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1.
QJM ; 115(12): 830-836, 2022 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-35866641

RESUMO

BACKGROUND: While progress is evident in gender and ethnic representation in the workplace, this disparity remains prevalent in academic positions. OBJECTIVES: We examined gender and Asian ethnic representation in editorial boards of cardiology journals. METHODS: A cross-sectional analysis was conducted using publicly available data on Cardiology and Cardiovascular medicine journals in the first quartile of the 2020 Scimago Journal & Country Rank indicator. The proportions of female and Asian editorial board members, associate editors and editors-in-chief were assessed. Subgroup analyses were conducted based on the journal's geographical origin, subspecialty and demographic of the editor-in-chief. RESULTS: Seventy-six cardiology journals, involving 8915 editorial board members, were included. Only 19.6% of editorial board members were female, 20.8% Asians and 4.0% Asian females. There were less female representation amongst editors-in-chief (9.9%) compared to associate editors (22.3%). European (18.1%) and North American-based journals (21.1%) had higher female representation compared to Asian-based journals (8.7%). There was lower Asian representation in European (18.1%) and North American-based journals (19.9%) compared to Asian-based journals (72.3%). Females were underrepresented in interventional (14.5%) journals, while Asians were underrepresented in general cardiology (18.3%) and heart failure (18.3%) journals. Journals led by female editors-in-chief had significantly higher female representation compared to male-led ones, while journals with Asian editors-in-chief had greater Asian representation compared to non-Asian led ones. CONCLUSION: This study highlights the female and Asian ethnic underrepresentation in academic roles in cardiology journal editorial boards. Further analysis is needed for other ethnicities, while the community pushes towards gender-balanced and ethnic diversity across editorial boards.


Assuntos
Asiático , Equidade de Gênero , Feminino , Humanos , Masculino , Estudos Transversais
2.
Clin Radiol ; 75(9): 714.e15-714.e20, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32591231

RESUMO

AIM: To differentiate dural arteriovenous fistula (DAVF) from reflux venous flow (RVF) by assessment of asymmetric enlargement of external carotid artery (ECA) branches on three-dimensional (3D) time-of-flight magnetic resonance angiography (TOF-MRA). MATERIALS AND METHODS: Nineteen patients with DAVF and 27 patients with RVF were included from September 2007 to April 2019. The locations of DAVF were the cavernous (n=9) and sigmoid-transverse (n=6) sinuses, and the jugular (n=3) and sphenoparietal (n=1) veins. Two radiologists visually assessed asymmetric enlargement of the ascending pharyngeal artery (ASP), middle meningeal artery (MMA), accessory meningeal artery (AMA), artery of the foramen rotundum, and occipital artery. MMA size was also measured quantitatively. RESULTS: More frequent asymmetric enlargement of the ASP and MMA were seen in DAVF than in RVF (17 of 19 versus 3 of 27 for ASP; 16 of 19 versus 1 of 27 for MMA, p<0.01). The AMA, artery of the foramen rotundum, and occipital arteries were not visualised in RVF patients. The ipsilateral MMA size was significantly larger in DAVF than in RVF (2.14 versus 0.64 mm2, p< 0.01). The diagnostic performance of ipsilateral MMA size for DAVF was good, with an area under the receiver operating characteristic curve of 0.89, with a sensitivity of 84.2% and a specificity of 81.5% at a cut-off of 1.08 mm2. CONCLUSIONS: DAVF showed significantly larger ECA branches than RVF on 3D TOF-MRA. Therefore, thorough evaluation of ECA branches could help to differentiate DAVF from RVF.


Assuntos
Artéria Carótida Externa/diagnóstico por imagem , Malformações Vasculares do Sistema Nervoso Central/diagnóstico , Angiografia Cerebral/métodos , Imageamento Tridimensional/métodos , Angiografia por Ressonância Magnética/métodos , Fluxo Sanguíneo Regional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Artéria Carótida Externa/fisiopatologia , Malformações Vasculares do Sistema Nervoso Central/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
3.
Clin Microbiol Infect ; 26(11): 1495-1500, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32062049

