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1.
Eur J Nutr ; 2024 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-39180555

RESUMO

PURPOSE: Investigate the associations of ultra-processed foods (UPF) in healthful (hPDI) and unhealthful (uPDI) plant-based diets with all-cause mortality, greenhouse gas emissions (GHGE), and blue water consumption (BWC). METHODS: Analyses were based on 35,030 participants (20-70 years; 74% females) from the EPIC-NL cohort who were followed up from 1993 to 1997 through 2014. Plant-based diet indices (hPDI and uPDI) and UPF consumption were calculated from a validated FFQ, assessed at baseline. Cox proportional hazard and multiple linear regression models were used to estimate associations between combined quartiles of the PDI indices and UPF consumption. RESULTS: With lower hPDI and higher UPF diets as the reference, we observed the following. Risk estimates of all-cause mortality were 0.98 (95% CI: 0.83, 1.16) for lower UPF consumption, 0.86 (95% CI: 0.68, 1.08) for higher hPDI, and 0.78 (95% CI: 0.66, 0.89) for combined higher hPDI and lower UPF consumption. Results with the uPDI were inconclusive. Mean differences in GHGE and BWC were 1.4% (95% CI: 0.3, 2.4) and 1.6% (95% CI: -0.5, 3.7) for lower UPF consumption, -7.4% (95% CI: -8.6, -6.4) and 9.6% (95% CI: 7.2, 12.0) for higher hPDI, and - 6.8% (95% CI: -7.4, -6.1) and 13.1% (95% CI: 11.6, 14.8) for combined higher hPDI and lower UPF consumption. No apparent conflict between environmental impacts was observed for the uPDI; GHGE and BWC were lower for higher uPDI scores. CONCLUSION: Mortality risk and environmental impacts were mostly associated with the amount of plant-based foods and to a lesser extent UPF in the diet. Shifting to a more healthful plant-based diet could improve human health and reduce most aspects of environmental impact (GHGE, but not BWC) irrespective of UPF consumption.

3.
Int J Health Geogr ; 23(1): 3, 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38321477

RESUMO

BACKGROUND: Geographic access to food may affect dietary choices and health outcomes, but the strength and direction of associations may depend on the operationalization of exposure measures. We aimed to systematically review the literature on up-to-date evidence on the association between food environment exposures based on Global Positioning System (GPS) and diet-related and cardiometabolic health outcomes. METHODS: The databases PubMed, Embase.com, APA PsycInfo (via Ebsco), Cinahl (via Ebsco), the Web of Science Core Collection, Scopus, and the International Bibliography of the Social Sciences (via ProQuest) were searched from inception to October 31, 2022. We included studies that measured the activity space through GPS tracking data to identify exposure to food outlets and assessed associations with either diet-related or cardiometabolic health outcomes. Quality assessment was evaluated using the criteria from a modified version of the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. We additionally used four items from a quality assessment tool to specifically assess the quality of GPS measurements. RESULTS: Of 2949 studies retrieved, 14 studies fulfilled our inclusion criteria. They were heterogeneous and represent inconsistent evidence. Yet, three studies found associations between food outlets and food purchases, for example, more exposure to junk food outlets was associated with higher odds of junk food purchases. Two studies found associations between greater exposure to fast food outlets and higher fast food consumption and out of three studies that investigated food environment in relation to metabolic outcomes, two studies found that higher exposure to an unhealthy food environment was associated with higher odds of being overweight. CONCLUSIONS: The current and limited evidence base does not provide strong evidence for consistent associations of GPS-based exposures of the food environment with diet-related and cardiometabolic health outcomes.


