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Synthetic Notch (synNotch) receptors are genetically encoded, modular synthetic receptors that enable mammalian cells to detect environmental signals and respond by activating user-prescribed transcriptional programs. Although some materials have been modified to present synNotch ligands with coarse spatial control, applications in tissue engineering generally require extracellular matrix (ECM)-derived scaffolds and/or finer spatial positioning of multiple ligands. Thus, we develop here a suite of materials that activate synNotch receptors for generalizable engineering of material-to-cell signaling. We genetically and chemically fuse functional synNotch ligands to ECM proteins and ECM-derived materials. We also generate tissues with microscale precision over four distinct reporter phenotypes by culturing cells with two orthogonal synNotch programs on surfaces microcontact-printed with two synNotch ligands. Finally, we showcase applications in tissue engineering by co-transdifferentiating fibroblasts into skeletal muscle or endothelial cell precursors in user-defined micropatterns. These technologies provide avenues for spatially controlling cellular phenotypes in mammalian tissues.
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Diferenciación Celular , Receptores Notch , Transducción de Señal , Ingeniería de Tejidos , Receptores Notch/metabolismo , Ingeniería de Tejidos/métodos , Animales , Humanos , Ratones , Matriz Extracelular/metabolismo , Fibroblastos/metabolismo , Fibroblastos/citología , Proteínas de la Matriz Extracelular/metabolismo , Proteínas de la Matriz Extracelular/genética , Ligandos , Andamios del Tejido/química , Músculo Esquelético/metabolismo , Músculo Esquelético/citología , Células Endoteliales/metabolismo , Células Endoteliales/citología , Células HEK293RESUMEN
AIMS: Patients with aortic dissection have a high prevalence of left ventricular structural alterations, including left ventricular hypertrophy (LVH), but little is known about the impact of sex on this regard. This study compared clinical, cardiac, and prognostic characteristics between men and women with aortic dissection. METHODS: We retrospectively assessed clinical and echocardiographic characteristics, and 1-year mortality in 367 aortic dissection patients (30% women; 66% with Stanford-A) who underwent echocardiography 60âdays before or after the diagnosis of aortic dissection from three Brazilian centers. RESULTS: Men and women had similar clinical characteristics, except for higher age (59.4â±â13.4 vs. 55.9â±â11.6âyears; P â=â0.013) and use of antihypertensive classes (1.4â±â1.3 vs. 1.1â±â1.2; P â=â0.024) and diuretics (32 vs. 19%; P â=â0.004) in women compared with men. Women had a higher prevalence of LVH (78 vs. 65%; P â=â0.010) and lower prevalence of normal left ventricular geometry (20 vs. 10%; P â=â0.015) than men. Logistic regression analysis adjusted for confounding factors showed that women were less likely to have normal left ventricular geometry (odds ratio, 95% confidence intervalâ=â0.42, 0.20-0.87; P â=â0.019) and were more likely to have LVH (odds ratio, 95% confidence intervalâ=â1.91, 1.11-3.27; P â=â0.019). Conversely, multivariable Cox-regression analysis showed that women had a similar risk of death compared to men 1 year after aortic dissection diagnosis (hazard ratio, 95% confidence intervalâ=â1.16, 0.77-1.75; P â=â0.49). CONCLUSION: In aortic dissection patients, women were typically older, had higher use of antihypertensive medications, and exhibited a greater prevalence of LVH compared with men. However, 1-year mortality after aortic dissection diagnosis did not differ between men and women.
