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1.
Rev Sci Instrum ; 94(9)2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37732831

RESUMO

GOAL: The present study aimed to investigate the behavior of dynamic electrical impedance myography (dEIM) signals during a 100-s period of the dynamic contraction of Wistar rats' gastrocnemius evoked by electrical stimulation and to link the variations in bioimpedance with muscular energy systems. METHODS: Muscle contraction used 30% of the maximum muscular force and persisted for 100 s, along which dynamic bioimpedance signals were acquired. Based on the bioimpedance signals, two parameters, ΔZc and ΔZpc, were calculated to allow the analysis of their changes with the energy systems that supplied adenosine triphosphate (ATP) to the muscle. ΔZc indicated the variation of impedance of a twitch cycle compared to the values observed during the rest period preceding the cycle, and ΔZpc indicated slow bioimpedance variations compared to the values obtained during the rest period. RESULTS: The results indicated that ΔZc followed the force behavior, achieving a change rate of ∼14%. This parameter was associated with instantaneous impedance changes owing to the occurrence of each twitch. CONCLUSION: Although the findings of this study were linked to energy system processes, future studies are required for improving the understanding of the underlying mechanisms involved in dEIM. SIGNIFICANCE: The results contributed to understanding the relation of energy systems that supply ATP to the muscles with dEIM variations that occurred during muscle activity.


Assuntos
Trifosfato de Adenosina , Músculo Esquelético , Ratos , Animais , Impedância Elétrica , Ratos Wistar , Miografia
3.
J Electromyogr Kinesiol ; 70: 102776, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37163815

RESUMO

BACKGROUND: Among the most effective therapeutic interventions in non-specific chronic low back pain (NSCLBP), clinical practice guidelines highlight exercise therapy and patient education; However, regarding the combined intervention of exercise and Pain Neuroscience Education (PNE), there is no consensus on the most effective form of exercise. OBJETIVE: To find out what changes occurred after the application of two exercise modalities [Supervised Exercise (SE) and Laser-Guided Exercise (LGE)] and PNE on pain, pain pressure thresholds, disability, catastrophizing, kinesiophobia and lumbar proprioception in subjects with NSCLBP. METHODS: Single-blind randomized clinical controlled trial. 60 subjects with NSCLBP. Both groups performed a a total of 16 therapeutic exercise sessions and 8 Pain Neuroscience Education sessions. With the Laser-Guided Exercise Therapy group performing laser-guided exercises. RESULTS: A significant decrease was observed for pain intensity for both groups between baseline and post-intervention and the 3 month follow-up (p < 0.001). There was a significant between-group difference between baseline and post-intervention scores in terms of pain intensity and kinesiophobia in favour of the LGE group. CONCLUSION: Supervised exercise with or without laser feedback, when combined with PNE, reduces pain intensity, disability, pain catastrophizing, kinesiophobia and improves proprioception and PPTs in patients with NSCLBP. At a 3-month follow-up, the combination of LGE plus PNE is most effective for reducing pain intensity.


Assuntos
Dor Crônica , Dor Lombar , Humanos , Dor Lombar/terapia , Método Simples-Cego , Retroalimentação , Dor Crônica/terapia , Músculo Esquelético , Terapia por Exercício , Lasers
4.
Sci Rep ; 13(1): 2740, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36792714

RESUMO

Hybrid layers consisting of Fe oxide, Fe hydroxide, and nitrogen doped graphene-like platelets have been synthesized by an eco-friendly laser-based method for photocatalytic applications. The complex composite layers show high photodecomposition efficiency towards degradation of antibiotic molecules under visible light irradiation. The photodecomposition efficiency was investigated as a function of relative concentrations of base materials, Fe oxide nanoparticles and graphene oxide platelets used for the preparation of target dispersions submitted to laser irradiation. Although reference pure Fe oxide/Fe hydroxide layers have high absorption in the visible spectral region, their photodecomposition efficiency is negligible under the same irradiation conditions. The high photocatalytic decomposition efficiency of the nanohybrid layer, up to 80% of the initial antibiotic molecules was assigned to synergistic effects between the constituent materials, efficient separation of the electron-hole pairs generated by visible light irradiation on the surface of Fe oxide and Fe hydroxide nanoparticles, in the presence of conducting graphene-like platelets. Nitrogen doped graphene-like platelets contribute also to the generation of electron-hole pairs under visible light irradiation, as demonstrated by the photocatalytic activity of pure, reference nitrogen doped graphene-like layers. The results also showed that adsorption processes do not contribute significantly to the removal of antibiotic molecules from the test solutions. The decrease of the antibiotic concentration under visible light irradiation was assigned primarily to photocatalytic decomposition mechanisms.