Assuntos
Doenças Cardiovasculares , Sistemas de Informação Geográfica , Humanos , Estudos Transversais , Meio Ambiente , Dieta
4.
Genet Mol Biol ; 46(3 Suppl 1): e20230132, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38373162

RESUMO

Tuberous Sclerosis Complex (TSC) is caused by loss of function germline variants in the TSC1 or TSC2 tumor suppressor genes. Genetic testing for the detection of pathogenic variants in either TSC1 or TSC2 was implemented as a diagnostic criterion for TSC. However, TSC molecular diagnosis can be challenging due to the absence of variant hotspots and the high number of variants described. This review aimed to perform an overview of TSC1/2 variants submitted in the ClinVar database. Variants of uncertain significance (VUS), missense and single nucleotide variants were the most frequent in clinical significance (37-40%), molecular consequence (37%-39%) and variation type (82%-83%) categories in ClinVar in TSC1 and TSC2 variants, respectively. Frameshift and nonsense VUS have potential for pathogenic reclassification if further functional and segregation studies were performed. Indeed, there were few functional assays deposited in the database and literature. In addition, we did not observe hotspots for variation and many variants presented conflicting submissions regarding clinical significance. This study underscored the importance of disseminating molecular diagnostic results in a public database to render the information largely accessible and promote accurate diagnosis. We encourage the performance of functional studies evaluating the pathogenicity of TSC1/2 variants.

5.
Genet Mol Biol ; 46(3 Suppl 1): e20230134, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38259034

RESUMO

Bioinformatics is a growing research field that received great notoriety in the years of the COVID-19 pandemic. It is a very integrative area, comprising professionals from science, technology, engineering, and mathematics (STEM). In agreement with the other STEM areas, several women have greatly contributed to bioinformatics ascension; however, they had to surpass prejudice and stereotypes to achieve recognition and leadership positions, a path that studies have demonstrated to be more comfortable to their male colleagues. In this review, we discuss the several difficulties that women in STEM, including bioinformatics, surpass during their careers. First, we present a historical context on bioinformatics and the main applications for this area. Then, we discuss gender disparity in STEM and present the challenges that still contribute to women's inequality in STEM compared to their male colleagues. We also present the opportunities and the transformation that we can start, acting in academia, inside the family and school environments, and as a society, hence contributing to gender equality in STEM. Finally, we discuss specific challenges in the bioinformatics field and how we can act to overcome them, especially in low and middle-income countries, such as Brazil.

6.
Public Health Nutr ; 26(12): 2945-2952, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37850441

RESUMO

OBJECTIVE: We examined whether associations between the food environment, frequency of home cooking, diet quality and BMI were modified by the level of cooking skills. DESIGN: Cross-sectional study using linear and modified Poisson regression models adjusted for age, sex, energy intake, education, income, household size and urbanisation. The frequency of home cooking was categorised into <6 and 6-7 d. Diet quality was based on a validated Dutch healthy diet index (0-150 points). Count of restaurants and food stores were determined by their count in a 1000m buffer around home and work. Cooking skills (score 1-5) were assessed using a validated questionnaire and added as interaction term. SETTING: The Netherlands. PARTICIPANTS: 1461 adults aged 18-65 years. RESULTS: Count of restaurants and food stores were not associated with the frequency of home cooking. A 10-unit higher count of food stores was associated with a higher diet quality (ß: 0·58 (95 % CI (0·04, 1·12)), and a 10-unit higher count of restaurants was associated with a lower BMI kg/m2 (ß: -0·02 (95 % CI (-0·04, -0·004)). Better cooking skills were associated with a higher likelihood of cooking 6-7 d compared with <6 d (risk ratio: 1·24 (95 % CI (1·16, 1·31)) and a higher diet quality (ß: 4·45 (95 % CI (3·27, 5·63)) but not with BMI. We observed no interaction between the food environment and cooking skills (P-for-interaction > 0·1). CONCLUSIONS: Exposure to food stores was associated with a higher diet quality and exposure to restaurants with a lower BMI. Better cooking skills were associated with a higher frequency of home cooking and better diet quality but did not modify associations with the food environment. Future studies should explore different approaches to understand how individuals interact with their food environment.


