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71.
André C Marques Daniela Calderaro Pai C Yu Danielle M Gualandro Gabriel A L Carmo Fernanda R Azevedo Adriana F Pastana Eneas M O Lima Maristela Monachini Bruno Caramelli 《Clinics (S?o Paulo, Brazil)》2014,69(10):666-671
OBJECTIVES:
Cardiology referral is common for patients admitted for non-cardiac diseases. Recommendations from cardiologists may involve complex and aggressive treatments that could be ignored or denied by other physicians. The purpose of this study was to compare the outcomes of patients who were given recommendations during cardiology referrals and to examine the clinical outcomes of patients who did not follow the recommendations.METHODS:
We enrolled 589 consecutive patients who received in-hospital cardiology consultations. Data on recommendations, implementation of suggestions and outcomes were collected.RESULTS:
Regarding adherence of the referring service to the recommendations, 77% of patients were classified in the adherence group and 23% were classified in the non-adherence group. Membership in the non-adherence group (p<0.001; odds ratio: 10.25; 95% CI: 4.45-23.62) and advanced age (p = 0.017; OR: 1.04; 95% CI: 1.01-1.07) were associated with unfavorable outcomes. Multivariate analysis identified four independent predictors of adherence to recommendations: follow-up notes in the medical chart (p<0.001; OR: 2.43; 95% CI: 1.48-4.01); verbal reinforcement (p = 0.001; OR: 1.86; 95% CI: 1.23-2.81); a small number of recommendation (p = 0.001; OR: 0.87; 95% CI: 0.80-0.94); and a younger patient age (p = 0.002; OR: 0.98; 95% CI: 0.96-0.99).CONCLUSIONS:
Poor adherence to cardiology referral recommendations was associated with unfavorable clinical outcomes. Follow-up notes in the medical chart, verbal reinforcement, a limited number of recommendations and a patient age were associated with greater adherence to recommendations. 相似文献72.
Frederico Sampaio Neves Monikelly Carmo Chagas Nascimento Matheus Lima Oliveira Solange Maria Almeida Frab Norberto Bóscolo 《Oral and maxillofacial surgery》2014,18(4):419-424
Purpose
The objective of this study is to compare the ability of panoramic radiography and cone beam computed tomography (CBCT) in detecting anatomical variations of the mandibular canal and mental foramen.Methods
One hundred twenty-seven preoperative panoramic and CBCT images were evaluated. Two oral and maxillofacial radiologists investigated the presence of bifid mandibular canals and/or additional mental foramina on the right, left, or both sides of the mandible. Intra- and interobserver reliability was determined using Cohen’s kappa coefficient. McNemar’s test compared the prevalence of mandibular anatomical variations between panoramic radiography and CBCT. The significance level was set at 0.05.Results
Additional mental foramen and bifid mandibular canal were detected in 1.2 and 7.4 % of the panoramic radiographs and 7.4 and 9.8 % of the CBCT images, respectively. The incidence of anatomical variations on the mandibular canal was not significantly different between both imaging modalities (P?>?0.05).Conclusions
Although CBCT provides better viewing of anatomical structures, including location, shape, and relationship with the surrounding area, panoramic radiography is a conventional imaging modality that can be used in the study of the bifid mandibular canals. 相似文献73.
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76.
Caroline Xavier-Carvalho Renata Duarte da Silva Cezar Naishe Matos Freire Carla Maria Mola de Vasconcelos Victor Edgar Fiestas Solorzano Thiago Gomes de Toledo-Pinto Luciana Gomes Fialho Rodrigo Feliciano do Carmo Luydson Richardson Silva Vasconcelos Marli Tenório Cordeiro Paulo Baptista Elzinandes leal de Azeredo Rivaldo Venâncio da Cunha Luiz José de Souza Antonio Guilherme Pacheco Claire Fernandes Kubelka Patrícia Muniz Mendes Freire de Moura Milton Ozorio Moraes 《Human immunology》2017,78(10):649-656
Outbreaks of the Zika, dengue, and chikungunya viruses, especially in the Americas, pose a global threat due to their rapid spread and difficulty controlling the vector. Extreme phenotypes are often observed, from asymptomatic to severe clinical manifestations, which are well-studied in dengue. Host variations are also important contributors to disease outcomes, and many case-control studies have associated single nucleotide polymorphisms (SNPs) with severe dengue. Here, we found that the TC genotype and T-carriers for SNP rs1285933 in the C-type lectin superfamily member 5 (CLEC5A) gene was associated with severe dengue in a Northern Brazilian population (OR = 2.75 and p-value = 0.01, OR = 2.11 and p-value = 0.04, respectively). We also tested the functional effect of the CLEC5A protein and found that it is upregulated on the surface of human monocytes after in vitro dengue infection. CLEC5A was correlated with viral load inside the monocytes (Spearman r = 0.55, p = 0.008) and TNF production in culture supernatants (Spearman r = 0.72, p = 0.03). Analysis of mRNA in blood samples from DENV4-infected patients exhibiting mild symptoms showed that CLEC5A mRNA expression is correlated with TNF (r = 0.67, p = 0.0001) and other immune mediators. Monocytes from rs1285933 TT/TC individuals showed lower CLEC5A expression compared to CC genotypes. However, in these cells, CLEC5A was not correlated with TNF production. In summary, we confirmed that CLEC5A is genetically associated with dengue severity outcome, playing a central role during the immune response triggered by a dengue viral infection, and rs1285933 is a relevant SNP that is able to regulate signaling pathways after interactions between the dengue virus and CLEC5A receptors. 相似文献
77.