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Disección Aórtica , Hipertrofia Ventricular Izquierda , Remodelación Ventricular , Humanos , Masculino , Femenino , Disección Aórtica/epidemiología , Disección Aórtica/fisiopatología , Disección Aórtica/mortalidad , Persona de Mediana Edad , Estudios Retrospectivos , Factores Sexuales , Anciano , Hipertrofia Ventricular Izquierda/fisiopatología , Hipertrofia Ventricular Izquierda/epidemiología , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Brasil/epidemiología , Prevalencia , Adulto , Factores de Riesgo , Ecocardiografía , Aneurisma de la Aorta/epidemiología , Aneurisma de la Aorta/mortalidad , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/fisiopatología , Pronóstico , Factores de TiempoRESUMEN
A solar position sensor is an essential optoelectronic device used to monitor the sun's position in solar tracking systems. In closed-loop systems, this sensor is responsible for providing feedback signals to the control system, allowing motor adjustments to optimize the angle of incidence and minimize positioning errors. The accuracy required for solar tracking systems varies depending on the specific photovoltaic concentration. In the case of the concentrator photovoltaic (CPV), it is normally essential to track the sun with a position error of less than ±0.6°. To achieve such precision, a proposed sensor configuration composed of low-cost embedded electronics and multifiber optical cable is subjected to characterization through a series of measurements covering range, sensitivity, and resolution. These measurements are performed in controlled indoor environments as well as outdoor conditions. The results obtained exhibit a resolution of 2.6×10-3 degrees when the sensor is illuminated within its designated field of view of ±0.1°, particularly in external conditions. Considering the performance demonstrated by the proposed solar position sensor, coupled with its straightforward modeling and assembly compared to position sensors documented in the literature, it emerges as a promising candidate for integration into solar tracking systems.
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To evaluate the inflammatory tissue response to BioRoot™ RCS (BR) and AH Plus Jet (AHPJ) sealers implanted in mice subcutaneous tissue. It was hypothesized that the inflammatory tissue response to BR would be milder than to AHPJ. An in vivo study was carried out using isogenic mice. The sealers were implanted during standardized surgical procedures. The inflammatory response was evaluated by microscopic analysis and von Kossa reaction in the reactionary tissue around the specimens after 7, 21, and 63 days. For comparisons, a zinc oxide and eugenol sealer (ZOE) was used as a positive control, in addition to a negative control without a sealer (n = 10 per group/period). All statistical analyses considered a significance level of 5%. All endodontic sealers triggered an inflammatory tissue response after 7 days. BR had a higher inflammatory cell count and a thicker fibrous capsule when compared with AHPJ, but both were less inflammatory than ZOE (p < .001). After 21 days, BR continued to trigger an intense inflammatory tissue response, higher in both microscopic parameters compared to AHPJ, and a thicker fibrous capsule than ZOE (p < .001). After 63 days, the inflammatory tissue response decreased in BR, matching the fibrous capsule thickness with AHPJ and ZOE. BR promoted intense calcium precipitation in all study periods. After 63 days, AHPJ and BR sealers were more biocompatible to subcutaneous mice tissue, but AHPJ present better early inflammatory response, as well as BR showed potential bioactivity. RESEARCH HIGHLIGHTS: The inflammatory tissue response triggered by a bioceramic endodontic sealer (BR) was not milder than that triggered by an epoxy-resin based endodontic sealer (AHPJ) during the first 3 weeks, considering the microscopic analysis of the reactionary tissue.
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AIM: The aim of this study was to evaluate outpatient and inpatient dental care for patients with disabilities from 2014 to 2023. MATERIAL AND METHODS: A time series analysis was carried out with data from Brazil's public healthcare system, considering the outpatient productivity of Special Needs Dentistry specialists and hospitalizations (inpatient admissions) of patients with disabilities for dental procedures, both normalized to every 100,000 inhabitants (incidence). The significance level was set at 5%. RESULTS: In the last 10 years, 22,420,859 procedures were carried out and 89,380 hospitalizations were approved. Trend analysis showed no significant temporal variation in the incidence of both variables. Regarding the procedures, the majority were low-complexity (82.1%, p < .001) and clinical (71.2%, p < .001). Periodontal (19.9%) and restorative (19.5%) procedures were the most frequent. Considering the hospitalizations, almost (R$) 40 million was allocated, and the majority were classified as elective (71.9%, p = .002) and of short duration (less than a day). CONCLUSION: Dental care for patients with disabilities presented patterns related to the types of procedures, complexity and circumstance, in addition to not showing significant temporal variation over the last 10 years.
