RESUMO
PURPOSE: The present study aims to assess the impact of the local language on the view count of patient-oriented educational Sports Medicine videos in an Orthopaedic and Sports Medicine Hospital in the Middle East and North Africa. METHODS: An observational study on English and Arabic versions of Aspetar's YouTube channel patient-oriented educational video series was conducted in February 2023, comparing the view count and viewer characteristics. Included videos were posted either simultaneously or in English version first, in both languages, and shared on the same media platforms. Collected data of interest included video title, view count in each language, age and sex of the viewers, location, and traffic source. RESULTS: Eleven videos of the patient-oriented educational video series were included in the present study. Except for one, the view count was significantly higher in the Arabic version of all 11 videos (minimum sevenfold, P = 0.03). Viewers were predominantly males (73.9%) and between 18 and 44 years old (81.1%). Eleven out of 19 countries of the Middle East and North Africa region [11] were among the viewers' top 20 countries. Traffic sources included YouTube search (45.9%), YouTube suggested videos (17%), external sources (14.4%), YouTube browse features (8.5%), and YouTube advertising (6%). CONCLUSION: Patient-oriented educational Sports Medicine videos in Arabic yield higher view counts than their English version in young adult viewers from 11 countries in the Middle East and Africa among the top 20. Content creation on languages with limited online representation could effectively reach the targeted population by breaking language barriers.
Assuntos
Mídias Sociais , Masculino , Adulto Jovem , Humanos , Adolescente , Adulto , Feminino , Idioma , África do Norte , Oriente Médio , África , Gravação em VídeoRESUMO
OBJECTIVE: To examine outcomes of neonates based on the mode and intensity of resuscitation received in the delivery room (DR). STUDY DESIGN: A retrospective study of 439 infants with birth weight ⩽1500 g receiving DR resuscitation at two hospital centers in Philadelphia, Pennsylvania. RESULTS: Of 439 infants, 22 (5%) received routine care, 188 (43%) received noninvasive positive pressure ventilation (PPV) and 229 (52%) received endotracheal tube (ETT) intubation in the DR. Adjusted odds for respiratory distress syndrome was associated with lower rates in infants requiring lower intensity of DR resuscitation (P<0.001). Noninvasive PPV vs ETT was associated with decreased odds of developing intraventricular hemorrhage and retinopathy of prematurity (P<0.05). Routine vs noninvasive PPV or ETT had decreased odds of developing bronchopulmonary dysplasia (P<0.05). CONCLUSION: Decreased intensity of DR resuscitation was associated with a decreased risk of specific morbidities.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas/estatística & dados numéricos , Intubação Intratraqueal/estatística & dados numéricos , Ventilação não Invasiva/estatística & dados numéricos , Ressuscitação/métodos , Adulto , Estudos de Casos e Controles , Cesárea/estatística & dados numéricos , Salas de Parto , Feminino , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva/estatística & dados numéricos , Intubação Intratraqueal/efeitos adversos , Masculino , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Ressuscitação/efeitos adversos , Estudos Retrospectivos , Adulto JovemRESUMO
Previously we investigated the tissue factor (TF)-dependent coagulation pathway and key haemostatic cofactors in white women with preeclampsia (P-EC) and suggested that plasma factor VII (FVII) levels can differentiate women with P-EC from healthy nonpregnant women or normal pregnant women, at the same trimester, with high sensitivity, specificity, positive and negative predictive values. Here we re-examine the TF-dependent pathway in a large cohort of Brazilian women. A total of 240 women were studied. These included healthy nonpregnant women (nâ=â79), normotensive pregnant women (nâ=â80) and women with severe P-EC (nâ=â81). Commercially available enzyme-linked immunosorbent assays were used to measure plasma FVII, activated factor VII (FVIIa), TF and tissue factor pathway inhibitor (TFPI). All study participants were matched for age. Pregnant women (with/without P-EC) were matched for gestational age and parity. Plasma levels of FVII, FVIIa and TFPI were significantly increased in women with severe P-EC compared with healthy nonpregnant women (Pâ<â0.01) or normotensive pregnant women (Pâ<â0.01). FVIIa was also higher in normotensive pregnant women compared with nonpregnant women (Pâ<â0.01). However, no such significant trends were observed for plasma TF levels (Pâ=â0.074). In conclusion, circulating FVII, FVIIa and TFPI were significantly elevated in women with severe P-EC in the absence of comparable changes in plasma TF levels. The present work is in agreement with our previous report on FVII levels in white women with P-EC. Thus, this lends further support to the notion that plasma FVII levels are potentially valuable diagnostic marker for P-EC, irrespective of ethnicity.