5.
Obes Res Clin Pract ; 16(2): 170-173, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35396195

RESUMO

INTRODUCTION: Sleeve gastrectomy has currently become the most commonly performed bariatric. procedure worldwide according to the last IFSO survey, overtaking gastric bypass with. a share of more than 50% of all primary bariatric-metabolic surgery. Gastric leak, intraluminal bleeding, bleeding from the staple-line and strictures are the most common complications. Portomesenteric vein thrombosis (PMVT)after sleeve gastrectomy is. another complication that has been increasingly reported in case-series in recent.years, although it remains uncommon. In this case report is described an extended portomesenteric vein thrombosis after. sleeve gastrectomy interesting splenic vein too with a favorable course and an. uneventful follow-up. We try to search in this case for pathogenetic factors involved in. this complication. CASE REPORT: A 42-year old man, with a body mass index (BMI) of 45 kg/m2, with a medical history of Obstructive Sleep Apnea Sindrome (OSAS) underwent laparoscopic sleeve gastrectomy. Early postoperative course was uneventful. Six days after discharge he complained abdominal pain and was admitted at the Emergency Department. A CT scan with intravenous contrast showed an occlusion of the portal vein, of the intrahepatic major branches and an extension to the superior mesenteric vein and the splenic vein. The patient received heparin and oral anticoagulation together with intravenous hydration and proton pump inhibitors. Considering the favourable course the patient was discharged after six days with long-term oral anticoagulation therapy. Anticoagulation with acenocumarol was continued for six months after a CT scan showed resolution of the PMVT without cavernoma. He had no recurrence of symptoms. DISCUSSION: Porto-mesenteric thrombosis after sleeve gastrectomy is a rare complication but it has been increasingly reported over the last 10 years along with the extensive use of sleeve gastrectomy. Because PMVT is closely associated with sleeve gastrectomy in comparison with other bariatric procedures, we need to investigate what pathogenetic factors are involved in sleeve gastrectomy. Thrombophylic state, prolonged duration of surgery, high levels of pneumoperitoneum, thermal injury of the gastroepiploic vessels during greater curvature dissection, high intragastric pressure, inadequate antithrombotic prophylaxis and delayed mobilization of the patient after surgery have been reported as pathogenetic factors of portmesenteric vein thrombosis. Most of the cases presented in the literature such as our clinical case resolve with medical therapy, although portal vein thrombus extends into the superior mesenteric vein and the splenic vein. CONCLUSION: Portomesenteric venous thrombosis is a rare but serious complication of bariatric surgery, especially associated with sleeve gastrectomy. Diagnosis is based on CT examination with intravenous contrast, and initial therapy is anticoagulation. Etiologic factors reported in the literature include a long duration of surgery, a high degree of pneumoperitoneum, high intragastric pressure after sleeve gastrectomy and thermal injury to the short gastric vessels and gastroepiploic arcade. Limited operative time, controlled values of pneumoperitoneum, careful dissection with energy device of gastric greater curvature, appropriate prophylaxis with low molecular weight heparin may be useful tools to prevent and limit this complication. Nonetheless we have to search which factors may condition the evolution of an extended PMVT as that described in this case towards resolution or to a further worsening clinical state. Early diagnosis? Correct treatment? Undiscovered patientrelated factors?


Assuntos
Laparoscopia , Obesidade Mórbida , Pneumoperitônio , Trombose Venosa , Adulto , Anticoagulantes/uso terapêutico , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Masculino , Obesidade Mórbida/cirurgia , Pneumoperitônio/complicações , Pneumoperitônio/tratamento farmacológico , Pneumoperitônio/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Trombose Venosa/etiologia , Fatores de Virulência/uso terapêutico
6.
Heliyon ; 8(1): e08658, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35028446

RESUMO

Sludge generation from wastewater treatment plants in Uruguay has increased in recent years. Agricultural soils may be a final destination. A greenhouse experiment was conducted to quantify the effect of this sludge on 1) plant biomass production and nutrient concentration of sorghum (Sorghum bicolor var. vulgare); 2) the chemical properties of amended soils; and 3) assess whether heavy metal concentrations in sludge are appropriate according to environmental regulations. Two soils (S1 and S2) were amended with pure sludge (PS) and limed sludge (LS), with low dose (LD) of 16.0 and 17.3 Mg ha-1 and high dose (HD) of 32.0 and 34.6 Mg ha-1, respectively. Sludge treatments increased plants' nutrient absorption and dry matter production. The LS treatments incremented plant biomass production, depending on soil pH and nutrient availability. The effect of sludge treatments on elemental concentration in aboveground biomass depended on the element, treatments, and soil type. Mineralized nitrogen (N) and plant available phosphorus (P-Bray 1) values increased with sludge addition without exceeding Uruguay's critical soil level of P-Bray 1 for the sorghum crop. The PS did not increase metal concentration in soils. The LS slightly decreased soil Pb and slightly increased Cr and Zn soil concentration; levels were according to Uruguayan environmental guidelines. Therefore, agriculture soils are a viable final destination for PS and LS. Land applied sludge has acceptable levels of metals and promotes crop development.