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The transition from the second to the third millennium happened to be a turning point in the history of myocardial revascularization on a beating heart, which moved from technical development to critical evaluation. This article describes how the initial acceptance and spread of off-pump coronary artery bypass grafting (OPCABG) was followed by the general perception that the technique could not fulfill the expectations placed in it and provides some insight on what should we do with the know-how of OPCABG in the present and the future of coronary surgical revascularization.
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Puente de Arteria Coronaria Off-Pump , Humanos , Puente de Arteria Coronaria Off-Pump/métodos , Enfermedad de la Arteria Coronaria/cirugía , Puente de Arteria Coronaria/métodosRESUMEN
West Nile (WNV) is a zoonotic arbovirus with an expanding geographical range and epidemic activity in Europe. Not having yet experienced a human-associated epidemic, Portugal remains an outlier in the Mediterranean basin. In this study, we apply ecological niche modelling informed by WNV historical evidence and a multitude of environmental variables from across Portugal. We identify that ecological backgrounds compatible with WNV historical circulation are mostly restricted to the south, characterized by a warmer and drier climate, high avian diversity, specific avian species and land types. We estimate WNV ecological suitability across the country, identifying overlaps with the distributions of the three relevant hosts (humans, birds, equines) for public and animal health. From this, we propose a category-based spatial framework providing first of a kind valuable insights for WNV surveillance in Portugal under the One Health nexus. We forecast that near future climate trends alone will contribute to pushing adequate WNV ecological suitability northwards, towards regions with higher human density. This unique perspective on the past, present and future ecology of WNV addresses existing national knowledge gaps, enhances our understanding of the evolving emergence of WNV, and offers opportunities to prepare and respond to the first human-associated epidemic in Portugal.
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Aves , Salud Única , Fiebre del Nilo Occidental , Virus del Nilo Occidental , Portugal/epidemiología , Fiebre del Nilo Occidental/epidemiología , Animales , Humanos , Ecosistema , CaballosRESUMEN
Brazil's public healthcare system (SUS) offers specialized oral health services to Brazilians, but the productivity of specialists, such as Pediatric Dentists, has not been characterized. Therefore, the objective of this study was to characterize the outpatient dental procedures (ODPs) carried out by Pediatric Dentists within the SUS. An epidemiological study with an ecological, longitudinal, retrospective, and quantitative approach was conducted. The ODPs carried out by Pediatric Dentists within the SUS were characterized based on type of procedure, complexity level, and circumstance (urgent or elective). Data were analyzed using a descriptive and analytical approach, considering a significance level of 5%, as well as the impact of the COVID-19 pandemic (the 2020-2022 years were not included in secondary analyses). In the last 15 years, 29,234,972 ODPs were carried out by Pediatric Dentists within the SUS. Clinical procedures were the majority (55.4%), significantly more frequent than all other types of procedures (all p <0.05). Among these, restorative and periodontal procedures were the most common (30.7% and 21.0%, respectively). From 2008 to 2019, excluding COVID-19 pandemic years, the trend over the last 15 years was constant for all types of procedures (all p >0.05). In addition, low complexity ODPs were the majority (90.1%), significantly more frequent than medium (9.7%) and high complexity procedures (0.1%) (both p <0.05). At last, most ODPs were not characterized by circumstance in the outpatient production reports (96.9%). Therefore, it was possible to conclude that Pediatric Dentists carried out diverse ODPs within the SUS over the past 15 years, although there was a dominant pattern of type and complexity.
