyslipidemia, diabetes, pulmonary circulatory disorders, chronic pulmonary disease, coagulopathy, and deficiency anemia. The most common malignancies were leukemia, lymphoma, metastatic tumor, and solid tumor without metastasis. We found significantly higher odds of in-hospital mortality among patients with TLS compared to general inpatient population on unadjusted (OR 9.69, 95% CI: 9.27-10.13, P < .001) and adjusted (OR 4.62, 95% CI: 4.39-4.85) multivariable analyses. Overall in-hospital mortality (32% vs 21.3%), median length of stay (11 days vs 9 days), and hospital charges were higher among arrhythmic than nonarrhythmic patients. CONCLUSION: With the availability of more advanced cancer therapy in the US, nearly one in four inpatient encounters of TLS had arrhythmia. Arrhythmia in TLS patients was associated with higher odds of mortality and increased resource utilization. Therefore, strategies to improve the supportive care of TLS patients plus timely diagnosis and treatment of arrhythmia are of utmost importance in reducing mortality and health-care cost.

16.
South Med J ; 113(6): 311-319, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32483642

RESUMO

OBJECTIVES: Prevalence and trends in all cardiovascular disease (CVD) risk factors among young adults (18-39 years) have not been evaluated on a large scale stratified by sex and race. The aim of this study was to establish the prevalence and temporal trend of CVD risk factors in US inpatients younger than 40 years of age from 2007 through 2014 with racial and sex-based distinctions. In addition, the impact of these risk factors on inpatient outcomes and healthcare resource utilization was explored. METHODS: A cross-sectional nationwide analysis of all hospitalizations, comorbidities, and complications among young adults from 2007 to 2014 was performed. The primary outcomes were frequency, trends, and race- and sex-based differences in coexisting CVD risk factors. Coprimary outcomes were trends in all-cause mortality, acute myocardial infarction, arrhythmia, stroke, and venous thromboembolism in young adults with CVD risk factors. Secondary outcomes were demographics and resource utilization in young adults with versus without CVD risk factors. RESULTS: Of 63 million hospitalizations (mean 30.5 [standard deviation 5.9] years), 27% had at least one coexisting CVD risk factor. From 2007 to 2014, admission frequency with CVD risk factors increased from 42.8% to 55.1% in males and from 16.2% to 24.6% in females. Admissions with CVD risk were higher in male (41.4% vs 15.9%) and white (58.4% vs 53.8%) or African American (22.6% vs 15.9%) patients compared with those without CVD risk. Young adults in the Midwest (23.9% vs 21.1%) and South (40.8% vs 37.9%) documented comparatively higher hospitalizations rates with CVD risk. Young adults with CVD risk had higher all-cause in-hospital mortality (0.4% vs. 0.3%) with a higher average length of stay (4.3 vs 3.2 days) and charges per admission ($30,074 vs $20,124). CONCLUSIONS: Despite modern advances in screening, management, and interventional measures for CVD, rising trends in CVD risk factors across all sex and race/ethnic groups call for attention by preventive cardiologists.


Assuntos
Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Doenças Vasculares Periféricas/epidemiologia , Fumar/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/etnologia , Asiático/estatística & dados numéricos , Bases de Dados Factuais , Diabetes Mellitus/etnologia , Dislipidemias/etnologia , Etnicidade/estatística & dados numéricos , Feminino , Hispânico ou Latino/estatística & dados numéricos , Mortalidade Hospitalar , Hospitalização , Humanos , Hipertensão/etnologia , Indígenas Norte-Americanos/estatística & dados numéricos , Masculino , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Obesidade/etnologia , Doenças Vasculares Periféricas/etnologia , Prevalência , Fatores de Risco , Fatores Sexuais , Fumar/etnologia , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etnologia , Estados Unidos/epidemiologia , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etnologia , População Branca/estatística & dados numéricos , Adulto Jovem
17.
Anticancer Agents Med Chem ; 20(14): 1739-1751, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32416700