7.
Rev Sci Instrum ; 91(8): 084103, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32872900

RESUMO

Electrical impedance myography (EIM) is as an experimental technique that associates muscle impedance with muscular activity. Changes in muscle impedance during contraction occur mainly due to changes in the morphological and physiological characteristics of muscles that lead to different impeditivities in comparison with the resting condition. There is no consensus on the details of muscular impedance during muscle activity. EIM measurements on humans are also influenced by factors such as the electrode-skin interface, layers of skin and fat, and the connective tissue that can generate undesirable effects in the impedance signal. These effects can be avoided if EIM measurements are carried out directly on the muscle by using the models of animals. This study investigates changes in the EIM signal in the gastrocnemius muscles of Wistar rats during different levels of muscular contraction. In vivo experiments were conducted on 19 male rats. The muscle was exposed, fixed on a load cell, and electrically stimulated to evoke different levels of muscle contraction. Signals of the components of impedance were analyzed against the muscular force signal. The results show moderate correlations (p < 0.05) among the impedance-related parameters of resistance (r = -0.76), reactance (r = 0.57), and phase (r = 0.53). In addition to providing an experimental protocol for the invasive collection of data on electrical impedance to minimize problems associated with surface electrodes, this study shows that of the components of impedance, resistance is most affected by the intensity of muscular contractions and that morphological changes influence impedance mainly at low intensities.


Assuntos
Contração Muscular , Músculo Esquelético/fisiologia , Miografia/métodos , Animais , Fenômenos Biomecânicos , Impedância Elétrica , Estimulação Elétrica , Masculino , Miografia/instrumentação , Ratos , Ratos Wistar
8.
Nanotechnology ; 31(32): 325402, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32340003

RESUMO

The fabrication of bendable electronic devices is a scientific-technological area of very rapid advance in which new materials and fabrication techniques are being continuously developed. In these kinds of devices, the fabrication of flexible conductive electrodes adherent to the substrate is a key factor. Further, eco-friendliness, low cost and fast production are essential requirements for the successful progress of new technologies. In this work, a novel method for obtaining graphene-based flexible electrodes is presented. Conductive films were obtained by means of the visible laser irradiation of graphene oxide layers deposited on polyethylene terephthalate substrates and self-standing membranes sandwiched between glass slides. Despite the low power of the laser system, the numerical simulations indicate the development of temperatures over 1000 K throughout the irradiated material. The laser-induced spatially confined heating leads to the reduction of the graphene oxide material, whereas the glass-based sandwich assembly avoids reoxidation from the surrounding air. By scanning and pixelated modes, reduced graphene oxide electrodes, up to 100 µm in thickness, and with a resistivity as low as 6 × 10-4 Ωm, were obtained in an easy and versatile way. Proof-of-concept microsupercapacitors and electrochemical sensors were fabricated with this technique, showing promising performance.

9.
Diabetol Metab Syndr ; 11: 85, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31666811

RESUMO

The combined harmful effects of cigarette smoking and hyperglycemia can accelerate vascular damage in patients with diabetes who smoke, as is well known. Can smoking cause diabetes? What are the effects of smoking on macro and microvascular complications? Now growing evidence indicates that regular smokers are at risk of developing incident diabetes. Since the prevalence rates of smoking in patients with diabetes are relatively similar to those of the general population, it is essential to address the main modifiable risk factor of smoking to prevent the onset of diabetes and delay the development of its complications. Quitting smoking shows clear benefits in terms of reducing or slowing the risk of cardiovascular morbidity and mortality in people with diabetes. Does quitting smoking decrease the incidence of diabetes and its progression? What are the effects of quitting smoking on complications? The current evidence does not seem to unequivocally suggest a positive role for quitting in patients with diabetes. Quitting smoking has also been shown to have a negative impact on body weight, glycemic control and subsequent increased risk of new-onset diabetes. Moreover, its role on microvascular complications of the disease is unclear. What are the current smoking cessation treatments, and which ones are better for patients with diabetes? Stopping smoking may be of value for diabetes prevention and management of the disease and its macrovascular and microvascular complications. Unfortunately, achieving long-lasting abstinence is not easy and novel approaches for managing these patients are needed. This narrative review examines the evidence on the impact of smoking and smoking cessation in patients with diabetes and particularly in type 2 diabetes mellitus and its complications. In addition, management options and potential future directions will be discussed.

