RESUMEN
Carpal tunnel syndrome (CTS) is the most common cause of peripheral compressive neuropathy and consists of compression of the median nerve in the wrist. Although there are several etiologies, idiopathic is the most prevalent origin, and among the forms of treatment for CTS, conservative is the most indicated. However, despite the high prevalence in and impact of this syndrome on the healthcare system, there are still controversies regarding the best therapeutic approach for patients. Therefore, noting that some studies point to vitamin D deficiency as an independent risk factor, which increases the symptoms of the syndrome, this study evaluated the role of vitamin D supplementation and its influence on pain control, physical examination and response electroneuromyography to conservative treatment of carpal tunnel syndrome. For this, the sample consisted of 14 patients diagnosed with CTS and hypovitaminosis D, who were allocated into two groups. The control group received corticosteroid treatment, while the experimental group received corticosteroid treatment associated with vitamin D. Thus, from this study, it can be concluded that patients who received vitamin D, when compared to those who did not receive it, showed improvement in the degree of pain intensity, a reduction in symptom severity and an improvement in some electroneuromyographic parameters.
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Síndrome del Túnel Carpiano , Electromiografía , Deficiencia de Vitamina D , Vitamina D , Humanos , Síndrome del Túnel Carpiano/tratamiento farmacológico , Vitamina D/uso terapéutico , Femenino , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/complicaciones , Masculino , Persona de Mediana Edad , Adulto , Resultado del Tratamiento , Suplementos Dietéticos , Corticoesteroides/administración & dosificación , Nervio Mediano/fisiopatología , AncianoRESUMEN
The vascular tree is crucial for the survival and function of large living tissues. Despite breakthroughs in 3D bioprinting to endow engineered tissues with large blood vessels, there is currently no approach to engineer high-density capillary networks into living tissues in a scalable manner. Here, photoannealing of living microtissue (PALM) is presented as a scalable strategy to engineer capillary-rich tissues. Specifically, in-air microfluidics is used to produce living microtissues composed of cell-laden microgels in ultrahigh throughput, which can be photoannealed into a monolithic living matter. Annealed microtissues inherently give rise to an open and interconnected pore network within the resulting living matter. Interestingly, utilizing soft microgels enables microgel deformation, which leads to the uniform formation of capillary-sized pores. Importantly, the ultrahigh throughput nature underlying the microtissue formation uniquely facilitates scalable production of living tissues of clinically relevant sizes (>1 cm3 ) with an integrated high-density capillary network. In short, PALM generates monolithic, microporous, modular tissues that meet the previously unsolved need for large engineered tissues containing high-density vascular networks, which is anticipated to advance the fields of engineered organs, regenerative medicine, and drug screening.
RESUMEN
BACKGROUND: To determine the feasibility and effect of high-intensity interval training (HIIT) in individuals with Parkinson's and their effect on symptom modification and progression. METHODS: We conducted this systematic review following the Preferred Reporting Items for systematic review and meta-analysis (PRISMA). All studies were searched in seven databases: MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, SPORTDiscus, Virtual Health Library (VHL) and SCOPUS in September 2020 and updated in June 2023. The risk of bias was assessed by the Cochrane Collaboration tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. We used standardized mean difference (SMD) with a 95% confidence interval (CI) and random effects models, as well as the non-parametric Cochran's Q test and I2 inconsistency test to assess heterogeneity. RESULTS: A total of 15 randomized clinical trials with 654 participants (mean age, 65.4 years). The majority of studies included high intensity training interventions versus moderate intensity, usual care, or control group. The meta-analysis comparing high-intensity exercise versus control group showed an improvement in the disease severity (MD = -4.80 [95%CI, -6.38; -3.21 high evidence certainty); maximum oxygen consumption (MD = 1.81 [95%CI, 0.36; 3.27] very low evidence certainty) and quality of life (MD = -0.54 [95%CI, -0.94; -0.13] moderate evidence certainty). The results showed that high-intensity exercise compared with moderate intensity exercise group showed a improve motor function and functional mobility measured by the TUG test (MD = -0.38 [95%CI, -0.91; 0.16] moderate evidence certainty) with moderate heterogeneity between studies. CONCLUSION: High-intensity exercise performed in both continuous and interval modes when compared with control groups may provide motor function benefits for individuals with Parkinson's disease. HIIT may be feasible, but the intensity of the exercise may influence individuals with Parkinson's disease. However, there was a lack of evidence comparing high intensity and moderate intensity for this population, as the results showed heterogeneity.
