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1.
Rev Assoc Med Bras (1992) ; 70(8): e20240447, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39230146

RESUMO

OBJECTIVE: Stroke is a chronic health problem that affects all areas of life. The presence of thyroid autoantibodies can augment the severity of stroke. The aim of this work is to investigate whether there is a relationship between the site of stroke involvement and the anti-thyroid peroxidase antibody (anti-TPO) or not. This is the first study in the English-language literature. METHODS: A total of 39 patients with a diagnosis of acute ischemic stroke were included, and the cases under 18 years of age with an infection and the ones with autoimmune diseases other than Hashimoto's thyroiditis were excluded from the study design. The patients' age, gender, smoking status, comorbid conditions, and stroke localization in brain imaging were recorded. The region involving the anterior circulation area originating from the internal carotid artery was evaluated as anterior, and the region possessing the vertebrobasilar circulation area from the vertebral arteries was considered posterior involvement. Thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), C-reactive protein (CRP), sedimentation, and anti-TPO were retrospectively analyzed. RESULTS: As a consequence, gender distribution, smoking, comorbid conditions, TSH, T3, T4, triglyceride, HDL, LDL, CRP, and sedimentation did not differ significantly, while the age of the posterior-located stroke was lower than that of the cases with the anterior. The anti-TPO value was significantly lower in posterior-located strokes than in the anterior system. CONCLUSION: In summary, the anti-TPO value was recognized as higher in the anterior stroke localization. Thyroiditis and accompanying anti-TPO autoantibody positivity are conditions that should not be ignored by thyroidologists and thyroid-health providers.


Assuntos
Autoanticorpos , Iodeto Peroxidase , Humanos , Feminino , Masculino , Autoanticorpos/sangue , Pessoa de Meia-Idade , Iodeto Peroxidase/imunologia , Idoso , Estudos Retrospectivos , Acidente Vascular Cerebral/imunologia , Acidente Vascular Cerebral/diagnóstico por imagem , AVC Isquêmico/diagnóstico por imagem , AVC Isquêmico/imunologia , AVC Isquêmico/sangue , Adulto , Idoso de 80 Anos ou mais , Fatores de Risco
2.
Sports Med Health Sci ; 6(3): 279-286, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39234484

RESUMO

Previously, it was suggested that biological maturation (BM) could be linked to cardiac autonomic recovery (CAR) in the pediatric population. However, this influence hasn't been confirmed yet. Our aim was to investigate the impact of BM on CAR in female volleyball players. Experimental study with a sample of 38 volleyball players, comprising 20 girls (age: [11.6 â€‹± â€‹2.1] years) and 18 women (age: [24.5 â€‹± â€‹5.5] years), we analyzed BM, comparing maturing subjects (girls) with mature subjects (women). Additionally, we assessed peak height velocity (PHV) in girls. We conducted a training session involving repeated sprints (3 rounds of 6 sprints interspersed by 5 â€‹min [min] of passive rest). Using short-range radio telemetry, we analyzed CAR during (at the end of the 1st and 2nd rounds) and after (following the 3rd round) the training session of repeated sprints by applying the 60-s to 300-s heart rate recovery index (HRR-Index). Girls exhibited superior CAR compared to women (round 2: 60-s, 120-s, 240-s, and 300-s, p â€‹< â€‹0.005). Subgroup analyses of BM indicated that individuals in the Late-PHV stage demonstrated superior CAR compared to those in the Early-PHV and During-PHV groups. (60-s to 300-s, η 2 p â€‹> â€‹0.4, p â€‹< â€‹0.05). Subjects in the During-PHV stage were superior to those in the Early-PHV stage (240-s á 300-s, η 2 p â€‹> â€‹0.4, p â€‹< â€‹0.05). We have concluded that biological maturation has a significant impact on cardiac autonomic recovery.

