This study conducts a systematic literature review(SLR)of blockchain consensus mechanisms,an essential protocols that maintain the integrity,reliability,and decentralization of distributed ledger networks.The aim is t...This study conducts a systematic literature review(SLR)of blockchain consensus mechanisms,an essential protocols that maintain the integrity,reliability,and decentralization of distributed ledger networks.The aim is to comprehensively investigate prominent mechanisms’security features and vulnerabilities,emphasizing their security considerations,applications,challenges,and future directions.The existing literature offers valuable insights into various consensus mechanisms’strengths,limitations,and security vulnerabilities and their real-world applications.However,there remains a gap in synthesizing and analyzing this knowledge systematically.Addressing this gap would facilitate a structured approach to understanding consensus mechanisms’security and vulnerabilities comprehensively.The study adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines and computer science standards and reviewed 3749 research papers from 2016 to 2024,excluding grey literature,resulting in 290 articles for descriptive analysis.The research highlights an increased focus on blockchain consensus security,energy efficiency,and hybrid mechanisms within 60%of research papers post-2019,identifying gaps in scalability,privacy,and interoperability for future exploration.By synthesizing the existing research and identifying the key trends,this SLR contributes to advancing the understanding of blockchain consensus mechanisms’security and guiding future research and structured innovation in blockchain systems and applications.展开更多
Background Many epidemiological studies analyze the relationship between hyperuricemia and cardiovascular outcomes. This observational prospective study investigates the association of serum uric acid （SUA） levels w...Background Many epidemiological studies analyze the relationship between hyperuricemia and cardiovascular outcomes. This observational prospective study investigates the association of serum uric acid （SUA） levels with adverse cardiovascular events and deaths in an elderly population affected by advanced atherosclerosis. Methods Two hundred and seventy six elderly patients affected by advanced atherosclerosis （217 males and 59 females; aged 71.2 ±7.8 years） were included. All patients were assessed for history of cardiovascular disease, cancer, obesity and traditional risk factors. Patients were followed for approximately 31 ±11 months. Major events were recorded during follow-up, defined as myocardial infarction, cerebral isehemia, myocardial and/or peripheral revascularization and death. Results Mean SUA level was 5.47 ±1.43 mg/dL; then we further divided the population in two groups, according to the median value （5.36 mg/dL）. During a median follow up of 31 months （5 to 49 months）, 66 cardiovascular events, 9 fatal cardiovascular events and 14 cancer-related deaths have occurred. The patients with increased SUA level presented a higher significant incidence of total cardiovascular events （HR： 1.867, P = 0.014, 95% CI： 1.134-3.074）, The same patients showed a significant increased risk of cancer-related death （HR： 4.335, P = 0.025, 95% CI： 1.204-15.606）. Conclusions Increased SUA levels are independently and significantly associated with risk of cardiovascular events and cancer related death in a population of mainly elderly patients affected by peripheral vasculopathy.展开更多
The extraesophageal manifestations of gastroesophageal reflux disease that are similar to a heart attack or gastric diseases are well known, while those categorized as pulmonary or otolaryngological are less known and...The extraesophageal manifestations of gastroesophageal reflux disease that are similar to a heart attack or gastric diseases are well known, while those categorized as pulmonary or otolaryngological are less known and less studied. In this article, we introduce this less known aspect of gastroesophageal reflux.展开更多
A simple, accurate and sensitive high-performance liquid chromatography （HPLC） method was developed, validated and applied to the determination of either theophylline or paracetamol in milk-based samples. The method...A simple, accurate and sensitive high-performance liquid chromatography （HPLC） method was developed, validated and applied to the determination of either theophylline or paracetamol in milk-based samples. The method allowed drug quantification in fresh and powdered milk with a relatively short run time of analysis and it was also successfully applied to the quantification of the drugs in solid dosage forms intended for pediatric use. Moreover, the main significant advantages over other published works are the simplicity of the sample preparation, reduced assay time and sample loss. The method meets the International Conference on Harmonization guideline for analytical methods validation regarding specificity, linearity, accuracy, precision, specificity and robustness as required by health authorities and applied by industry while designing and marketing new drug products. The technique encompasses the separation of the analytes with a reverse phase C18 column under isocrafic conditions and UV detection at 272 nm and 243 nm, respectively, for theophylline and paraeetamol. The lower limit of quantification for both drugs was determined as 0.2 μg/mL and the between-batch accuracy was 99.7%. This HPLC method allows quantification of theophylline and paracetamol in milk matrices and it can be applied in the design, development and production of milk-based pediatric dosage forms.展开更多
