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  1. Article: A Comparison of Pathogenic Eukaryotic Elongation Factor 2 (EEF2) Variants in Spinocerebellar Ataxia 26 Versus De Novo Mutations.

    Zhao, Hongfei / Mata-Machado, Nikolas

    Cureus

    2022  Volume 14, Issue 7, Page(s) e26857

    Abstract: In this article, we present an eight-year-old boy with developmental delay and cerebellar symptoms who was found to have a de novo eukaryotic elongation factor 2 (EEF2) mutation on genetic testing. Previously, pathogenic mutations in EEF2 have been ... ...

    Abstract In this article, we present an eight-year-old boy with developmental delay and cerebellar symptoms who was found to have a de novo eukaryotic elongation factor 2 (EEF2) mutation on genetic testing. Previously, pathogenic mutations in EEF2 have been associated with spinocerebellar ataxia 26. An extremely rare disorder, spinocerebellar ataxia type 26 (SCA26), has only been documented as an autosomal dominant, inherited, late-onset ataxia in one six-generation family of Norwegian descent. However, three pediatric patients with de novo EEF2 mutations were recently discovered, presenting with noncerebellar symptoms such as syndactyly, developmental delay, and behavioral issues. The patient of this study was found to have features similar to both adult patients with SCA26 as well as previous pediatric patients with de novo mutations.
    Language English
    Publishing date 2022-07-14
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.26857
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Evolution of intra-operative parathyroid hormone and its application in parathyroid surgery.

    Machado, Nikita / Wilhelm, Scott M

    Vitamins and hormones

    2022  Volume 120, Page(s) 271–288

    Abstract: The history and evolution of parathyroid hormone is a true testament to inter-disciplinary collaboration among anatomists, biochemists and surgeons. The parathyroid glands were the last endocrine glands to be discovered in the mid-1800s. Over the next ... ...

    Abstract The history and evolution of parathyroid hormone is a true testament to inter-disciplinary collaboration among anatomists, biochemists and surgeons. The parathyroid glands were the last endocrine glands to be discovered in the mid-1800s. Over the next century, progress in the evaluation of primary hyperparathyroidism, the identification of parathyroid hormone (PTH) and its application for use in the field of parathyroid surgery have led to a significant improvement in surgical cure rates, accompanied by a shift toward minimally invasive surgical options. This chapter provides a historical lens through which we can view these relatively recent advancements, as well as the current role of parathyroid hormone, both with regards to pre-operative localization and intra-operative detection of abnormal glands. Furthermore, we discuss the importance of parathyroid hormone in the management of complex multiglandular disease and reoperative cases, as well as the significance of persistently elevated PTH levels post-parathyroidectomy.
    MeSH term(s) Humans ; Minimally Invasive Surgical Procedures ; Parathyroid Glands/surgery ; Parathyroid Hormone ; Parathyroidectomy
    Chemical Substances Parathyroid Hormone
    Language English
    Publishing date 2022-07-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 201161-x
    ISSN 2162-2620 ; 0083-6729
    ISSN (online) 2162-2620
    ISSN 0083-6729
    DOI 10.1016/bs.vh.2022.04.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Is early initiated cardiorespiratory fitness training within a model of stroke-integrated cardiac rehabilitation safe and feasible?

    Machado, Natasha / Williams, Gavin / Olver, John / Johnson, Liam

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

    2023  Volume 33, Issue 2, Page(s) 107493

    Abstract: Objective: To investigate the safety and feasibility of an early initiated stroke-integrated Cardiac Rehabilitation program.: Methods: People with acute first or recurrent ischaemic stroke, admitted to Epworth HealthCare were screened for eligibility ...