3.
Planta Med ; 2024 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-39227040

RESUMO

Monoterpenes and sesquiterpenes are classes of organic compounds found in various natural products, such as the essential oil of Hyptis crenata (EOHc). The therapeutic potential of these terpenes present in EOHc is evidenced by their effect on smooth muscle and potential clinical applications. Among the highlighted monoterpenes, such as sabinene, α-pinene, and ß-pinene, a relaxing effect on rat intestinal smooth muscles is observed, attributed to interaction with calcium channels. Furthermore, monoterpenoids like borneol, cineole, and linalool also demonstrate vasorelaxant properties, suggesting potential in the treatment of cardiovascular conditions. Sesquiterpenes, such as caryophyllene and aromadendrenes, exhibit relaxing effects in various smooth muscle tissues, such as rat uterus and guinea pig ileum, indicating pharmacological potential in these areas. The translational exploration of targets, such as calcium channels and G protein-coupled receptors, highlights the importance of these compounds in discovering new therapies based on natural products for treating various medical conditions.

4.
Environ Sci Pollut Res Int ; 31(45): 56482-56498, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39271609

RESUMO

This study aims to conduct an applied and innovative investigation to enhance the energy quality of wood residues through hydrothermal carbonization pretreatment. For this purpose, the treatment was carried out at three different temperatures: 180, 220, and 240 °C under autogenous pressure. The in natura material and the hydrochars were characterized, and thermogravimetric analyses were performed in an O2 atmosphere with heating rates of 2.5, 5, 10, and 20 °C min-1. The global activation energy for natura biomass combustion was determined to be 112.49 kJ.mol-1. On the other hand, the hydrothermal carbonization process promoted a reduction in this value for the 94.85 kJ.mol-1. The conversion function for the in natura biomass was characterized as 1 - α , order 1, while the hydrochars was 2(1-α) [-ln(1-α)] (1/2), Avrami-Erofe'ev I. Triple kinetic parameters were ascertained, and the conversion curves along with their respective derivatives were modeled, exhibiting minimal deviations between theoretical and experimental data. This facilitated the mathematical representation of the reaction processes and allowed for a comprehensive comparison of the results.

5.
Ann Anat ; 257: 152338, 2024 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-39299656

RESUMO

This study aimed to conduct a morphoquantitative and stereological evaluation, analyzing the cerebellum of domestic cat fetuses in the latter third of the gestational period. Fetal samples were obtained from a neutering campaign conducted in the municipality of Guarulhos, São Paulo, Brazil. The procedures and protocols used in this work adhere to the guidelines established by the ethics committee of the School of Veterinary Medicine and Animal Science at the University of São Paulo (FMVZ/USP), under the number CEUA 1935251121. The five selected fetuses were fixed in 4 % formaldehyde, and their gestational age was determined by Crown Rump (CR) measurements, followed by an assessment of external characteristics. The cerebella were subjected to the evaluation of morphometric parameters and histological processing using stereology techniques. The obtained means for the cerebellar parameters were as follows: length: 1.0-centimeter, width: 0.54 centimeters, thickness: 0.44 centimeters, and weight: 0.84 g. Using stereology, the following parameters were determined: cerebellar volume, averaging 0.847 cm³; volume density of the cortex: 0.496 or 49 % (molecular layer), 0.0314 or 3.14 % (Purkinje cell layer), 0.232 or 23 % (granular layer), and 0.234 or 23 % (medullary white center). Consequently, the average total volume of the cerebellar cortex is 0.419 cm³ for the molecular layer, 0.026 cm³ for the Purkinje cell layer, 0.196 cm³ for the granular layer, and 0.196 cm³ for the medullary white center. The findings presented here have contributed to an in-depth discussion of the neuro-motor development and cerebellum of domestic cats.