10.
Diabet Med ; 36(8): 1037-1045, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31087451

RESUMO

AIM: To evaluate the effects of Alimentación Normal con Ajuste de Insulina (ANAIS), a group-based, therapeutic education programme for Type 1 diabetes based on a flexible insulin regimen adjusted to the individual's food intake. METHODS: Participants with Type 1 diabetes and HbA1c levels of 53-86 mmol/mol (7-10%) were recruited from outpatient clinics at a tertiary care centre. They were randomized (using opaque, sealed envelopes, with a 2:1 treatment allocation ratio) to attend the training course immediately (immediate ANAIS; intervention group) or a year later (delayed ANAIS; control group). The main outcome was HbA1c level at 1 year. Secondary outcomes included lipid levels, weight, hypoglycaemic events, insulin dose, treatment satisfaction, self-perceived dietary freedom, quality of life and participant-defined goals. RESULTS: A total of 48 participants were assigned to the intervention group and 32 to the control group. Twelve months after completing the training, adjusted HbA1c was not significantly different in the intervention group [64 ± 1.3 vs 68 ± 1.6 mmol/mol (8.0 ±0.1% vs 8.4 ±0.1%); P=0.081]. Treatment satisfaction was significantly higher in the intervention group, but no differences were found in hypoglycaemic events, weight, insulin dose or changes in dietary freedom. At 1 year after the intervention, 72% of the participants (vs 33% in the control group; P=0.046) reported exceeding their expectations regarding achievement of their main personal goal. CONCLUSION: Promoting dietary freedom and empowering people with Type 1 diabetes through structured education programmes, such as ANAIS, improves treatment satisfaction and self-defined goals. No significant improvement in HbA1c level was achieved.


Assuntos
Diabetes Mellitus Tipo 1/terapia , Educação de Pacientes como Assunto/métodos , Psicoterapia/métodos , Adulto , Peso Corporal/fisiologia , Protocolos Clínicos , Diabetes Mellitus Tipo 1/sangue , Ingestão de Energia , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Masculino , Resultado do Tratamento
11.
Ecology ; 100(5): e02678, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30825328

RESUMO

The impact of ecological light pollution involves alteration of periods of natural light, a fact that has proven effects on ecosystems. Few studies have focused on the impact of this pollution on wild plant species, and none on coastal dune plants. Many coastal dunes and their plants are adjacent to tourist areas, and these might be affected by light pollution. Such is the case of the Natural Reserve Dunas de Maspalomas (Gran Canaria), where some individuals of the plant species Traganum moquinii, located in the El Inglés beach foredune zone, are affected by light pollution. This study examines the effect of light pollution on the flowering process and, by extension, the reproductive cycle of these plants. Plants located closer to high artificial illumination sources receive ~2,120 h/yr of intense light more than plants located furthest from those artificial lighting sources. Parts of the plants of Traganum moquinii exposed directly to the artificial light show a significant decrease in the production of flowers, compared to the parts in plants in shade, and to the plants more distant from artificial lights. In consequence, plants exposed more directly to artificial light have a lower potential for seed reproduction. The spectrum of artificial light also affects the plants, and light between 600 and 700 nm primarily affects the reproductive cycle of the Traganum moquinii species. The implications for the ecological and geomorphological functioning of the dune system are discussed, because this species plays a decisive role in the formation of foredune zones and nebkhas in arid dune systems.


Assuntos
Ecologia , Ecossistema , Humanos , Plantas , Reprodução , Espanha
12.
Diabetes Metab ; 45(3): 268-275, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30223083