RESUMO

OBJECTIVES: To evaluate the effect of timing and appropriateness of antibiotics administration on mortality in patients diagnosed with sepsis according to the Sepsis-3 definition. METHODS: This prospective cohort study was conducted in patients diagnosed with sepsis according to the Sepsis-3 definition at the emergency department of Korea University Ansan Hospital from January 2016 to January 2019. The time to antibiotics was defined as the time in hours from emergency department arrival to the first antibiotic administration. Cox proportional hazards regression analysis was used to estimate the association between time to antibiotics and 7-, 14- and 28-day mortality. RESULTS: Of 482 patients enrolled onto this study, 203 (42.1%) of 482 and 312 (64.7%) of 482 were diagnosed with septic shock and high-grade infection respectively. The median time to receipt of antibiotic therapy was 115 minutes. Antibiotics were administered within 3 and 6 hours in 340 (70.4%) of 482 and 450 (93.2%) of 482 patients respectively. Initial appropriate empirical antibiotics were administered in 375 (77.8%) of 482 patients. The time to and appropriateness of the initial antibiotics were not associated with 7-, 14- and 28-day mortality in multivariate analysis. The Sequential Organ Failure Assessment (SOFA) score (adjusted hazard ratio (aHR) 1.229, 95% confidence interval (CI) 1.093-1.381, p 0.001) and initial lactate levels (aHR 1.128, 95% CI 1.034-1.230, p 0.007), Charlson comorbidity index (aHR 1.115, 95% CI 1.027-1.210, p 0.014), 2-hour lactate level (aHR 1.115, 95% CI 1.027-1.210, p 0.009) and SOFA score (aHR 1.077, 95% CI 1.013-1.144, p 0.018) affected 7-, 14- and 28-day mortality respectively. Subgroup analysis with septic shock, bacteraemia and high-grade infection did not affect mortality rates. CONCLUSIONS: Time to receipt of antibiotics may not affect the prognosis of patients with sepsis if a rapid and well-trained resuscitation is combined with appropriate antibiotic administration within a reasonable time.


Assuntos
Antibacterianos/administração & dosagem , Bacteriemia/tratamento farmacológico , Choque Séptico/tratamento farmacológico , Idoso , Antibacterianos/uso terapêutico , Bacteriemia/metabolismo , Feminino , Humanos , Ácido Láctico/análise , Masculino , Pessoa de Meia-Idade , Mortalidade , Análise Multivariada , Escores de Disfunção Orgânica , Prognóstico , Estudos Prospectivos , Choque Séptico/metabolismo , Choque Séptico/mortalidade , Fatores de Tempo , Tempo para o Tratamento
4.
Indoor Air ; 27(2): 320-328, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27007057

RESUMO

Whether indoor painting aggravates preexisting allergic diseases remains unclear. We aimed to evaluate the impact of new classroom painting on aggravation of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) in children. Studied school was previously painted with conventional water-based paint 20 years ago and had natural ventilation system. We identified a total of 172 children aged 10-12 years with allergic diseases in 17 classrooms, which were allocated to newly painted rooms with low-volatile organic compounds (VOC), water-based paint, or existing rooms. After painting, there was no intervention or internal airflow to influence indoor air environment in both classrooms. We prospectively assessed the symptom severity and serious events of allergic diseases between both classrooms at baseline and after one and eight weeks after painting. At one and eight weeks, there were no significant changes in the Childhood Asthma Control Test scores, the fractional nitric oxide levels, lung function in asthmatic children in either classroom. There were also no significant changes in the severity score of AR or AD, or serious events in all allergic diseases. These findings suggest classroom painting with this new paint at the levels encountered in this study might not be a major aggravating factor for school-aged children with allergic diseases.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Hipersensibilidade/etiologia , Pintura/toxicidade , Exacerbação dos Sintomas , Compostos Orgânicos Voláteis/toxicidade , Poluição do Ar em Ambientes Fechados/análise , Asma/induzido quimicamente , Criança , Dermatite Atópica/induzido quimicamente , Feminino , Humanos , Masculino , Pintura/análise , Estudos Prospectivos , Rinite Alérgica/induzido quimicamente , Compostos Orgânicos Voláteis/análise
5.
Int J Tuberc Lung Dis ; 20(9): 1174-80, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27510242

RESUMO

SETTING: The role of fractional exhaled nitric oxide (FeNO) in the diagnosis and treatment of pulmonary tuberculosis (PTB) is uncertain. OBJECTIVE: To examine the value of FeNO as a biomarker for PTB. DESIGN: Baseline FeNO levels were compared in 69 PTB patients and 118 healthy controls. The correlation between baseline FeNO levels and clinical variables of tuberculosis were studied. FeNO levels were checked twice in the PTB group, at diagnosis and after 2 months of anti-tuberculosis medication, and factors affecting changes in FeNO levels after treatment were analysed. RESULTS: FeNO levels were not significantly different in the PTB group and controls (mean ± standard deviation 27.7 ± 17.6 parts per billion [ppb] vs. 27.0 ± 10.8 ppb, P = 0.531). In a multivariate regression analysis, no variable was shown to affect FeNO levels at diagnosis. FeNO levels did not significantly change after 2 months of treatment (26.8 ± 18.3 ppb vs. 24.0 ± 10.7 ppb, P = 0.257). Only PTB with a high FeNO level (>25 ppb) was related to a decline in FeNO levels after 2 months of treatment. CONCLUSION: FeNO levels do not appear to be affected in PTB patients.