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Enfermedad de Parkinson , Humanos , Adulto , Anciano , Enfermedad de Parkinson/terapia , Calidad de Vida , Estudios de Factibilidad , Ejercicio FísicoRESUMEN
BACKGROUND: Asymptomatic visceral leishmaniasis (VL) infection is a risk for transfusion safety. Leukoreduction has been an alternative for the prevention of some blood-borne diseases, including VL. This study aimed to evaluate the role of leukoreduction of cellular blood components as a control measure for transfusional VL transmission. RESEARCH DESIGN AND METHODS: A total of 161 polytransfused patients with non-leukoreduced blood components (HNL), 95 polytransfused with leukoreduced blood components (LH), and 202 non-transfused (NT) from endemic regions for VL and with a similar epidemiological profile. The detection of antibodies against VL was performed by ELISA and the presence of the parasite was investigated by real-time PCR. Statistical significance was defined as p < .05. RESULTS: When comparing three groups, ELISA results were statistically significant (p = .0065). The residual analysis of ELISA showed statistically significant for the HNL group compared to the general group (p = .002; OR: 5.6; CI: 1.7-25.8), demonstrating that individuals who received non-leukoreduced transfusions are five times more likely to acquire Leishmania infantum infection than the general. DISCUSSION: Higher prevalence in the group with HNL and low prevalence in those who received LH, similar to NT patients, highlight the risk of transfusional VL transmission and reinforce the role of leukoreduction in its prevention.
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Leishmania infantum , Leishmaniasis Visceral , Humanos , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/prevención & control , Anticuerpos , Infecciones Asintomáticas , Ensayo de Inmunoadsorción Enzimática , Reacción en Cadena en Tiempo Real de la PolimerasaRESUMEN
Knowing the body parts affected in accidents at work is important to support managers and professionals in the sectors of work safety in the adoption of measures to promote health and prevent accidents. This study identifies the body parts affected in a work accident registered at the Reference Center for Occupational Health (CEREST) ââin Sobral, Ceará, Brazil. It is a cross-sectional study, carried out from the database of the Reference Center for Occupational Health in Sobral, Ceará, Brazil. Data were collected between March 2015 and February 2016, from notifications of occupational accidents from the National System of Notifiable Diseases (SINAN), referring to the period from 2009 to 2013, totaling 2,438 occurrences. There was accidents involving the hands (37.6%), upper limbs (15.4%), lower limbs (13.0%) and feet (10.9%) were the most frequent. Were observed a greater number of victims of occupational accidents among men (90.7%) in the age group of 20 to 59 years (85.6%). There is, in fact, a predominance of body parts involved in occupational accidents in the population, with emphasis on the hand, upper limb, lower limb and foot (p = 0.0001). The study showed workers' health promotion strategies should be encouraged in the workplace, as well as the guarantee of access and the correct use of personal protective equipment, for the prevention of risks, injuries and diseases, considering that accidents cause expenses for the State and losses for the victims.
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Accidentes de Trabajo , Salud Laboral , Enfermería del TrabajoRESUMEN
OBJECTIVES: to evaluate the effectiveness of educational intervention in the knowledge and attitude of candidates for gastroplasty. METHODS: randomized controlled clinical trial with 56 preoperative patients (intervention=28; control=28). The control group received routine care from the health institution and the intervention group participated in a book-mediated educational intervention. Forms were used for clinical-epidemiological characterization and evaluation of knowledge/attitude about bariatric surgery, which were reapplied seven weeks after intervention. RBR-297fzx. RESULTS: in the pre-test there was no significant difference between the groups (p=0.254). In the post-test, the group that received verbal guidance had a mean score of 19.5 (± 6.17) and the group reading the booklet averaged 31.1 (± 2.96), p=0.000. The attitude is adequate, especially for care such as vitamin supplement intake, water intake and physical activity practice. CONCLUSIONS: the educational intervention mediated by booklet was effective in improving knowledge and attitude when compared to verbal guidance. Thus, it can be replicated during the preoperative preparation.