The influence of pile-up on the nanoindentation measurements in Cu 2wt.%Be samples with precipitates was carefully studied.The precipitates were formed by aging treatments for 1 h at different temperatures between 540...The influence of pile-up on the nanoindentation measurements in Cu 2wt.%Be samples with precipitates was carefully studied.The precipitates were formed by aging treatments for 1 h at different temperatures between 540 and 680 K.The load depth curves were analyzed using the classical Oliver and Pharr method,and the obtained elastic modulus and hardness were compared with values estimated by other techniques.An important level of pile-up was found in samples with precipitates and differences in the load depth curves were observed between the unaged and aged samples.A correction of the contact depth considering the pile-up proposed by Loubet was used for hardness estimation.For the determination of the elastic modulus,an approach based on the relation between the ratio of unloading work to indentation total work,with the ratio H/Er(H is the hardness;Er is the reduced modulus),was employed.A specific relation between both parameters was developed.展开更多
Background: Basic and clinical studies suggest that statins may prevent and even ameliorate acute pan- creatitis. The present study was to evaluate whether statin decreases the risk of acute pancreatitis in patients u...Background: Basic and clinical studies suggest that statins may prevent and even ameliorate acute pan- creatitis. The present study was to evaluate whether statin decreases the risk of acute pancreatitis in patients undergoing endoscopic ultrasound-guided ne-needle aspiration of pancreatic cysts. Methods: Out of 456 patients with pancreatic cysts referred to our center between 2006 and 2018, 365 were nally included in analyses: 86 were treated with statins and 279 were not at the time of endo- scopic ultrasound ne-needle aspiration. We compared the acute pancreatitis incidence between the two groups, and we also compared other complications such as bleeding and infections. Results: Median age was 64 years [interquartile range (IQR) 62 69] and median cyst size was 24mm (IQR, 21 29). The most frequent histology was intraductal papillary mucinous neoplasm (45.3% and 42.3% in the two groups, respectively;P =0.98). All 13 patients experiencing post-endoscopic ultrasound acute pancreatitis were from the control group (4.7%), of which 3 were classi ed as severe pancreatitis. None of statin users developed post-procedural acute pancreatitis (odds ratio: 0.15;95% con dence interval: 0.03 0.98;P=0.03). No difference was registered with regard to severe pancreatitis and other complications. Conclusions: Statins exert a bene cial role in preventing acute pancreatitis in patients with pancreatic cysts undergoing endoscopic ultrasound-guided ne-needle aspiration. If con rmed in prospective trials, our ndings may pave the way to an extensive use of statins as prophylactic agents in pancreatic inter- ventional endoscopy.展开更多
Hepatocellular carcinoma(HCC) represents the sixth common cancer and the second leading cause of cancer-related death. Its incidence is higher in Eastern countries. HCC is frequently detected at advanced stage of dise...Hepatocellular carcinoma(HCC) represents the sixth common cancer and the second leading cause of cancer-related death. Its incidence is higher in Eastern countries. HCC is frequently detected at advanced stage of disease, and therefore, the mortality is high [1].展开更多
AIM:To determine initial medication adherence in newly diagnosed glaucoma patients treated with anti-glaucoma drugs.METHODS:This retrospective and observational study included all patients diagnosed with glaucoma in t...AIM:To determine initial medication adherence in newly diagnosed glaucoma patients treated with anti-glaucoma drugs.METHODS:This retrospective and observational study included all patients diagnosed with glaucoma in the Primary Health Care units in Portugal during the years 2012 and 2013,which in consequence received a first prescription for anti-glaucoma drugs.Data was collected from electronic prescribing records of the primary care units and from pharmacy claims records.Initiation of glaucoma treatment and early discontinuation were measured,and the combination of(non)-initiation and early discontinuation accounted for initial medication(non)-adherence.RESULTS:A total of 3548 new glaucoma patients(40.1%male;59.9%female)were included.The 1133(31.9%)patients were initially classified as non-users,since there was no pharmacy claim found for their first prescription for glaucoma treatment.Additionally,277(11.5%)patients early discontinued their treatment,acquiring only their first prescription.Overall,the initial medication non-adherence rate was 39.7%since 1410 patients either didn’t initiate treatment or discontinued it early.CONCLUSION:This study,reveals a major opportunity to improve glaucoma treatment and its control,since a large proportion of patients fail to engage with their prescribed therapy,which implies that implementation of individual or group strategies that enable patients with glaucoma to correctly perform their treatment is still needed.展开更多
The majority of patients infected with Severe Acute Respiratory Syndrome-COrona-Virus-2(SARS-CoV-2)either completely recover from symptoms in a few days or stay asymptomatic.[1−3]Nevertheless,a consistent proportion o...The majority of patients infected with Severe Acute Respiratory Syndrome-COrona-Virus-2(SARS-CoV-2)either completely recover from symptoms in a few days or stay asymptomatic.[1−3]Nevertheless,a consistent proportion of subjects with a history of probable or confirmed SARS-CoV-2 infection refers persistency,new occurrence,relapse,or fluctuation of symptoms,and these manifestations are defined as post-COVID-19 condition.[4]Of note,the post-acute sequelae of COVID-19 include several cardiac manifestations,including direct myocardial and pericardial injury/inflammation,as well as cardiomyopathies and arrythmias,sustained by viral infiltration and/or dysregulation of adaptive immune response.[5]Even though rare,acute myocarditis may be an important post-COVID-19 condition and may be associated with the occurrence of new-onset atrial fibrillation.展开更多