Assuntos
Expiração , Óxido Nítrico/análise , Tuberculose Pulmonar/diagnóstico , Adulto , Antituberculosos/uso terapêutico , Biomarcadores/análise , Índice de Massa Corporal , Peso Corporal , Testes Respiratórios , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Tuberculose Pulmonar/tratamento farmacológico
6.
AJNR Am J Neuroradiol ; 36(12): 2367-72, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26316569

RESUMO

BACKGROUND AND PURPOSE: Recently 4-hour delayed-enhanced 3D-FLAIR MR imaging has been used in pathophysiologic analysis of the inner ear in many auditory diseases, including sudden sensorineural hearing loss, but comparison among different time points is not clear in patients with unilateral inner ear symptoms. We compared the signal-intensity ratios of the inner ears in patients with unilateral inner ear symptoms on 10-minute delayed-enhanced and 4-hour delayed-enhanced 3D-FLAIR MR images after IV gadolinium injection. MATERIALS AND METHODS: The 10-minute delayed-enhanced and 4-hour delayed-enhanced 3D-FLAIR MR images were retrospectively analyzed. Signal-intensity ratios between the cerebellum and inner ear structures, such as the cochleae, vestibules, and vestibulocochlear nerve were assessed. Multiple comparisons were performed. RESULTS: Signal-intensity ratios of the affected cochleae, vestibules, and vestibulocochlear nerve were higher than those of unaffected sides in both 10-minute delayed-enhanced and 4-hour delayed-enhanced images. At the affected side, signal-intensity ratios of the vestibulocochlear nerve were higher in patients with nonsudden sensorineural hearing loss than in those with sudden sensorineural hearing loss on both 10-minute delayed-enhanced and 4-hour delayed-enhanced images. The signal-intensity ratios of some affected inner ear structures were higher than those of the unaffected sides in a group of 30 patients with sudden sensorineural hearing loss and 20 patients with nonsudden sensorineural hearing loss on 10-minute delayed-enhanced and 4-hour delayed-enhanced images. CONCLUSIONS: Signal-intensity ratios of the inner ear show statistically significant increases in many diseases, especially neuritis, in 10-minute delayed-enhanced and 4-hour delayed-enhanced images. The 4-hour delayed-enhanced images may be superior in neural inflammatory-dominant conditions, while 10-minute delayed-enhanced images may be superior in neural noninflammatory-dominant conditions.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Adulto , Meios de Contraste , Orelha Interna/patologia , Feminino , Gadolínio , Humanos , Aumento da Imagem/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
7.
Clin Microbiol Infect ; 20(10): O721-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24330047

RESUMO

In patients with community-onset acute pyelonephritis (CO-APN), assessing the risk factors for poor clinical response after 72 h of antibiotic treatment (early clinical failure) is important. The objectives of this study were to define those risk factors, and to assess whether early clinical failure influences mortality and treatment outcomes. We prospectively collected the clinical and microbiological data of women with CO-APN in South Korea from March 2010 to February 2012. The numbers of cases in the early clinical success and early clinical failure groups were 840 (79.1%) and 222 (20.9%), respectively. Final clinical failure and mortality were higher in the early clinical failure group than in the early clinical success group (14.9% vs 2.3%, p <0.001; 6.8% vs 0.1%, p 0.001, respectively). In a multiple logistic regression model, the risk factors for early clinical failure among the total 1062 patients were diabetes mellitus (OR 1.5; 95% CI 1.1-2.1), chronic liver diseases (OR 3.3; 95% CI 1.6-6.7), malignancy (OR 2.2; 95% CI 1.1-4.4), Pitt score ≥2 (OR 2.5; 95% CI 1.6-3.8), presence of azotaemia (OR 1.8; 95% CI 1.2-2.7), white blood cell count ≥20 000/mm(3) (OR 2.5; 95% CI 1.6-4.0), serum C-reactive protein level ≥20 mg/dL (OR 1.7; 95% CI 1.2-2.4), and history of antibiotic usage within the previous year (OR 1.5; 95% CI 1.1-2.2). Analysing the subgroup of 743 patients with CO-APN due to Enterobacteriaceae, fluoroquinolone resistance of the uropathogen was another factor associated with early clinical failure (OR 1.7; 95% CI 1.1-2.5). Simple variables of underlying diseases, previous antibiotic usage and initial laboratory test outcomes can be used to decide on the direction of treatment in CO-APN.