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Gastroplastia , Conocimientos, Actitudes y Práctica en Salud , Folletos , Atención Perioperativa , Adulto , Actitud , Suplementos Dietéticos , Femenino , Gastroplastia/psicología , Humanos , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto , Periodo Perioperatorio , Resultado del TratamientoRESUMEN
ABSTRACT Objectives: to evaluate the effectiveness of educational intervention in the knowledge and attitude of candidates for gastroplasty. Methods: randomized controlled clinical trial with 56 preoperative patients (intervention=28; control=28). The control group received routine care from the health institution and the intervention group participated in a book-mediated educational intervention. Forms were used for clinical-epidemiological characterization and evaluation of knowledge/attitude about bariatric surgery, which were reapplied seven weeks after intervention. RBR-297fzx. Results: in the pre-test there was no significant difference between the groups (p=0.254). In the post-test, the group that received verbal guidance had a mean score of 19.5 (± 6.17) and the group reading the booklet averaged 31.1 (± 2.96), p=0.000. The attitude is adequate, especially for care such as vitamin supplement intake, water intake and physical activity practice. Conclusions: the educational intervention mediated by booklet was effective in improving knowledge and attitude when compared to verbal guidance. Thus, it can be replicated during the preoperative preparation.
RESUMEN Objetivos: evaluar la efectividad de la intervención educativa en el conocimiento y la actitud de los candidatos a la gastroplastia. Métodos: ensayo clínico controlado aleatorizado con 56 pacientes del preoperatorio (intervención=28; Control=28). El grupo control recibió la atención de rutina de la institución de salud y el grupo intervención participó de intervención educativa mediada por un folleto. Se utilizaron formularios para la caracterización clínico-epidemiológica y evaluación del conocimiento/actitud sobre cirugía bariátrica, que se volvieron a aplicar siete semanas después de la intervención. RBR-297fzx. Resultados: en la pre-prueba, no hubo diferencias significativas entre los grupos (p=0,254). En la prueba posterior, el grupo que recibió orientación verbal tuvo un promedio de aciertos de 19,5 (± 6,17) y el grupo que leyó el folleto tuvo un promedio de aciertos de 31,1 (± 2,96), p=0,000. La actitud es adecuada, especialmente para los cuidados como tomar el suplemento vitamínico, tomar agua y practicar actividad física. Conclusiones: la intervención educativa mediada por un folleto demostró ser efectiva para mejorar el conocimiento y mantener una actitud positiva hacia la cirugía bariátrica, en comparación con la orientación verbal. Por lo tanto, se puede replicar durante la preparación preoperatoria.
RESUMO Objetivos: avaliar efetividade de intervenção educativa no conhecimento e atitude de candidatos à gastroplastia. Métodos: ensaio clínico controlado randomizado com 56 pacientes do pré-operatório (intervenção=28 e controle=28). O grupo controle recebeu cuidados de rotina da instituição de saúde e o grupo intervenção participou de intervenção educativa mediada por cartilha. Foram utilizados formulários para caracterização clínica-epidemiológica e avaliação do conhecimento/atitude sobre cirurgia bariátrica, os quais foram reaplicados sete semanas após intervenção. RBR-297fzx. Resultados: no pré-teste, não houve diferença significativa entre os grupos (p=0,254). No pós-teste, o grupo que recebeu orientação verbal teve média de acertos de 19,5 (± 6,17) e o grupo que leu a cartilha acertou, em média, 31,1 (± 2,96) p=0,000. A atitude é adequada, principalmente, para cuidados como tomada do suplemento vitamínico, ingesta hídrica e prática de atividade física. Conclusões: a intervenção educativa mediada por cartilha mostrou-se eficaz na melhoria do conhecimento e manutenção de atitude positiva em relação à cirurgia bariátrica, quando comparada à orientação verbal. Assim, pode ser replicada durante o preparo pré-operatório.
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Folletos , Gastroplastia , Conocimientos, Actitudes y Práctica en Salud , Atención Perioperativa , Gastroplastia/psicología , Actitud , Educación del Paciente como Asunto , Resultado del Tratamiento , Suplementos Dietéticos , Periodo PerioperatorioRESUMEN
OBJECTIVE: To identify HTLV-II revalence in blood donors at the Blood Center Net of Ceará (Hemorrede do Ceará - HEMOCE) and epidemiological aspects of positive cases. METHODS: Cases considered positive were surveyed from data bases through the immunoenzymatic method ELISA and confirmed by Western Blot from 2001 to 2008. In this period, 679,610 blood samples from voluntary donors were tested. RESULTS: From all donors, 164 samples were actually positive in both tests; of these, 33 (20.1%) were typed as HTLV-II, showing a prevalence of 0.006%. In positive cases, a mean age 28.2 years, and a predominantly male gender (54.5%) were observed, the race was mixed in 78.8%, most donors had Fortaleza as hometown (72.7%), with 51.5% being married/consensual union, and 33.3% reported to have completed high school education. CONCLUSION: Although HTLV-II infection is low, its presence is universal, being similar in males and females mostly in urban centers. The need of preventive measures as a way of avoiding infection spread is stressed.