The indentation size effect(ISE)was studied by instrumented nanoindentation and Vickers hardness measurements on polycrystalline copper,βCuAlBe pseudoelastic and age-hardenable CuBe alloys.Variations in the load-dept...The indentation size effect(ISE)was studied by instrumented nanoindentation and Vickers hardness measurements on polycrystalline copper,βCuAlBe pseudoelastic and age-hardenable CuBe alloys.Variations in the load-depth curves at different loads would suggest a change in the behavior of the materials as the load increases.Nanohardness was estimated at different loads taking into account the pile-up in each case,which was estimated from the images of the topography obtained by atomic force microscopy(AFM).The effect of the microstructure of Cu-2Be(wt%)samples on the ISE was also studied.For each copper alloy,the Nix and Gao model was applied to the hardness-depth curves,and significant differences were found for the parameters obtained.Cu is in the constant nanohardness regime for depths below 500 nm,while microhardness exhibits the ISE effect.The behavior of the nanohardness and the plastic strain with the depth is almost inverse.CuAlBe presents the lowest values of plastic strains due to the pseudoelastic effect,while Cu presents an almost constant value around 8%,which corresponds to the highest plastic strain obtained.展开更多
To evaluate the effect of preoperative keratometry on visual and refractive outcomes after Myopic LASER in Situ Keratomileusis (LASIK) in eyes with preoperative spherical equivalent (SE) of -6.00D or less. Material an...To evaluate the effect of preoperative keratometry on visual and refractive outcomes after Myopic LASER in Situ Keratomileusis (LASIK) in eyes with preoperative spherical equivalent (SE) of -6.00D or less. Material and Methods: A retrospective study enrolling clinical records of 482 eyes of 275 patients with myopia who underwent LASIK between 2009 and 2016. Subjects were grouped according to the degree of preoperative mean keratometry (Km), into three groups: Group 1 (Flat Cornea): Km ≤ 42.00 diopters (D);Group 2: 42.00 46.00D;Group 3 (Steep Cornea): Km ≥ 46.00D. To evaluate the prognostic impact of keratometry in Myopic LASIK, we considered the results measured at 6 months postoperatively, including uncorrected distance visual acuity (UDVA), postoperative sphere, cylinder, SE and its variation. Results: The mean preoperative SE was -3.91 ± 1.54D, ranging between -0.88 and -6.00D. The percentage of eyes achieving a postoperative SE of ±0.50D was 39.5%, 31.8% and 26% in groups 1, 2 and 3 respectively. Moreover, in group 3, 14.3% of the eyes had a residual SE of -2.00D or greater, contrasting with the groups 1 and 2 with only 6% - 7%. These results were found to be statistically significant. Concerning UDVA, eyes achieving 20/25 or more were 81.5%, 81.8% and 71.5%, and 20/50 or less were 6.7%, 6.2% and 11.7% in groups 1, 2 and 3 respectively. Conclusions: Myopic eyes with steeper corneas seem to have greater tendency to undercorrection, also presenting worse visual outcomes.展开更多
Purpose: Brown’s Syndrome (BS) is a restrictive strabismus characterized by a limitation of elevation in adduction. Several etiologies have been described, usually involving the superior oblique muscle. Spontaneous i...Purpose: Brown’s Syndrome (BS) is a restrictive strabismus characterized by a limitation of elevation in adduction. Several etiologies have been described, usually involving the superior oblique muscle. Spontaneous improvement has been reported in several studies, so surgery is reserved for a minority of cases. Our purpose is to review the characteristics, natural history and treatment of this pathology and present the experience of the Instituto de Oftalmologia Dr. Gama Pinto (IOGP). Methods: A consecutive retrospective series of BS patients seen at the Strabismus Department of IOGP between 1983 and 2014 was reviewed. All patients with complete clinical data were included in this study. The epidemiologic characteristics, clinical features, treatment, and clinical progression were reviewed. Results: Thirty-nine cases were selected, with a mean age at first diagnosis of 6.5 years. Of the thirty-nine cases, 6 were iatrogenic and the remainder idiopathic. Thirty-six cases were followed for a mean period of 6.1 years. Surgical intervention for BS was performed in 11 patients, using different approaches. Of these, 9 cases were considered successful. The remaining 25 cases were kept under observation without surgery, of which 17 showed spontaneous improvement and the other 7 remained unchanged. Conclusions: The surgical success rate was 82%, which demonstrates the good efficacy of the surgery despite the complexity and variety of pathophysiological mechanisms of the syndrome. In the patients kept under observation there was spontaneous improvement in 68%, confirming that a conservative approach seems to be adequate in most cases.展开更多
Marine biodiversity has emerged as a very promising resource of bioactive compounds and secondary metabolites from different sea organisms.The sponge’s secondary metabolites demonstrated various bioactivities and pot...Marine biodiversity has emerged as a very promising resource of bioactive compounds and secondary metabolites from different sea organisms.The sponge’s secondary metabolites demonstrated various bioactivities and potential pharmacological properties.This systematic review of the literature focuses on the advances achieved in the antioxidant potential of marine sponges in vitro.The review was performed in accordance with PRISMA guidelines.The main inclusion criterion for analysis was articles with identification of compounds from terpene classes that demonstrate antioxidant activity in vitro.Searching in three different databases,two hundred articles were selected.After screening abstracts,titles and evaluating for eligibility of manuscripts 14 articles were included.The most performed analyzes to detect antioxidant activity were scavenging activity 2,2-diphenyl-1-picrylhydrazyl(DPPH)and measurement of intracellular reactive oxygen species(ROS).It was possible to identify 17 compounds of the terpene class with pronounced antioxidant activity in vitro.Scientific evidence of the studies included in this review was accessed by the GRADE analysis.Terpenes play an important ecological role,moreover these molecules have a pharmaceutical and industrial application.展开更多
