Resultados: 4
#1
au:Allan, Richard
Filtros
Ordenar por
Página
de 1
Próxima
1.
Narrative review of the valgus knee in primary total joint arthroplasty
Facebook Twitter
Facebook Twitter
- Outras redes sociais
- Google+
- StambleUpon
- CiteULike
- Mendeley
- Outras redes
- Métricas
Almeida, Richard P
; Sekeitto, Allan R
; Sikhauli, Nkhodiseni
; Pietrzak, Jurek RT
; Mokete, Lipalo
.
The valgus knee is less common than the neutral or varus aligned knees in primary total knee arthroplasty (TKA). TKA is technically more challenging in the valgus knee because of the relative difficulty of restoring the joint line, correcting limb alignment, ensuring stability and correcting patellofemoral tracking. Consequently, TKA outcomes are poorer in the valgus knee. The valgus deformity may be intra- or extra-articular or a combination of both, with bony and soft tissue changes resulting in alteration of the rotational profile of the lower limb. Bony changes in the femur include hypoplasia of the distal femur lateral condyle and erosion of the posterior aspect of the lateral condyle. Bony changes in the tibia include remodelling of the lateral tibia plateau and metaphyseal bone. Soft tissue structures on the lateral aspect of the knee may be contracted or tightened with attenuation of the medial stabilising structures. These features contribute to a change in the rotational profile of the knee resulting in external rotation of the tibia and lateral subluxation of the patella with maltracking. Clinical examination should be thorough in both standing and supine positions and must the include the foot and ankle as hindfoot alignment affects the mechanical axis of the weight-bearing lower limb. Neurovascular assessment of the limb should document peroneal nerve integrity as this nerve is at risk of damage at the time of deformity correction. Radiological assessment should, ideally, include long limb weight-bearing views in multiple planes. Computer tomography scanning may be appropriate in cases of severe bony deformities or poorly appreciated anatomical landmarks on standard radiographs. This review delves into the various classification systems for valgus knees and finally, focuses on surgical approaches, appropriate implant choices and technological advancements in the management of the valgus knee. A clear understanding of the pathoanotomy of the valgus knee together with a thorough clinical assessment and appropriate use of technology should help improve outcomes of TKA in the valgus knee. Level of evidence: Level 5
2.
Building clinical pharmacology laboratory capacity in low- and middle-income countries: Experience from Uganda
Facebook Twitter
Facebook Twitter
- Outras redes sociais
- Google+
- StambleUpon
- CiteULike
- Mendeley
- Outras redes
- Métricas
Omali, Denis
; Buzibye, Allan
; Kwizera, Richard
; Byakika-Kibwika, Pauline
; Namakula, Rhoda
; Matovu, Joshua
; Mbabazi, Olive
; Mande, Emmanuel
; Sekaggya-Wiltshire, Christine
; Nakanjako, Damalie
; Gutteck, Ursula
; McAdam, Keith
; Easterbrook, Philippa
; Kambugu, Andrew
; Fehr, Jan
; Castelnuovo, Barbara
; Manabe, Yukari C.
; Lamorde, Mohammed
; Mueller, Daniel
; Merry, Concepta
.
BACKGROUND: Research and clinical use of clinical pharmacology laboratories are limited in low- and middle-income countries. We describe our experience in building and sustaining laboratory capacity for clinical pharmacology at the Infectious Diseases Institute, Kampala, Uganda INTERVENTION: Existing laboratory infrastructure was repurposed, and new equipment was acquired. Laboratory personnel were hired and trained to optimise, validate, and develop in-house methods for testing antiretroviral, anti-tuberculosis and other drugs, including 10 high-performance liquid chromatography methods and four mass spectrometry methods. We reviewed all research collaborations and projects for which samples were assayed in the laboratory from January 2006 to November 2020. We assessed laboratory staff mentorship from collaborative relationships and the contribution of research projects towards human resource development, assay development, and equipment and maintenance costs. We further assessed the quality of testing and use of the laboratory for research and clinical care LESSONS LEARNT: Fourteen years post inception, the clinical pharmacology laboratory had contributed significantly to the overall research output at the institute by supporting 26 pharmacokinetic studies. The laboratory has actively participated in an international external quality assurance programme for the last four years. For clinical care, a therapeutic drug monitoring service is accessible to patients living with HIV at the Adult Infectious Diseases clinic in Kampala, Uganda RECOMMENDATIONS: Driven primarily by research projects, clinical pharmacology laboratory capacity was successfully established in Uganda, resulting in sustained research output and clinical support. Strategies implemented in building capacity for this laboratory may guide similar processes in other low- and middle-income countries
3.
Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
Facebook Twitter
Facebook Twitter
- Outras redes sociais
- Google+
- StambleUpon
- CiteULike
- Mendeley
- Outras redes
- Métricas
Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
Revista Brasileira de Terapia Intensiva
- Métricas do periódico
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
4.
Averting a malaria disaster in Africa: where does the buck stop?
Facebook Twitter
Facebook Twitter
- Outras redes sociais
- Google+
- StambleUpon
- CiteULike
- Mendeley
- Outras redes
- Métricas
Whitty, Christopher J.M.