Assuntos
Dieta , Comportamento Alimentar , Adulto , Humanos , Estudos Transversais , Culinária , Fast Foods , Restaurantes
7.
Health Place ; 84: 103135, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37832327

RESUMO

This area-level cross-sectional study examined online food outlet availability through the most popular online food delivery service platforms (OFDS) across seven European countries, and explored how this online food outlet availability was socioeconomically distributed. Data collection of online food outlet availability was automated in England, Italy, Luxembourg, the Netherlands, Portugal, Spain and Switzerland. We used a geographic information system to join online food outlet availability to socio-demographic information. Median number of food outlets delivering through OFDS was highest in England and lowest in Italy, Portugal and Spain. We also found that high-income areas have the greatest online food outlet availability in most countries. In England, areas with a middle income had the least online food outlets available and no income data was available for Switzerland. Further work is needed to understand drivers of disparities in online food outlet availability, as well as possible implications for public health.


Assuntos
Fast Foods , Renda , Humanos , Estudos Transversais , Inglaterra , Europa (Continente) , Características de Residência , Abastecimento de Alimentos
8.
Nutr J ; 22(1): 43, 2023 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-37697383

RESUMO

BACKGROUND: Existing evidence suggests that the intake of sugar-sweetened beverages (SSB) among adolescents remains a public health concern and that socioeconomic differences in intake exist. Tackling these challenges requires identifying the factors associated with SSB intake and the mediators of socioeconomic differences in SSB intake among adolescents. Thus, this study aimed to explore (i) factors at different levels of the ecological model associated with the intake of carbonated soft drinks with added sugar (hereafter called soft drinks), (ii) mediators of the association between parental education and the intake of soft drinks(iii) whether neighbourhood income moderates the indirect effect of parental education on adolescents' soft drink intake through potential mediators. METHODS: Data from 826 7th graders in Oslo, Norway, who participated in the TACKLE cross-sectional study conducted in 2020 were used. The association between factors at the individual, interpersonal and neighbourhood food environment levels and the intake of soft drinks among adolescents was assessed, as well as the mediating roles of these factors for the differences in intake by parental education, using multiple logistic regression and mediation analysis, respectively. Moderated mediation analyses were used to explore whether an indirect effect of parental education on adolescents' soft drink intake through potential mediators varies across neighbourhood income areas. RESULTS: Higher perceived accessibility of SSB at home, increased parental modelling for SSB intake, and increased frequency of food/drink purchased from the neighbourhood store were associated with a higher intake of soft drinks among adolescents and mediated the differences in intake by parental education. Neighbourhood food environment factors were neither statistically significantly associated with adolescents' higher intake of soft drinks nor explained the differences in intake by parental education. Moderated mediation analysis showed that the mediating effect of perceived accessibility of SSB at home on the association between parental education and adolescent soft drink intake was stronger among those living in low neighbourhood income. CONCLUSIONS: Our study identified modifiable factors at the intrapersonal level (perceived accessibility of SSB at home and frequency of food/drink purchased from neighbourhood shops) and interpersonal levels (parental modelling for SSB intake) associated with a higher intake of soft drinks among adolescents and mediated the differences in the intake by parental education. The modifiable factors identified in this study could be targeted in public health initiatives among adolescents aimed at reducing the intake of soft drinks and the related differences by parental education.


Assuntos
Bebidas Adoçadas com Açúcar , Açúcares , Adolescente , Humanos , Estudos Transversais , Escolaridade , Renda
9.
Eur J Med Genet ; 66(10): 104827, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37657632

RESUMO

Autosomal recessive keratitis-ichthyosis-deafness syndrome (KIDAR MIM #242150) is a very rare disorder caused by pathogenic loss-of-function variants in the AP1B1 gene. So far, nine patients have been reported in the literature and more clinical descriptions are essential to further delineate the phenotype of KIDAR. Here we report a new patient with KIDAR and compare the clinical findings with those from the other published cases with molecular confirmation. We describe a 14-year-old male born to non-consanguineous parents with unremarkable family history. The patient had fetal ascites, neonatal pancreatic insufficiency with consequent failure to thrive, feeding difficulties, recurrent infections and sepsis. The skin examination was remarkable for an ichthyosis with conspicuous palmoplantar keratoderma, sparse and brittle hair with alopecia on the vertex and slight bilateral ectropion. He had short stature, thin build, frontal bossing, small teeth and prominent abdomen. Additional features were congenital profound bilateral sensorineural deafness, photosensitivity and photophobia. Mild global developmental delay was noted. Persistent mild anemia, neutropenia, thrombocytopenia, and low serum copper, ceruloplasmin and growth hormone were also present. Brain magnetic resonance imaging (MRI) showed cerebral atrophy and thin corpus callosum. Genetic testing revealed a homozygous deletion in the AP1B1 gene, possibly including the same exons as a previously reported deletion. Comparing the phenotypes of all reported individuals, they are highly concordant and major features are enteropathy with feeding difficulties, failure to thrive, ichthyosis, palmoplantar keratoderma, sensorineural deafness and sparse and brittle hair. Here we report other features present in more than one patient that could be part of the phenotypic spectrum and suggest copy number variation analysis to be performed alongside sequencing of the AP1B1 gene in case of suspicion.

