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5.
Rev Prat ; 73(7): 727-728, 2023 Sep.
Artigo em Francês | MEDLINE | ID: mdl-37796257

RESUMO

NEIGHBOURHOOD NOISE POLLUTION IN HOUSING. The discomfort caused by environmental noise in home living space is very frequently observed in our time, its consequences are underestimated. The genesis of this nuisance lies in the poor quality of buildings, which are subject to a series of regulations and obligations that are often not respected, as well as incivism and non-compliance with Public Health Code decrees governing noise emissions from various activities. Physician practitioners or specialists are sometimes solicited by their patients on the repercussions on their health and on the action to be taken to obtain a reduction of this nuisance.


GESTION DE LA POLLUTION SONORE LIÉE AU VOISINAGE. La gêne provoquée par les bruits de l'environnement dans l'espace de vie à domicile constitue une doléance fréquente en milieu urbain. Dans la genèse de ces nuisances interviennent la mauvaise qualité des constructions soumises à une série de réglementations et d'obligations souvent non respectées, et l'incivisme et le non-respect des décrets du code de la santé publique régissant les émissions sonores de diverses activités. Les médecins ou spécialistes sollicités par leurs patients doivent en connaître les conséquences cliniques, socio-comportementales et économiques souvent sous-estimées, et la conduite à tenir pour obtenir une réduction de ces nuisances.


Assuntos
Habitação , Ruído , Humanos , Ruído/efeitos adversos , Saúde Pública
7.
PLoS One ; 18(9): e0291201, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37708111

RESUMO

BACKGROUND: Job satisfaction is an important factor affecting job performance and turnover of healthcare workers, especially hospital pharmacists. Nevertheless, limited studies have reported this issue in the context of Vietnam. OBJECTIVES: To help maintain the quality and size of the limited hospital pharmacy workforce in Vietnam, especially in the Mekong Delta area, this study investigated the job satisfaction of hospital pharmacists, and the associated factors, in Vinh Long province, a representative province in the central Mekong Delta. METHODS: A cross-sectional survey was conducted, recruiting hospital pharmacists working in all 17 province/district-affiliated healthcare facilities across Vinh Long province, Vietnam, between August and September 2022. RESULTS: Among the 235 survey participants (representing a response rate of 97.1%), 189 pharmacists (80.4%) reported that they were satisfied with their job. Working conditions, leadership styles, and benefits were factors found to significantly influence job satisfaction. Pharmacists who had worked in the field for 3-5 years (OR = 3.752, 95% CI = 1.036-13.595), more than 5 years (OR = 6.361, 95% CI = 2.264-17.875), did not have additional duties besides their primary responsibilities (OR = 2.046, 95% CI = 1.005-4.163), and worked in a private healthcare facility (OR = 12.021, 95% CI = 1.470-98.316), were significantly more likely to be satisfied with their job. CONCLUSIONS: Most hospital pharmacists were satisfied with their current job. To further improve job satisfaction in this population, further improvements to working conditions are necessary.


Assuntos
Satisfação no Emprego , Farmacêuticos , Humanos , Estudos Transversais , Vietnã , Recursos Humanos em Hospital , Hospitais
8.
J Clin Lab Anal ; 37(15-16): e24958, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37621139