Assuntos
Fator VII/genética , Fator VIIa/genética , Lipoproteínas/genética , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/diagnóstico , Tromboplastina/genética , Adulto , Coagulação Sanguínea , Pressão Sanguínea , Brasil , Estudos de Casos e Controles , Estudos de Coortes , Fator VII/metabolismo , Fator VIIa/metabolismo , Feminino , Expressão Gênica , Humanos , Lipoproteínas/sangue , Pré-Eclâmpsia/genética , Pré-Eclâmpsia/patologia , Gravidez , Índice de Gravidade de Doença , Tromboplastina/metabolismoRESUMO
BACKGROUND: There may be a relationship between endothelial dysfunction, coagulation activation and nitric oxide (NO) synthesis in women with mild and severe preeclampsia (PE). METHODS: Plasma thrombomodulin (TM), D-Dimer (D-Di), cyclic guanosine monophosphate (cGMP) and placental nitric oxide synthase activity (NOS) were investigated in 21 normotensive pregnant women (G1), 22 pregnant women with mild PE (G2) and 20 pregnant women with severe PE (G3). RESULTS: TM and D-Di were significantly increased in G3 compared to G1 (P=0.001 and P=0.006, respectively) and G2 (P=0.001, in both cases). However, there was no significant difference when G1 was compared to G2. For total NOS, calcium independent NOS, calcium dependent NOS no significant difference was observed among the groups studied. CONCLUSIONS: TM and D-Di levels are raised in women with severe PE compared to normotensive pregnant women and women with mild PE. While increased TM levels may reflect endothelial dysfunction, raised D-Di levels indicate a hypercoagulable state. NO assessed by 2 indirect methods did not show any significant difference among the groups studied. Due to current limitations with in vitro NO measurements and interferences associated with NO bioavailability, particularly in PE, such findings should not be over-interpreted.
Assuntos
Coagulação Sanguínea , Células Endoteliais/metabolismo , Óxido Nítrico/sangue , Placenta/metabolismo , Pré-Eclâmpsia/sangue , Adulto , GMP Cíclico/sangue , Células Endoteliais/patologia , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Óxido Nítrico/biossíntese , Óxido Nítrico Sintase Tipo II/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Placenta/patologia , Pré-Eclâmpsia/patologia , Gravidez , Índice de Gravidade de Doença , Trombomodulina/sangueRESUMO
Preeclampsia (PE) is a multi-system disorder of human pregnancy, whose etiology remains poorly understood. Preeclamptic women are known to have an increased hypercoagulable state that result in excess fibrin deposition in several organs, which compromises their function. Tissue factor (TF) is the main physiological initiator of blood coagulation and its activity is regulated by a specific inhibitor known as Tissue factor pathway inhibitor (TFPI). Based on the important role of TF and TFPI in hemostasis, we hypothesize that their levels may change in the severe PE contributing to exacerbate hypercoagulable state. Some studies have assessed the balance between TF and TFPI in preeclamptic women, but results are inconsistent. Therefore, the aim of this study was to examine these inconsistencies and to assess TF and TFPI plasma levels in three groups of age matched women; pregnant with severe PE (n = 60), normotensive pregnant (n = 50) and normotensive non-pregnant women (n = 50). There was not significantly different among the three groups for TF plasma levels; severe PE women: 338.4 pg/mL (248.1-457.6), normotensive pregnant women: 301.5 pg/mL (216.4-442.9) and normotensive non-pregnant women 393 pg/mL (310.3-522.9). TFPI plasma levels were higher in severe PE comparing to normotensive pregnant women and normotensive non-pregnant women, 115.8 ng/mL (75-149.8); 80.3 ng/mL (59.6-99.7) and 74.5 ng/mL (47.1-98.0), respectively No difference was found between normotensive pregnant women and normotensive non-pregnant women. As for gestational age, a significant difference in TFPI levels was found between severe PE and normotensive pregnant women up to the 33rd week of pregnancy (p = 0.001), and severe PE and non-pregnant women up to the 34th (p = 0.01). In summary, our results indicated that TF plasma levels did not vary in the studied groups, while TFPI plasma levels were significantly increased in severe PE compared to normotensive pregnant and normotensive non-pregnant women. So, our data do not explain the exacerbated hypercoagulability state observed in severe PE. Further studies evaluating genes expression, TF activity and antigen, total and free TFPI and TFPI-2, both in plasma and obstetric tissues, throughout the pregnancy in PE (mild and severe forms) are required.