    Abstract Objective: To investigate the safety and feasibility of an early initiated stroke-integrated Cardiac Rehabilitation program.
    Methods: People with acute first or recurrent ischaemic stroke, admitted to Epworth HealthCare were screened for eligibility and invited to participate. In addition to usual care neurorehabilitation, participants performed 1) cardiorespiratory fitness training 3-days/week during inpatient rehabilitation (Phase 1), and/or 2) 2-days/week centre-based cardiorespiratory fitness training plus education and 1-day/week home-based cardiorespiratory fitness training for 6-weeks during outpatient rehabilitation (Phase 2). Safety was determined by the number of adverse and serious adverse events. Feasibility was determined by participant recruitment, retention, and attendance rates, adherence to exercise recommendations, and participant satisfaction.
    Results: There were no study-related adverse or serious adverse events. Of 117 eligible stroke admissions, 62 (53%) were recruited, while 10 (16.1%) participants withdrew. Participants attended 189 of 201 (94%) scheduled cardiorespiratory fitness training sessions in Phase 1 and 341/381 (89.5%) scheduled sessions in Phase 2. Only 220/381 (58%) scheduled education sessions were attended. The minimum recommended cardiorespiratory fitness training intensity (40% heart rate reserve) and duration (20 minutes) was achieved by 57% and 55% of participants respectively during Phase 1, and 60% and 92% respectively during Phase 2. All respondents strongly agreed (69%) or agreed (31%) they would recommend the stroke-integrated Cardiac Rehabilitation program to other people with stroke.
    Conclusion: Cardiorespiratory fitness training in line with multiple clinical practice guidelines included within a model of stroke-integrated Cardiac Rehabilitation appears to be safe and feasible in the early subacute phase post-stroke.
    MeSH term(s) Humans ; Stroke/diagnosis ; Stroke/therapy ; Stroke/etiology ; Cardiorespiratory Fitness ; Exercise Therapy/adverse effects ; Cardiac Rehabilitation ; Brain Ischemia/etiology ; Treatment Outcome ; Stroke Rehabilitation/adverse effects
    Language English
    Publishing date 2023-12-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1131675-5
    ISSN 1532-8511 ; 1052-3057
    ISSN (online) 1532-8511
    ISSN 1052-3057
    DOI 10.1016/j.jstrokecerebrovasdis.2023.107493
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Book: Using the bodies of the dead

    Machado, Nora

    legal, ethical and organisational dimensions of organ transplantation

    1998  

    Author's details Nora Machado
    Keywords Transplantation ; Ethik ; Recht
    Subject Verpflanzung ; Organtransplantation ; Organ ; Organverpflanzung ; Ethische Theorie ; Moral ; Philosophische Ethik ; Sittenlehre ; Moralphilosophie
    Language English
    Size 262 S. : Ill.
    Publisher Ashgate Dartmouth
    Publishing place Aldershot u.a.
    Publishing country Great Britain
    Document type Book
    Note Includes bibliographical references and index
    HBZ-ID HT010830468
    ISBN 1-85521-973-5 ; 978-1-85521-973-1
    Database Catalogue ZB MED Medicine, Health

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  5. Article: The Anesthetic Complexity of Eisenmenger Syndrome: A Clinical Case.

    Calaia, Rúben / Machado, Neuza / Branquinho, Juliana / Figueiredo, Eduarda / Pereira, Carla / Guedes, Alexandra

    Cureus

    2024  Volume 16, Issue 2, Page(s) e54285

    Abstract: Eisenmenger syndrome (ES) is a complex, multisystemic, and rare clinical entity, given that currently, most congenital heart diseases can be corrected in childhood. The high anesthetic risk in these patients poses a challenge for anesthesiology. There ... ...