; Allan, Richard
; Wiseman, Virginia
; Ochola, Sam
; Nakyanzi-Mugisha, Maria Veronicah
; Vonhm, Benjamin
; Mwita, Mahemba
; Miaka, Constantin
; Oloo, Aggrey
; Premji, Zul
; Burgess, Craig
; Mutabingwa, Theonest K.
.
Bulletin of the World Health Organization
- Métricas do periódico
The serious threat posed by the spread of drug-resistant malaria in Africa has been widely acknowledged. Chloroquine resistance is now almost universal, and resistance to the successor drug, sulfadoxine-pyrimethamine (SP), is growing rapidly. Combination therapy has been suggested as being an available and potentially lasting solution to this impending crisis. However, the current cost of combination therapy, and especially that of artemisinin combination therapy (ACT), is potentially a serious drawback, even if a significant part of its cost is passed on to the end-user. If the question of cost is not successfully addressed this could lead to adverse results from the deployment of combination therapy as first-line treatment. These adverse effects range from an increase in potentially fatal delays in infected individuals presenting to medical services, to exclusion of the poorest malaria sufferers from receiving treatment altogether. Urgent steps are needed to reduce the cost of combination therapy to the end-user in a sustainable way if it is to be usable, and some possible approaches are discussed.
La grave amenaza planteada por la propagación de la malaria farmacorresistente en África es un problema ampliamente reconocido. La resistencia a la cloroquina es ya casi universal, y la resistencia al medicamento sucesor, la sulfadoxina-pirimetamina (SP), está extendiéndose rápidamente. Se ha sugerido el recurso a la politerapia como solución disponible y potencialmente duradera para esta crisis inminente. Sin embargo, el actual costo de la politerapia, especialmente el de las combinaciones basadas en la artemisinina (PA), constituye un posible inconveniente grave, aun cuando una parte significativa de ese costo se traslade al usuario. Si no se aborda satisfactoriamente ese problema, el despliegue de la politerapia como tratamiento de primera línea podría conducir a resultados adversos, desde un aumento de los retrasos potencialmente mortales en la búsqueda de atención médica por los individuos infectados, hasta la exclusión total del tratamiento de los enfermos de malaria más pobres. Se requieren medidas urgentes a fin de reducir el costo de la politerapia para el usuario de manera sostenible y hacer así viable esa opción, y se examinan aquí algunas de las posibles estrategias en esa línea.
La grave menace que constitue la propagation du paludisme pharmacorésistant en Afrique est largement reconnue. La résistance à la chloroquine est maintenant presque générale et la résistance à la sulfadoxine-pyriméthamine, le successeur de la chloroquine, gagne rapidement du terrain. On a émis l'idée que la polychimiothérapie pouvait représenter une solution accessible et peut-être durable à cette crise imminente. Cependant, le coût actuel d'un tel traitement, en particulier lorsqu'il comporte une artémisinine, risque d'être un inconvénient majeur, même s'il est supporté pour une grande partie par le patient lui-même. Si l'on ne résout pas la question du coût du traitement, l'adoption de la polychimiothérapie comme traitement de première intention risque d'avoir des conséquences fâcheuses, allant du décès de malades qui auront attendu trop longtemps avant de faire appel aux services médicaux, à l'exclusion des malades les plus pauvres de tout traitement. Il est urgent de prendre des mesures pour réduire durablement le coût de la polychimiothérapie pour le patient si l'on veut qu'elle soit applicable; certaines orientations sont proposées.
1894 downloads
Exibindo
itens por página
Página
de 1
Próxima
Visualizar estatísticas de
Enviar resultado
Exportar resultados
Sem resultados
Não foram encontrados documentos para sua pesquisa
Glossário e ajuda para busca
Você pode enriquecer sua busca de uma forma muito simples. Use os índices de pesquisa combinados com os conectores (AND ou OR) e especifique cada vez mais sua busca.
Por exemplo, se você deseja buscar artigos sobre
casos de dengue no Brasil em 2015, use:ti:dengue and publication_year:2015 and aff_country:Brasil
Veja abaixo a lista completa de índices de pesquisa que podem ser usados:
Cód. do Índice | Elemento |
---|---|
ti | título do artigo |
au | autor |
kw | palavras-chave do artigo |
subject | assunto (palavras do título, resumo e palavras-chave) |
ab | resumo |
ta | título abreviado da revista (ex. Cad. Saúde Pública) |
journal_title | título completo da revista (ex. Cadernos de Saúde Pública) |
la | código do idioma da publicação (ex. pt - Português, es - Espanhol) |
type | tipo do documento |
pid | identificador da publicação |
publication_year | ano de publicação do artigo |
sponsor | financiador |
aff_country | código do país de afiliação do autor |
aff_institution | instituição de afiliação do autor |
volume | volume do artigo |
issue | número do artigo |
elocation | elocation |
doi | número DOI |
issn | ISSN da revista |
in | código da coleção SciELO (ex. scl - Brasil, col - Colômbia) |
use_license | código da licença de uso do artigo |