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COVID-19 , Humanos , Brasil/epidemiología , Estudios Retrospectivos , COVID-19/epidemiología , Niño , Atención Dental para Niños/estadística & datos numéricos , Atención Ambulatoria/estadística & datos numéricos , Estudios Longitudinales , Odontología Pediátrica/estadística & datos numéricos , Pautas de la Práctica en Odontología/estadística & datos numéricos , PandemiasRESUMEN
PURPOSE: This cohort study aimed to investigate the relationship between subjective (wellness and internal training load [ITL]) and objective (neuromuscular fatigue) monitoring markers and performance aspects (reception quality [RQ] and attack efficiency [AE]) in professional female volleyball players. METHODS: The study was conducted over an 8-week period during the final mesocycle of the competitive phase. A total of 24 training sessions and 10 matches were included in the analysis. Subjective measures of wellness and ITL were assessed, and neuromuscular fatigue was evaluated using countermovement-jump (CMJ) height. RQ and AE were determined based on game statistics. RESULTS: The study found a positive relationship between wellness and RQ, particularly affecting outside hitters and liberos. ITL showed a positive association with AE, primarily impacting outside hitters, opposite hitters, and middle blockers. Additionally, ITL demonstrated a negative correlation with RQ, mainly affecting outside hitters and liberos. CMJ performance was associated with AE, where a decrease in CMJ height was linked to reduced AE. CONCLUSIONS: The findings highlight the importance of considering players' wellness scores in training and match strategies for different positions. Careful management of training loads, considering both physical and technical demands, is crucial for optimizing performance outcomes. Monitoring neuromuscular fatigue, as indicated by CMJ performance, is particularly relevant for outside hitters, opposite hitters, and middle blockers involved in attack actions. Coaches, trainers, and sports practitioners can use these insights to develop position-specific training protocols and implement effective strategies for maintaining or improving performance metrics under various stressors.
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Rendimiento Atlético , Fatiga Muscular , Voleibol , Humanos , Femenino , Voleibol/fisiología , Rendimiento Atlético/fisiología , Fatiga Muscular/fisiología , Adulto Joven , Acondicionamiento Físico Humano/métodos , Conducta Competitiva/fisiología , Adulto , Estado de Salud , Estudios de CohortesRESUMEN
This study evaluated territorial disparities in dental care for disabled persons in Brazil's public healthcare system from 2014 to 2023. The person-year incidence of outpatient dental procedures carried out by special care dentistry specialists and hospitalizations for dental procedures for disabled persons were compared across different regions and against the national estimate. In addition, productivity was correlated with oral health-related indicators. The significance level was set at 5%. The northern region exhibited the highest outpatient productivity, while the southern region showed lower productivity compared to the national estimate (both p-value < 0.05). This pattern was reversed in inpatient productivity (both p-value < 0.05), with the northeastern and central-western regions also below average (both p-value < 0.05). There were no significant correlations between the indicators and inpatient productivity, but outpatient productivity was positively correlated with the proportions of inhabitants who self-rated their general and oral health as "poor" or "very poor", who have never visited a dentist, and who visited a dentist for tooth extraction (all p-values < 0.05). Territorial disparities in dental care for disabled persons were observed within Brazil's public healthcare system, and they were correlated with unfavorable oral health-related indicators at the population level.
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Personas con Discapacidad , Salud Bucal , Brasil , Humanos , Salud Bucal/estadística & datos numéricos , Personas con Discapacidad/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Atención Dental para la Persona con Discapacidad/estadística & datos numéricos , Atención Odontológica/estadística & datos numéricos , MasculinoRESUMEN
PURPOSE: To apply the ESPEN-EASO diagnostic criteria for Sarcopenic Obesity (SO) in older women and to assess its association with the risk of falls, fear of falls (FOF), and bone mineral density (BMD). METHODS: After exclusion criteria, 232 women aged ≥60 years (68.2 ± 6.1) were enrolled in the study. Volunteers had handgrip strength (HGS; dynamometer) and body composition assessed by DXA before risk of falls was evaluated using the QuickScreen and FOF evaluated by the Falls Efficiency Scale. SO was defined according to the ESPEN-EASO algorithm, which includes reduced HGS and fat-free mass, and elevated fat mass. RESULTS: The prevalence of SO was 6.5 %, which was associated with a higher proportion of fallers in the previous year (X2 6.2, P = 0.04), reduced reaction time (X2 6.2, P = 0.04), reduced sit-to-stand performance (X2 6.2, P = 0.04), and a higher probability of falls [ê2(6) = 17.689, p = 0.004]. FOF was lower in the eutrophic group (ê2(2) = 15,662, p < 0,001) than both the obesity (p = 0.001) and SO (p = 0.05) groups. For total and femoral neck BMD, the eutrophic group presented significantly lower values (1.05 and 0.79 g/cm2) than the obesity group (1.10 and 0.87 g/cm2), but similar to the SO group (1.02 and 0.83 g/cm2). These results remained significant after adjustments for potential confounders. CONCLUSIONS: SO specified by the ESPEN-EASO framework was associated with a higher risk of falls but not with increased FOF than obesity alone. The favorable influence of overweight and obesity on BMD seems to be attenuated in individuals with SO. Our findings support the clinical significance of the ESPEN-EASO definition.