7.
AAPS PharmSciTech ; 25(7): 212, 2024 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-39242428

RESUMO

UV radiation causes long- and short-term skin damage, such as erythema and skin cancer. Therefore, the use of sunscreens is extremely important. However, concerns about UV filter safety have prompted exploration into alternative solutions, with nanotechnology emerging as a promising avenue. This systematic review identified 23 experimental studies utilizing nanocarriers to encapsulate sunscreens with the aim of enhancing their efficacy and safety. Polymeric and lipid nanoparticles are frequently employed to encapsulate both organic and inorganic UV filters along with natural antioxidants. Nanocarriers have demonstrated benefits including reduced active ingredient usage, increased sun protection factor, and mitigated photoinstability. Notably, they also decreased the skin absorption of UV filters. In summary, nanocarriers represent a viable strategy for improving sunscreen formulations, offering enhanced physicochemical properties and bolstered photoprotective effects, thereby addressing concerns regarding UV filter safety and efficacy in cosmetic applications.


Assuntos
Nanopartículas , Nanotecnologia , Protetores Solares , Raios Ultravioleta , Animais , Humanos , Antioxidantes/administração & dosagem , Antioxidantes/química , Antioxidantes/farmacologia , Portadores de Fármacos/química , Lipídeos/química , Nanopartículas/química , Nanotecnologia/métodos , Polímeros/química , Pele/metabolismo , Pele/efeitos dos fármacos , Absorção Cutânea/efeitos dos fármacos , Fator de Proteção Solar , Protetores Solares/química , Protetores Solares/administração & dosagem , Raios Ultravioleta/efeitos adversos
8.
Trop Anim Health Prod ; 56(8): 261, 2024 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-39292295

RESUMO

We developed a study to determine the ideal level of inclusion of soybean oil (SBOil) in the diet without affecting the quantitative and qualitative parameters of the carcass and meat of lambs in a feedlot system; therefore, determining the ideal level of inclusion. Forty male lambs (Santa Inês breed) were used. The initial body weight and age averaged 34.88 ± 3.19 kg and 5 months, respectively. Experimental units (lambs) were randomly distributed in 5 different diets: inclusion levels of SBOil: 0, 30, 60, 90, and 120 g/kg of dry matter (DM). The SOil inclusion reduced the DM intake (P < 0.001), Total digestible nutrients (P = 0.004), and crude protein (P < 0.001). Total weight gain (P < 0.001) decreased with the SBOil inclusion and subcutaneous fat thickness (P = 0.017) showed the same behaviour. The final body weight decreased by 42.9 g/kgDM until the inclusion level of 30 g/kgDM; from this level it was reduced by 145 g/kgDM. The hot and cold carcass weights (P = 0.013) decreased by 36.6 g/kgDM after including 30 g/kgDM of SBOil. Meat physicochemical composition was not altered (P > 0.05). Lower meat tenderness values ​​were obtained at the levels of 60 and 90 g/kgDM. The inclusion above 30 g/kgDM decreased meat tenderness. It is concluded that soybean oil should be included up to 30 g/kgDM in diets. It is important to note that with diets with 60% concentrate, SBOil levels greater than 30 g/kgDM promote yield losses.


Assuntos
Ração Animal , Dieta , Carneiro Doméstico , Óleo de Soja , Animais , Óleo de Soja/administração & dosagem , Óleo de Soja/análise , Masculino , Ração Animal/análise , Dieta/veterinária , Carneiro Doméstico/fisiologia , Ácido Linoleico/análise , Ácido Linoleico/administração & dosagem , Fenômenos Fisiológicos da Nutrição Animal , Distribuição Aleatória , Carne Vermelha/análise , Carne/análise
9.
Cien Saude Colet ; 29(10): e08722023, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39292042

RESUMO

The performance evaluation of services through instruments is relevant, as it can support thoughts, actions and political approaches to meet a social need. The objective of the article was to develop and validate the Quality and Strengthening of Primary Care Questionnaire (QSPC-Q) for professionals and users based on Starfield attributes and Donabedian pillars. A mixed sequential study was performed to develop the QSPC-Q. The test was applied to 149 doctors and 795 users of basic health units. Psychometric properties was assessed by testing internal consistency using Cronbach's alpha and exploratory factor analysis. Reproducibility od scale was assessed using intraclass cognitive and test-retest correlation. The final version of the follow-up consisted of 45 items aimed at physicians (Cronbach's alpha = 0.921) and 33 at users (Cronbach's alpha = 0.86); the intraclass respiratory capacity was 0.88. An exploratory factor analysis identified 13 factors associated with the pattern components. A short version with 29 items for professionals was also elaborated. Professional QSPC-Q (short and braided versions) and user QSPC-Q were valid.