RESUMO

AIMS: To assess the effect of the GLP-1 analogue liraglutide on measures of cardiac function and physical performance in patients with type 2 diabetes (T2D). METHODS: In this phase-IV randomized double-blind placebo-controlled parallel-group clinical trial at a tertiary hospital, T2D patients with HbA1c levels of 7-10% with oral agents and/or intermediate-/long-acting insulin were allocated (computer-generated randomization, ratio 1:1) to either liraglutide 1.8 mg/day or a placebo for 6 months. The primary endpoint was maximum oxygen consumption (VO2max) during cycle ergometry, while other procedures included a 6-min walk test, echocardiography, anthropometry and blood tests. Safety endpoints were also monitored, and an intention-to-treat analysis was performed. RESULTS: A total of 24 patients (15 women) aged 52 (11.7) years, with diabetes duration of 8.7 (5.8) years, BMI 34.98 (6.2) kg/m2 and HbA1c 8.2% (0.68%), were randomized to liraglutide 1.8 mg daily or placebo. There were no differences in VO2max [17.98 (4.8) vs. 15.90 (4.96) mL/kg/min; P > 0.10], VE/VCO2 slope [30.18 (4.8) vs. 32 (4.49)], left ventricular ejection fraction or 6-min walk test [530.7 (86) vs. 503.9 (84) m] at 6 months. HbA1c was lower (6.7% vs. 7.7%; P = 0.005), with a trend towards lower maximum systolic blood pressure during ergometry [171.7 (24.4) vs. 192.5 (25.6); P = 0.052] in the liraglutide group at the end of the study. There were no severe adverse events. CONCLUSION: In this trial, liraglutide improved glycaemic control in T2D, but had no significant effects on either physical performance or myocardial function.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/farmacologia , Liraglutida/farmacologia , Consumo de Oxigênio/efeitos dos fármacos , Desempenho Físico Funcional , Adulto , Idoso , Glicemia , Método Duplo-Cego , Teste de Esforço , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Liraglutida/uso terapêutico , Masculino , Pessoa de Meia-Idade , Volume Sistólico/efeitos dos fármacos
13.
Nutr Metab Cardiovasc Dis ; 28(12): 1222-1229, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30348591

RESUMO

BACKGROUND AND AIMS: Metabolic syndrome (MetS) is currently considered to raise the risk for type 2 diabetes and cardiovascular events. It has been suggested that part of this risk excess may be due to a cluster of additional factors associated with MetS. We aimed to investigate the role of inflammation on the ventricular-vascular coupling in patients with MetS. METHODS AND RESULTS: We enrolled a total of 227 hypertensive patients (106 with MetS and 121 without MetS) matched for age and gender. Aortic pulse wave velocity (aPWV), intima-media thickness (IMT) and high sensitivity C-reactive protein (CRP) increased according to the number of MetS components. Patients with MetS showed increased aPWV (11.5 ± 3.7 vs. 10.3 ± 2.5 m/s, P = 0.03) compared with controls. In a model adjusted for age, sex, heart rate and mean blood pressure, aPWV resulted increased in patients with CKD (beta 1.29 m/s, 95%CI 0.61-1.96 m/s, P < 0.001) and MetS (beta 0.89 m/s, 95%CI 0.28-1.51 m/s, P = 0.005). After additional adjustment for CRP and IMT, the slope of aPWV was respectively reduced by 16% and 62%, suggesting that inflammation and intima-media thickening could contribute to aortic stiffening in patients with MetS. In these patients, aPWV was also associated with left-ventricular mass index (beta 0.79 g/m2.7, 95%CI 0.05-1.52 g/m2.7, P = 0.05). CONCLUSION: MetS is characterized by an inflammation-dependent acceleration in cardiovascular ageing. This pattern of pathophysiological abnormalities may contribute to amplify the burden of cardiovascular risk in patients with MetS.


Assuntos
Hemodinâmica , Hipertensão/fisiopatologia , Inflamação/fisiopatologia , Síndrome Metabólica/fisiopatologia , Função Ventricular Esquerda , Biomarcadores/sangue , Proteína C-Reativa/análise , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Hipertensão/sangue , Hipertensão/diagnóstico , Inflamação/sangue , Inflamação/diagnóstico , Mediadores da Inflamação/sangue , Itália , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Prognóstico , Medição de Risco , Fatores de Risco , Rigidez Vascular , Remodelação Ventricular
14.
Toxicol Lett ; 298: 25-32, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-29953930

RESUMO

Although high or repeated exposure to different forms of Hg can have serious health consequences, the most important toxicity risk for humans is as methylmercury (MeHg) which exposure is mainly through consumption of fish. Generally, more than the 80% of Hg in hair is as MeHg, which is taken up by hair follicles as MeHg-cysteine complexes. In this context, hair samples were collected from 200 children (7 years) living in a coastal site in the North-East (A) of Italy and from 299 children (6-11 years) living in a urban area of South of Italy (B) to determine the levels of MeHg. Considering the neurotoxicity of MeHg, children were subjected to cognitive and neuropsychological tests. The hair values of Hg in the children population groups were comparable with data reported in other international surveys. On the other hand, combining results of the neurological tests with Hg levels, a possible relationship between Hg and an increase of the errors average reported in some neurological tests has been noted. Although the Hg levels were not elevated, a possible neurological influence in children, a population more susceptible than adults, might not be excluded, but the influence on neurological performances of the children could be also due to the family environment (socio economic status, educational level, etc.).