    Abstract Eisenmenger syndrome (ES) is a complex, multisystemic, and rare clinical entity, given that currently, most congenital heart diseases can be corrected in childhood. The high anesthetic risk in these patients poses a challenge for anesthesiology. There are few cases described in the literature of anesthetic approaches using ketamine and dexmedetomidine in ES cases, particularly under Monitored Anesthesia Care (MAC). We describe the clinical case of a 40-year-old patient with trisomy 21, intellectual disability, and ES secondary to a single atrioventricular (AV) valve, scheduled for cranial magnetic resonance imaging (MRI) under sedation due to a suspected space-occupying lesion. Sedation was performed under MAC with dexmedetomidine and ketamine. The procedure proceeded without complications. The anesthetic approach in ES patients, given the clinical complexity, requires planning by a multidisciplinary team and should be tailored to the procedure and its duration.
    Language English
    Publishing date 2024-02-16
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.54285
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Effectiveness of Nonpharmacological Interventions in the Field of Ventilation: An Umbrella Review.

    Reis, Neuza / Gaspar, Luis / Paiva, Abel / Sousa, Paula / Machado, Natália

    International journal of environmental research and public health

    2023  Volume 20, Issue 7

    Abstract: This umbrella review aimed to determine the effectiveness of nonpharmacological interventions in pulmonary ventilation and their impact on respiratory function. An individual with impaired ventilation displays visible variations manifested in their ... ...

    Abstract This umbrella review aimed to determine the effectiveness of nonpharmacological interventions in pulmonary ventilation and their impact on respiratory function. An individual with impaired ventilation displays visible variations manifested in their respiratory frequency, breathing rhythm ratio (I:E), thoracic symmetry, use of accessory muscles, dyspnea (feeling short of breath), oxygen saturation, diaphragm mobility, minute ventilation, peak flow, walking test, spirometry, Pimax/Pemax, diffusion, and respiratory muscle strength. Any variation in these markers demands the need for interventions in order to duly manage the signs and symptoms and to improve ventilation.
    Method: Systematic reviews of the literature published in English, Spanish, French, and Portuguese were used, which included studies in which nonpharmacological interventions were used as a response to impaired ventilation in adults in any given context of the clinical practice. The recommendations given by the Joanna Briggs Institute (JBI) for umbrella reviews were followed. This research took place in several databases such as MEDLINE, CINAHL Complete, CINHAL, MedicLatina, ERIC, Cochrane Reviews (Embase), and PubMed. The Joanna Briggs critical analysis verification list was used for the systematic review. The data extraction was performed independently by two investigators based on the data extraction tools of the Joanna Briggs Institute, and the data were presented in a summary table alongside the support text.
    Results: Forty-four systematic reviews, thirty randomized clinical essays, and fourteen observational studies were included in this review. The number of participants varied between n = 103 and n = 13,370. Fifteen systematic revisions evaluated the effect of isolated respiratory muscular training; six systematic revisions evaluated, in isolation, breathing control (relaxed breathing, pursed-lip breathing, and diaphragmatic breathing exercises) and thoracic expansion exercises; and one systematic review evaluated, in isolation, the positions that optimize ventilation. Nineteen systematic reviews with combined interventions that reinforced the role of education and capacitation while also aiming for their success were considered. The articles analyzed isolated interventions and presented their efficacy. The interventions based on respiratory exercises and respiratory muscular training were the most common, and one article mentioned the efficacy of positioning in the compromisation of ventilation. Combined interventions in which the educational component was included were found to be effective in improving pulmonary function, diffusion, oxygenation, and functional capacity. The outcomes used in each study were variable, leading to a more difficult analysis of the data.
    Conclusions: The interventions that were the focus of the review were duly mapped. The results suggest that nonpharmacological interventions used to optimize ventilation are effective, with a moderate to high level of evidence. There is a strong foundation for the use of the chosen interventions. The lack of studies on the intervention of "positioning to optimize ventilation" points out the need for a deeper analysis of its effects and for studies with a clear focus. This study supports the decisions and recommendations for the prescription of these interventions to patients with impaired ventilation.
    MeSH term(s) Adult ; Humans ; Breathing Exercises ; Exercise/physiology ; Respiration ; Systematic Reviews as Topic
    Language English
    Publishing date 2023-03-23
    Publishing country Switzerland
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph20075239
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Impact of frailty on complications and length of stay after minimally invasive adrenalectomy surgery.