Assuntos
Atenção Primária à Saúde , Psicometria , Atenção Primária à Saúde/normas , Brasil , Humanos , Inquéritos e Questionários , Reprodutibilidade dos Testes , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Análise Fatorial , Qualidade da Assistência à Saúde , Médicos/normas
11.
Gynecol Oncol Rep ; 55: 101490, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39281844

RESUMO

Introduction: Cervical cancer is a significant public health problem worldwide. The development of cervical neoplasms is associated with persistent infection by oncogenic subtypes of the HPV virus, which are responsible for around 70% of cervical cancers.A study carried out in Brazil between 2002 and 2021 recorded 133,429 deaths from cervical cancer.. Methodology: An observational, retrospective, cross-sectional, quantitative study was carried out using data collected by the Cancer Registry Service of the Haroldo Juaçaba Hospital/Ceará Cancer Institute (HHJ/ICC) over 22 years. Results: The sample consisted of 9096 women. The mean age was 51.4 ± 15.5, ranging from 15 to 100, with a median age of 60 years. Median overall survival was 59.77. The most frequent histological type was squamous cell carcinoma, with 8023 (88.2 %) cases. Around 25 % of patients (n = 2270) entered the service with stage 4A. The most common treatment was radiotherapy combined with chemotherapy (n = 3270, 35.9 %), followed by surgical removal (n = 1909, 21.0 %).In multivariate analysis, age (p = 0.019), race (p = 0.016), low level of education (p < 0.001), tumor location, staging (p < 0.001), and treatment (p = 0.011) were risk factors independently associated with a higher chance of death in the sample studied. Conclusion: The sociodemographic characteristics of mortality from cervical cancer in patients followed up at the Haroldo Juaçaba Hospital (HHJ/ICC) highlight the higher frequency of deaths in women aged over 60, indigenous and black, with low levels of education, as well as clinical variables related to tumor location, staging and type of treatment.

12.
Arq. bras. cardiol ; 121(9 supl.1): 224-224, set.2024. ilus
Artigo em Português | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1568418

RESUMO

INTRODUÇÃO: A cirurgia de revascularização miocárdica continua sendo realizada em grande número de pacientes. Apesar dos enxertos arteriais serem preferidos devido sua patência, enxertos de veia safena continuam sendo usados regularmente. Os aneurismas de enxertos venosos são uma rara complicação cirúrgica tardia, aprensentandose em média 10 anos após a revascularização. A maioria dos pacientes com aneurisma são assintomáticos e suas principais complicações são embolização distal, IAM e formação de fístula e rotura. RELATO DE CASO: Paciente feminina, 65 anos, com antecedente de RVM com ponte mamária para coronária descendente anterior (MIE-DA) e pontes safena para diagonal, primeiro e segundo marginal e coronária direita. Em cateterismo 2023, ponte MIE-DA estava pérvia, com oclusão das demais. Relatou dor torácica típica, com piora do padrão há 15 dias. Apresentou ECG com padrão de isquemia circunferencial e curva ascendente de troponina, sendo Internada por IAMSSST. No ecocardiograma visualizou-se aumento da porção distal de aorta ascendente com grande dilatação e formação de uma neocavidade medindo 63x57mm, adjacente a parede posterior da aorta ascendente próximo a junção sinotubular com fluxo, rechaçando a parede do átrio esquerdo e o anel valvar mitral e possível compressão do tronco da coronária esquerda e artéria pulmonar. À ressonância cardíaca evidenciou neocavidade junto à raiz da aorta e porção ascendente com sinais de compressão extrínseca importante das artérias pulmonares. Foi considerado como hipótese diagnóstica um aneurisma do enxerto Ao-MG2, com compressão extrínseca da circulação coronariana causando dor e isquemia. DISCUSSÃO: Aneurisma de enxertos venosos geralmente são assintomáticos, mesmo quando possuem diâmetros entre 5 e 10 cm. A compressão do leito coronariano nativo por efeito de massa pode levar a IAM, até mesmo com alteração de ECG, como observado no caso relatado. O tratamento mais comumente proposto é a correção cirúrgica, contudo, em pacientes com múltiplas toracotomias e alto risco cirúrgico, pode-se optar pela embolização percutânea. CONCLUSÃO: Apesar de complicação relativamente rara, os aneurismas de enxertos venosos devem ser considerados diante de episódio de dor torácica em pacientes previamente submetidos à revascularização miocárdica.