Background: Recently, gamma-glutamyl transferase (GGT) has been investigated as a predictive factor for therapy response in hepatitis C patients, but so far its value in pretreatment screening has not been established...Background: Recently, gamma-glutamyl transferase (GGT) has been investigated as a predictive factor for therapy response in hepatitis C patients, but so far its value in pretreatment screening has not been established. Therefore, this study aimed at evaluating GGT as an independent predictive factor for the response to treatment with interferon-α and ribavirin in hepatitis C virus (HCV)infected patients. Methods: Naive chronic hepatitis C patients undergoing a 6-month follow-up after interferon-alpha and ribavirin therapy had their sustained virologic response (SVR) analyzed according to age, sex, body mass index, GGT levels, genotype, and liver histology by use of a multivariate logistic regression model. Results: Of the 211 patients studied with amean age of 48 ± 10 years, 125 (59% )were males. Overweight was detected in 47% of patients. Genotype 1 was detected in 141 (75% ) of the 187 patients tested. Cirrhosis was present in 67 (32% ). A high pretreatment GGT level was observed in 134 (63% ). SVR was obtained in 84 (40% ) patients. In the final logistic regression model, the variables independently associated with SVR were GGT (P < 0.001), genotype (P < 0.001), and liver histology (P < 0.001). Conclusion: A normal GGT level is an independent predictive factor for SVR in HCV-infected patients and should be considered for pretreatment screening.展开更多
Background: Small intestinal ultrasonography with anechoic contrast agents (SICUS) has been shown to have a diagnostic accuracy on small bowel morphology similar to X-ray barium follow-through. Although extremely inve...Background: Small intestinal ultrasonography with anechoic contrast agents (SICUS) has been shown to have a diagnostic accuracy on small bowel morphology similar to X-ray barium follow-through. Although extremely investigated by transabdominal ultrasonography, celiac disease, a common disorder of the small bowel, has been never studied by SICUS. Aim: To asses SICUS characteristics of celiac disease patients. Patients and Methods: SICUS was performed using PEG 4000 as contrast agent. Twenty-three patients with celiac disease at the first diagnosis were enrolled and 30 healthy volunteers, matched for sex and age, were selected as control group. Celiac disease diagnosis was based on anti-gluten, anti-endomysium, and anti-transglutaminase positivity as well as jejunal histology. The following seven echographic parameters were considered: liquid endoluminal content before contrast, loop diameter, Kerckring’ s folds, peristaltic waves, ileal jejunalization, mesenteric lymphoadenomegaly,and Doppler resistance index (RI) of mesenteric superior artery. Statistical analysis was performed by Student’ s t test for unpaired data; one-way analysis of variance was used to correlate echographic and histologic pictures. Results: Loop diameter, Kerckring’ s fold number, peristaltic waves, and Doppler RI appeared to be significantly different between celiac disease patients and controls. Additionally, liquid content, ileal jejunalization, and mesenteric lymphoadenomegaly were present only in the celiacs (52.1% ,47.7% , and 95.6% , respectively), but not in controls. Only Doppler RI values significantly correlated with the histologic degree of damage. Conclusions: SICUS could be a reliable and noninvasive technique to confirm a diagnosis of celiac disease performed using conventional investigations. The possibility of investigating the whole small bowel and the safety of repeating examinations could be useful in the follow-up of celiac patients.展开更多
Objective: This study aims to describe the experience with diode laser cyclophotocoagulation in the control of intraocular pressure and resolution of pain in patients with refractory glaucoma. Methods: Retrospective s...Objective: This study aims to describe the experience with diode laser cyclophotocoagulation in the control of intraocular pressure and resolution of pain in patients with refractory glaucoma. Methods: Retrospective study. 64 eyes of 60 patients who underwent cyclophotocoagulation between January 2008 and March 2014. Evaluation of the pre- and post-operative intraocular pressure, the control of ocular pain, the number of anti-glaucoma drugs used in pre- and post-intervention, the rate of complications and the success rate. Results: There was an overall success rate of 81.3%, with 9 eyes needing a second intervention. There was a mean reduction of 52.6% of the preoperative mean intraocular pressure of 41.25 to 19.56 mmHg at 12 months observation (p < 0.001). There was also a statistically significant reduction in the number of anti-glaucoma drugs used from 3.19 to 2.01 per eye and the resolution of pain in 75% of patients. Conclusions: cyclophotocoagulation is an effective procedure, with an expected positive impact on quality of life of patients as a result from the decreased number of anti-glaucoma drugs, sustained intraocular pressure reduction and resolution of pain.展开更多
Five patients (4 males; mean age, 46.4 years) with pain-ful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretrovira...Five patients (4 males; mean age, 46.4 years) with pain-ful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4+ counts ranged from 73 to 370/mm3. All lesions were submitted to resection under subdural anesthesia. Histologic examinations revealed epithelial hyperplasia and dense inflammatory process, composed mainly of lymphocytes and plasma cells, extended just to the hypodermis. Immunohistochemistry was positive for herpes simplex virus Type 2 in four patients and for herpes simplex virus Type 1 in one patient, and did not detect human papillomavirus antigens. Three patients had recurrences after 3, 10, and 12 months. Resection was performed on two patients; one had a new recurrence after three months. Oral acyclovir eliminated the lesion in the third patient. The analysis of our patients suggests that herpes simplex virus, Types 1 and 2, may cause verrucous lesions simulating neoplasia in patients with AIDS using antiretroviral therapy.展开更多
基金funded by Universiti Teknologi PETRONAS and grants(YUTP-PRG:015PBC-011).