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Accidentes por Caídas , Densidad Ósea , Fuerza de la Mano , Obesidad , Sarcopenia , Humanos , Accidentes por Caídas/estadística & datos numéricos , Accidentes por Caídas/prevención & control , Femenino , Anciano , Densidad Ósea/fisiología , Obesidad/epidemiología , Obesidad/complicaciones , Sarcopenia/epidemiología , Sarcopenia/diagnóstico , Fuerza de la Mano/fisiología , Persona de Mediana Edad , Factores de Riesgo , Composición Corporal/fisiología , Consenso , Prevalencia , Absorciometría de FotónRESUMEN
OBJECTIVE: To evaluate the effects of NLRP3 inflammasome inhibition or knockout in experimental apical periodontitis (AP) induced in mice. METHODS: The experimental AP was induced by pulpal exposure. To evaluate NLRP3-specific inhibitor medication (MCC950), WT mice received intraperitoneal injections, while the control received PBS (n = 10). In addition, to evaluate NLRP3 knockout, 35 wild-type (WT) and 35 NLRP3-/- mice were divided into a control group (without pulpal exposure, n = 5) and three experimental groups: after 2, 14 and 42 days after pulpal exposure (n = 10). Microscopic and molecular analyzes were carried out using a significance level of 5%. RESULTS: Exposure to MCC950 did not affect the periapical lesion size after 14 days (P = 0.584). However, exposed mice had a lower expression of IL-1ß, IL-18 and caspase-1 (P = 0.010, 0.016 and 0.002, respectively). Moreover, NLRP3-/- mice showed a smaller periapical lesion after 14 and 42 days (P = 0.023 and 0.031, respectively), as well as a lower expression of IL-1ß after 42 days (P < 0.001), of IL-18 and caspase-1 after 14 (P < 0.001 and 0.035, respectively) and 42 days (P = 0.002 and 0.002, respectively). NLRP3-/- mice also showed a lower mRNA for Il-1ß, Il-18 and Casp1 after 2 (P = 0.002, 0.036 and 0.001, respectively) and 14 days (P = 0.002, 0.002 and 0.001, respectively). CONCLUSIONS: NLRP3 inflammasome inhibition or knockout can attenuate the inflammatory events that result in the periapical lesion (AP) formation after pulpal exposure in mice. CLINICAL RELEVANCE: The NLRP3 inflammasome may be a therapeutic target for AP, and new approaches may verify the impact of its inhibition (through intracanal medications or filling materials) on the bone repair process and treatment success.