78.
Grance SR Teixeira MA Leite RS Guimarães EB de Siqueira JM de Oliveira Filiu WF de Souza Vasconcelos SB do Carmo Vieira M 《Journal of ethnopharmacology》2008,117(1):28-33
AIM OF THE STUDY: This investigation evaluated the effect of a hydroethanolic extract of Baccharis trimera on pregnant Wistar rats, once the plant is well-known consumed in pregnancy and little is known on its potentially toxic effects on pregnant women. MATERIAL AND METHODS: Thirty-five female rats were distributed into three groups. Those in treatments 1 and 2 were given 8.4 mg/kg of the extract orally from gestational day (GD) 1 to 19 and from GD 6 to 15, respectively, whereas those in the control group received distilled water orally from GD 1 to 19. Body weights were recorded on GD 1, 6, 15, and 20. On GD 20 animals were anesthetized, blood samples were collected and maternal livers, kidneys, and spleens were weighed and processed for histological studies. RESULTS: No clinical signs of maternal toxicity and no changes in hematological parameters were observed. Urea levels and kidney weights differed significantly between animals receiving treatment 1 and controls. Histopathological alterations were found in kidneys and livers in both treatment groups. CONCLUSIONS: The hydroethanolic extract of Baccharis trimera administered to pregnant rats at 8.4 mg/kg was toxic to maternal kidney and liver cells, although such alterations are reversible once administration is discontinued. 相似文献
79.
Denny C Zacharias ME Ruiz AL do Carmo E do Amaral M Bittrich V Kohn LK de Oliveira Sousa IM Rodrigues RA de Carvalho JE Foglio MA 《Phytotherapy research : PTR》2008,22(1):127-130
An activity-guided fractionation of Virola sebifera Aubl. methylene chloride-soluble fraction provided novel 3,5-dihydro-2-(1'-oxo-3'-hexadecenyl)-2-cyclohexen-1-one (3), two known lignans (1, 2) and dehydro hexadecanoyl resorcinol (4). Isolation and purification were conducted with the application of column chromatography and structures were assigned by spetral analysis (1D and 2D NMR, HREIMS). Compounds 1-4 were evaluated for cytotoxic activities against human tumour cell lines UACC62 (melanoma), MCF-7 (breast), NCI 460 (lung, non-small cells), OVCAR03 (ovarian), PC-03 (prostate), HT-29 (colon), 786-0 (renal) and NCI-ADR (breast expressing phenotype multiple drugs resistance) in vitro. The new polyketide (3) showed selectivity against human OVCAR03 and NCI-ADR cell lines, ranging from 2 to 4 microg/mL. 相似文献
80.
Marcia Maria Oliveira Lima P.T. M.Sc. Maria Carmo P. Nunes M.D. Ph.D. Manoel O.C. Rocha M.D. Ph.D. Francilu Rodrigues Beloti M.D. Maria Clara N. Alencar M.D. Antônio Luiz P. Ribeiro M.D. Ph.D. 《Echocardiography (Mount Kisco, N.Y.)》2010,27(5):519-524
Parameters of diastolic function have been shown to correlate with exercise capacity (EC) in individuals with impaired left ventricular (LV) systolic function. However, the role of LV diastolic function in predicting EC in Chagas cardiomyopathy has not been reported. Objectives: This study aimed to determine the relationship between LV diastolic parameters assessed by echocardiography and EC in patients with Chagas cardiomyopathy. Methods: We studied 40 patients (23 men; 49 ± 8 years), with diagnosis of Chagas disease and dilated cardiomyopathy. Medical therapy was individually adjusted according to standardized guidelines. Methods of acquiring two‐dimensional Doppler, tissue Doppler imaging (TDI), and their measurements were described. Exercise testing was performed by a Bruce protocol. Brain natriuretic peptide (BNP) levels were also determined. Results: Most patients (63%) were in NYHA functional class I. Mean peak oxygen consumption estimated (peakVO2) was 31.7 ± 10.2 mL/kg per minute, and mean left ventricular ejection fraction (LVEF) was 36.3 ± 7.8%. Univariate analysis showed that various echocardiographic parameters of diastolic function were correlated with peakVO2. There was no correlation between BNP levels or LVEF and EC. Multivariate analysis, after adjustment for age and gender, revealed that E/E′ ratio and left atrial volume (LAV), emerged as independent predictors of EC, as demonstrated in the model: peakVO2= 60.825 + (0.439 × LAV) ? (1.620 × E/E′ ratio) ? (0.483 × age) ? (4.821 × female gender). The R2 of this model was 0.52. Conclusions: Functional capacity assessed by peakVO2 was related to increase LV filling pressures, independently on systolic function in patients with Chagas cardiomyopathy. (Echocardiography 2010;27:519‐524) 相似文献