54 research outputs found
Doença hepática gordurosa não alcoólica e cirurgia bariátrica: uma revisão abrangente
sem informaçãoNonalcoholic fatty liver disease (NAFLD) has been increasingly diagnosed worldwide and is now recognized as a source of public health concern. It comprises a wide spectrum of histological features that range from simple steatosis to severe forms of fibros1353277295sem informaçãosem informaçãosem informaçã
Predictors for weight loss failure following roux-en-y gastric bypass
Weight loss failure is a widely recognized occurrence following Roux-en-Y gastric bypass. This study aims to identify predictors associated with weight loss failure. It is a retrospective cohort which enrolled 187 subjects who underwent RYGB. Comparisons were made between patients' features at baseline and 24 months after surgery. A weight loss failure rate of 11.2% was found. Advanced age and diabetes were statistically associated with failure. The results found were close to previous reports. As weight loss failure represents an important concern, there is the possibility to perform revisional surgeries, which may emphasize the restrictive or malabsorptive characteristics of RYGB, leading to varied results. It is reinforced that weight loss cannot be used as the unique outcome to evaluate the success of surgery.Weight loss failure is a widely recognized occurrence following Roux-en-Y gastric bypass. This study aims to identify predictors associated with weight loss failure. It is a retrospective cohort which enrolled 187 subjects who underwent RYGB. Comparisons514328330sem informaçãosem informaçã
Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals: a cross-sectional study
Nonalcoholic fatty liver disease (NAFLD) has become a public health concern. It encompasses a wide spectrum of histological abnormalities and has close relationships with insulin resistance and type 2 diabetes mellitus (T2DM). This study sought to compare13417983sem informaçãosem informaçã
Effect of biliopancreatic diversion on sleep quality and daytime sleepiness in patients with obesity and type 2 diabetes
sem informaçãoThe poor quality of sleep and the deprivation thereof have been associated with disruption of metabolic homeostasis, favoring the development of obesity and type 2 diabetes (T2DM). We aimed to evaluate the influence of biliopancreatic diversion (BPD) surg616623627sem informaçãosem informaçãosem informaçã
On shape design and optimization of gerotor pumps
A gerotor pump is a two-piece mechanism where two rotational components, interior and exterior, engage each other via a rotational motion to transfer a fluid in a direction parallel to their rotational axes. A natural question arises on what shape of the gerotor is the optimal one in the sense of maximum fluid being pumped for a unit of time, given the constraint of a fixed material needed to manufacture the pump. As there is no closed-formula to answer this question, we propose a new algorithm to design and optimize the shape of gerotor pumps to be as efficient as possible. The proposed algorithm is based on a fast construction of the envelope of the interior component and subsequent optimization. We demonstrate our algorithm on a benchmark gerotor and show that the optimized solution increases the estimated flowrate by 16%. We also use our algorithm to study the effect of the number of teeth on the cavity area of a gerotor.RYC-2017-22649 funded by MICIU/AEI/10.13039/501100011033 and EI ESF "ESF Investing in your future
Cirurgia bariátrica em indivíduos com déficits cognitivos graves: relato de dois casos
sem informaçãoBariatric surgery has become the gold-standard treatment for refractory morbid obesity. Obesity is frequently associated with certain syndromes that include coexisting cognitive deficits. However, the outcomes from bariatric surgery in this group of indiv13618488sem informaçãosem informaçãosem informaçã
Investigation of conduction band structure, electron scattering mechanisms and phase transitions in indium selenide by means of transport measurements under pressure
In this work we report on Hall effect, resistivity and thermopower
measurements in n-type indium selenide at room temperature under either
hydrostatic and quasi-hydrostatic pressure. Up to 40 kbar (= 4 GPa), the
decrease of carrier concentration as the pressure increases is explained
through the existence of a subsidiary minimum in the conduction band. This
minimum shifts towards lower energies under pressure, with a pressure
coefficient of about -105 meV/GPa, and its related impurity level traps
electrons as it reaches the band gap and approaches the Fermi level. The
pressure value at which the electron trapping starts is shown to depend on the
electron concentration at ambient pressure and the dimensionality of the
electron gas. At low pressures the electron mobility increases under pressure
for both 3D and 2D electrons, the increase rate being higher for 2D electrons,
which is shown to be coherent with previous scattering mechanisms models. The
phase transition from the semiconductor layered phase to the metallic sodium
cloride phase is observed as a drop in resistivity around 105 kbar, but above
40 kbar a sharp nonreversible increase of the carrier concentration is
observed, which is attributed to the formation of donor defects as precursors
of the phase transition.Comment: 18 pages, Latex, 10 postscript figure
A review of diagnostic and functional imaging in headache
The neuroimaging of
headache patients has revolutionised
our understanding of the pathophysiology
of primary headaches and provided
unique insights into these syndromes.