Assuntos
Humanos , Feminino , Idoso , Veia Safena/cirurgia , Doença da Artéria Coronariana , Aneurisma/complicações , Dor no Peito , Isquemia , Revascularização Miocárdica
13.
Artigo em Inglês | MEDLINE | ID: mdl-39222873

RESUMO

OBJECTIVE: To investigate the effects of implementing early multi-professional mobilization on quality indicators of intensive care in Brazil. DESIGN: This is a retrospective cohort study. SETTING: A Brazilian educational and research-intensive care unit (ICU). PARTICIPANTS: 1047 patients hospitalized from May 2016 to April 2018. INTERVENTIONS: Implementation of early multi-professional mobilization by the MobilizAÇÃO Program (MAP). MAIN OUTCOME MEASURES: Clinical, ventilation and safety quality indicators, and physical function before (pre-program period) and after (post-program period) the MAP. RESULTS: There was a reduction in sedation time (4 vs. 1 day), hospital stay (21 vs. 14 days) and ICU stay (14 vs. 7 days), mechanical ventilation (8 vs. 4 days), hospital death rate (46 vs. 26%) (p<0.001) and ICU readmission (21 vs. 16%; p=0.030) from pre to post MAP. Successful weaning (42 vs. 55%) and discharge rate (50 vs. 71%) (p <0.001) increased after MAP. No differences were found to safety quality indicators between periods. After MAP, complex physical functions assessed by the Manchester Mobility Score (MMS) were more frequent. The in-bed intervention was a predictor for readmission (p=0.009; R²=0.689) and death (p=0.035; R²=0.217), while walking was a predictor for successful weaning (p=0.030; R²=0.907) and discharge (p=0.033; R²=0.373). The post-program period was associated with the MMS at ICU discharge (p<0.001; R²=0.40). CONCLUSION: Early mobilization implementation through changes in low mobility culture and multi-professional actions improved quality indicators, including clinical, ventilation, and physical functional quality, without compromising patient safety in the ICU.

14.
Rev Col Bras Cir ; 51: e20243770, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39166610

RESUMO

INTRODUCTION: Appendectomy is the standard treatment for appendicitis, with the laparoscopic technique offering benefits like lower infection rates and quicker recovery. However, residents often have their first practical experience with the procedure on real patients, increasing surgical risks. In this context, medical simulation emerges as a crucial methodology, allowing professionals to experience a variety of scenarios while preventing harm to patients. The objective of this study is to describe the production of an "ex-vivo" simulation model for laparoscopic appendectomy. METHODOLOGY: Cold ceramic structures were used to manually shape the anatomical model of the appendix, ensuring its rigidity. On this model, we poured materials to create a flexible mold using acetic silicone. Once the mold was made, we filled it with thermo-moldable styrene polymer rubber, along with dye, and fused it at a specific temperature. RESULTS: This process resulted in the manufacture of a piece that simulates the appendix, being tear-resistant and suturable, faithfully replicating the structure and characteristics of a human organ. The low weight of the materials facilitates transport, allowing them to be reproduced and used in various situations, from training in hospital settings to universities. The model is applicable in didactic simulations with medical students, residents, and surgeons. Its ease of production and low cost contribute to the practices being repeatable, ensuring a better development of surgical skills. CONCLUSION: This work not only contributes to the advancement of medical simulation but also highlights the importance of innovative and collaborative solutions in improving medical education and promoting patient safety.