RESUMO

OBJECTIVE: To develop and validate an LC-M/SMS method for the determination of tacrolimus in human whole blood. METHOD: The LC-MS/MS method for the determination of tacrolimus in whole blood was developed and validated according to the guidelines. Concentrations of TAC in 100 kidney transplant patients measured by LC-MS/MS were compared with CMIA using correlation analysis and Bland-Altman plots. RESULTS: The method had a total chromatographic run time of 5 min. The calibration curves were linear over the range of 0.5-100.0 ng/mL with a lower limit of quantification of 1 ng/mL. The intra- and interday accuracy was within the range of 93.3%-109.2% and 96.0%-108.4%, respectively, with precision ranging from 0.8 to 9.4%. The mean extraction recoveries of TAC ranged from 102.6 to 107.8%. The mean concentrations of TAC in whole blood of kidney transplant patients measured by the two assays were different at 1, 3 months and all time points (p < 0.001), but no significant difference was observed at 6 months (p = 0.094). The correlation of data was good with the correlation coefficients (r2 ) of 0.7581, 0.8811, 0.8777, and 0.8077, respectively. Passing-Bablok regression analysis demonstrated good correlations with r2 values higher than 0.88 between TAC levels measured by LC-MS/MS and CMIA. Using Bland-Altman plots yielded average biases of 1.29, 0.79, 0.11, and 0.65 ng/mL at 1, 3, and 6 months and all time points. CONCLUSION: The LC-MS/MS method was validated for the accurate determination of TAC in human whole blood. The comparison of tacrolimus concentrations measured by the LC-MS/MS with CMIA showed a good correlation and agreement of two methods, suggesting LC-MS/MS should be used routinely to monitor TAC concentrations in kidney transplant patients.


Assuntos
Transplante de Rim , Tacrolimo , Humanos , Cromatografia Líquida/métodos , Espectrometria de Massas em Tandem/métodos , Monitoramento de Medicamentos/métodos , Imunossupressores
9.
J Phys Chem B ; 127(31): 7091-7102, 2023 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-37527454

RESUMO

A thorough understanding of the relevant factors governing the transport of nanoparticles in poly(ethylene glycol) diacrylate (PEGDA) is crucial for many applications utilizing this polymer. Here, single-particle tracking (SPT) was used to systematically investigate the role of the probe size (3-200 nm) on the diffusion behaviors of individual fluorescent nanoparticles in semidilute and unentangled PEGDA solutions. The quantitative assessment of the SPT data via the recorded single-particle trajectories and diffusion coefficients (D) not only showed that the observed probe dynamics in PEGDA were temporally and spatially heterogeneous, but more importantly that the measured D were observed to be significantly reduced (vs in solvent) and strongly size-dependent. We explained these results based on a modified multiscale model for particle diffusion, built upon well-established hydrodynamics and obstruction theories. We furthermore showed that the presence of steric interactions and probe confinement effects in highly crowded, unentangled PEGDA microstructures can lead to deviations in the single-particle displacements from the expected Gaussian behavior, as revealed by the van Hove displacement distributions and the associated non-Gaussian parameters. This study has demonstrated the power of SPT methods in offering an advanced characterization of the transport characteristics in complex polymer structures, overcoming challenges posed by traditional characterization techniques.

10.
J Clin Med ; 12(15)2023 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-37568502

RESUMO

AIM: Since beds are unavailable, we prospectively investigated whether early hospital discharge will be safe and useful in patients hospitalized for COVID-19, regardless of their need for home oxygen therapy. POPULATION AND METHODS: Extending the initial inclusion criteria, 62 patients were included and 51 benefited from home telemonitoring, mainly assessing clinical parameters (blood pressure, heart rate, respiratory rate, dyspnea, temperature) and peripheral saturation (SpO2) at follow-up. RESULTS: 47% of the patients were older than 65 years; 63% needed home oxygen therapy and/or presented with more than one comorbidity. At home, the mean time to dyspnea and tachypnea resolutions ranged from 21 to 24 days. The mean oxygen-weaning duration was 13.3 ± 10.4 days, and the mean SpO2 was 95.7 ± 1.6%. The nurses and/or doctors managed 1238 alerts. Two re-hospitalizations were required, related to transient chest pain or pulmonary embolism, but no death occurred. Patient satisfaction was good, and 743 potential days of hospitalization were saved for other patients. CONCLUSION: The remote monitoring of vital parameters and symptoms is safe, allowing for early hospital discharge in patients hospitalized for COVID-19, whether or not home oxygen therapy was required. Oxygen tapering outside the hospital allowed for a greater reduction in hospital stay. Randomized controlled trials are necessary to confirm this beneficial effect.