Assuntos
Antibacterianos/administração & dosagem , Pielonefrite/tratamento farmacológico , Pielonefrite/mortalidade , Adulto , Idoso , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/mortalidade , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Regressão , República da Coreia/epidemiologia , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Falha de Tratamento
8.
Infection ; 41(3): 603-12, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23504297

RESUMO

OBJECTIVES: The aim of this study was to determine the risk factors and clinical characteristics of community-acquired acute pyelonephritis (CA-APN) caused by extended-spectrum ß-lactamase (ESBL)-producing organisms. METHODS: From March 2010 to February 2011, patients with CA-APN were recruited in 11 hospitals in South Korea. Clinical and microbiological data were collected prospectively, and the ESBLs and multilocus sequence types of the ESBL-producing Escherichia coli were characterized. Comparison between CA-APN caused by ESBL-producing Enterobacteriaceae and those by non-ESBL-producing organisms was performed. RESULTS: A total of 566 patients were recruited. Enterobacteriaceae were detected in 526 patients. Forty-six isolates (46/526, 8.7 %) were positive for ESBLs. Clinical and microbiological failure did not differ between the two groups, despite there being fewer patients with ESBL-positive isolates provided with appropriate antibiotics initially (19.6 vs. 93.8 %, p < 0.001). However, the duration of hospitalization was longer in the ESBL group (10.5 vs. 7.0 days, p = 0.012). In a logistic regression model, Charlson score ≥1 point [odds ratio (OR) 3.4, 95 % confidence interval (CI) 1.6-7.0, p = 0.001], antibiotics usage during the previous year (OR 3.1, 95 % CI 1.4-7.2, p = 0.008), and urinary catheterization during the previous month (OR 4.4, 95 % CI 1.1-17.6, p = 0.035) were associated with the risks of CA-APN by ESBL producers. CTX-M-15 (48 %) and CTX-M-14 (38 %) were the most common ESBLs. ST131 was the most common clone (7/24, 29.1 %), which was more frequently resistant to cefepime, fosfomycin, and temocillin. CONCLUSIONS: The risk factors for CA-APN by ESBL producers were Charlson score ≥1 point, antibiotics usage during the previous year, and urinary catheterization during the previous month.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Infecções por Enterobacteriaceae/epidemiologia , Enterobacteriaceae/enzimologia , Pielonefrite/epidemiologia , beta-Lactamases/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/patologia , Enterobacteriaceae/classificação , Enterobacteriaceae/genética , Enterobacteriaceae/isolamento & purificação , Infecções por Enterobacteriaceae/microbiologia , Infecções por Enterobacteriaceae/patologia , Humanos , Pessoa de Meia-Idade , Tipagem de Sequências Multilocus , Estudos Prospectivos , Pielonefrite/microbiologia , Pielonefrite/patologia , República da Coreia/epidemiologia , Fatores de Risco
9.
Eur J Surg Oncol ; 39(2): 191-6, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22863305

RESUMO

AIMS: Adequate evaluation and surgical management of cervical lymph node metastasis is very important in papillary thyroid carcinoma (PTC). The aim of this study was to evaluate the impact of preoperative ultrasonography (US) and computed tomography (CT) on the surgical management of cervical lymph node metastases in PTC. METHODS: Medical records and imaging findings were retrospectively analyzed for 252 patients with PTC who underwent thyroidectomy with neck dissection. RESULTS: The sensitivity of both imaging techniques was lower in the central neck (US 23%, CT 41%) than in the lateral neck (US 70%, CT 82%). The specificities of US and CT were 97% and 90% in the central neck, and 84% and 64% in the lateral neck, respectively. Our surgical plans for therapeutic neck dissection were based on imaging findings in 59% of patients who underwent lateral compartment neck dissection and in 32.1% of patients who underwent central compartment neck dissection, respectively. CONCLUSIONS: The roles of preoperative US and CT in surgical planning for central compartment neck dissection in PTC are limited because of their low sensitivity in the central neck, but US and CT may be useful in cases with non-palpable lateral neck nodes.