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Modelos Animales de Enfermedad , Indenos , Inflamasomas , Ratones Noqueados , Proteína con Dominio Pirina 3 de la Familia NLR , Periodontitis Periapical , Animales , Proteína con Dominio Pirina 3 de la Familia NLR/antagonistas & inhibidores , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Proteína con Dominio Pirina 3 de la Familia NLR/genética , Ratones , Inflamasomas/metabolismo , Sulfonamidas/farmacología , Furanos/farmacología , Caspasa 1/metabolismo , Interleucina-1beta/metabolismo , Sulfonas/farmacología , Ratones Endogámicos C57BL , MasculinoRESUMEN
BACKGROUND: The conicity of the root canals of primary teeth is an important measure for endodontic therapies. However, determining this conicity depends on the methods employed, which requires further investigation. AIM: The aim of this study was to determine the conicity of the root canals of the upper and lower primary second molars using nanotomography (nCT). DESIGN: An in vitro study was performed using nine primary second molars, both upper and lower, subjected to nCT. Comparisons between the diameters of root canals were performed between the thirds (cervical-D0, middle-D5, and apical-D7). The conicity (%) was determined for each root canal from cervical to apical. Data were statistically analyzed with a significance level of 5%. RESULTS: The conicity ranged from 2% to 8% for the upper primary second molars. Significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in the mesio- and distobuccal roots (p < .05), but not in the palatal roots (p > .05). For the lower primary second molars, the conicity ranged from 2% to 17%, as well as significant differences in root canal diameter between the thirds (D0, D5, and D7 points) were observed in all roots (distal, mesiobuccal, and mesiolingual; p < .05). CONCLUSION: The conicity of the upper primary second molars was different from that of the lower ones, which showed a greater variability.
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OBJECTIVE: Investigate evidence of validity of the Family Vulnerability Scale (EVFAM-BR) as an instrument to support population-based management in primary health care (PHC), in the scope of Health Care Planning (PAS). METHODS: This is a psychometric study to assess any additional evidence of the internal structure of EVFAM-BR using confirmatory factor analysis (CFA) and network analysis (NA). A preliminary version of the scale with 38 items was submitted to patients of PHC facilities that use the PAS methodology, distributed across the five regions of Brazil. For the primary CFA data, factor loadings and predictive power (R2) of the item were used. Seven model adjustment indices were adopted and reliability was measured by three indicators, using Bayesian estimation. RESULTS: The preliminary version of the scale was applied to 1,255 patients. Using the AFC, factor loadings ranged from 0.66 to 0.90 and R2 from 0.44 to 0.81. Both the primary indicators and the model adequacy indices presented satisfactory and consistent levels. According to the NA, the items were appropriately associated with their peers, respecting the established dimensions, thus demonstrating sustainability and stability of the proposed model. CONCLUSIONS: The evidence of validity presented by EVFAM-BR indicates, for the first time in Brazil, a concise instrument that is able to assertively measure family vulnerability, potentially supporting population-based management.
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Atención Primaria de Salud , Humanos , Encuestas y Cuestionarios , Reproducibilidad de los Resultados , Teorema de Bayes , Brasil , Psicometría , Análisis FactorialRESUMEN
Introduction: Segmental and Focal Glomerulosclerosis (FSGS) is an entity characterized by glomerular damage involving the podocyte as the main target. A variant with a worse prognosis, poor response to corticosteroid therapy, and rapid progression to end-stage renal disease is recognized as collapsing FSGS. Case Report: A 102-year-old man with nephrotic syndrome and acute kidney injury underwent renal biopsy, revealing collapsing FSGS. He achieved an excellent response to immunosuppressive treatment, presenting renal recovery, and was discharged from dialysis treatment. Discussion: Diagnosis and definition of treatment in the elderly are challenging, and each case must be individualized and have functionality and risk assessed in a naturally immunosuppressed population.
Introdução: Glomeruloesclerose Segmentar e Focal (GESF) é uma entidade caracterizada por lesão glomerular que envolve o podócito como principal alvo. Uma variante de pior prognóstico, baixa resposta à corticoterapia, e rápida evolução para doença renal terminal é reconhecida como GESF colapsante. Relato de Caso: Um homem de 102 anos com síndrome nefrótica e lesão renal aguda foi submetido a biópsia renal, revelando GESF colapsante. Ele obteve excelente resposta ao tratamento imunossupressor, apresentando recuperação renal e recebendo alta de terapia renal substitutiva. Discussão: Diagnóstico e definição de tratamento nos idosos são desafiadores, devendo-se individualizar cada caso, avaliar funcionalidade e risco em uma população naturalmente imunossupressa.