Assuntos
Lipoproteínas/sangue , Pré-Eclâmpsia/sangue , Terceiro Trimestre da Gravidez/sangue , Tromboplastina/metabolismo , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Pré-Eclâmpsia/fisiopatologia , Gravidez , Índice de Gravidade de DoençaRESUMO
The association between type 2 diabetes and cardiovascular disease is long recognized. Although perturbations of haemostatic markers have been shown to be associated with macrovascular disease in patients with type 2 diabetes, it is unclear whether these are primarily due to endothelial dysfunction or a result of inflammation. The present study was undertaken to elucidate whether elevated levels of factor VIII (FVIII) and von Willebrand factor (vWF) in women with type 2 diabetes represent endothelial dysfunction, inflammation or an alternate mechanism. Sixty-four women with type 2 diabetes were evaluated using ultrasonography Doppler for carotid intima-media thickness (IMT) and were classified as group A--having no (<1 âmm), group B - mild (≥1 âmm and no plaque) and group C--moderate (≥1âmm and presence of plaque and stenosis) macrovascular disease. Several haemostatic markers including, FVIII, vWF and fibrinogen were assessed. In addition, thrombomodulin, a marker for endothelial damage, and high-sensitivity C-reactive protein (hsCRP), an inflammatory marker, were also measured. A significant association of elevated FVIII was found in group B and C patients (i.e. patients with IMT ≥1âmm and with plaque). Elevated fibrinogen and vWF levels were also found but confined to group C patients. No significant difference among subgroups was found for any other variable evaluated (hsCRP, thrombomodulin and FVII). In conclusion, plasma FVIII levels are elevated in women with type 2 diabetes and macrovascular disease. It also appears that this is not mediated by inflammation or endothelial injury and is likely to be due to an alternate mechanism.
Assuntos
Doenças Cardiovasculares/sangue , Diabetes Mellitus Tipo 2/sangue , Endotélio Vascular/metabolismo , Fator VIII/metabolismo , Inflamação/sangue , Fator de von Willebrand/metabolismo , Idoso , Biomarcadores/sangue , Proteína C-Reativa/análise , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/fisiopatologia , Espessura Intima-Media Carotídea , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Diabetes Mellitus Tipo 2/fisiopatologia , Endotélio Vascular/diagnóstico por imagem , Endotélio Vascular/fisiopatologia , Feminino , Fibrinogênio/metabolismo , Humanos , Inflamação/diagnóstico por imagem , Inflamação/fisiopatologia , Pessoa de Meia-Idade , Trombomodulina/sangue , Túnica Íntima/anatomia & histologia , Túnica Íntima/diagnóstico por imagem , Ultrassonografia Doppler em CoresRESUMO
A plethora of evidence exists to show that endothelial perturbations underlie many of the clinical features of pre-eclampsia (P-EC), and consequently the markers signifying endothelial disturbance exhibit a rise in plasma. Among others, plasma thrombomodulin (TM) level rises significantly. TM is a transmembrane glycoprotein expressed abundantly on the endothelium of the microvasculature. It neutralizes the thrombotic potential of thrombin, mediating this anticoagulant effect through activation of protein C. Endothelial injury results in a localized loss of TM with a focal impairment of protein C activation and resultant thrombotic tendency. Mainly expressed on the endothelial cells, a small amount of TM is found in plasma with levels rising in certain pathological conditions. Although elevation in levels of TM can be due to endothelial TM proteolysis secondary to endothelial insult, ineffective clearance may account for this in renal and hepatic dysfunction. In P-EC not only is there ongoing endothelial injury, but renal function is also affected. To establish the cause of elevated TM level in P-EC, three groups of pregnant women were investigated. It appears that the elevation in plasma TM is not related to renal or hepatic dysfunction in P-EC. It is more likely that plasma TM is derived from placental or vascular endothelial cells subsequent to activation or damage, confirming the hypothesis that damage to vascular endothelial cells is the primary underlying cause of P-EC.
Assuntos
Endotélio Vascular/metabolismo , Pré-Eclâmpsia/sangue , Trombomodulina/sangue , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Creatinina/sangue , Endotélio Vascular/patologia , Feminino , Humanos , Hipertensão Induzida pela Gravidez/sangue , Gravidez , Proteína C/metabolismo , Ureia/sangueRESUMO
INTRODUCTION: Normal pregnancy is associated with a local hypercoagulable state that becomes more profound in certain obstetric complications such pre-eclampsia (P-EC). Current literature on the levels of individual haemostatic factors in women with P-EC is limited and results are inconsistent. In this study we provide detailed investigation on the tissue factor (TF)-dependent pathway in women with P-EC. MATERIALS AND METHODS: Enzyme-linked immunosorbent assays (ELISA) were used to measure plasma factor (F) FVII, FVIIa, TF and tissue factor pathway inhibitor (TFPI) in healthy non-pregnant women (n = 22), normal pregnant women (n = 15), and women with P-EC (n = 20). All subjects were age matched. In addition, pregnant women were matched for gestational age, parity and were all at the third trimester. RESULTS: Plasma FVII levels were significantly higher in women with P-EC compared to the healthy non-pregnant (P<0.001) or the normal pregnant groups (P<0.001). No such significant trends were observed for plasma FVIIa, TF or TFPI levels. Plasma FVII levels can distinguish women with P-EC from healthy non-pregnant women or normal pregnant women at the third trimester, with high sensitivity (90%), specificity (80%), positive and negative predictive values (86%). CONCLUSIONS: Plasma FVII levels are significantly elevated in women with P-EC, in the absence of comparable changes in other TF-dependent pathway factors (FVIIa, TF and TFPI). We propose the use of plasma FVII as a marker for P-EC.