Assuntos
Carcinoma/cirurgia , Linfonodos/diagnóstico por imagem , Esvaziamento Cervical , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/patologia , Carcinoma Papilar/cirurgia , Feminino , Humanos , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Palpação , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/patologia , Ultrassonografia
10.
Dalton Trans ; 41(46): 14197-203, 2012 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-23047727

RESUMO

We demonstrate a much green synthesis method for highly selective synthesis of 6,8-di-t-butylated flavan (6,8-DTBF) by liquid phase alkylation of 2,4-di-t-butylphenol (2,4-DTBP) with cinnamyl alcohol (Cin-OH) over mesoporous Zn-Al-MCM-41 catalysts synthesized under direct basic hydrothermal method. The main alkylated product, 6,8-DTBF is importantly used as an intermediate in the manufacture of biosynthetic organic compounds. The recyclable mesoporous Zn-Al-MCM-41 catalysts have also been reused in this reaction to study their catalytic activities. The influences of various reaction parameters such as temperature, time, ratios of reactant (2,4-DTBP-to-Cin-OH) have been extensively investigated for the synthesis of 6,8-DTBF. In addition, dimethyl sulfoxide (DMSO) has also been used as a solvent in this catalytic reaction. The mesoporous Zn-Al-MCM-41(75) gives excellent catalytic activity with 6,8-DTBF selectivity (86.0%) and 2,4-DTBP conversion (63.1%), and these catalytic results have also compared with that obtained using other mesoporous and microporous catalysts. On the basis of catalytic activity obtained by using the all catalysts, the Zn-Al-MCM-41(75) catalyst is found to be a highly active, recyclable and eco-friendly heterogeneous catalyst in the liquid-phase alkylation of 2,4-DTBP.

11.
Dalton Trans ; 41(46): 14204-10, 2012 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-23064633

RESUMO

We approach a green method in the production of alkylaromatic ketones over hexagonally ordered mesoporous CrSBA-15 catalysts, which were used, in green routes, in the liquid-phase oxidation of alkylaromatics. A promising chemical treatment method was used with ammonium acetate solution to remove the toxic nature of non-framework chromium oxides deposited on the surface of calcined CrSBA-15(8), and the obtained green mesoporous CrSBA-15(8) catalyst was used to find its catalytic activity while the recyclability of mesoporous CrSBA-15 catalysts was also studied. Particularly, the mesoporous CrSBA-15 catalysts synthesized with a variety of chromium contents were extensively used in the production of acetophenone (AP=O) with various reaction parameters. On the basis of all catalytic results, the mesoporous CrSBA-15(8) catalyst produced a higher selectivity of alkylaromatic ketones (76-100%) as compared to other CrSBA-15 catalysts and was found to be a highly active, recyclable and promising heterogeneous catalyst for selective synthesis of alkylaromatic ketones.

12.
Dalton Trans ; 41(32): 9633-8, 2012 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-22797675

RESUMO

Well hexagonally ordered NbSBA-15 catalysts synthesized by an efficient hydrothermal method were used, for the first time, for the selective synthesis of vitamin K(3) by liquid-phase oxidation of 2-methyl-1-naphthol (2MN1-OH) under various reaction conditions. The recyclable NbSBA-15 catalysts were also reused to find their catalytic activities. To investigate the leaching of non-framework niobium species on the surface of silica networks, the results of original and recyclable NbSBA-15 catalysts were correlated and compared. To find an optimum condition for the selective synthesis of vitamin K(3), the washed NbSBA-15(2.2pH) was extensively used in this reaction with various reaction parameters such as temperature, time and ratios of reactant (2M1N-OH to H(2)O(2)), and the obtained results were also demonstrated. Additionally, the liquid-phase oxidation of 2M1N-OH was carried out with different solvents to find the best solvent with a good catalytic activity. Based on the all catalytic studies, the vitamin K(3) selectivity (97.3%) is higher in NbSBA-15(2.2pH) than that of other NbSBA-15 catalysts, and the NbSBA-15(2.2pH) is found to be a highly active and eco-friendly heterogeneous catalyst for the selective synthesis of vitamin K(3).


Assuntos
Naftóis/química , Nióbio/química , Dióxido de Silício/química , Vitamina K 3/síntese química , Catálise , Oxirredução , Porosidade , Temperatura
13.
Clin Microbiol Infect ; 17(7): 1084-90, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20946409

RESUMO

An outbreak of post-acupuncture cutaneous infections due to Mycobacterium abscessus occurred in Ansan, Korea, from November 2007 through to May 2008. During this time a prospective, observational, non-randomized study was conducted involving 52 patients that were diagnosed with cutaneous M. abscessus infection. We compared the clinical response between patients treated with clarithromycin plus amikacin regimen and those treated with clarithromycin plus moxifloxacin regimens with regard to time to resolution of the cutaneous lesions. Among the 52 study patients, 33 were treated with clarithromycin plus amikacin, and 19 were treated with clarithromycin plus moxifloxacin. The baseline characteristics for the treatment groups were not significantly different, except for initial surgical excision (n = 27 vs. 6, respectively, p = 0.001). The median time (weeks) to resolution of the lesions in the clarithromycin plus moxifloxacin-treated subjects was significantly shorter than that in the clarithromycin plus amikacin-treated subjects (17 ± 1.1 vs. 20 ± 0.9, respectively, p = 0.017). With adjustments for age, location of lesions, prior incision and drainage, and excision during medical therapy, clarithromycin plus moxifloxacin-treated subjects were more likely to have resolved lesions (hazard ratio, 0.387; 95% confidence interval, 0.165-0.907; p = 0.029). The frequency of drug-related adverse events in the two treatment groups was not significantly different (n = 18 vs. 14, respectively; p = 0.240). The most common adverse event was gastrointestinal discomfort. The results of our study showed that the combination regimen of clarithromycin and moxifloxacin resulted in a better clinical response than a regimen of clarithromycin plus amikacin when used for treatment of cutaneous M. abscessus infection.