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Humanos , Masculino , Anciano de 80 o más Años , Anciano , Anciano Frágil , Glomerulonefritis , Fallo Renal Crónico , Síndrome NefróticoRESUMEN
Objetivo: avaliar as notificações de intoxicação exógena por raticida no Brasil entre 2008 e 2022. Métodos: foi realizado um estudo ecológico, do tipo série temporal, avaliando a quantidade anual de notificações nos últimos 15 anos, considerando os casos confirmados pelo Sistema de Informação de Agravos de Notificação (SINAN). A tendência temporal e as razões de incidência antes e durante a pandemia de COVID-19 foram examinadas com nível de significância de 5%. Resultados: entre 2008 e 2022, 48.448 notificações de intoxicação exógena por raticidas foram registradas. A tendência temporal foi estabelecida como estacionária nos últimos 15 anos (p = 0,285), mas tornou-se, significativamente, crescente ao remover os anos relacionados à pandemia de COVID-19 (p = 0,001; VPA = 5,4% [IC95% = 2,1, 8,6). Além disso, ao comparar com período pré-pandemia, a incidência de notificações foi 34% menor (RI = 0,66 [IC95% = 0,59, 0,73]) no primeiro e 28% menor (RI = 0,72 [IC95% = 0,65, 0,79]) no segundo ano da pandemia de COVID-19. Por fim, observou-se que 82,2% das circunstâncias foram tentativas de suicídio, 89,4% foram exposições do tipo aguda-única e a maioria (91,1%) evoluíram para cura sem sequelas. Conclusão: foi possível concluir que as intoxicações exógenas por raticidas persistem como um problema de Saúde Pública no Brasil.
Objectives: to evaluate notifications of exogenous poisoning by rodenticides in Brazil between 2008 and 2022. Methods: an ecological time-series study was carried out, evaluating the annual number of notifications in the last 15 years, considering the cases confirmed by the Notifiable Diseases Information System (SINAN). Temporal tendency and incidence ratios before and during the COVID-19 pandemic were examined at a 5% significance level. Results: between 2008 and 2022, 48,448 notifications of exogenous poisoning by rodenticides were reported. The temporal tendency was established as stationary over the last 15 years (p = 0.285) but became significantly increasing when removing the COVID-19 pandemic years (p = 0.001; VPA = 5.4% [95%CI = 2 .1, 8.6). In addition, when compared to the pre-pandemic period, the incidence of notifications was 34% lower (IRR = 0.66 [CI95% = 0.59, 0.73]) in the first and 28% lower (IRR = 0,72 [CI95% = 0.65, 0.79]) in the second year of the COVID-19 pandemic. At last, it was observed that 82.2% of the circumstances were suicide attempts, 89.4% were acute-single exposures, and most (91.1%) evolved to cure without sequelae. Conclusion: it was possible to conclude that exogenous poisoning by rodenticides persists as a Public Health problem in Brazil.
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Rodenticidas , Brasil , EpidemiologíaRESUMEN
Sarcopenia is a risk factor for adverse clinical outcomes in chronic kidney disease (CKD) patients, including mortality. Diagnosis depends on adopted consensus definition and cutoff values; thus, prevalence rates are generally heterogeneous. We conducted a systematic review and meta-analysis to investigate the global prevalence of sarcopenia and its traits across the wide spectrum of CKD. A systematic search was conducted using databases, including MEDLINE and EMBASE, for observational studies reporting the prevalence of sarcopenia. We considered sarcopenia according to the consensus definition of the European Working Group on Sarcopenia in Older People (EWGSOP), the Asian Working Group for Sarcopenia, the Foundation for the National Institutes of Health Sarcopenia Project, and the International Working Group on Sarcopenia (IWGS). Subgroup analyses by CKD stages, consensus, and gender were performed. Pooled prevalence was obtained from random-effect models. A total of 140 studies (42 041 patients) across 25 countries were included in this systematic review and meta-analyses. Global prevalence of sarcopenia was 24.5% [95% confidence interval (CI): 20.9-28.3) and did not differ among stages (P = 0.33). Prevalence varied according to the consensus definition from 11% to 30%, with no significant difference (P = 0.42). Prevalence of severe sarcopenia was 21.0% (95% CI: 