    Ahuja, Vanita / Gibson, Courtney / Machado, Nikita / King, Joseph T

    Surgery

    2023  Volume 175, Issue 2, Page(s) 336–341

    Abstract: Background: Adrenal disease requiring surgery incidence increases with age, and minimally invasive adrenalectomy procedures have improved the safety of adrenal surgery. This study evaluates the perioperative outcomes of elective adrenalectomies when ... ...

    Abstract Background: Adrenal disease requiring surgery incidence increases with age, and minimally invasive adrenalectomy procedures have improved the safety of adrenal surgery. This study evaluates the perioperative outcomes of elective adrenalectomies when performed in older patients and how frailty affects such outcomes.
    Methods: Patients undergoing elective minimally invasive adrenalectomy were identified using the American College of Surgeon's National Surgical Quality Improvement Program Participant Use Targeted File years 2005 to 2020. The surgical indication was categorized as a benign disease, an endocrine disorder, or a malignant disease. Frailty was defined using the 5-item modified frailty index. Multivariable regressions were used to model the relationship of age and frailty with surgical outcomes.
    Results: In 8,693 minimally invasive adrenalectomy patients, 5,281 (61%) were female, 5,026 (58%) were White, and 1,924 (22%) were aged 65 years or older. Surgical indications were benign disease 5,487 (63%), endocrinopathy 2,850 (33%), and malignancy 356 (4%). Patients aged <65 years (compared to those aged ≥65) were more likely to have a 5-item modified frailty index = 0 (26% vs 14%, respectively) and less likely to have a 5-item modified frailty index = ≥3 (2% vs 4%, respectively; P < .001).
    Outcomes: 30-day mortality 20 (0.2%), complications 459 (5%), return to operating room 73 (0.8%), and median length of stay 2 days. Thirty-day mortality was associated with a 5-item modified frailty index ≥3 (P = .009) and endocrine disease (P = .005) but not with age. Complications were associated with a 5-item modified frailty index ≥2 (≤P < .001) and malignant disease (P = .002), but not with age.
    Conclusion: Minimally invasive adrenalectomy has low 30-day mortality and complication rates that increase with frailty and not age. Frailty is a better predictor than the age of most adverse outcomes after elective minimally invasive adrenalectomy.
    MeSH term(s) Humans ; Female ; Aged ; Male ; Adrenalectomy/adverse effects ; Adrenalectomy/methods ; Frailty/complications ; Frailty/epidemiology ; Length of Stay ; Retrospective Studies ; Adrenal Gland Neoplasms/pathology ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery
    Language English
    Publishing date 2023-12-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2023.10.023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Pandemic preparedness means policy makers need to work with social scientists.

    Pickersgill, Martyn / Manda-Taylor, Lucinda / Niño-Machado, Natalia

    Lancet (London, England)

    2022  Volume 400, Issue 10352, Page(s) 547–549

    MeSH term(s) Administrative Personnel ; Humans ; Influenza, Human/epidemiology ; Pandemics/prevention & control
    Language English
    Publishing date 2022-05-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(22)00983-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: The safety and feasibility of early cardiorespiratory fitness testing after stroke.

    Machado, Natasha / Williams, Gavin / Olver, John / Johnson, Liam

    PM & R : the journal of injury, function, and rehabilitation

    2022  Volume 15, Issue 3, Page(s) 291–301

    Abstract: Background: Cardiorespiratory fitness testing is recommended as part of a pre-exercise evaluation to aid the programming of safe, tailored cardiorespiratory fitness training after stroke. But there is limited evidence for its safety and feasibility in ... ...