10.
Membranes (Basel) ; 13(8)2023 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-37623804

RESUMO

The present work investigates nanofiltration (NF) and ultrafiltration (UF) for the removal of three widely used pharmaceutically active compounds (PhACs), namely atenolol, sulfamethoxazole, and rosuvastatin. Four membranes, two polyamide NF membranes (NF90 and NF270) and two polyethersulfone UF membranes (XT and ST), were evaluated in terms of productivity (permeate flux) and selectivity (rejection of PhACs) at pressures from 2 to 8 bar. Although the UF membranes have a much higher molecular weight cut-off (1000 and 10,000 Da), when compared to the molecular weight of the PhACs (253-482 Da), moderate rejections were observed. For UF, rejections were dependent on the molecular weight and charge of the PhACs, membrane molecular weight cut-off (MWCO), and operating pressure, demonstrating that electrostatic interactions play an important role in the removal of PhACs, especially at low operating pressures. On the other hand, both NF membranes displayed high rejections for all PhACs studied (75-98%). Hence, considering the optimal operating conditions, the NF270 membrane (MWCO = 400 Da) presented the best performance, achieving permeate fluxes of about 100 kg h-1 m-2 and rejections above 80% at a pressure of 8 bar, that is, a productivity of about twice that of the NF90 membrane (MWCO = 200 Da). Therefore, NF270 was the most suitable membrane for this application, although the tight UF membranes under low operating pressures displayed satisfactory results.

11.
Health Place ; 83: 103075, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37454481

RESUMO

We assessed the quality of food-related OpenStreetMap (OSM) data in urban areas of five European countries. We calculated agreement statistics between point-of-interests (POIs) from OSM and from Google Street View (GSV) in five European regions. We furthermore assessed correlations between exposure measures (distance and counts) from OSM data and administrative data from local data sources on food environment data in three European countries. Agreement between POI data in OSM compared to GSV was poor, but correlations were moderate to high between exposures from OSM and local data sources. OSM data downloaded in 2020 seems to be an acceptable source of data for generating count-based food exposure measures for research in selected European regions.


Assuntos
Estudos Epidemiológicos , Humanos , Europa (Continente)
12.
Public Health Nutr ; 26(9): 1775-1783, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37340803

RESUMO

OBJECTIVE: The purpose of this study is to determine if healthier neighbourhood food environments are associated with healthier diet quality. DESIGN: This was a cross-sectional study using linear regression models to analyse data from the Maastricht Study. Diet quality was assessed using data collected with a FFQ to calculate the Dutch Healthy Diet (DHD). A buffer zone encompassing a 1000 m radius was created around each participant home address. The Food Environment Healthiness Index (FEHI) was calculated using a Kernel density analysis within the buffers of available food outlets. The association between the FEHI and the DHD score was analysed and adjusted for socio-economic variables. SETTING: The region of Maastricht including the surrounding food retailers in the Netherlands. PARTICIPANTS: 7367 subjects aged 40-75 years in the south of the Netherlands. RESULTS: No relationship was identified between either the FEHI (B = 0·62; 95 % CI = -2·54, 3·78) or individual food outlets, such as fast food (B = -0·07; 95 % CI = -0·20, 0·07) and diet quality. Similar null findings using the FEHI were identified at the 500 m (B = 0·95; 95 % CI = -0·85, 2·75) and 1500 m (B = 1·57; 95 % CI = -3·30, 6·44) buffer. There was also no association between the food environment and individual items of the DHD including fruits, vegetables and sugar-sweetened beverages. CONCLUSION: The food environment in the Maastricht area appeared marginally unhealthy, but the differences in the food environment were not related to the quality of food that participants reported as intake.