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Donantes de Sangre/estadística & datos numéricos , Infecciones por HTLV-II/epidemiología , Virus Linfotrópico T Tipo 2 Humano/aislamiento & purificación , Adulto , Brasil/epidemiología , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por HTLV-I/sangre , Infecciones por HTLV-I/epidemiología , Infecciones por HTLV-II/sangre , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
OBJETIVO: O objetivo do trabalho foi identificar a prevalência do HTLV-II em doadores de sangue da Hemorrede do Ceará e aspectos epidemiológicos de casos positivos. MÉTODOS: Foram levantados em bancos de dados os casos considerados positivos, através de método Imunoenzimático (ELISA) e confirmados pelo Western Blot, no período de 2001 a 2008. Foram identificados que 679.610 amostras de sangue de doadores voluntários foram testadas neste período. RESULTADOS: Do total de doadores, 164 amostras foram efetivamente positivas em ambos os testes, destes 33 (20,1 por cento) foram tipadas como HTLV II, mostrando uma prevalência do último de 0,006 por cento. Nos casos positivos, observou-se idade média de 28,2 anos, o sexo predominantemente masculino (54,5 por cento), a cor foi considerada mulato/parda em 78,8 por cento, a maioria procedia de Fortaleza (72,7 por cento), sendo 51,5 por cento casados/união consensual e 33,3 por cento referiam ter ensino médio completo. CONCLUSÃO: Embora a infecção por HTLV-II seja baixa, sua presença é universal, sendo semelhante entre homens e mulheres, em sua maioria de centro urbano. É enfatizada a necessidade de medidas de prevenção como forma de evitar a expansão da infecção.
OBJECTIVE: To identify HTLV-II revalence in blood donors at the Blood Center Net of Ceará (Hemorrede do Ceará - HEMOCE) and epidemiological aspects of positive cases. METHODS: Cases considered positive were surveyed from data bases through the immunoenzymatic method ELISA and confirmed by Western Blot from 2001 to 2008. In this period, 679,610 blood samples from voluntary donors were tested. RESULTS: From all donors, 164 samples were actually positive in both tests; of these, 33 (20.1 percent) were typed as HTLV-II, showing a prevalence of 0.006 percent. In positive cases, a mean age 28.2 years, and a predominantly male gender (54.5 percent) were observed, the race was mixed in 78.8 percent, most donors had Fortaleza as hometown (72.7 percent), with 51.5 percent being married/consensual union, and 33.3 percent reported to have completed high school education. CONCLUSION: Although HTLV-II infection is low, its presence is universal, being similar in males and females mostly in urban centers. The need of preventive measures as a way of avoiding infection spread is stressed.
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Donantes de Sangre/estadística & datos numéricos , Infecciones por HTLV-II/epidemiología , /aislamiento & purificación , Brasil/epidemiología , Ensayo de Inmunoadsorción Enzimática , Infecciones por HTLV-I/sangre , Infecciones por HTLV-I/epidemiología , Infecciones por HTLV-II/sangre , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificaciónRESUMEN
A lise das hemácias, de causa imune ou não imune, pode provocar a elevação da hemoglobina plasmática induzindo efeitos deletérios principalmente nos rins e no sistema cardiovascular. Este trabalho objetiva evidenciar o possível efeito hemolítico induzido pelo trauma mecânico provocado pela passagem das hemácias em diferentes modelos de bombas de infusão de soluções, em concentrados de hemácias com até dez dias de armazenamento, preparados com Sag-Manitol. Foram utilizados três modelos de bombas (Nutrimat, Infusomat Compact e Volumed), com quatro aparelhos de cada modelo, testados em três velocidades de infusão (120 mL/h, 240 mL/h e 360 mL/h). Os parâmetros utilizados para evidenciar o grau de hemólise foram o percentual de hemólise e os níveis de hemoglobina e potássio livres no plasma. As amostras foram coletadas antes da passagem do concentrado de hemácias pelas bombas, na metade do tempo de infusão e no final da infusão, nas diferentes velocidades. Não ocorreu variação significativa entre os valores dos parâmetros analisados nas amostras controle e naquelas coletadas nas diferentes velocidades, marcas de bombas, mecanismos de infusão entre as bombas da mesma marca e entre os diferentes tempos de infusão. A principal variação encontrada foi relacionada com o potássio livre, devido à variação inerente aos próprios concentrados, o que foi evidenciado ao se compararem os valores obtidos nas amostras controle e nas amostras colhidas nos tempos médio e final em cada bomba. De acordo com os resultados obtidos, não houve alteração estatisticamente significativa do percentual de hemólise após a passagem pelas bombas de infusão nos modelos analisados.