11.
Radiol Case Rep ; 18(10): 3598-3602, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37577079

RESUMO

Acute promyelocytic leukemia is a special type of acute myeloid leukemia. Patients with this disease are at high risk of complications. Right atrial thrombosis is a rare but potentially serious complication. A 55-month-old girl with acute promyelocytic leukemia M3 was in her last phase of treatment. Radiologic examination revealed an echo structure in the right atrium that was still present after 6 weeks of anticoagulation treatment with enoxaparin. Cardiac surgery was performed to remove the mass, which was found to be a calcified thrombus. Although this is a rare occurrence, recognition of the possibility of a calcified thrombus may minimize misdiagnosis and allow surgical retrieval if the thrombus is sufficiently large.

12.
Radiol Case Rep ; 18(9): 2903-2906, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37388535

RESUMO

Primary pericardial mesothelioma is an extremely rare cancer with a short survival prognosis. Clinical symptoms are often atypical, and most patients are diagnosed after surgery or at autopsy. We report a case of a 35-year-old female patient with multiple serous membrane effusion for more than 1 year. The patient underwent pericardial, pleural, and peritoneal fluid drainage many times and underwent many laboratory tests to find the cause; however, there was no definitive diagnosis. She was admitted to the hospital because of shortness of breath, cough, and sputum for 5 days. She underwent extensive pericardiectomy to resolve the dyspnea and pericardial surgery to find the cause of the multiple serous membrane effusion. After surgery, her dyspnea was relieved, and the serous effusion gradually decreased.

13.
Sarcoidosis Vasc Diffuse Lung Dis ; 40(2): e2023023, 2023 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-37382068

RESUMO

Sarcoidosis is a multisystemic granulomatous disease of unknown origin. It has been argued that the skin is one of the entry doors of the possible antigen that causes sarcoidosis and after entering the skin, the causal agent may progress to the underlying bone. We report four cases with development of sarcoidosis in old scars located on the forehead, and contiguous bone involvement of the frontal bone. In most cases scar sarcoidosis was the first manifestation of the disease, and in most cases it was asymptomatic. Two patients never required treatment, and in all cases the frontal problem improved or remained stable spontaneously or under sarcoidosis treatment. Scar sarcoidosis in the frontal area may have contiguous bone damage. This bone involvement does not seem to be associated with neurological extension.

15.
Radiol Case Rep ; 18(8): 2621-2627, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37273728

RESUMO

Coronary artery fistulas (CAFs) are abnormal connections of coronary arteries where venous circuits bypass the normal capillaries in the myocardium. CAFs are rare, and most patients are asymptomatic. However, CAFs are the most common coronary artery anomalies affecting coronary hemodynamics. While most CAFs are asymptomatic in young patients, symptoms and complications become more frequent with increasing age. CAFs are characterized by variable clinical manifestations based on their size, origin, and drainage site. We describe a 35-year-old woman presenting with the shortness of breath after walking. Despite attempting medical treatment, the patient continued to experience dyspnea, fatigue, fainting the and chest pain episodes. After admission, cardiac imaging was immediately performed and recorded symptomatic CAFs. Percutaneous transcatheter closure treatment was indicated. The patient was discharged with clinical recovery. The treatment of symptomatic CAFs often requires the clear cardiac imaging and endovascular approach to achieve the best clinical results.