Assuntos
Dieta Saudável , Dieta , Humanos , Estudos Transversais , Frutas , Verduras
13.
Coimbra; s.n; jun. 2023. 78 p. tab., ilus..
Tese em Português | BDENF - Enfermagem | ID: biblio-1531518

RESUMO

O contexto social atual e? marcado por uma evolução constante nas mais diversas áreas e a saúde não e? exceção. Estes avanços, traduzem-se numa melhoria dos cuidados de saúde, e decorrem não só ao nível das unidades de saúde, mas também no contexto de emergência extra-hospitalar. O Relatório Final de Estágio retrata a descrição e análise das atividades e competências comuns e específicas do Enfermeiro Especialista de Enfermagem Médico-Cirúrgica desenvolvidas no contexto do ensino clínico e uma investigação secundária do tipo scoping review relativa à temática da via nasal, subutilizada no contexto extra-hospitalar português. O desenvolvimento das competências seguiu a metodologia crítico-reflexiva e tem por base o Projeto de Estágio. A investigação secundária do tipo scoping review, cujo objetivo foi mapear os fármacos administrados por via nasal à pessoa em contexto extra-hospitalar, seguiu o método do Joanna Briggs Institute, através de pesquisa em base de dados de relevo para a temática, repositório científico e literatura cinzenta para identificar estudos relevantes que respondam a critérios de inclusão previamente definidos. Para tal, foi definida a questão de pesquisa, segundo a mnemónica Population, Concept, Context, ?quais os fármacos administrados por via nasal à pessoa em contexto extra-hospitalar??. Desta forma, o relatório emerge as contribuições do ensino clínico para a consolidação das competências e, consequentemente, o seu impacto positivo tanto no domínio pessoal como profissional. Por outro lado, a investigação realizada resultou no mapeamento dos fármacos administrados por via nasal à pessoa, em contexto extra-hospitalar, servindo de mote para a revisão e atualização de procedimentos e protocolos nesta área. Assim, este relatório tem repercussões na área de Enfermagem Médico-Cirúrgica no sentido em que contribui para a melhoria da prestação de cuidados diferenciados, tendo em vista a segurança e qualidade em saúde e, consequentemente, a obtenção de ganhos em saúde.


Assuntos
Garantia da Qualidade dos Cuidados de Saúde , Preparações Farmacêuticas , Absorção Nasal , Enfermagem Médico-Cirúrgica , Enfermeiras e Enfermeiros
14.
Front Psychol ; 14: 1176564, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37213356

RESUMO

Background: Substance abuse has an impact on various cognitive domains, including memory. Even though this impact has been extensively examined across different subdomains, false memory has been sparsely studied. This systematic review and meta-analysis seek to synthesize the current scientific data concerning false memory formation in individuals with a history of substance abuse. Methods: PubMed, Scopus, the Cochrane Library, Web of Science, and PsycINFO were searched to identify all experimental and observational studies in English, Portuguese, and Spanish. Studies were then examined by four independent reviewers and, if they met the inclusion criteria, assessed for their quality. The Cochrane Risk of Bias Tool for randomized controlled trials (RCT) and the Joanna Briggs Institute (JBI) critical appraisal checklists for quasi-experimental and analytic cross-sectional studies were used to assess the risk of bias. Results: From the 443 screened studies, 27 (and two more from other sources) were considered eligible for full-text review. A final 18 studies were included in the present review. Of these, 10 were conducted with alcoholics or heavy drinkers, four focused on ecstasy/polydrug users, three were done with cannabis users and one focused on methadone maintenance patients with current cocaine dependence. Regarding false memory type, 15 studies focused on false recognition/recall, and three on provoked confabulation. Conclusions: None but one of the studies considering false recognition/recall of critical lures found any significant differences between individuals with a history of substance abuse and healthy controls. However, most of the studies taking into account false recognition/recall of related and unrelated events found that individuals with a history of substance abuse showed significantly higher rates of false memories than controls. Future research should continue to consider different types of false memories as well as their potential association with relevant clinical variables. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266503, identifier: CRD42021266503.