Assuntos
Poluentes Ambientais/análise , Cabelo/química , Compostos de Metilmercúrio/análise , Fatores Etários , Criança , Comportamento Infantil , Desenvolvimento Infantil , Cognição , Monitoramento Ambiental/métodos , Poluentes Ambientais/efeitos adversos , Feminino , Contaminação de Alimentos , Humanos , Masculino , Intoxicação do Sistema Nervoso por Mercúrio/diagnóstico , Intoxicação do Sistema Nervoso por Mercúrio/etiologia , Intoxicação do Sistema Nervoso por Mercúrio/fisiopatologia , Intoxicação do Sistema Nervoso por Mercúrio/psicologia , Compostos de Metilmercúrio/efeitos adversos , Testes Neuropsicológicos , Características de Residência , Medição de Risco , Alimentos Marinhos/efeitos adversos
15.
BJOG ; 125(10): 1294-1302, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29325216

RESUMO

OBJECTIVE: To describe obstetrical providers' delivery preferences and attitudes towards caesarean section without medical indication, including on maternal request, and to examine the association between provider characteristics and preferences/attitudes. DESIGN: Cross-sectional study. SETTING: Two public and two private hospitals in Argentina. POPULATION: Obstetrician-gynaecologists and midwives who provide prenatal care and/or labour/delivery services. METHODS: Providers in hospitals with at least 1000 births per year completed a self-administered, anonymous survey. MAIN OUTCOME MEASURES: Provider delivery preference for low-risk women, perception of women's preferred delivery method, support for a woman's right to choose her delivery method and willingness to perform caesarean section on maternal request. RESULTS: 168 providers participated (89.8% coverage rate). Providers (93.2%) preferred a vaginal delivery for their patients in the absence of a medical indication for caesarean section. Whereas 74.4% of providers supported their patient's right to choose a delivery method in the absence of a medical indication for caesarean section and 66.7% would perform a caesarean section upon maternal request, only 30.4% would consider a non-medically indicated caesarean section for their own personal delivery or that of their partner. In multivariate adjusted analysis, providers in the private sector [odds ratio (OR) 4.70, 95% CI 1.19-18.62] and obstetrician-gynaecologists (OR 4.37, 95% CI 1.58-12.09) were more willing than either providers working in the public/both settings or midwives to perform a caesarean section on maternal request. CONCLUSIONS: Despite the ethical debate surrounding non-medically indicated caesarean sections, we observe very high levels of support, especially by providers in the private sector and obstetrician-gynaecologists, as aligned with the high caesarean section rates in Argentina. TWEETABLE ABSTRACT: Non-medically indicated c-section? 74% of sampled Argentine OB providers support women's right to choose.


Assuntos
Atitude do Pessoal de Saúde , Cesárea , Procedimentos Cirúrgicos Eletivos/métodos , Obstetrícia , Preferência do Paciente , Adulto , Argentina/epidemiologia , Atitude Frente a Saúde , Cesárea/ética , Cesárea/psicologia , Cesárea/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Obstetrícia/ética , Obstetrícia/métodos , Preferência do Paciente/psicologia , Preferência do Paciente/estatística & dados numéricos , Direitos do Paciente , Gravidez , Utilização de Procedimentos e Técnicas/estatística & dados numéricos
16.
Nutr Metab Cardiovasc Dis ; 28(1): 35-43, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28958694

RESUMO

BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is underdiagnosed and public cholesterol screening may be useful to find new subjects. In this study, we aim to investigate the prevalence of FH patients in a hospital screening program and evaluate their atherosclerotic burden using intima-media thickness (IMT). METHODS AND RESULTS: We screened 1575 lipid profiles and included for genetic analysis adults with a low-density lipoprotein (LDL) cholesterol >190 mg/dL and triglycerides <200 mg/dL and first-degree child relatives with LDL cholesterol >160 mg/dL and triglycerides <200 mg/dL. The diagnosis of FH was presumed by Dutch Lipid Clinic Network (DLCN) criteria and confirmed by the presence of the genetic variant. Mean common carotid intima-media thickness (IMT) was assessed using consensus criteria. After confirming LDL cholesterol value and excluding secondary hypercholesterolemia, 56 subjects with a DLCN ≥4 performed genetic analysis. Of these, 26 had an FH genetic variant. The proportion of patients with a mutation having a DLCN score of 6-8 was 75%; in individuals with a DLCN score >8 it was 100%. Mean IMT was higher in FH patients compared to non FH (0.73 [0.61-0.83] vs 0.71 [0.60-0.75] mm, p < 0.01). Moreover, we detected two mutations not previously described. Finally, simple regression analysis showed a correlation of IMT with LDL cholesterol >190 mg/dL and corneal arcus (p < 0.01 and p < 0.001, respectively). CONCLUSIONS: A hospital screening was useful to detect FH subjects with increased atherosclerosis. Also, next-generation sequencing was able to detect new FH mutations.


