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201.
Vanessa Chaves Barreto Ferreira de Lima Ana Luiza Bierrenbach Gizelton Pereira Alencar Ana Lucia Andrade Luciano Cesar Pontes Azevedo 《Intensive care medicine》2018,44(7):1090-1096
Purpose
To describe long-term mortality and hospital readmissions of patients admitted to Brazilian intensive care units (ICU).Methods
Retrospective cohort study of adult patients admitted to Brazilian hospitals affiliated to the Public Healthcare System from 10 state capitals. ICU patients were paired to non-ICU patients by frequency matching (ratio 1:2), according to postal code and admission semester. Hospitalization records were linked through deterministic linkage to national mortality data. Primary outcome was mortality up to 1 year. Other outcomes were mortality and readmissions at 30 and 90 days and 3 years. Multiple Cox regressions were used adjusting for age, sex, cancer diagnosis, type of hospital, and surgical status.Results
We included 324,594 patients (108,302 ICU and 216,292 non-ICU). ICU patients had increased hospital length of stay [9 (5–17) vs. 3 (1–6) days, p?<?0.001] and mortality (18.5 vs. 3.6%, p?<?0.001) versus non-ICU patients. One year after discharge, ICU patients were more frequently readmitted to hospital (25.4 vs. 17.4%, p?<?0.001) and to ICU (31.4 vs. 7.3%, p?<?0.001) than controls. Mortality up to 1 year was also higher for ICU patients (14.3 vs. 3.9%, p?<?0.001). A significant interaction between surgical status and mortality was found, with adjusted hazard ratios (HRs) up to 1 year of 2.7 [95% confidence interval (CI) 2.5–2.9] for surgical patients, and 3.4 (95%CI 3.3–3.5) for medical patients. The risk for death and readmission diminished over time up to 3 years.Conclusions
In a public healthcare system of a developing country, ICU patients have excessive long-term mortality and frequent readmissions. The ICU burden tended to reduce over time after hospital discharge.202.
Ana Paula de Oliveira Carnevalli Débora Bevilaqua-Grossi Ana Izabela Sobral Oliveira Gabriela Ferreira Carvalho César Fernández-De-Las-Peñas Lidiane Lima Florencio 《Journal of manipulative and physiological therapeutics》2018,41(7):621-627
Objective
This study aimed to determine the inter-rater and intrarater reliability, agreement, and minimal detectable change (MDC) of the neck muscle strength test using a handheld dynamometer in healthy women and women with headaches.Methods
Neck muscle strength in maximal voluntary contraction was measured using the Lafayette Manual Muscle Testing attached to a nonelastic belt in 25 women with migraines and in 25 healthy women. Three repetitions of flexion, extension, and lateral flexion were performed. The tests were performed by 2 examiners on the same day, with a 10-minute interval, and by 1 examiner, with a 1-week interval. The reliability was verified by the intraclass correlation coefficient, the agreement determined by standard error measurement, and the MDC calculated.Results
The protocol exhibited moderate to excellent intrarater and inter-rater reliabilities in both groups (intraclass correlation coefficientrange, 0.53-0.90). The standard error measurement ranged from 0.43 to 1.81 and the MDC from 1.49 up to 4.61.Conclusion
Quantification of neck muscle strength using the handheld dynamometer with an attached nonelastic belt exhibited moderate to excellent intra- and inter-rater reliability in women with and without migraines. Moreover, the standard error measurement and MDC were proven to be useful in the interpretation of data and in guiding clinical decisions. 相似文献203.
Simone Aparecida Penimpedo Calamita Daniela Aparecida Biasotto-Gonzalez Nívea Cristina De Melo Marco Antônio Fumagalli César Ferreira Amorim Cid André Fidelis de Paula Gomes Fabiano Politti 《Journal of manipulative and physiological therapeutics》2018,41(3):208-217
Objective
The objective of this study was to assess changes in upper trapezius myoelectric activity and pain in patients with nonspecific neck pain after a single session of acupuncture (ACP).Methods
A blinded randomized clinical trial was conducted. Fifteen patients with nonspecific neck pain and 15 healthy participants were enrolled in a randomized, single-blinded, crossover study. Each participant was subjected to a single session of ACP and sham acupuncture (SACP). The electromyography (EMG) signal of the upper trapezius muscle was recorded during different step contractions of shoulder elevation force (15%-30% maximal voluntary contraction) before and after ACP treatment.Results
Significant effects were confirmed after the treatment (ACP and SACP) for Numeric Rating Scale scores (F1,28 = 51.61; P < .0001) and pain area (F1,2 = 32.03; P < .0001). Significant decreases in the EMG amplitude were identified for the nonspecific neck pain group (NPG) (F1,112 = 26.82; P < .0001) and the healthy participant group (HPG) (F1,112 = 21.69; P < .0001) after ACP treatment. No differences were identified between the ACP and SACP treatment protocols for Numeric Rating Scale score (NPG: F1,28 = 0.95; P = .33), pain area (NPG: F1,28 = 1.97; P = .17), or EMG amplitude (NPG: F1,112 = 0.47; P = .49; HPG: F1,112 = 0.75; P = .38).Conclusion
The effect of ACP at acupoints triple energizer 5 and large intestine 11 triple energizer 5, or in close proximity, contributes to pain relief among patients with nonspecific neck pain. The electromyographic analysis indicated a greater resistance to muscle fatigue and decrease of activity of the upper trapezius muscle among healthy participants and patients with nonspecific neck pain. 相似文献204.
205.