Assuntos
Apendicectomia , Laparoscopia , Modelos Anatômicos , Apendicectomia/métodos , Laparoscopia/métodos , Laparoscopia/educação , Humanos
15.
Front Oncol ; 14: 1440109, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39169936

RESUMO

Introduction: Breast cancer is one of the most common types of cancer affecting women. Despite advancements in early diagnosis, neoadjuvant therapy, and various treatment modalities, mastectomy remains a common procedure for many women. Although some women opt for reconstructive surgery (BR), many do not have the indication, desire, or opportunity to undergo this procedure. Methods: An easily manufactured, washable, lightweight, and inexpensive external breast prosthesis (EBP) model was developed specifically for the study. Participants were presented with five EBP models-one commercially available, three manufactured options, and one created for the study-and were asked to choose a prosthesis. We also evaluated the factors associated with non-adherence to EBP among women who had undergone mastectomy without BR. The chi-square test was used to assess adherence or non-adherence to EBP, while logistic regression was used to identify factors associated with non-adherence. Results: We introduced a low-cost, lightweight, washable EBP model. When participants were asked to choose between two prostheses, the silicone prosthesis was the first choice for 33.9% of the participants, while the prosthesis created for the study emerged as the second choice for 70.5%. Out of the 72 women assessed, 45.8% (33) opted not to use any of the EBP models. Our analysis revealed that age and BMI were significantly associated with non-use of EBP. Conclusion: Multiple barriers contribute to non-adherence to EBP, underscoring the need for interventions aimed at improving patient knowledge and adherence. This study introduces a lightweight, easily reproducible, and low-cost EBP model.

16.
Respir Care ; 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39191455

RESUMO

Background: The reduced mobility in critically ill patients is still a reality in many intensive care units. This study aims to investigate if mobility level is associated with extubation outcome in adult patients.Methods: Prospective cohort study which comprised adults who had undergone initial invasive mechanical ventilation for more than 24 hours and were independently mobile before hospitalization. Patient progress was monitored from ICU admission to discharge. Data were collected daily from medical records and multidisciplinary teams, considering variables such as age, sex, BMI, SAPS III score, type of ICU admission, comorbidities, sedation, usage of vasoactive drugs, neuromuscular blockers, duration of mechanical ventilation, and ICU mobility scale (IMS). The primary outcome was the success of extubation.Results: IMS values did not directly associate with extubation outcome. Older patients demonstrated a reduced tendency for high IMS values, as did those on prolonged usage of vasoactive drugs or mechanical ventilation. Patients with higher IMS values achieved successful extubation earlier, suggesting a link between mobility and faster extubation success.Conclusion: The level of mobility assessed 24 hours after extubation was not associated with extubation success. The following characteristics were associated with a lower propensity to present high IMS: older age, greater number of days of use of vasoactive drugs and mechanical ventilation. Patients with higher levels of mobility had a successful extubation event earlier in the ICU. Studies that assess mobility on a continuous basis would be more precise in identifying this association.