Assuntos
Doenças das Artérias Carótidas/diagnóstico , Artéria Carótida Primitiva/diagnóstico por imagem , Espessura Intima-Media Carotídea , Análise Mutacional de DNA/métodos , Hospitais , Hiperlipoproteinemia Tipo II/diagnóstico , Lipídeos/sangue , Programas de Rastreamento/métodos , Mutação , Idoso , Biomarcadores/sangue , Doenças das Artérias Carótidas/sangue , Doenças das Artérias Carótidas/epidemiologia , Doenças das Artérias Carótidas/genética , Feminino , Predisposição Genética para Doença , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/epidemiologia , Hiperlipoproteinemia Tipo II/genética , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Fenótipo , Placa Aterosclerótica , Valor Preditivo dos Testes , Prevalência , Avaliação de Programas e Projetos de Saúde , Fatores de Risco
17.
Nutr Metab Cardiovasc Dis ; 27(11): 978-984, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28958695

RESUMO

BACKGROUND AND AIMS: Modern diets are high in advanced glycation end-products (dAGEs), derived from processing methods, exerting a pivotal role in promoting atherosclerotic risk. In this cross-sectional study we investigate the relationship between dAGE intake, arterial stiffness, inflammatory profile and macronutrient composition, in subjects with type 2 diabetes without overt cardiovascular disease. METHODS AND RESULTS: Arterial stiffness, carboxy-methyl-lysine, endogenous secretory receptor for AGEs (esRAGE), high sensitivity C reactive protein (hs-CRP), S100A12 and macronutrient intake were evaluated in 85 subjects with type 2 diabetes. The subjects were stratified into two groups according to dAGE consumption: high and low dAGE intake (≥ or <15.000 kU/day, respectively). Subjects with high dAGE intake (n = 45) showed a higher augmentation, augmentation index and pulse wave velocity (PWV) compared with those subjects with low dAGE intake (18 ± 5.4 vs 12.2 ± 6.3 mmHg, P < 0.05; 38.3 ± 5.4 vs 29.3 ± 10%; 9.2 ± 1.4 m/sec vs 7.9 ± 1.7, P < 0.05, respectively). hs-CRP were higher in subjects with high dAGE intake [0.42 (0.18-0.54) vs 0.21 (0.14-0.52) mg/dL, P < 0.05] whereas esRAGE plasma levels were lower [0.16 (0.23-0.81) vs 0.2 (0.14-0.54) ng/dL, P < 0.05]. Simple regression analysis showed a correlation between dAGEs and fat intake. Multivariate analysis showed an independent association between augmentation, systolic blood pressure (BP) and dAGE consumption; BMI and esRAGE were the major determinants of PWV. CONCLUSIONS: Our data suggests that a chronic high dAGE diet could lead to a vascular dysfunction and inflammatory activation, contributing to the development of vascular complications in subjects with type 2 diabetes. Testing this hypothesis may represent a direction of future research.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/etiologia , Dieta/efeitos adversos , Produtos Finais de Glicação Avançada/efeitos adversos , Inflamação/etiologia , Rigidez Vascular , Adulto , Idoso , Biomarcadores/sangue , Proteína C-Reativa/análise , Espessura Intima-Media Carotídea , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Angiopatias Diabéticas/sangue , Angiopatias Diabéticas/diagnóstico , Angiopatias Diabéticas/fisiopatologia , Feminino , Produtos Finais de Glicação Avançada/administração & dosagem , Humanos , Inflamação/sangue , Inflamação/diagnóstico , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Receptor para Produtos Finais de Glicação Avançada/sangue , Medição de Risco , Fatores de Risco
18.
Nanotechnology ; 28(39): 395405, 2017 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-28737504

RESUMO

Carbon nanotubes-transition metal oxide systems are intensively studied due to their excellent properties for electrochemical applications. In this work, an innovative procedure is developed for the synthesis of vertically aligned multi-walled carbon nanotubes (VACNTs) coated with transition metal oxide nanostructures. VACNTs are grown by plasma enhanced chemical vapor deposition and coated with a manganese-based metal organic precursor (MOP) film based on manganese acetate solution. Subsequent UV pulsed laser irradiation induces the effective heating-decomposition of the MOP leading to the crystallization of manganese oxide nanostructures on the VACNT surface. The study of the morphology, structure and composition of the synthesized materials shows the formation of randomly oriented MnO2 crystals, with few nanometers in size, and to their alignment in hundreds of nm long filament-like structures, parallel to the CNT's long axis. Electrochemical measurements reveal a significant increase of the specific capacitance of the MnO2-VACNT system (100 F g-1) as compared to the initial VACNT one (21 F g-1).