文摘This study conducts a systematic literature review(SLR)of blockchain consensus mechanisms,an essential protocols that maintain the integrity,reliability,and decentralization of distributed ledger networks.The aim is to comprehensively investigate prominent mechanisms’security features and vulnerabilities,emphasizing their security considerations,applications,challenges,and future directions.The existing literature offers valuable insights into various consensus mechanisms’strengths,limitations,and security vulnerabilities and their real-world applications.However,there remains a gap in synthesizing and analyzing this knowledge systematically.Addressing this gap would facilitate a structured approach to understanding consensus mechanisms’security and vulnerabilities comprehensively.The study adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines and computer science standards and reviewed 3749 research papers from 2016 to 2024,excluding grey literature,resulting in 290 articles for descriptive analysis.The research highlights an increased focus on blockchain consensus security,energy efficiency,and hybrid mechanisms within 60%of research papers post-2019,identifying gaps in scalability,privacy,and interoperability for future exploration.By synthesizing the existing research and identifying the key trends,this SLR contributes to advancing the understanding of blockchain consensus mechanisms’security and guiding future research and structured innovation in blockchain systems and applications.
文摘Background Many epidemiological studies analyze the relationship between hyperuricemia and cardiovascular outcomes. This observational prospective study investigates the association of serum uric acid （SUA） levels with adverse cardiovascular events and deaths in an elderly population affected by advanced atherosclerosis. Methods Two hundred and seventy six elderly patients affected by advanced atherosclerosis （217 males and 59 females; aged 71.2 ±7.8 years） were included. All patients were assessed for history of cardiovascular disease, cancer, obesity and traditional risk factors. Patients were followed for approximately 31 ±11 months. Major events were recorded during follow-up, defined as myocardial infarction, cerebral isehemia, myocardial and/or peripheral revascularization and death. Results Mean SUA level was 5.47 ±1.43 mg/dL; then we further divided the population in two groups, according to the median value （5.36 mg/dL）. During a median follow up of 31 months （5 to 49 months）, 66 cardiovascular events, 9 fatal cardiovascular events and 14 cancer-related deaths have occurred. The patients with increased SUA level presented a higher significant incidence of total cardiovascular events （HR： 1.867, P = 0.014, 95% CI： 1.134-3.074）, The same patients showed a significant increased risk of cancer-related death （HR： 4.335, P = 0.025, 95% CI： 1.204-15.606）. Conclusions Increased SUA levels are independently and significantly associated with risk of cardiovascular events and cancer related death in a population of mainly elderly patients affected by peripheral vasculopathy.
文摘The extraesophageal manifestations of gastroesophageal reflux disease that are similar to a heart attack or gastric diseases are well known, while those categorized as pulmonary or otolaryngological are less known and less studied. In this article, we introduce this less known aspect of gastroesophageal reflux.
基金the financial support provided by Fundacao para a Ciência e a Tecnologia,Portugal(PTDC/DTP-FTO/1057/2012)
文摘A simple, accurate and sensitive high-performance liquid chromatography （HPLC） method was developed, validated and applied to the determination of either theophylline or paracetamol in milk-based samples. The method allowed drug quantification in fresh and powdered milk with a relatively short run time of analysis and it was also successfully applied to the quantification of the drugs in solid dosage forms intended for pediatric use. Moreover, the main significant advantages over other published works are the simplicity of the sample preparation, reduced assay time and sample loss. The method meets the International Conference on Harmonization guideline for analytical methods validation regarding specificity, linearity, accuracy, precision, specificity and robustness as required by health authorities and applied by industry while designing and marketing new drug products. The technique encompasses the separation of the analytes with a reverse phase C18 column under isocrafic conditions and UV detection at 272 nm and 243 nm, respectively, for theophylline and paraeetamol. The lower limit of quantification for both drugs was determined as 0.2 μg/mL and the between-batch accuracy was 99.7%. This HPLC method allows quantification of theophylline and paracetamol in milk matrices and it can be applied in the design, development and production of milk-based pediatric dosage forms.