Modern imaging studies
point, together with the clinical picture,
towards a central triggering
cause. The early functional imaging
work using positron emission
tomography shed light on the genesis
of some syndromes, and has
recently been refined, implying that
the observed activation in migraine
(brainstem) and in several trigeminal-autonomic headaches (hypothalamic
grey) is involved in the pain
process in either a permissive or
triggering manner rather than simply
as a response to first-division nociception
per se. Using the advanced
method of voxel-based morphometry,
it has been suggested that there
is a correlation between the brain
area activated specifically in acute
cluster headache — the posterior
hypothalamic grey matter — and an
increase in grey matter in the same
region. No structural changes have
been found for migraine and medication
overuse headache, whereas
patients with chronic tension-type
headache demonstrated a significant
grey matter decrease in regions
known to be involved in pain processing.
Modern neuroimaging thus
clearly suggests that most primary
headache syndromes are predominantly
driven from the brain, activating
the trigeminovascular reflex and
needing therapeutics that act on both
sides: centrally and peripherally
Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.
BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362
Registro ACESUR: atención de pacientes adultos con crisis epilépticas en servicios de urgencias: diferencias entre primer episodio y recurrencia
Objetivo. Describir las características y la atención recibida de pacientes adultos que consultan por crisis epiléptica (CE) en los servicios de urgencias hospitalarios (SUH), diferenciando entre primera crisis y recurrencia en epiléptico conocido.
Método. ACESUR es un registro observacional de cohortes multipropósito, prospectivo y multicéntrico con un muestreo sistemático, los días pares de febrero y julio alternando con los impares de abril y octubre de 2017. Se incluyeron pacientes 18 años con diagnóstico de CE en los SUH. Se recogieron variables clínico-asistenciales de la visita índice de pacientes, distinguiendo entre primera CE y recurrencia en epiléptico.
Resultados. El registro ACESUR recogió a 664 pacientes procedentes de 18 SUH españoles, 229 (34, 5%) con primera CE y 435 (65, 5%) con CE recurrentes. Los pacientes con primera CE fueron de mayor edad (p < 0, 001), presentaron motivos de consulta distintos (p < 0, 001) y requirieron más traslados en ambulancia (p < 0, 001). La atención recibida en el SUH fue diferente, en pacientes con primera CE se solicitó con mayor probabilidad una prueba complementaria específica (OR ajustada = 13, 94; IC95%:7, 29-26, 7; p < 0, 001) y se necesitó mayor hospitalización o estancia prolongada en el SUH (OR ajustada = 1, 69; IC95%:1, 11-2, 58; p = 0, 015). No hubo diferencias en cuanto al tratamiento farmacológico en fase aguda ni preventivo (OR ajustada = 1, 40; IC95%:0, 94-2, 09; p = 0, 096). Se inició tratamiento con fármacos antiepiépticos (FAE) en 100 pacientes (43, 7%) tras primera CE y se reinició o modificó añadiendo nuevo FAE en 142 pacientes (32, 6%) con CE recurrentes.
Conclusiones. Las características clínicas y la atención recibida de pacientes adultos con primera CE en SUH en España difieren de las recurrencias en epiléptico conocido.
Objective. To describe the characteristics of care received by patients who come to the emergency department with a first epileptic seizure versus a recurrent seizure in a patient with diagnosed epilepsy.
Methods. ACESUR (Acute Epileptic Seizures in the Emergency Department) is a prospective multicenter, multipurpose registry of cases obtained by systematic sampling on even days in February and July 2017 and on odd days in April and October 2017. Patients were aged 18 years or older and had an emergency department diagnosis of epileptic seizure. We recorded clinical variables and details related to care given during each patient''s visit, including whether the event was a first or recurrent seizure.
Results. A total of 664 patients attended by 18 Spanish emergency departments were entered into the ACESUR registry. Two hundred twenty-nine (34.5%) were first seizures and 435 (65.5%) were recurrences. Patients who were attended for first seizures were older, consulted for a wider variety of reasons, and were transported in ambulances (P<.001, all comparisons). Care received differed between patients with first seizures versus recurrent seizures. Specific complementary testing was more likely in patients with first seizures (adjusted odds ratio [aOR], 13.94; 95% CI, 29-26.7; P<.001), and they were more often hospitalized or stayed longer in the emergency department, (aOR, 1.69; 95% CI, 1.11-2.58; P=.015). Pharmacologic treatment did not differ between the groups, either in the acute phase or for prevention (aOR, 1.40; 95% CI, 0.94-2.09; P=.096). Antiepileptic drugs were given to 100 patients (43.7%) after a first seizure and were restarted or changed in 142 patients with recurrent seizure (32.6%).
Conclusions. The clinical characteristics of adults attended for a first epileptic seizure differ from those of patients with diagnosed epilepsy who were attended for recurrent seizures in Spain. The care received also differs
- …