16.
Respir Res ; 24(1): 151, 2023 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-37291562

RESUMO

OBJECTIVE: To investigate the association of air pollution exposure with the severity of interstitial lung disease (ILD) at diagnosis and ILD progression among patients with systemic sclerosis (SSc)-associated ILD. METHODS: We conducted a retrospective two-center study of patients with SSc-associated ILD diagnosed between 2006 and 2019. Exposure to the air pollutants particulate matter of up to 10 and 2.5 µm in diameter (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3) was assessed at the geolocalization coordinates of the patients' residential address. Logistic regression models were used to evaluate the association between air pollution and severity at diagnosis according to the Goh staging algorithm, and progression at 12 and 24 months. RESULTS: We included 181 patients, 80% of whom were women; 44% had diffuse cutaneous scleroderma, and 56% had anti-topoisomerase I antibodies. ILD was extensive, according to the Goh staging algorithm, in 29% of patients. O3 exposure was associated with the presence of extensive ILD at diagnosis (adjusted OR: 1.12, 95% CI 1.05-1.21; p value = 0.002). At 12 and 24 months, progression was noted in 27/105 (26%) and 48/113 (43%) patients, respectively. O3 exposure was associated with progression at 24 months (adjusted OR: 1.10, 95% CI 1.02-1.19; p value = 0.02). We found no association between exposure to other air pollutants and severity at diagnosis and progression. CONCLUSION: Our findings suggest that high levels of O3 exposure are associated with more severe SSc-associated ILD at diagnosis, and progression at 24 months.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doenças Pulmonares Intersticiais , Ozônio , Escleroderma Sistêmico , Humanos , Feminino , Masculino , Estudos Retrospectivos , Poluição do Ar/efeitos adversos , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/epidemiologia , Doenças Pulmonares Intersticiais/etiologia , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Ozônio/efeitos adversos , Material Particulado/análise , Escleroderma Sistêmico/diagnóstico , Escleroderma Sistêmico/epidemiologia , Escleroderma Sistêmico/complicações , Exposição Ambiental/efeitos adversos
17.
Injury ; 54(8): 110813, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37258404

RESUMO

BACKGROUND: Early hip fracture surgery is recommended to decrease mortality, however the impact of a delay in surgery due to previous treatment with direct oral anticoagulants (DOA) is unknown. Our objective was to determine if early surgery, defined as surgery within 48 h of hospital admission is associated with decreased postoperative mortality. We tested the hypothesis that early surgery was beneficial with regard for mortality in patients treated with direct oral anticoagulants. METHODS: Retrospective cohort study in a French University Hospital including patient admitted for Hip fracture. The main exposure was wait time for surgery defined as the total time, in hours, between hospital admission and surgery. The main outcome was mortality within 30 days after hip fracture surgery. RESULTS: In 3429 patients, the overall 30-day mortality was 4.1% (95% CI 3.5%; 4.9%). In DOA + patients, the 30-day mortality rates in the early and delayed surgery groups were 1.2% and 5.9%, respectively, with estimated risk difference of -4.4 (with a 2% probability of this difference is > 0). In the DOA + group, early surgery tended to be associated with a higher percentage receiving red-blood cells (64.6% vs 54.8%, respectively, estimated risk difference of 9.9% with a 93% probability of this difference is > 0) and lower risk of pneumonia (1.2% vs 8.2%, respectively; estimated difference of -6.7% with 0.3% probability of superiority). CONCLUSION: Early hip fracture surgery was associated with improved survival in patients previously treated with DOAs.


Assuntos
Anticoagulantes , Fraturas do Quadril , Humanos , Anticoagulantes/uso terapêutico , Estudos Retrospectivos , Hospitalização
18.
Radiol Case Rep ; 18(7): 2349-2353, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37179813

RESUMO

Congenital abnormalities of the iliac artery are uncommon and often discovered incidentally during the diagnosis or treatment of peripheral vascular diseases such as abdominal aortic aneurysm (AAA) and peripheral arterial diseases. The endovascular treatment of infrarenal AAA can be complicated by anatomic abnormalities in the iliac arteries, such as the absence of the common iliac artery (CIA) or overly short bilateral common iliac arteries. We present a case of a patient with a ruptured AAA and bilateral absence of the CIA, successfully treated by endovascular intervention combined with preservation of the internal iliac artery using the sandwich technique.