RESUMO

BACKGROUND: Human P-glycoprotein (P-gp) is a transmembrane protein that belongs to the ATPBinding Cassette (ABC) transporters family. Physiologically, it exports toxins out of the cell, however, its overexpression leads to the phenomena of Multidrug-Resistance (MDR) by exporting a diverse range of compounds, which are structurally and chemically different from each other, thus creating a hurdle in the treatment of various diseases including cancer. The current study was designed to screen benzophenone sulfonamide derivatives as a class of inhibitors and potential anticancer agents for P-gp. METHODS: A total number of 15 compounds were evaluated. These compounds were screened in daunorubicin efflux inhibition assays using CCRF-CEM Vcr1000 cell line that overexpressed human P-gp. Cytotoxicity assay was also performed for active compounds 11, 14, and 13. These scaffolds were then docked in the homology model of human P-gp using mouse P-gp as a template (PDB ID: 4MIM) and the recently published Cryo Electron Microscopy (CEM) structure of human mouse chimeric P-gp to find their interactions with specified residues in the binding pocket. Analysis was performed using Labview VI and Graph pad prism version 5.0. RESULTS: Results revealed the potency of all these compounds in low nanomolar range whereas, compound 14 was found to be most active with IC50 value of 18.35nM±4.90 followed by 11 and 13 having IC50 values of 30.66nM±5.49 and 46.12nM±3.06, respectively. Moreover, IC50 values calculated for 14, 11 and 13 in cytotoxicity assay were found to be 22.97µM±0.026, 583.1µM±0.027 and 117.8µM±0.062, respectively. Docking results showed the interaction of these scaffolds in transmembrane helices (TM) where Tyr307, Tyr310, Tyr953, Met986 and Gln946 were found to be the major interaction partners, thus they might play a significant role in the transport of these scaffolds. CONCLUSION: Benzophenone sulfonamide derivatives showed IC50 values in low nanomolar range comparable to the standard inhibitor Verapamil, therefore they can be good inhibitors of P-gp and can serve as anticancer agents. Also, they have shown interactions in the transmembrane region sharing the same binding region of verapamil and zosuquidar.


Assuntos
Membro 1 da Subfamília B de Cassetes de Ligação de ATP/antagonistas & inibidores , Antineoplásicos/farmacologia , Benzofenonas/farmacologia , Sulfonamidas/farmacologia , Antineoplásicos/química , Benzofenonas/química , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Simulação de Acoplamento Molecular , Estrutura Molecular , Relação Estrutura-Atividade , Sulfonamidas/química
18.
Int J Cardiol ; 299: 63-66, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31611084

RESUMO

BACKGROUND: Patients with myasthenia gravis (MG) remain at a higher risk of developing takotsubo syndrome (TS), particularly during a myasthenic crisis (MC) event. The prevalence of MC-associated TS and its impact on subsequent in-hospital outcomes have not been explored previously. METHODS: We queried the National Inpatient Sample (NIS) databases (2007-2014) using weighted data and ICD-9 CM codes to evaluate the prevalence of MC-associated TS, demographics, comorbidities and inpatient outcomes of TS secondary to MC vs. other triggers. RESULTS: The nationwide prevalence of MC-associated TS was 0.3% (175/56,472). Of all 156,506 TS encounters, MC was present in 0.11% (n = 175) of cases. The groups were comparable in terms of demographics (median age 68-73 years, Caucasian >70%, females >80%). In comparison to non-MC TS, MC-associated TS demonstrated a higher frequency of coexisting diabetes and a lower frequency of smoking. The MC-TS cohort experienced significantly higher rates of all-cause mortality [8.6% vs. 4.7%, p = 0.014, unadjusted (OR1.91, p = 0.017) and adjusted (OR1.82, p = 0.038)] and complications including respiratory failure, the need of intubation/mechanical ventilation, and arrhythmia. The MC-TS cohort had fewer routine discharges and frequent transfers. The median stay was 6 days longer (10 vs. 4 days) and median hospital charges per admission were nearly $100,000 higher ($133,999 vs. $38,367) with MC-associated TS. CONCLUSIONS: This population-based analysis revealed a 15 times greater prevalence of secondary TS following MC as compared to the general inpatient population, a nearly 2 times higher odds of all-cause mortality, and significantly higher resource utilization in MC-associated TS as compared to TS triggered by other etiologies.