19.
Rev Sci Instrum ; 88(4): 045105, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28456219

RESUMO

Lactate threshold (LT) is one of the physiological parameters usually used in rowing sport training prescription because it indicates the transitions from aerobic to anaerobic metabolism. Assessment of LT is classically based on a series of values of blood lactate concentrations obtained during progressive exercise tests and thus has an invasive aspect. The feasibility of noninvasive LT estimative through bioelectrical impedance spectroscopy (BIS) data collected in thigh muscles during rowing ergometer exercise tests was investigated. Nineteen professional rowers, age 19 (mean) ± 4.8 (standard deviation) yr, height 187.3 ± 6.6 cm, body mass 83 ± 7.7 kg, and training experience of 7 ± 4 yr, were evaluated in a rowing ergometer progressive test with paired measures of blood lactate concentration and BIS in thigh muscles. Bioelectrical impedance data were obtained by using a bipolar method of spectroscopy based on the current response to a voltage step. An electrical model was used to interpret BIS data and to derive parameters that were investigated to estimate LT noninvasively. From the serial blood lactate measurements, LT was also determined through Dmax method (LTDmax). The zero crossing of the second derivative of kinetic of the capacitance electrode (Ce), one of the BIS parameters, was used to estimate LT. The agreement between the LT estimates through BIS (LTBIS) and through Dmax method (LTDmax) was evaluated using Bland-Altman plots, leading to a mean difference between the estimates of just 0.07 W and a Pearson correlation coefficient r = 0.85. This result supports the utilization of the proposed method based on BIS parameters for estimating noninvasively the lactate threshold in rowing.


Assuntos
Impedância Elétrica , Ácido Láctico/metabolismo , Músculo Esquelético/metabolismo , Adolescente , Humanos , Masculino , Análise de Regressão , Esportes , Adulto Jovem
20.
J Wound Care ; 25(11): 680-687, 2016 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-27827279

RESUMO

OBJECTIVE: The use of plasma rich in growth factors (PRGF) has gained importance in many medical fields due to its regenerative potential. The aim of this study is to evaluate the effects of PRGF on primary skin fibroblasts assessing cell proliferation, migration and secretion of growth factors. The age of the patients from who PRGF was prepared was also studied to determine whether it influenced the outcomes. METHOD: Human dermal fibroblasts were isolated from three healthy volunteers. Using PRGF-Endoret technology, PRGF was prepared from two groups of different ages (18-35 years and 50+ years). The effects of increasing concentration of PRGF (5%, 10% and 20%) on cell proliferation and migration was evaluated. Biosynthetic behaviour of cells was also analysed measuring vascular endothelial growth factor (VEGF), transforming growth factor b1 (TGFb1) and pro-collagen type I secreted levels with or without PRGF treatment. RESULTS: Mean platelet enrichment reached 2.4X and 2X in 18-35 and 50+ groups respectively. A dose-dependent response was observed in proliferation assays achieving the highest levels with 20% PRGF. Migration was also promoted in cells but not in a dose-dependent manner. Cell proliferation and migration outcomes obtained with PRGF (from both groups) were significantly higher compared to non-stimulated groups (p<0.05), with no statistical significances were observed between the different age groups. Production of VEGF, TGFb and procollagen type I was significantly increased by cells treated with PRGF, however, with the exception of VEGF, no statistical significances were observed between the different age groups. CONCLUSION: Results from this study concluded that PRGF is safe and effective in stimulating skin regeneration by enhancing proliferation, migration and expression of pivotal bioactive molecules involved in wound healing and haemostasis.


Assuntos
Proliferação de Células/efeitos dos fármacos , Células Cultivadas/efeitos dos fármacos , Fibroblastos/efeitos dos fármacos , Plasma Rico em Plaquetas , Fator A de Crescimento do Endotélio Vascular/uso terapêutico , Cicatrização/fisiologia , Ferimentos e Lesões/tratamento farmacológico , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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