19.
Angew Chem Int Ed Engl ; 62(30): e202304648, 2023 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-37221959

RESUMO

Mechanistic studies of substrate insertion into dimeric [(NHC)CuH]2 (NHC=N-heterocyclic carbene) complexes with two bridging hydrides have been shown to require dimer dissociation to generate transient, highly reactive (NHC)Cu-H monomers in solution. Using single-crystal to single-crystal (SC-SC) transformations, we discovered a new pathway of stepwise insertion of CO2 into [(NHC)CuH]2 without complete dissociation of the dimer. The first CO2 insertion into dimeric [(IPr*OMe)CuH]2 (IPr*OMe=N,N'-bis(2,6-bis(diphenylmethyl)-4-methoxy-phenyl)imidazole-2-ylidene) produced a dicopper formate hydride [(IPr*OMe)Cu]2 (µ-1,3-O2 CH)(µ-H). A second CO2 insertion produced a dicopper bis(formate), [(IPr*OMe)Cu]2 (µ-1,3-O2 CH)(µ-1,1-O2 CH), containing two different bonding modes of the bridging formate. These dicopper formate complexes are inaccessible from solution reactions since the dicopper core cleanly ruptures to monomeric complexes when dissolved in a solvent.

20.
Eur Radiol ; 33(8): 5540-5548, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36826504

RESUMO

OBJECTIVES: The objective was to define a safe strategy to exclude pulmonary embolism (PE) in COVID-19 outpatients, without performing CT pulmonary angiogram (CTPA). METHODS: COVID-19 outpatients from 15 university hospitals who underwent a CTPA were retrospectively evaluated. D-Dimers, variables of the revised Geneva and Wells scores, as well as laboratory findings and clinical characteristics related to COVID-19 pneumonia, were collected. CTPA reports were reviewed for the presence of PE and the extent of COVID-19 disease. PE rule-out strategies were based solely on D-Dimer tests using different thresholds, the revised Geneva and Wells scores, and a COVID-19 PE prediction model built on our dataset were compared. The area under the receiver operating characteristics curve (AUC), failure rate, and efficiency were calculated. RESULTS: In total, 1369 patients were included of whom 124 were PE positive (9.1%). Failure rate and efficiency of D-Dimer > 500 µg/l were 0.9% (95%CI, 0.2-4.8%) and 10.1% (8.5-11.9%), respectively, increasing to 1.0% (0.2-5.3%) and 16.4% (14.4-18.7%), respectively, for an age-adjusted D-Dimer level. D-dimer > 1000 µg/l led to an unacceptable failure rate to 8.1% (4.4-14.5%). The best performances of the revised Geneva and Wells scores were obtained using the age-adjusted D-Dimer level. They had the same failure rate of 1.0% (0.2-5.3%) for efficiency of 16.8% (14.7-19.1%), and 16.9% (14.8-19.2%) respectively. The developed COVID-19 PE prediction model had an AUC of 0.609 (0.594-0.623) with an efficiency of 20.5% (18.4-22.8%) when its failure was set to 0.8%. CONCLUSIONS: The strategy to safely exclude PE in COVID-19 outpatients should not differ from that used in non-COVID-19 patients. The added value of the COVID-19 PE prediction model is minor. KEY POINTS: • D-dimer level remains the most important predictor of pulmonary embolism in COVID-19 patients. • The AUCs of the revised Geneva and Wells scores using an age-adjusted D-dimer threshold were 0.587 (95%CI, 0.572 to 0.603) and 0.588 (95%CI, 0.572 to 0.603). • The AUC of COVID-19-specific strategy to rule out pulmonary embolism ranged from 0.513 (95%CI: 0.503 to 0.522) to 0.609 (95%CI: 0.594 to 0.623).


Assuntos
COVID-19 , Embolia Pulmonar , Humanos , Estudos Retrospectivos , Pacientes Ambulatoriais , Curva ROC
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