The lyses of red blood cells, both for immune or non-immune reasons, can cause an elevation in plasmatic hemoglobin, inducing harmful effects mainly in the kidneys and cardiovascular system. This work aims at identifying the possible hemolytic effect, related to mechanical trauma due to the use of different models of infusion pumps, on red blood cells transfused after up to ten days of storage. Three models of pumps were studied (Nutrimat, Infusomat Compact and Volumed), (four devices of each model) with three infusion speeds being tested (120 mL/h, 240 mL/h and 360 mL/h). The parameters used to report the degree of hemolysis were the percentile of hemolysis, hemoglobin levels and free potassium in the plasma. Samples were collected before infusion of red blood cells using the pumps, half way through infusion (1/2 T) and at the end of infusion (T), for the three different speeds. Significant variations were not seen in the analyzed parameters between the control samples and those collected at different speeds, using different models of pumps and infusion mechanisms and among pumps of the same brand and at different infusion times. The greatest variation found involved free potassium, probably due to the different levels found in red blood cell concentrates seen when control samples were compared to values obtained half way through and at the end of infusion for each pump. In agreement with the obtained results changes in the percentile of hemolysis were not found after infusion of the cells using the different infusion pumps.
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Hemólisis , Transfusión Sanguínea , Bombas de Infusión , EritrocitosRESUMEN
Com o objetivo de avaliar a coagulação sanguinea em gestantes da maternidade Escol a ASsis Chateaumbriand (MEAC), no periodo de 25 de janeiro a 25 de maio de 1992, foi analisado o plasma de 22 gestantes e 30 mulheres não grávidas que serviu como grupo de controle. Ficou evidenciado que os testes hemostáticos (tempo de protrombina, tempo parcial de de tromboplastina e tempo de trombina) resultaram em um aumento da coagulação com a diminuição da média dos tempos de coagulação, quando comparado ao grupo controle. O número de plaquetas dominuiu, com média de 175.545/mm3 na 26a semana para 148.727/mm3 na 36a semana de gestação. A concentração do fibrinogênio aumentou consideravelmente de 310mg/dl para 465,4mg/dl. Diante deste resultado, ficou evidente que o estudo é concordante com a literatura, onde as mudanças hemostáticas durante a gravidez levam a um estado de hipercoagulabilidade.
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Humanos , Femenino , Embarazo , Adolescente , Adulto , Coagulación Sanguínea , Plaquetas , Fibrinógeno , Técnicas Hemostáticas , Tiempo de Tromboplastina Parcial , Mujeres Embarazadas , Tiempo de Protrombina , Tiempo de Trombina , TrombofiliaRESUMEN
Revisamos os aspirados medulares de 71 casos de leucemias agudas, em crianças e adultos, diagnosticados nos últimos três anos (1983-85) no Hospital Universitário Walter Cantídio e os reclassificamos segundo as recomendaçöes da Classificaçäo FAB. 81,7% dos casos revistos foram diagnosticados pelo autor enquanto 18,3% obtiveram os laudos iniciais de outros hematologistas. A reprodutibilidade de Classificaçäo FAB é analisada. Obtivemos pelo critério morfológico uma concordância de 87,3% para os dois grandes grupos (LMA e LLA) e de 63,4% ao analisarmos os diferentes subtipos. Quando comparado com o estudo citoquímico a concordância foi de 83,8%. As limitaçöes da morfologia e citoquímica, além dos resultados discrepantes, säo discutidos
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Niño , Adulto , Humanos , Leucemia/clasificaciónRESUMEN
Estudamos 133 pacientes portadores de calazar, maiores de 18 anos de idade, registrados no Instituto de Medicina Preventiva (IMP) e Hospital Universitário Walter Cantídio (HUWC) da Universidade Federal do Ceará no período de janeiro de 1956 a dezembro de 1982. Utilizamos os dados da série vermelha do primeiro hemograma realizado por ocasiäo do do diagnóstico e antes do tratamento. Para análise estatística os pacientes foram divididos em grupos de acordo com o sexo e os resultados comparados com os valores de série vermelha de indivíduos normais do nosso meio. Consideramos também na avaliaçäo dos resultados da série vermelha se os pacientes eram portadores ou näo de verminose, especialmente ancilostomose e/ou esqüistomosse