基金supported by Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Comisión de Investigaciones Científicas de la Provincia de Buenos Aires (CICPBA)SECAT (UNCPBA) Argentina
文摘The influence of pile-up on the nanoindentation measurements in Cu 2wt.%Be samples with precipitates was carefully studied.The precipitates were formed by aging treatments for 1 h at different temperatures between 540 and 680 K.The load depth curves were analyzed using the classical Oliver and Pharr method,and the obtained elastic modulus and hardness were compared with values estimated by other techniques.An important level of pile-up was found in samples with precipitates and differences in the load depth curves were observed between the unaged and aged samples.A correction of the contact depth considering the pile-up proposed by Loubet was used for hardness estimation.For the determination of the elastic modulus,an approach based on the relation between the ratio of unloading work to indentation total work,with the ratio H/Er(H is the hardness;Er is the reduced modulus),was employed.A specific relation between both parameters was developed.
文摘Background: Basic and clinical studies suggest that statins may prevent and even ameliorate acute pan- creatitis. The present study was to evaluate whether statin decreases the risk of acute pancreatitis in patients undergoing endoscopic ultrasound-guided ne-needle aspiration of pancreatic cysts. Methods: Out of 456 patients with pancreatic cysts referred to our center between 2006 and 2018, 365 were nally included in analyses: 86 were treated with statins and 279 were not at the time of endo- scopic ultrasound ne-needle aspiration. We compared the acute pancreatitis incidence between the two groups, and we also compared other complications such as bleeding and infections. Results: Median age was 64 years [interquartile range (IQR) 62 69] and median cyst size was 24mm (IQR, 21 29). The most frequent histology was intraductal papillary mucinous neoplasm (45.3% and 42.3% in the two groups, respectively;P =0.98). All 13 patients experiencing post-endoscopic ultrasound acute pancreatitis were from the control group (4.7%), of which 3 were classi ed as severe pancreatitis. None of statin users developed post-procedural acute pancreatitis (odds ratio: 0.15;95% con dence interval: 0.03 0.98;P=0.03). No difference was registered with regard to severe pancreatitis and other complications. Conclusions: Statins exert a bene cial role in preventing acute pancreatitis in patients with pancreatic cysts undergoing endoscopic ultrasound-guided ne-needle aspiration. If con rmed in prospective trials, our ndings may pave the way to an extensive use of statins as prophylactic agents in pancreatic inter- ventional endoscopy.
文摘Hepatocellular carcinoma(HCC) represents the sixth common cancer and the second leading cause of cancer-related death. Its incidence is higher in Eastern countries. HCC is frequently detected at advanced stage of disease, and therefore, the mortality is high [1].
文摘AIM:To determine initial medication adherence in newly diagnosed glaucoma patients treated with anti-glaucoma drugs.METHODS:This retrospective and observational study included all patients diagnosed with glaucoma in the Primary Health Care units in Portugal during the years 2012 and 2013,which in consequence received a first prescription for anti-glaucoma drugs.Data was collected from electronic prescribing records of the primary care units and from pharmacy claims records.Initiation of glaucoma treatment and early discontinuation were measured,and the combination of(non)-initiation and early discontinuation accounted for initial medication(non)-adherence.RESULTS:A total of 3548 new glaucoma patients(40.1%male;59.9%female)were included.The 1133(31.9%)patients were initially classified as non-users,since there was no pharmacy claim found for their first prescription for glaucoma treatment.Additionally,277(11.5%)patients early discontinued their treatment,acquiring only their first prescription.Overall,the initial medication non-adherence rate was 39.7%since 1410 patients either didn’t initiate treatment or discontinued it early.CONCLUSION:This study,reveals a major opportunity to improve glaucoma treatment and its control,since a large proportion of patients fail to engage with their prescribed therapy,which implies that implementation of individual or group strategies that enable patients with glaucoma to correctly perform their treatment is still needed.
文摘The majority of patients infected with Severe Acute Respiratory Syndrome-COrona-Virus-2(SARS-CoV-2)either completely recover from symptoms in a few days or stay asymptomatic.[1−3]Nevertheless,a consistent proportion of subjects with a history of probable or confirmed SARS-CoV-2 infection refers persistency,new occurrence,relapse,or fluctuation of symptoms,and these manifestations are defined as post-COVID-19 condition.[4]Of note,the post-acute sequelae of COVID-19 include several cardiac manifestations,including direct myocardial and pericardial injury/inflammation,as well as cardiomyopathies and arrythmias,sustained by viral infiltration and/or dysregulation of adaptive immune response.[5]Even though rare,acute myocarditis may be an important post-COVID-19 condition and may be associated with the occurrence of new-onset atrial fibrillation.
基金This work was financially supported by the Consejo Nacional de Investigaciones Cientfficas y Tecnicas(CONI-CET)the Comision de Investigaciones Cientfficas de la Provincia de Buenos Aires(CICPBA)the SECAT(UNCPBA)Argentina.