15.
Health Place ; 81: 103009, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37043941

RESUMO

The aim of this study is to describe how individuals use different food retailers and how food retail usage varies according to socio-demographic and diet-related characteristics. A cross-sectional survey among Dutch adults (N = 1784) was used. Results from the Two-step cluster analysis indicated that there were five clusters of food retail users. Use of discount supermarkets, organic supermarkets, fast-food outlets, and restaurants contributed to clustering, but use of regular supermarkets, local food shops and whether food retailers were close to home or further from home did not. The clusters included mixed food outlet users, discount supermarket and restaurant users, fast-food and restaurant users, predominant discount supermarket users and supermarkets, fast-food and restaurant users. Participants in each cluster had their own characteristics especially in terms of socio-economic position and diet quality. Future studies need to consider further how food retail selection links physical exposure to the food environment and diet.


Assuntos
Dieta , Abastecimento de Alimentos , Marketing , Adulto , Humanos , Análise por Conglomerados , Comércio , Estudos Transversais , Fast Foods , Países Baixos , Características de Residência , Restaurantes
16.
Food Nutr Bull ; 44(1): 12-26, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36601667

RESUMO

OBJECTIVE: To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments. METHODS: Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics. RESULTS: Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome. CONCLUSIONS: Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents.


Assuntos
Sobrepeso , Obesidade Infantil , Criança , Humanos , Adolescente , Sobrepeso/epidemiologia , Obesidade Infantil/epidemiologia , Obesidade Infantil/etiologia , Estudos Transversais , Exercício Físico , Serviço Social
17.
Health Place ; 79: 102966, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36608585

RESUMO

There is a need for conceptual and methodological innovation in food environment-health research. We compared different operationalizations of survey-derived activity space exposures to fast food outlets (FFOs) in associations with use of FFO, diet quality and body mass index (BMI). FFO exposure was determined for home, work and a maximum of sixteen other locations reported by 1728 Dutch adults. Considerable differences in count of FFO between locations were found. Adjusted linear regression analyses resulted in small, unexpected associations with use of FFO, diet quality and BMI, whereby the strength of associations differed between exposure measures. Using home and work areas may be a cost-efficient compromise to capture large parts of the exposure to FFOs.


Assuntos
Dieta , Fast Foods , Adulto , Humanos , Índice de Massa Corporal , Estudos Transversais , Inquéritos e Questionários , Características de Residência , Restaurantes
18.
Int J Neurosci ; 133(10): 1204-1210, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35465825

RESUMO

INTRODUCTION: Life expectancy in individuals has increased in recent years. There is no consensus in the literature on the best treatment for a ruptured aneurysm in the elderly (> 60 years), but some places only have microsurgery as a therapeutic strategy. This work aims to develop a prognostic scale for ruptured intracranial aneurysms in the elderly. MATERIAL AND METHODS: Two thousand five hundred thirty patients with subarachnoid hemorrhage were retrospectively evaluated in the last ten years, and 550 of them were elderly. We developed a prognostic scale from the analysis of medical records, clinical and tomographic features that had statistical significance. Glasgow Coma Outcome (GOS) was the outcome of interest and p value < 0,05 was considered statistically significant. RESULTS: Five hundred fifty patients were evaluated, and the comorbidities that were independent variables for poor prognosis were smoking and arterial hypertension; clinical variables were Hunt-Hess, modified Rankin and Glasgow Coma Scale; tomographic was Fisher scale. Poor outcome was defined as GOS ≤ 3. Poor surgical outcomes were more remarkable in the high-risk factor categories, being 6.41 times higher among individuals who had 3 to 4 risk factors and 8.80 times higher among individuals with 5 to 6 risk factors. CONCLUSION: In some vascular neurosurgery services worldwide, microsurgery is the only therapeutic option. This scale aimed at the elderly patient individualizes the treatment and can predict the clinical outcome in ruptured intracranial aneurysms.