17.
J Mycol Med ; 34(3): 101503, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39173426

RESUMO

INTRODUCTION: The present study investigated the impact of immune recovery and the duration of antifungal adherence in the consolidation phase of disseminated histoplasmosis (DH) in acquired immune deficiency syndrome (AIDS) patients living in a hyperendemic area in northeastern Brazil. MATERIAL AND METHODS: Sixty-nine patients with DH/AIDS, admitted to the São José Hospital between 2010 and 2015, who continued histoplasmosis consolidation therapy at the outpatient clinic were studied. The follow-up duration was at least 24 months. RESULTS: Sixty-eight patients used itraconazole 200-400 mg/day or amphotericin B deoxycholate weekly during the consolidation phase, and six patients relapsed during follow-up. The overall median duration of consolidation antifungal use was 250 days [IQR 101 - 372]. Antifungal withdrawal by medical decision occurred in 41 patients (70.7 %) after a median of 293 days [IQR 128 - 372] of use; 16 patients discontinued by their own decision, with a median of 106 days [IQR 37 - 244] of therapy; three patients had no information available, and nine continued on AF therapy. The median CD4+ T-cell count in the group without relapse was 248 cells/µL [IQR 115-355] within 6 months after admission; conversely, in the relapse group, the median cell count remained below 100 cells/µL. Irregular adherence to highly active antiretroviral therapy (HAART) was the leading risk factor associated with relapse and death (p< 0.01). DISCUSSION: The regular use of HAART, combined with immune recovery, proved to be highly effective in preventing relapses in DH/AIDS patients, suggesting that long-term antifungal therapy may not be necessary.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS , Síndrome da Imunodeficiência Adquirida , Anfotericina B , Antifúngicos , Ácido Desoxicólico , Histoplasmose , Humanos , Histoplasmose/tratamento farmacológico , Histoplasmose/imunologia , Masculino , Feminino , Antifúngicos/uso terapêutico , Antifúngicos/administração & dosagem , Adulto , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/imunologia , Pessoa de Meia-Idade , Ácido Desoxicólico/uso terapêutico , Ácido Desoxicólico/administração & dosagem , Anfotericina B/uso terapêutico , Anfotericina B/administração & dosagem , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Contagem de Linfócito CD4 , Brasil/epidemiologia , Itraconazol/uso terapêutico , Itraconazol/administração & dosagem , Reconstituição Imune , Combinação de Medicamentos , Quimioterapia de Consolidação , Estudos Retrospectivos , Adesão à Medicação/estatística & dados numéricos , Recidiva , Duração da Terapia , Resultado do Tratamento , Seguimentos , Terapia Antirretroviral de Alta Atividade
18.
Artigo em Inglês | MEDLINE | ID: mdl-39200715

RESUMO

This review aims to analyze the evidence related to violence perpetrated against transgender individuals in health services based on their narratives. This is a systematic literature review of qualitative studies. A search was carried out in the Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and MEDLINE databases using the descriptors "transgender people", "violence", and "health services". The eligibility criteria included original qualitative articles addressing the research question, with fully available text, reporting violence specifically by health workers, involving trans individuals aged 18 and above, and published in Portuguese, English, or Spanish. In addition, studies were included that reported experiences of violence suffered by the trans population, through their narratives, in health services. A total of 3477 studies were found, of which 25 were included for analysis. The results highlighted situations such as refusal of service; resistance to the use of social names and pronouns; barriers to accessing health services; discrimination and stigma; insensitivity of health workers; lack of specialized care and professional preparedness; and a system focused on binarism. The analysis of the studies listed in this review highlights the multiple facets of institutional violence faced by the transgender population in health services. It is evident that the forms of violence often interlink and reinforce each other, creating a hostile environment for the transgender population in health services. Thus, there is an urgent need to create strategies that ensure access to dignified and respectful care for all individuals, regardless of their gender identity.


Assuntos
Pessoas Transgênero , Humanos , Pessoas Transgênero/psicologia , Pessoal de Saúde/psicologia , Violência , Pesquisa Qualitativa , Serviços de Saúde , Masculino , Estigma Social , Feminino
19.
Artigo em Inglês | MEDLINE | ID: mdl-39147299