文摘The indentation size effect(ISE)was studied by instrumented nanoindentation and Vickers hardness measurements on polycrystalline copper,βCuAlBe pseudoelastic and age-hardenable CuBe alloys.Variations in the load-depth curves at different loads would suggest a change in the behavior of the materials as the load increases.Nanohardness was estimated at different loads taking into account the pile-up in each case,which was estimated from the images of the topography obtained by atomic force microscopy(AFM).The effect of the microstructure of Cu-2Be(wt%)samples on the ISE was also studied.For each copper alloy,the Nix and Gao model was applied to the hardness-depth curves,and significant differences were found for the parameters obtained.Cu is in the constant nanohardness regime for depths below 500 nm,while microhardness exhibits the ISE effect.The behavior of the nanohardness and the plastic strain with the depth is almost inverse.CuAlBe presents the lowest values of plastic strains due to the pseudoelastic effect,while Cu presents an almost constant value around 8%,which corresponds to the highest plastic strain obtained.
文摘To evaluate the effect of preoperative keratometry on visual and refractive outcomes after Myopic LASER in Situ Keratomileusis (LASIK) in eyes with preoperative spherical equivalent (SE) of -6.00D or less. Material and Methods: A retrospective study enrolling clinical records of 482 eyes of 275 patients with myopia who underwent LASIK between 2009 and 2016. Subjects were grouped according to the degree of preoperative mean keratometry (Km), into three groups: Group 1 (Flat Cornea): Km ≤ 42.00 diopters (D);Group 2: 42.00 46.00D;Group 3 (Steep Cornea): Km ≥ 46.00D. To evaluate the prognostic impact of keratometry in Myopic LASIK, we considered the results measured at 6 months postoperatively, including uncorrected distance visual acuity (UDVA), postoperative sphere, cylinder, SE and its variation. Results: The mean preoperative SE was -3.91 ± 1.54D, ranging between -0.88 and -6.00D. The percentage of eyes achieving a postoperative SE of ±0.50D was 39.5%, 31.8% and 26% in groups 1, 2 and 3 respectively. Moreover, in group 3, 14.3% of the eyes had a residual SE of -2.00D or greater, contrasting with the groups 1 and 2 with only 6% - 7%. These results were found to be statistically significant. Concerning UDVA, eyes achieving 20/25 or more were 81.5%, 81.8% and 71.5%, and 20/50 or less were 6.7%, 6.2% and 11.7% in groups 1, 2 and 3 respectively. Conclusions: Myopic eyes with steeper corneas seem to have greater tendency to undercorrection, also presenting worse visual outcomes.
文摘Purpose: Brown’s Syndrome (BS) is a restrictive strabismus characterized by a limitation of elevation in adduction. Several etiologies have been described, usually involving the superior oblique muscle. Spontaneous improvement has been reported in several studies, so surgery is reserved for a minority of cases. Our purpose is to review the characteristics, natural history and treatment of this pathology and present the experience of the Instituto de Oftalmologia Dr. Gama Pinto (IOGP). Methods: A consecutive retrospective series of BS patients seen at the Strabismus Department of IOGP between 1983 and 2014 was reviewed. All patients with complete clinical data were included in this study. The epidemiologic characteristics, clinical features, treatment, and clinical progression were reviewed. Results: Thirty-nine cases were selected, with a mean age at first diagnosis of 6.5 years. Of the thirty-nine cases, 6 were iatrogenic and the remainder idiopathic. Thirty-six cases were followed for a mean period of 6.1 years. Surgical intervention for BS was performed in 11 patients, using different approaches. Of these, 9 cases were considered successful. The remaining 25 cases were kept under observation without surgery, of which 17 showed spontaneous improvement and the other 7 remained unchanged. Conclusions: The surgical success rate was 82%, which demonstrates the good efficacy of the surgery despite the complexity and variety of pathophysiological mechanisms of the syndrome. In the patients kept under observation there was spontaneous improvement in 68%, confirming that a conservative approach seems to be adequate in most cases.
基金the FAPESP(Fundação de AmparoàPesquisa do Estado de São Paulo)A.C.M.R(2019/10228-5)A.C.C.A.(2019/19708-0).FAPEG(Fundação de AmparoàPesquisa do Estado de Goiás)L.R.F.S(202110267000075).
文摘Marine biodiversity has emerged as a very promising resource of bioactive compounds and secondary metabolites from different sea organisms.The sponge’s secondary metabolites demonstrated various bioactivities and potential pharmacological properties.This systematic review of the literature focuses on the advances achieved in the antioxidant potential of marine sponges in vitro.The review was performed in accordance with PRISMA guidelines.The main inclusion criterion for analysis was articles with identification of compounds from terpene classes that demonstrate antioxidant activity in vitro.Searching in three different databases,two hundred articles were selected.After screening abstracts,titles and evaluating for eligibility of manuscripts 14 articles were included.The most performed analyzes to detect antioxidant activity were scavenging activity 2,2-diphenyl-1-picrylhydrazyl(DPPH)and measurement of intracellular reactive oxygen species(ROS).It was possible to identify 17 compounds of the terpene class with pronounced antioxidant activity in vitro.Scientific evidence of the studies included in this review was accessed by the GRADE analysis.Terpenes play an important ecological role,moreover these molecules have a pharmaceutical and industrial application.