Assuntos
Aneurisma Roto , Aneurisma Intracraniano , Hemorragia Subaracnóidea , Humanos , Idoso , Aneurisma Intracraniano/cirurgia , Aneurisma Intracraniano/complicações , Estudos Retrospectivos , Microcirurgia/efeitos adversos , Microcirurgia/métodos , Resultado do Tratamento , Hemorragia Subaracnóidea/cirurgia , Hemorragia Subaracnóidea/etiologia , Aneurisma Roto/cirurgia , Aneurisma Roto/complicações
19.
Membranes (Basel) ; 12(11)2022 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-36363677

RESUMO

This study presents the characterization of water dynamics in cellulose acetate-silica asymmetric membranes with very different pore structures that are associated with a wide range of selective transport properties of ultrafiltration (UF) and nanofiltration (NF). By combining 1H NMR spectroscopy, diffusometry and relaxometry and considering that the spin-lattice relaxation rate of the studied systems is mainly determined by translational diffusion, individual rotations and rotations mediated by translational displacements, it was possible to assess the influence of the porous matrix's confinement on the degree of water ordering and dynamics and to correlate this with UF/NF permeation characteristics. In fact, the less permeable membranes, CA/SiO2-22, characterized by smaller pores induce significant orientational order to the water molecules close to/interacting with the membrane matrix's interface. Conversely, the model fitting analysis of the relaxometry results obtained for the more permeable sets of membranes, CA/SiO2-30 and CA/SiO2-34, did not evidence surface-induced orientational order, which might be explained by the reduced surface-to-volume ratio of the pores and consequent loss of sensitivity to the signal of surface-bound water. Comparing the findings with those of previous studies, it is clear that the fraction of more confined water molecules in the CA/SiO2-22-G20, CA/SiO2-30-G20 and CA/SiO2-34-G20 membranes of 0.83, 0.24 and 0.35, respectively, is in agreement with the obtained diffusion coefficients as well as with the pore sizes and hydraulic permeabilities of 3.5, 38 and 81 kg h-1 m-2 bar-1, respectively, reported in the literature. It was also possible to conclude that the post-treatment of the membranes with Triton X-100 surfactants produced no significant structural changes but increased the hydrophobic character of the surface, leading to higher diffusion coefficients, especially for systems associated with average smaller pore dimensions. Altogether, these findings evidence the potential of combining complementary NMR techniques to indirectly study hydrated asymmetric porous media, assess the influence of drying post-treatments on hybrid CA/SiO2 membrane' surface characteristics and discriminate between ultra- and nano-filtration membrane systems.

20.
Eur Respir Rev ; 31(165)2022 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-35948392

RESUMO

Previous studies have explored the relationships of air pollution and metabolic profiles with lung function. However, the metabolites linking air pollution and lung function and the associated mechanisms have not been reviewed from a life-course perspective. Here, we provide a narrative review summarising recent evidence on the associations of metabolic profiles with air pollution exposure and lung function in children and adults. Twenty-six studies identified through a systematic PubMed search were included with 10 studies analysing air pollution-related metabolic profiles and 16 studies analysing lung function-related metabolic profiles. A wide range of metabolites were associated with short- and long-term exposure, partly overlapping with those linked to lung function in the general population and with respiratory diseases such as asthma and COPD. The existing studies show that metabolomics offers the potential to identify biomarkers linked to both environmental exposures and respiratory outcomes, but many studies suffer from small sample sizes, cross-sectional designs, a preponderance on adult lung function, heterogeneity in exposure assessment, lack of confounding control and omics integration. The ongoing EXposome Powered tools for healthy living in urbAN Settings (EXPANSE) project aims to address some of these shortcomings by combining biospecimens from large European cohorts and harmonised air pollution exposure and exposome data.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Criança , Estudos Transversais , Exposição Ambiental/efeitos adversos , Humanos , Material Particulado
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