11.7-32.0), with higher rates for patients on dialysis (26.2%, 95% CI: 16.6-37.1) compared to non-dialysis (3.0%, 95% CI: 0-11.1; P < 0.01). Sarcopenic obesity was observed in 10.8% (95% CI: 3.5-21.2). Regarding sarcopenia traits, low muscle strength was found in 43.4% (95%CI: 35.0-51.9), low muscle mass in 29.1% (95% CI: 23.9-34.5), and low physical performance in 38.6 (95% CI: 30.9-46.6) for overall CKD. Prevalence was only higher in patients on dialysis (50.0%, 95% CI: 41.7-57.4) compared to non-dialysis (19.6%, 95% CI: 12.8-27.3; P < 0.01) for low muscle strength. We found a high global prevalence of sarcopenia in the wide spectrum of CKD. Low muscle strength, the primary sarcopenia trait, was found in almost half of the overall population with CKD. Patients on dialysis were more prevalent to low muscle strength and severe sarcopenia. Nephrology professionals should be aware of regularly assessing sarcopenia and its traits in patients with CKD, especially those on dialysis.
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Insuficiencia Renal Crónica , Sarcopenia , Humanos , Sarcopenia/epidemiología , Insuficiencia Renal Crónica/epidemiología , Insuficiencia Renal Crónica/complicaciones , PrevalenciaRESUMEN
Vertical jump is an important skill that influences volleyball performance. In this study, we analyzed the relationship between vertical jump performance and birth quartile of Brazilian male youth volleyball players. We calculated chi-square goodness-of-fit tests to compare the athletes' birthdate distributions in quarters of their birth years (Q1, Q2, Q3, and Q4) according to player age categories (U17, U18, U19, and U21). We calculated one-way ANOVAs to compare spike jump and block jump heights of players born in different quarters of the same year. Overall, we found a relative age effect (i.e., more players with birth dates early in the birth year) in U17 (p < .001), U18 (p < .001), U19 (p < .001), and U21 (p = .04). Regarding vertical jump performance, U18 athletes born in Q2 reached higher spike jump heights (p = .006) and block jump heights (p = .002) than athletes born in Q4, and U19 athletes born in Q1 reached higher block jump heights than athletes born in Q3 (p = .049). There were no significant differences in vertical jump performance across birth quartiles among U17 and U21 athletes. Thus, a relative age effect was present in all age categories but not always reflected in vertical jump performance. Volleyball coaches and policymakers are still advised to employ strategies to ensure fairer opportunities for players born later in the year of their eligibility dates, as we found RAE to be sometimes, but not always, related to higher spike or block jump heights even among these older adolescents and young adult athletes.
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Rendimiento Atlético , Voleibol , Adulto Joven , Adolescente , Humanos , Masculino , Atletas , BrasilRESUMEN
Wound healing is a natural regenerative response to tissue injury and the conventional treatments consists of the use wound dressings with local administration of medicines, but, in some cases, are only partially effective and limited by toxicity or ineffective anti-microbial protection. Medicinal plants such as Lippia sidoides and Myracrodruon urundeuva have shown interesting pharmacological activities, allied to this, the association of these medicinal plants and nanotechnology, could mean an advantage in relation to classical approach. This study investigated the effect of a nanogel loaded with Lippia sidoides essential oil and Myracrodruon urundeuva extract (NAA) in an excisional wound healing model in rats. Animals were anesthetized and skin wounds were made using a metal punch. The groups were treated with vehicle, NAA or collagenase gel, for 7, 14 or 21â days and then sacrificed for tissue analysis. NAA did not show acute dermal irritation, further significantly reduced (p<0.05) the final wound area, accelerated the wound contraction and organization of collagen in the group treated for 14â days. The data presented here demonstrate the therapeutic potential for the use of nanotechnology associated with medicinal plants and provides evidence that corroborate with the use of L.â sidoides and M.â urundeuva as healing medicinal plants.