RESUMO

Mammalian and reptilian vascular tissues present basal release of 6-nitrodopamine, which is reduced when the tissues are pre-incubated with the NO synthase inhibitor L-NG-Nitro arginine methyl ester (L-NAME), or when the endothelium is mechanically removed. 6-Nitrodopamine induces vasorelaxation in pre-contracted vascular rings by antagonizing the dopaminergic D2-like receptor. Here it was investigated whether male swine vessels (including carotid, left descendent coronary, renal, and femoral arteries) release 6-nitrodopamine, dopamine, noradrenaline, and adrenaline, as measured by liquid chromatography coupled to tandem mass spectrometry. The in vitro vasorelaxant action of 6-nitrodopamine was evaluated in carotid, coronary, renal, and femoral arteries precontracted by U-46619 (3 nM), and compared to that induced by the dopamine D2-receptor antagonist L-741,626. Expression of tyrosine hydroxylase and the neuromaker calretinin was investigated by immunohistochemistry. All vascular tissues presented basal release of endothelium-derived catecholamines. The relaxation induced by 6-nitrodopamine was not affected by preincubation of the tissues with either L-NAME (100 µM, 30-min preincubation) or the heme-site inhibitor of soluble guanylyl cyclase ODQ (100 µM, 30-min preincubation). Electrical field stimulation (EFS)-induced contractions were significantly potentiated by previous incubation with L-NAME, but unaffected by ODQ preincubation. The contractions induced by EFS were reduced by preincubation with either 6-nitrodopamine or L-741,626. Immunohistochemistry in all arteries revealed the presence of tyrosine hydroxylase in the endothelium, whereas immunoreactivity for calretinin was negative. Swine vessels present basal release of endothelium-derived catecholamines and expression of tyrosine hydroxylase in the endothelium. The vasodilation induced by 6-nitrodopamine is due to blockade of dopaminergic D2-like receptors.


Assuntos
Vasodilatação , Animais , Masculino , Vasodilatação/efeitos dos fármacos , Suínos , Artéria Femoral/efeitos dos fármacos , Artéria Femoral/metabolismo , Artéria Femoral/fisiologia , Vasos Coronários/efeitos dos fármacos , Vasos Coronários/fisiologia , Vasos Coronários/metabolismo , Artéria Renal/efeitos dos fármacos , Artéria Renal/metabolismo , Artéria Renal/fisiologia , Dopamina/metabolismo , Artérias Carótidas/efeitos dos fármacos , Artérias Carótidas/metabolismo , Artérias Carótidas/fisiologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/metabolismo , Endotélio Vascular/fisiologia , Vasodilatadores/farmacologia
20.
Int Urol Nephrol ; 2024 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-39153132

RESUMO

PURPOSE: After radical prostatectomy (RP), it is rarely acknowledged that several sexual dysfunctions can arise. These include issues in the orgasmic domain (e.g., decreased orgasm intensity, dysorgasmia), problems with ejaculation (e.g., absence of ejaculation), the development of penile deformities, and low sexual desire. This article aims to report the occurrence of orgasmic and ejaculatory dysfunction when actively investigated, documenting those rates and characterizing specific features of these conditions following RP. METHODS: This study has analyzed retrospective data from men who underwent RP and were experiencing erectile dysfunction. During a structured visit, patients were systematically questioned about dysorgasmia, altered orgasmic sensation, climacturia, and arousal incontinence. Continuous variables were analyzed using the Student T or ANOVA tests, while categorical variables were analyzed using Chi-squared or Fisher's exact tests. The associations were described as odds ratios with precise confidence intervals. All tests were two sided; a p value < 0.05 was considered statistically significant. RESULTS: Sixty patients were included, out of which 3 (5%) reported dysorgasmia, while 33.3% presented a decrease in orgasm intensity. Climacturia was reported as the most common orgasmic disorder in 40 (66.6%) patients. However, only 14 patients (35%) reported that it frequently occurs, i.e., more than half of the time. Among the patients who reported climacturia, 72.5% classified it as mild losses. Additionally, arousal incontinence (AI) was noted in the study by 19 (26.3%) patients. CONCLUSION: Our study highlights the importance of discussing orgasmic dysfunctions after RP, which can be frequent and bothersome but are often overlooked in preoperative counseling.

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