Assuntos
Amicacina/administração & dosagem , Compostos Aza/administração & dosagem , Claritromicina/administração & dosagem , Infecções por Mycobacterium/tratamento farmacológico , Infecções por Mycobacterium/epidemiologia , Quinolinas/administração & dosagem , Dermatopatias Bacterianas/tratamento farmacológico , Dermatopatias Bacterianas/epidemiologia , Terapia por Acupuntura/efeitos adversos , Amicacina/efeitos adversos , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Compostos Aza/efeitos adversos , Claritromicina/efeitos adversos , Surtos de Doenças , Quimioterapia Combinada/efeitos adversos , Quimioterapia Combinada/métodos , Feminino , Fluoroquinolonas , Humanos , Coreia (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Moxifloxacina , Mycobacterium/isolamento & purificação , Estudos Prospectivos , Quinolinas/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
15.
Vet Parasitol ; 163(1-2): 123-6, 2009 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-19450929

RESUMO

Avian coccidiosis is caused by several distinct species of Eimeria protozoa and is the major parasitic disease of poultry of economic importance. As an alternative strategy to control avian coccidiosis without using prophylactic medications, we have investigated the efficacy of inducing passive immunity against coccidiosis by orally feeding hyperimmune IgY antibodies. In this study, a commercially available egg yolk powder, Supracox (SC), a purified IgY fraction of egg yolk prepared from hens hyperimmunized with three major species of Eimeria oocysts, were continuously fed to young chicks from hatch. Upon orally infecting these broiler chicks with Eimeria tenella and Eimeria maxima oocysts at 1 week of age, they showed significantly higher body weight gains (P<0.05) compared to the untreated controls. Furthermore, SC-fed chicks showed significantly less intestinal lesions and reduced fecal oocyst output compared to the untreated controls following oral infections with E. tenella and E. maxima. These results provide clear evidence that passive immunization of chicks with hyperimmune egg yolk IgY antibodies provide significant protection against E. tenella or E. maxima infections.


Assuntos
Anticorpos Antiprotozoários/imunologia , Galinhas , Coccidiose/prevenção & controle , Gema de Ovo/imunologia , Imunoglobulinas/imunologia , Doenças das Aves Domésticas/prevenção & controle , Animais , Suplementos Nutricionais , Relação Dose-Resposta Imunológica , Eimeria , Fezes/parasitologia , Oocistos , Doenças das Aves Domésticas/imunologia , Aumento de Peso
16.
Poult Sci ; 88(3): 562-6, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19211525

RESUMO

The protective effect of hyperimmune IgY fraction of egg yolk prepared from hens hyperimmunized with multiple species of Eimeria oocysts on experimental coccidiosis was evaluated in young broilers. Chickens were continuously fed from hatch with a standard diet containing hyperimmune IgY egg yolk powder or a nonsupplemented control diet and orally challenged at d 7 posthatch with 5.0 x 10(3) sporulated Eimeria acervulina oocysts. Body weight gain between d 0 and 10 and fecal oocyst shedding between d 5 and 10 postinfection were determined as parameters of protective immunity. Chickens given 10 or 20% hyperimmune IgY egg yolk powder showed significantly increased BW gain and reduced fecal oocyst shedding compared with control birds fed the nonsupplemented diet. In another trial, lower IgY concentrations (0.01, 0.02, and 0.05%) were used to treat birds with 1.0 x 10(4) oocysts of E. acervulina. Total oocyst shedding was significantly (P < 0.05) reduced in chickens fed the 0.02 and 0.05% hyperimmune IgY supplemented-diets compared with animals fed the nonsupplemented diet. Similarly, chickens fed 0.5% of hyperimmune IgY egg yolk powder diet and challenged with 1.0 x 10(4) oocysts exhibited reduced oocyst shedding compared with the control birds given 0.5% of IgY from nonimmunized hen eggs, although BW gain was not affected. We conclude that passive immunization of chickens with anti-coccidia IgY antibodies provide protective immunity against coccidiosis challenge infection.


