714 research outputs found
Diagnostic Accuracy of CT Angiography for A Infrapopliteal Lesions in Patientes with Diabetic Foot Ulcers Undergoing Endovascular Revascularization
Introdução: A angiografia por tomografia computorizada (AngioTC) é aceite como técnica para seleção de doentes com doença arterial periférica candidatos a terapêutica endovascular ou cirúrgica. Não existe suficiente evidencia em relação à sua acuidade em doentes com pé diabético e patologia infrapopliteia.
Objetivo: Avaliar a acuidade diagnóstica da AngioTC nas artérias infrapopliteias em doentes com pé diabético.
Métodos: Estudo unicêntrico retrospetivo dos achados AngioTC e da angiografia digital de subtração em 14 doentes submetidos a revascularização endovascular periférica com pé diabético. A sensibilidade e especificidade da AngioTC foram calculadas para cada segmento arterial de acordo com uma classificação modificada da classificação de Rutherford.
Resultados: A sensibilidade e especificidade global da AngioTC na deteção de lesões estenóticas significativas foi de 1 (95% C.I. 0.89-1) e 0.7 (95% C.I. 0.35-0.93), respetivamente.
Por segmento arterial a sensibilidade e especificidade foram de 0.96 (95% C.I. 0.88-0.99) e 0.86 (95% C.I. 0.57-0.98) na artéria tibial anterior, de 0.98 (95% C.I. 0.90-0.99) e 0.93 (95% C.I. 0.66-0.99) na artéria tibial posterior, de 0.93 (95% C.I. 0.83-0.98) e 0.72 (95% C.I. 0.42-0.92) na artéria peroneal, respetivamente.
Conclusão: A AngioTC tem excelente acuidade diagnóstica e permite a triagem de doentes diabéticos com doença arterial periférica infrapopliteia.info:eu-repo/semantics/publishedVersio
Systematic study of constitutive cyclo-oxygenase-2 expression: role of NFκB and NFAT transcriptional pathways
Cyclooxygenase-2 (COX-2) is an inducible enzyme that drives inflammation and is the therapeutic target for widely used nonsteroidal antiinflammatory drugs (NSAIDs). However, COX-2 is also constitutively expressed, in the absence of overt inflammation, with a specific tissue distribution that includes the kidney, gastrointestinal tract, brain, and thymus. Constitutive COX-2 expression is therapeutically important because NSAIDs cause cardiovascular and renal side effects in otherwise healthy individuals. These side effects are now of major concern globally. However, the pathways driving constitutive COX-2 expression remain poorly understood. Here we show that in the kidney and other sites, constitutive COX-2 expression is a sterile response, independent of commensal microorganisms and not associated with activity of the inflammatory transcription factor NF-κB. Instead, COX-2 expression in the kidney but not other regions colocalized with nuclear factor of activated T cells (NFAT) transcription factor activity and was sensitive to inhibition of calcineurin-dependent NFAT activation. However, calcineurin/NFAT regulation did not contribute to constitutive expression elsewhere or to inflammatory COX-2 induction at any site. These data address the mechanisms driving constitutive COX-2 and suggest that by targeting transcription it may be possible to develop antiinflammatory therapies that spare the constitutive expression necessary for normal homeostatic functions, including those important to the cardiovascular-renal system
Impact of the first wave of the COVID-19 pandemic on non-COVID inpatient care in southern Spain
We assessed the impact of the first wave of COVID-19 pandemic on non-COVID hospital admissions, non-COVID mortality, factors associated with non-COVID mortality, and changes in the profile of non-COVID patients admitted to hospital. We used the Spanish Minimum Basic Data Set with diagnosis grouped according to the Diagnostic Related Groups. A total of 10,594 patients (3% COVID-19; 97% non-COVID) hospitalised during the first wave in 2020 (27-February/07-June) were compared with those hospitalised within the same dates of 2017-2019 (average annual admissions: 14,037). We found a decrease in non-COVID medical (22%) and surgical (33%) hospitalisations and a 25.7% increase in hospital mortality among non-COVID patients during the first pandemic wave compared to pre-pandemic years. During the officially declared sub-period of excess mortality in the area (17-March/20-April, in-hospital non-COVID mortality was even higher (58.7% higher than the pre-pandemic years). Non-COVID patients hospitalised during the first pandemic wave (compared to pre-pandemic years) were older, more frequently men, with longer hospital stay and increased disease severity. Hospitalisation during the first pandemic wave in 2020, compared to hospitalisation during the pre-pandemic years, was an independent risk factor for non-COVID mortality (HR 1.30, 95% CI 1.07-1.57, p = 0.008), reflecting the negative impact of the pandemic on hospitalised patients
Accreting Protoplanets in the LkCa 15 Transition Disk
Exoplanet detections have revolutionized astronomy, offering new insights
into solar system architecture and planet demographics. While nearly 1900
exoplanets have now been discovered and confirmed, none are still in the
process of formation. Transition discs, protoplanetary disks with inner
clearings best explained by the influence of accreting planets, are natural
laboratories for the study of planet formation. Some transition discs show
evidence for the presence of young planets in the form of disc asymmetries or
infrared sources detected within their clearings, as in the case of LkCa 15.