    Abstract Background: Cardiorespiratory fitness testing is recommended as part of a pre-exercise evaluation to aid the programming of safe, tailored cardiorespiratory fitness training after stroke. But there is limited evidence for its safety and feasibility in people with stroke with varying impairment levels in the early subacute phase of stroke recovery.
    Objective: To assess the safety and feasibility of cardiorespiratory fitness testing in the early subacute phase after stroke.
    Design: A sub-study of a larger single service, multi-site, prospective cohort feasibility study (Cardiac Rehabilitation in Stroke Survivors to Improve Survivorship [CRiSSIS]).
    Setting: Private subacute inpatient rehabilitation facilities.
    Participants: Consecutive admissions of people with ischemic stroke admitted to subacute rehabilitation facilities.
    Intervention: Not applicable.
    Main outcome(s): Safety was determined by the occurrence of adverse or serious adverse events. Feasibility was determined by assessing the (1) number of participants recruited and (2) number of participants able to complete the fitness test.
    Results: Between April 2018 and December 2019, a total of 165 people with stroke were screened to participate; 109 were eligible and 65 were recruited. Of the 62 who completed testing, 41 participants were able to complete a submaximal fitness test at a median of 12 days post-stroke. One minor adverse event was recorded. Of the 21 participants unable to complete the fitness test; 4 declined to complete the test, 9 were unable to commence the test, and 8 were unable to complete the first stage of the protocol due to stroke-related impairments. Participants with mild stroke, greater motor and cognitive function, and fewer depressive symptoms were more likely to be able to complete the cardiorespiratory fitness test.
    Conclusion: Cardiorespiratory fitness testing was safe for most people with mild-to-moderately severe ischemic stroke and transient ischemic attack in the early subacute phase, but only two-thirds of the participants could complete the test.
    MeSH term(s) Humans ; Cardiorespiratory Fitness ; Physical Fitness ; Exercise Therapy/adverse effects ; Exercise Therapy/methods ; Feasibility Studies ; Prospective Studies ; Stroke ; Stroke Rehabilitation/methods ; Ischemic Stroke/etiology
    Language English
    Publishing date 2022-04-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2608988-9
    ISSN 1934-1563 ; 1934-1482
    ISSN (online) 1934-1563
    ISSN 1934-1482
    DOI 10.1002/pmrj.12787
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Gasto público y ciclo electoral en Venezuela. Período 1977–2012

    Machado N., Gustavo E.

    Revista de Ciencias Sociales, Vol 23, Iss 2, Pp 99-

    2017  Volume 111

    Abstract: Durante el período 1977–2012, la economía venezolana experimentó un desempeño macroeconómico precario; situación que fue acompañada por la existencia de dificultades en las finanzas públicas, que terminaron tornándose en un factor que contribuía a la ... ...

    Abstract Durante el período 1977–2012, la economía venezolana experimentó un desempeño macroeconómico precario; situación que fue acompañada por la existencia de dificultades en las finanzas públicas, que terminaron tornándose en un factor que contribuía a la continuidad de dicho desempeño. Por ello, se consideró pertinente estudiar el impacto de las motivaciones de los actores del ámbito político sobre dicho comportamiento durante el período 1977-2012. En particular, el presente artículo analiza la relación entre el ciclo electoral, específicamente los eventos de carácter presidencial, y el nivel per cápita de gasto público, utilizando para ello como marco de referencia la Teoría del Ciclo Político Económico. El estudio realizado es de carácter explicativo, y en él se utilizaron modelos econométricos basados en los aportes teóricos de Tufte (1978). El resultado principal de esta investigación, en el caso de Venezuela para el período 1977-2012, es la obtención de indicios que reflejan la carencia de vínculos entre el nivel de gasto público y el ciclo electoral, en contraposición a lo planteado por el marco teórico utilizado, a pesar del incremento de la primera variable durante los años 2000, 2004, 2006 y 2012, por lo que no se deben descartar futuras investigaciones sobre el tema.
    Keywords gasto público ; teoría del ciclo político económico ; economía política ; venezuela ; conducta oportunista ; Political science (General) ; JA1-92 ; Social sciences (General) ; H1-99
    Language Spanish
    Publishing date 2017-04-01T00:00:00Z
    Publisher Universidad del Zulia
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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