Assuntos
Galinhas , Coccidiose/veterinária , Proteínas do Ovo/imunologia , Eimeria , Imunoglobulinas/imunologia , Doenças das Aves Domésticas/prevenção & controle , Ração Animal , Animais , Coccidiose/imunologia , Coccidiose/parasitologia , Dieta/veterinária , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Fezes/parasitologia , Imunoglobulinas/administração & dosagem , Doenças das Aves Domésticas/parasitologia , Aumento de Peso
17.
Emerg Med J ; 25(10): 659-65, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18843064

RESUMO

OBJECTIVE: To compare the prognostic abilities of lactic acidosis and hyperlactatemia and determine the influence of metabolic acidosis when attempting to predict the outcome of septic patients using serum lactate levels. METHOD: 126 patients with severe sepsis or septic shock were prospectively included in this study at an emergency department. Haemodynamic variables, simplified acute physiology score (SAPS) II, arterial blood gas studies and serum lactate levels were obtained at the time of presentation (0 h) and 4 h after presentation. The probability of mortality was calculated using SAPS II scores and compared with actual inhospital mortality at different serum lactate levels and arterial pH. Survival curves for lactic acidosis and severe hyperlactatemia were analysed using the Kaplan-Meier method. RESULTS: The calculated probability of mortality decreased from 35.7% (95% CI 30.2 to 41.2) at presentation to 29.3% (95% CI 24.2 to 34.4) at 4 h post-presentation. 27.0% of patients (34) died in hospital. Arterial pH and SAPS II scores were independent factors for predicting mortality of septic patients, at 0 h and 4 h. Serum lactate levels were closely related to severity of illness and metabolic acidosis in septic patients. Patients with lactic acidosis had significantly higher inhospital mortality than patients with normal pH and normal lactate levels by Kaplan-Meier survival analysis as determined based on measurements made at 0 h and 4 h (p<0.001, p<0.001 by the log-rank test, respectively). No significant difference in survival was found between patients with hyperlactatemia and those with normal pH and serum lactate levels. CONCLUSION: Lactic acidosis not hyperlactatemia was found to predict inhospital mortality more exactly in severe sepsis and septic shock patients. The acid-base state should be considered when attempting to predict the outcome of septic patients using serum lactate levels.


Assuntos
Acidose Láctica/mortalidade , Mortalidade Hospitalar , Ácido Láctico/sangue , Sepse/mortalidade , Acidose Láctica/sangue , Serviço Hospitalar de Emergência , Métodos Epidemiológicos , Feminino , Humanos , Concentração de Íons de Hidrogênio , Masculino , Pessoa de Meia-Idade , Prognóstico , Sepse/sangue , Índice de Gravidade de Doença , Análise de Sobrevida
18.
Dev Biol (Basel) ; 132: 131-140, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18817295

RESUMO

Two M5.1 and M15.2 B complex congenic lines of Fayoumi chickens were evaluated for body weight loss and faecal oocyst counts as parameters of avian coccidiosis. M5.1 chickens exhibited resistance to E. maxima compared with M15.2. To correlate the differential responses of the M5.1 and M15.2 lines to E. maxima infection with cellular immune responses, the expression levels of mRNAs encoding 14 immune-related molecules were measured by quantitative RT-PCR in intestinal intraepithelial lymphocytes (IELs) and splenocytes at 0, 3, 4, and 5 days following parasite infection. Intestinal IELs from M5.1 chickens expressed higher levels of transcripts encoding interferon gamma (IFNG), interleukin-lbeta (1L1B), IL6, IL8, IL12, IL15, IL17A, inducible nitric oxide synthase (iNOS), and lipopolysaccharide-induced tumour necrosis a factor (LITAF), and lower levels of mRNAs for IFNA, IL10, IL17D, NK-lysin (NKL), and tumour necrosis factor superfamily 15 (TNFSF15) at 3 days post infection, compared with the M15.2 line. In the spleen, E. maxima infection was associated with higher expression levels of IFNA, and IL15 and lower levels of IL6, IL17D, and IL12 in M5.1 compared to M15.2 birds. Using an intestinal IEL cDNA microarray, the differential dynamics of gene expression in the gut of M5.1 and M15.2 chickens following experimental coccidiosis were evident. In particular, the genes encoding lymphotactin and parathymosin were expressed at significantly higher levels in M5.1 compared with M15.2 line chickens. In conclusion, genetic determinants within the chicken major histocompatibility complex (MHC) B complex influence resistance to E. maxima infection by controlling the local and systemic expression of immune-related cytokine and chemokine genes.


