550 research outputs found
Evidence for central hypercortisolism and elevated blood pressure in adolescent offspring of mothers with pre-eclampsia
No full textObjective: Maternal total and free cortisol concentrations are reduced in pre-eclampsia (PE) and gestational hypertension (GH). However, the effect of this on the hypothalamic–pituitary–adrenal (HPA) axis function in the offspring is unknown. We examined the basal HPA axis activity in adolescent offspring of mothers with pre-pregnancy hypertension/GH/PE. Design and subjects A total of 1182 participants (mean age 17·1 years) recruited from the Western Australian Pregnancy Cohort (Raine) Study provided fasting morning blood samples for basal HPA axis and concomitant clinical assessments, including blood pressure. Measurements: Plasma ACTH, total cortisol, corticosteroid-binding globulin (CBG) and free cortisol calculated by Coolens' equation were measured from the blood samples collected at home before 10:00 am. Results: Total plasma cortisol (689 ± 153 nmol/l vs 583 ± 172 nmol/l, P = 0·024), ACTH (15·5 ± 13 pmol/l vs 10·8 ± 5·1 pmol/l, P = 0·040) and calculated free cortisol (52 ± 21 nmol/l vs 42 ± 22 nmol/l, P = 0·052) were higher in the PE offspring than in controls. The pre-pregnancy hypertension group had evidence of a lower ACTH/plasma free cortisol ratio (0·22 vs 0·33 P = 0·020) and lower CBG (713 nmol/l vs 821 nmol/l, P = 0·004) compared with controls. Systolic blood pressure was elevated in the GH/PE group compared with controls (120 mmHg vs 116 mmHg, P = 0·006). Conclusions: Hypothalamic–pituitary–adrenal axis activity is increased in the adolescent offspring of mothers with pre-eclampsia. This may be an adaptation resulting from the reduced maternal cortisol during foetal life. The resulting mild hypercortisolism may have implications for long-term health outcomes and warrants further investigation.David Henley, Suzanne Brown, Craig Pennell, Stephen Lye and David J. Torp
Motricidade fina no teste de batidas do dedo com crianças: análise da variabilidade com expoente de lyapunov
No full textRecent advancements in nonlinear methodologies have allowed deeper analysis of motor control during development. This study aimed to analyse the evolution of the fine motor skills in children aged 6 to 9 years old through the Lypaunov Exponent (LyE). It was asked to 60 children (M=8,141±1,064 years) to perform the finger taping test, 6 trials in each hand, starting with their preferred one. An inertial sensor was attached to the index finger to collect three-dimensional angular velocity. The LyE values were calculated per child, hand, and movement axis. The results highlighted a notable distinction between the 6- and 7-year-old and the 8- and 9-year-old, aligned with the different phases of motor development. The older ones presented higher variability, which can reflect their greater proficiency in this fine motor task, due to their extensive practice at school context. LyE analysis seems to be sensitive to changes that occur during different phases of motor development.Recentes avanços nas metodologias não lineares permitiram uma análise mais profunda do controlo motor durante o desenvolvimento. Este estudo teve como objetivo analisar a evolução da motricidade fina em crianças dos 6 aos 9 anos de idade através do Expoente de Lyapunov (LyE). Foi pedido a 60 crianças (M=8,141±1,064 anos) que realizassem o teste de batidas do dedo, 6 tentativas em cada mão, começando pela sua preferida. Foi colocado um sensor inercial no dedo indicador para recolher a velocidade angular tridimensional. Valores de LyE foram calculados por criança, mão e eixo de movimento. Os resultados evidenciaram uma distinção notável entre as crianças de 6 e 7 anos e as de 8 e 9 anos, o que está de acordo com as diferentes fases de desenvolvimento motor. Os mais velhos apresentaram maior variabilidade, o que pode refletir a sua maior proficiência nesta tarefa motora fina, devido à sua prática extensiva no contexto escolar. A análise de LyE parece ser sensível às mudanças que ocorrem durante as diferentes fases do desenvolvimento motor.info:eu-repo/semantics/publishedVersio
Emerg Infect Dis
No full textOn April 25, 2009, Singapore implemented strict containment measures for pandemic (H1N1) 2009 with enhanced surveillance and hospital isolation. In the first month, seasonal influenza, predominantly virus subtype H3N2, was diagnosed for 32% of patients with acute febrile respiratory illness. Our findings underscore the high prevalence of seasonal influenza in Singapore
Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance: A Randomized Clinical Trial
No full textExtended-spectrum β-lactamases mediate resistance to third-generation cephalosporins (eg, ceftriaxone) in Escherichia coli and Klebsiella pneumoniae. Significant infections caused by these strains are usually treated with carbapenems, potentially selecting for carbapenem resistance. Piperacillin-tazobactam may be an effective "carbapenem-sparing" option to treat extended-spectrum β-lactamase producers
Hot topics in the diagnosis and management of skin and soft-tissue infections
No full textEighteen hot topics regarding the diagnosis and management of skin and soft-tissue infections (SSTIs) were selected and reviewed by members of the SSTI Working Group of the International Society of Chemotherapy (ISC). Despite the large amount of literature available on the issue selected, there are still many unknowns with regard to many of them and further studies are required to answer these challenging issues that face clinicians on a daily basis
One size does not fit all : Assuming the same normal body temperature for everyone is not justified
No full textDespite the increasing personalization of medicine, surprisingly ~37.0˚C (98.6˚F) continues
as the estimate of normal temperature. We investigated between-subject and within-subject
thermal variability, whether a significant percentage of individuals have a low mean oral temperature, and whether these differ by sex, age, time of day, ethnicity, body mass index
(BMI), or menstrual phase. Oral temperature was measured by Life Brand® Fast-Read Digital Oral Thermometers and sampled 14 times over two weeks, seven morning and seven
evening readings. The volunteer sample consisted of 96 adults (42 men, 54 women; 27 couples, 42 singletons), ages 18–67 years. We found sizeable individual differences in body
temperature and that the normal temperature of many individuals is considerably lower than
37.0˚C (98.6˚F). Mean temperatures ranged from 35.2˚C (95.4˚F) to 37.4˚C (99.3˚F). The
mean temperature across all participants was 36.1˚C (97.0˚F)—lower than most studies
have reported, consistent with recent evidence of temperature declining over decades. 77%
had mean temperatures at least 0.55˚C (1˚F) lower than 37.0˚C (98.6˚F). Mean temperature
did not differ by age, but women had higher temperatures than men, even within a couple
with room temperature and warmth of clothing equated. Although oral temperature varied
widely across individuals, it showed marked stability within individuals over days. Variability
of temperature over days did not differ by sex, but was larger among younger adults. Using
37.0˚C (98.6˚F) as the assumed normal temperature for everyone can result in healthcare
professionals failing to detect a serious fever in individuals with a low normal temperature
or obtaining false negatives for those individuals when using temperature to screen for
COVID-19, mistaking their elevated temperature as normal. Some have called for lowering
the estimate of normal temperature slightly (e.g., 0.2˚C [0.36˚F]). That still seems an overly
high estimate. More important, using any standardized “normal” temperature will lead to
errors for many people. Individual differences are simply too great. Personalizing body temperature is needed. Temperature could be measured at yearly doctor visits, as blood pressure is now. That would be simple to implement. Since our results show marked thermal
stability within an individual, sampling temperature only once yearly could provide an accurate indication of a person’s normal temperature at that time of day. Such records over
time would also provide a more accurate understanding of how temperature changes over
the lifespan.Medicine, Faculty ofNon UBCPsychiatry, Department ofReviewedFacultyResearcherOthe
Film, Video, and Digitality: An Analysis of Cultural Form in Time-based Media
No full textThis thesis examines the material properties of time-based image media, in particular live video. The project is practice-based with a theoretical underpinning drawn from the debates on form and meaning associated with Walter Benjamin
Emerg Infect Dis
No full textSingapore experienced its first documented Zika virus outbreak in 2016. We identified clinical and laboratory parameters that increase the probability for Zika or dengue virus infection. Early during the illness, combinations of key parameters obtained through clinical assessment and hematologic tests can help distinguish between these infections
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