Assuntos
Efeitos Psicossociais da Doença , Hospitalização/tendências , Miastenia Gravis/mortalidade , Cardiomiopatia de Takotsubo/mortalidade , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Bases de Dados Factuais/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miastenia Gravis/diagnóstico , Miastenia Gravis/terapia , Respiração Artificial/tendências , Cardiomiopatia de Takotsubo/diagnóstico , Cardiomiopatia de Takotsubo/terapia
19.
J Interv Cardiol ; 2019: 2753146, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31772521

RESUMO

OBJECTIVES: To compare percutaneous mitral valve repair (PMVR) with optimal medical therapy (OMT) in patients with heart failure (HF) and severe functional mitral regurgitation (FMR). BACKGROUND: Many patients with HF and FMR are not suitable for surgical valve replacement and remain symptomatic despite maximal OMT. PMVR has recently emerged as an alternative solution. METHODS: We performed a systematic review and a meta-analysis to address this question. Cochrane CENTRAL, MEDLINE, and Scopus were searched for randomized (RCT) and nonrandomized studies comparing PMVR with OMT in patients with HF and FMR. Primary endpoint was all-cause midterm mortality (at 1 and 2 years). Secondary endpoints were 30-day mortality and cardiovascular mortality and HF hospitalizations, at maximum follow-up. Studies including mixed cohort of degenerative and functional MR were allowed initially but were excluded in a secondary sensitivity analysis for each of the study's end points. This meta-analysis was performed following the publication of two RCTs (MITRA-FR and COAPT). RESULTS: Eight studies (six observational, two RCTs) comprising 3,009 patients were included in the meta-analysis. In comparison with OMT, PMVR significantly reduced 1-year mortality (RR: 0.70 [0.56, 0.87]; p=0.002; I2=47.6%), 2-year mortality (RR: 0.63 [0.55, 0.73]; p<0.001; I2=0%), and cardiovascular mortality (RR: 0.32 [0.23, 0.44]; p<0.001; I2=0%). No significant difference between PMVR+OMT and OMT was noted in HF hospitalization (HR: 0.69 [0.40, 1.20]; p=0.19; I2=85%) and 30-day mortality (RR: 1.13 [0.68, 1.87]; p=0.16; I2=0%). CONCLUSIONS: In comparison with OMT, PMVR significantly reduces 1-year mortality, 2-year mortality, and cardiovascular mortality in patients with HF and severe MR.


Assuntos
Insuficiência da Valva Mitral/tratamento farmacológico , Insuficiência da Valva Mitral/cirurgia , Fármacos Cardiovasculares/uso terapêutico , Insuficiência Cardíaca/terapia , Implante de Prótese de Valva Cardíaca , Humanos , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/mortalidade
20.
Opt Lett ; 44(16): 3968-3971, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31415524

RESUMO

This Letter presents a framework for computational imaging (CI) in fiber-bundle-based endoscopy systems. Multiple observations are acquired of objects spatially modulated with different random binary masks. Sparse-recovery algorithms then reconstruct images with more resolved pixels than individual fibers in the bundle. Object details lying within the diameter of single fibers are resolved, allowing images with 41,663 resolvable points to be generated through a bundle with 2,420 fibers. Computational fiber bundle imaging of micro- and macro-scale objects is demonstrated using fluorescent standards and biological tissues, including in vivo imaging of a human fingertip. In each case, CI recovers details that conventional endoscopy does not provide.

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