Liyun Zhang Vivien Jane Coulson-Thomas Tarsis Gesteira Ferreira Winston W. Y. Kao 《BMC ophthalmology》2015,15(1):155
Mesenchymal stem cells (MSC) have become a promising tool for cell therapy in regenerative medicine. They are readily available, demonstrate powerful differentiation capabilities and present immunosuppressive properties that aid them in surviving from host immune rejection for its great potential use in allograft. Currently clinical trials are underway using MSC, both culture-expanded allogeneic and autologous, for the treatment of a range of diseases not treatable by conventional therapies. A vast array of studies has dedicated towards the use of MSC for treating corneal diseases with very promising outcomes. MSC have successfully differentiated into keratocytes both in vitro and in vivo, and corneal epithelial cells in vitro, but it is uncertain if MSC can assume corneal epithelial cells in vivo. However, to date few studies have unequivocally established the efficacy of MSC for treating corneal endothelial defects. Currently, the diversity in protocols of the isolation and expansion of MSC are hindering to the assessment of cell treatment ability and the further development of treatment regimens. Therefore, future studies should develop international standards for MSC isolation and characterization. In this review, we discuss recent advances in MSC for treating ocular surface diseases. 相似文献
206.
207.
208.
Medial prefrontal circuits have been reported to undergo a major reorganization over time and gradually take a more important role for remote emotional memories such as contextual fear memory or food aversion memory. The medial prefrontal cortex, and specifically its ventral subregion, the infralimbic cortex (IL), was also reported to be critical for recent memory extinction of contextual fear conditioning and conditioned odor aversion. However, its exact role in the extinction of remotely acquired information is still not clear. Using postretrieval blockade of protein synthesis or inactivation of the IL, we showed that the IL is similarly required for extinction consolidation of recent and remote fear memory. However, in odor aversion memory, the IL was only involved in extinction consolidation of recent, but not remote, memory. In contrast, only remote retrieval of aversion memory induced c-Fos activation in the IL and preretrieval inactivation of the IL with lidocaine impaired subsequent extinction of remote but not recent memory, indicating IL is necessary for extinction learning of remote aversion memory. In contrast to the effects in odor aversion, our data show that the involvement of the IL in the consolidation of fear extinction does not depend on the memory age. More importantly, our data indicate that the IL is implicated in the extinction of fear and nonfear-based associations and suggest dissociation in the engagement of the IL in the learning and consolidation of food aversion extinction over time. 相似文献
209.
Ana Galrinho Luísa M. Branco António Fiarresga Duarte Cacela Lídia Sousa Ruben Ramos Rui C. Ferreira 《Revista portuguesa de cardiologia》2021,40(4):261-269
IntroductionParavalvular leak (PVL) is a common serious complication associated with prosthetic valve implantation.ObjectiveThe aim of this study was to report our single-center experience in a retrospective review and to analyze possible predictors of success.MethodsWe performed 33 percutaneous PVL closures in 26 patients (54% female, mean age 65±13 years). All mitral prostheses were studied previously with 3D transesophageal echocardiography (TEE), and aortic prostheses with 2D/3D TEE. 3D TEE and fluoroscopy were used for the assessment, planning, and guidance of the interventions. Twelve patients also underwent computed tomography angiography for better characterization of anatomic details.ResultsEighteen patients (69.2%) were admitted due to heart failure (New York Heart Association [NYHA] III or IV, seven (26.9%) because of heart failure and hemolysis, and one (3.8%) due to hemolysis only. Regarding the leaks, 46.2% were in aortic and 53.8% in mitral prostheses, 88.5% in mechanical and 7.7% in biological prostheses, and 3.8% in transcatheter aortic valve implants. All the aortic patients had severe aortic regurgitation. Furthermore, all mitral patients but one had moderate to severe or severe mitral regurgitation. Closure was successful in 17 patients (65.4%), partially successful in four (15.4%) and unsuccessful in five (19.2%). After the procedure, 69% were in NYHA I-II. Hemolysis worsened in three patients despite successful closure; all required further valvular surgery and two died. Regarding angiographic and echocardiographic procedural success, we analyzed age, gender, type of prosthesis (mechanical or biological), location (aortic or mitral), clinical data, maximum leak diameter, anatomic regurgitant orifice, leak location (anterior, posterior, inferior and lateral for mitral leaks and left, right and non-coronary sinus for aortic leaks), and number of devices (plugs) used for closure. No parameters presented a significant relationship with success excepting previous hemolysis. There was a relationship between clinical improvement and reduction of PVL (p=0.0001). In follow-up, cardiac-related events (new hospital admissions, cardiac valvular surgery, need for transfusion) were more frequent in patients with partially successful or unsuccessful closure (p=0.012). There was a relationship between cardiac-related events and death (p=0.029).ConclusionPercutaneous PVL closure has emerged as an alternative treatment for PVL. Predictors of procedural success are difficult to establish. Survival is related to reduction of regurgitation and improvement in NYHA functional class. 相似文献
210.
Klemen Dovc MD Michelle Van Name MD Barbara Jenko Bizjan PhD Ewa Rusak MD Claudia Piona MD Gul Yesiltepe-Mutlu MD Rosaline Mentink MD Giulio Frontino MD Maddalena Macedoni MD Sofia Helena Ferreira MD Joana Serra-Caetano MD Júlia Galhardo MD Julie Pelicand MD Francesca Silvestri MD Jennifer Sherr MD Agata Chobot MD Torben Biester MD for the ISPAD JENIOUS Group 《Diabetes, obesity & metabolism》2022,24(3):564-569