Assuntos
Galinhas/genética , Coccidiose/veterinária , Eimeria/isolamento & purificação , Regulação da Expressão Gênica , Sistema Imunitário/imunologia , Animais , Coccidiose/genética , Coccidiose/imunologia , Análise de Sequência com Séries de Oligonucleotídeos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Especificidade da Espécie
19.
Poult Sci ; 87(3): 433-43, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18281568

RESUMO

To investigate the influence of genetic differences in the MHC on susceptibility to avian coccidiosis, M5.1 and M15.2 B-haplotype-disparate Fayoumi chickens were orally infected with live Eimeria maxima oocysts, and BW gain, fecal oocyst production, and expression of 14 immune-related genes were determined as parameters of protective immunity. Weight loss was reduced and fecal parasite numbers were lower in birds of the M5.1 line compared with M15.2 line birds. Intestinal intraepithelial lymphocytes from M5.1 chickens expressed greater levels of transcripts encoding interferon-gamma (IFN-gamma), interleukin-1beta (IL-1beta), IL-6, IL-8, IL-12, IL-15, IL-17A, inducible nitric oxide synthase, and lipopolysaccharide-induced tumor necrosis factor-alpha factor and lower levels of mRNA for IFN-alpha, IL-10, IL-17D, NK-lysin, and tumor necrosis factor superfamily 15 compared with the M15.2 line. In the spleen, E. maxima infection was associated with greater expression levels of IFN-gamma, IL-15, and IL-8 and lower levels of IL-6, IL-17D, and IL-12 in M5.1 vs. M15.2 birds. These results suggest that genetic determinants within the chicken MHC influence resistance to E. maxima infection by controlling the local and systemic expression of immune-related cytokine and chemokine genes.


Assuntos
Galinhas , Coccidiose/veterinária , Eimeria/imunologia , Enteropatias Parasitárias/veterinária , Complexo Principal de Histocompatibilidade , Doenças das Aves Domésticas/imunologia , Animais , Coccidiose/imunologia , Suscetibilidade a Doenças/veterinária , Fezes/parasitologia , Expressão Gênica , Predisposição Genética para Doença , Enteropatias Parasitárias/imunologia , Mucosa Intestinal/imunologia , Mucosa Intestinal/parasitologia , Complexo Principal de Histocompatibilidade/genética , Complexo Principal de Histocompatibilidade/imunologia , Oocistos , Contagem de Ovos de Parasitas/veterinária
20.
Poult Sci ; 86(1): 63-6, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17179417

RESUMO

Coccidiosis is the major parasitic disease of poultry and is caused by the apicomplexan parasites Eimeria. Drugs and live vaccines are the 2 main control measures of the disease; however, due to increasing concerns with prophylactic drug use and the high cost of vaccines, alternative control methods are needed. Recent evidence that various dietary and live microbial supplements can influence host immunity against enteric diseases prompted us to investigate the role of a Pediococcus-based probiotic on coccidiosis in broiler chickens. In the present study, we examined BW gains, oocyst shedding, and antibody responses of broilers fed the commercial probiotic MitoGrow. Day-old chicks were fed either a regular broiler diet or 1 of 2 probiotic diets supplemented with 0.1% (MG 0.1) or 0.2% MitoGrow. Chicks were orally challenged with 5,000 or 10,000 sporulated oocysts of Eimeria acervulina or with 5,000 Eimeria tenella oocysts on d 10 or 12 of age, respectively. In E. acervulina-infected birds, the MG 0.1 group improved (P < 0.05) weight gain as compared with the other 2 groups and reduced (P < 0.05) oocyst shedding in birds infected with 5,000 E. acervulina oocysts. In E. tenella-infected birds, Eimeria-specific antibody levels were higher (P < 0.05) in the Mito-Grow-fed groups, especially in the MG 0.1 birds, compared with the regular diet group, although their oocyst shedding and weight gains were not clearly improved. These results demonstrate that this Pediococcus acidilactici-based probiotic effectively enhances the resistance of birds and partially protects against the negative growth effects associated with coccidiosis, particularly when supplemented at 0.1% MitoGrow of the diet.


Assuntos
Coccidiose/veterinária , Pediococcus/fisiologia , Doenças das Aves Domésticas/prevenção & controle , Doenças das Aves Domésticas/parasitologia , Probióticos/uso terapêutico , Ração Animal , Animais , Anticorpos Antiprotozoários/sangue , Galinhas/microbiologia , Galinhas/parasitologia , Coccidiose/parasitologia , Coccidiose/prevenção & controle , Dieta/veterinária , Eimeria , Oocistos , Doenças das Aves Domésticas/microbiologia , Aumento de Peso
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