文摘Background: Recently, gamma-glutamyl transferase (GGT) has been investigated as a predictive factor for therapy response in hepatitis C patients, but so far its value in pretreatment screening has not been established. Therefore, this study aimed at evaluating GGT as an independent predictive factor for the response to treatment with interferon-α and ribavirin in hepatitis C virus (HCV)infected patients. Methods: Naive chronic hepatitis C patients undergoing a 6-month follow-up after interferon-alpha and ribavirin therapy had their sustained virologic response (SVR) analyzed according to age, sex, body mass index, GGT levels, genotype, and liver histology by use of a multivariate logistic regression model. Results: Of the 211 patients studied with amean age of 48 ± 10 years, 125 (59% )were males. Overweight was detected in 47% of patients. Genotype 1 was detected in 141 (75% ) of the 187 patients tested. Cirrhosis was present in 67 (32% ). A high pretreatment GGT level was observed in 134 (63% ). SVR was obtained in 84 (40% ) patients. In the final logistic regression model, the variables independently associated with SVR were GGT (P < 0.001), genotype (P < 0.001), and liver histology (P < 0.001). Conclusion: A normal GGT level is an independent predictive factor for SVR in HCV-infected patients and should be considered for pretreatment screening.
文摘Background: Small intestinal ultrasonography with anechoic contrast agents (SICUS) has been shown to have a diagnostic accuracy on small bowel morphology similar to X-ray barium follow-through. Although extremely investigated by transabdominal ultrasonography, celiac disease, a common disorder of the small bowel, has been never studied by SICUS. Aim: To asses SICUS characteristics of celiac disease patients. Patients and Methods: SICUS was performed using PEG 4000 as contrast agent. Twenty-three patients with celiac disease at the first diagnosis were enrolled and 30 healthy volunteers, matched for sex and age, were selected as control group. Celiac disease diagnosis was based on anti-gluten, anti-endomysium, and anti-transglutaminase positivity as well as jejunal histology. The following seven echographic parameters were considered: liquid endoluminal content before contrast, loop diameter, Kerckring’ s folds, peristaltic waves, ileal jejunalization, mesenteric lymphoadenomegaly,and Doppler resistance index (RI) of mesenteric superior artery. Statistical analysis was performed by Student’ s t test for unpaired data; one-way analysis of variance was used to correlate echographic and histologic pictures. Results: Loop diameter, Kerckring’ s fold number, peristaltic waves, and Doppler RI appeared to be significantly different between celiac disease patients and controls. Additionally, liquid content, ileal jejunalization, and mesenteric lymphoadenomegaly were present only in the celiacs (52.1% ,47.7% , and 95.6% , respectively), but not in controls. Only Doppler RI values significantly correlated with the histologic degree of damage. Conclusions: SICUS could be a reliable and noninvasive technique to confirm a diagnosis of celiac disease performed using conventional investigations. The possibility of investigating the whole small bowel and the safety of repeating examinations could be useful in the follow-up of celiac patients.
文摘Objective: This study aims to describe the experience with diode laser cyclophotocoagulation in the control of intraocular pressure and resolution of pain in patients with refractory glaucoma. Methods: Retrospective study. 64 eyes of 60 patients who underwent cyclophotocoagulation between January 2008 and March 2014. Evaluation of the pre- and post-operative intraocular pressure, the control of ocular pain, the number of anti-glaucoma drugs used in pre- and post-intervention, the rate of complications and the success rate. Results: There was an overall success rate of 81.3%, with 9 eyes needing a second intervention. There was a mean reduction of 52.6% of the preoperative mean intraocular pressure of 41.25 to 19.56 mmHg at 12 months observation (p < 0.001). There was also a statistically significant reduction in the number of anti-glaucoma drugs used from 3.19 to 2.01 per eye and the resolution of pain in 75% of patients. Conclusions: cyclophotocoagulation is an effective procedure, with an expected positive impact on quality of life of patients as a result from the decreased number of anti-glaucoma drugs, sustained intraocular pressure reduction and resolution of pain.
文摘Five patients (4 males; mean age, 46.4 years) with pain-ful verrucous perianal lesions caused by herpes simplex virus are described. All patients had had AIDS for a long time and were using highly active antiretroviral therapy. CD4+ counts ranged from 73 to 370/mm3. All lesions were submitted to resection under subdural anesthesia. Histologic examinations revealed epithelial hyperplasia and dense inflammatory process, composed mainly of lymphocytes and plasma cells, extended just to the hypodermis. Immunohistochemistry was positive for herpes simplex virus Type 2 in four patients and for herpes simplex virus Type 1 in one patient, and did not detect human papillomavirus antigens. Three patients had recurrences after 3, 10, and 12 months. Resection was performed on two patients; one had a new recurrence after three months. Oral acyclovir eliminated the lesion in the third patient. The analysis of our patients suggests that herpes simplex virus, Types 1 and 2, may cause verrucous lesions simulating neoplasia in patients with AIDS using antiretroviral therapy.