Attempts to observe directly signatures of accretion onto protoplanets have
hitherto proven unsuccessful. Here we report adaptive optics observations of
LkCa 15 that probe within the disc clearing. With accurate source positions
over multiple epochs spanning 2009 - 2015, we infer the presence of multiple
companions on Keplerian orbits. We directly detect H{\alpha} emission from the
innermost companion, LkCa 15 b, evincing hot (~10,000 K) gas falling deep into
the potential well of an accreting protoplanet.Comment: 35 pages, 3 figures, 1 table, 9 extended data item
Accurate masses and radii of normal stars: modern results and applications
This paper presents and discusses a critical compilation of accurate,
fundamental determinations of stellar masses and radii. We have identified 95
detached binary systems containing 190 stars (94 eclipsing systems, and alpha
Centauri) that satisfy our criterion that the mass and radius of both stars be
known to 3% or better. To these we add interstellar reddening, effective
temperature, metal abundance, rotational velocity and apsidal motion
determinations when available, and we compute a number of other physical
parameters, notably luminosity and distance. We discuss the use of this
information for testing models of stellar evolution. The amount and quality of
the data also allow us to analyse the tidal evolution of the systems in
considerable depth, testing prescriptions of rotational synchronisation and
orbital circularisation in greater detail than possible before. The new data
also enable us to derive empirical calibrations of M and R for single (post-)
main-sequence stars above 0.6 M(Sun). Simple, polynomial functions of T(eff),
log g and [Fe/H] yield M and R with errors of 6% and 3%, respectively.
Excellent agreement is found with independent determinations for host stars of
transiting extrasolar planets, and good agreement with determinations of M and
R from stellar models as constrained by trigonometric parallaxes and
spectroscopic values of T(eff) and [Fe/H]. Finally, we list a set of 23
interferometric binaries with masses known to better than 3%, but without
fundamental radius determinations (except alpha Aur). We discuss the prospects
for improving these and other stellar parameters in the near future.Comment: 56 pages including figures and tables. To appear in The Astronomy and
Astrophysics Review. Ascii versions of the tables will appear in the online
version of the articl
A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons.
BACKGROUND: Prisoners experience significantly worse health than the general population. This review examines the effectiveness and cost-effectiveness of peer interventions in prison settings. METHODS: A mixed methods systematic review of effectiveness and cost-effectiveness studies, including qualitative and quantitative synthesis was conducted. In addition to grey literature identified and searches of websites, nineteen electronic databases were searched from 1985 to 2012. Study selection criteria were: Population: Prisoners resident in adult prisons and children resident in Young Offender Institutions (YOIs). INTERVENTION: Peer-based interventions Comparators: Review questions 3 and 4 compared peer and professionally led approaches. OUTCOMES: Prisoner health or determinants of health; organisational/ process outcomes; views of prison populations. STUDY DESIGNS: Quantitative, qualitative and mixed method evaluations. RESULTS: Fifty-seven studies were included in the effectiveness review and one study in the cost-effectiveness review; most were of poor methodological quality. Evidence suggested that peer education interventions are effective at reducing risky behaviours, and that peer support services are acceptable within the prison environment and have a positive effect on recipients, practically or emotionally. Consistent evidence from many, predominantly qualitative, studies, suggested that being a peer deliverer was associated with positive effects. There was little evidence on cost-effectiveness of peer-based interventions. CONCLUSIONS: There is consistent evidence from a large number of studies that being a peer worker is associated with positive health; peer support services are also an acceptable source of help within the prison environment and can have a positive effect on recipients. Research into cost-effectiveness is sparse. SYSTEMATIC REVIEW REGISTRATION: PROSPERO ref: CRD42012002349
First report on dung beetles in intra-Amazonian savannahs in Roraima, Brazil
This is the first study to address the dung beetle (Coleoptera: Scarabaeidae: Scarabaeinae) diversity in intra-Amazonian savannahs in the state of Roraima, Brazil. Our aim was to survey the dung beetle fauna associated with these savannahs (regionally called 'lavrado'), since little is known about the dung beetles from this environment. We conducted three field samples using pitfall traps baited with human dung in savannah areas near the city of Boa Vista during the rainy seasons of 1996, 1997, and 2008. We collected 383 individuals from ten species, wherein six have no previous record in intra-Amazonian savannahs. The most abundant species were Ontherus appendiculatus (Mannerheim, 1829), Canthidium aff. humerale (Germar, 1813), Dichotomius nisus (Olivier, 1789), and Pseudocanthon aff. xanthurus (Blanchard, 1846). We believe that knowing the dung beetles diversity associated with the intra-Amazonian savannahs is ideal for understanding the occurrence and distribution of these organisms in a highly threatened environment, it thus being the first step towards conservation strategy development
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