RESUMO
BACKGROUND AND AIM: The rising incidence of hepatocellular carcinoma (HCC) in Australia is related to increasing rates of metabolic-associated fatty liver disease (MAFLD). This study aimed to prospectively characterize the metabolic profile, lifestyle, biometric features, and response to treatment of HCC patients in an Australian population. METHOD: Multicenter prospective cohort analysis of newly diagnosed HCC patients at six multidisciplinary team meetings over a 2-year period. RESULTS: Three hundred and thirteen (313) newly diagnosed HCC patients with MAFLD (n = 77), MAFLD plus other liver disease (n = 57) (the "mixed" group), and non-MAFLD (n = 179) were included in the study. Alcohol-associated liver disease (ALD) (43%) and MAFLD (43%) were the most common underlying liver diseases. MAFLD-HCC patients were older (73 years vs 67 years vs 63 years), more likely to be female (40% vs 14% vs 20%), less likely to have cirrhosis (69% vs 88% vs 85%), showed higher ECOG, and were less likely to be identified by screening (29% vs 53% vs 45%). Metabolic syndrome was more prevalent in the MAFLD and mixed groups. The severity of underlying liver disease and HCC characteristics were the same across groups. While the MAFLD population self-reported more sedentary lifestyles, reported dietary patterns were no different across the groups. Dyslipidemia was associated with tumor size, and those taking statins had a lower recurrence rate. CONCLUSION: Equal to ALD, MAFLD is now the most common underlying liver disease seen in HCC patients in Australia. Future HCC prevention screening and treatment strategies need to take this important group of patients into consideration.
Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Síndrome Metabólica , Humanos , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/etiologia , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/etiologia , Feminino , Masculino , Estudos Prospectivos , Pessoa de Meia-Idade , Idoso , Síndrome Metabólica/epidemiologia , Austrália/epidemiologia , Estilo de Vida , Resultado do Tratamento , Fígado Gorduroso/epidemiologia , Fígado Gorduroso/terapia , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/etiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/terapia , Estudos de CoortesRESUMO
Diabetes Mellitus (DM) is both, correlated and a known risk factor for colorectal cancer (CRC). Besides favoring the incidence of CRC, DM also accelerates its progression, worsening its prognosis. Previously, hyperglycemia, the DM hallmark, has been shown to lead to aberrant glycosylation of CRC cells, heightening their malignancy both in vivo and in vitro. Here we use mass spectrometry to elucidate the composition and putative structures of N-glycans expressed by MC38 cultured in normoglycemic (LG) and hyperglycemic-like conditions (HG). N-glycans, 67, were identified in MC38 cells cultured in LG and HG. The cells grown in HG showed a greater abundance of N-glycans when compared to LNG cells, without changes in the proportion of sialylated, fucosylated and mannosylated N-glycans. Among the identified N-glycans, 16 were differentially expressed, mostly mannosylated and fucosylated, with a minority of them being sialylated. Metabolomics analysis indicates that the alterations observed in the N-glycosylation may be mostly due to increase of the activated monosaccharides pool, through an increased glucose entrance into the cells. The alterations found here corroborate data from the literature regarding the progression of CRC, advocating for development or repositioning of effective treatments against CRC in diabetic patients.
Assuntos
Neoplasias do Colo , Hiperglicemia , Glicosilação , Humanos , Monossacarídeos/química , Polissacarídeos/químicaRESUMO
OBJECTIVES: To determine the predictive value of early transcranial color-coded sonography (TCCS) for intracranial hemorrhage (ICH) in patients with large artery occlusion (LAO) stroke of carotid circulation, who were submitted to endovascular therapy (EVT) with successful reperfusion. MATERIALS AND METHODS: Retrospective study evaluating a cohort of consecutive stroke patients with LAO of the carotid circulation that were recanalyzed with EVT. We measured angle-corrected peak systolic velocities, end-diastolic velocities and mean flow velocities (PSV, EDV and MFV) of the symptomatic and asymptomatic middle cerebral artery (MCA). The ratio between MFV of the symptomatic MCA and MFV of the asymptomatic MCA (MCA-Ra) was calculated. Parenchymal hematoma in the 24 hours control CT was considered as ICH. Univariate associations and multivariate analyses were used to identify early independent predictors for ICH among TCCS findings. RESULTS: We included 234 patients, mean age 72.5 (SD 12.6) years, 52.1% male. The mean time between recanalization and TCCS was 12.3 hours (range 3-22). Patients who developed postinterventional ICH showed a higher MCA-Ra (1.02 ± 0.26 vs 1.16 ± 0,21, p = 0.036). In multivariate analysis, only higher MCA-Ra remained independently associated with postinterventional ICH (OR: 6.778, 95%CI: 1.152-39.892, p = 0.034). A value of MCA-Ra ≥ 1,05 was associated with ICH, showing a sensitivity of 81.3% and a specificity of 65.9%; the AUC based of the ROC analysis was 0.688 (95% CI 0.570-0.806). CONCLUSION: TCCS performed within the first 24 hours after stroke onset can help to predict hemorrhagic transformation in patients with LAO.
Assuntos
Procedimentos Endovasculares/efeitos adversos , Infarto da Artéria Cerebral Média/terapia , Hemorragias Intracranianas/diagnóstico por imagem , AVC Isquêmico/terapia , Trombectomia/efeitos adversos , Ultrassonografia Doppler em Cores , Ultrassonografia Doppler Transcraniana , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo , Circulação Cerebrovascular , Feminino , Humanos , Infarto da Artéria Cerebral Média/diagnóstico por imagem , Infarto da Artéria Cerebral Média/fisiopatologia , Hemorragias Intracranianas/etiologia , AVC Isquêmico/diagnóstico por imagem , AVC Isquêmico/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sistema de Registros , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
The objective of this study was to determine changes on intraocular pressure (IOP) and pupil diameter (PD) in healthy cats anesthetized with isoflurane, and premedicated with acepromazine alone or in combination with tramadol. Thirty cats were allocated in two groups (n=15/each) and were treated with acepromazine (AG) or acepromazine/tramadol (ATG). PD and IOP were assessed before and following 30 (PM1), and 40 minutes (PM2) of treatments. Anesthesia was induced with propofol, and IOP and DP were recorded (A10) at 10 minute intervals until the end of anesthesia (A40). IOP decreased in AG and ATG, when comparing baseline with PM1. IOP decreased only in AG, in comparisons between baseline and PM2. During anesthesia, IOP did not change within and between groups. Comparisons between baseline with those recorded at PM1 and 2 showed that PD increased in the ATG. During anesthesia, PD decreased significantly in AG and ATG. Both protocols maintained the IOP within the reference range to perform corneal or intraocular surgery in healthy cats but did not sustain pre-anesthetic pupil dilation observed in ATG.(AU)
O objetivo do presente artigo é determinar possíveis alterações na pressão intraocular (PIO) e no diâmetro pupilar (DP) em gatos saudáveis anestesiados com isoflurano e pré-medicados com acepromazina isolada ou em combinação com acepromazina/tramadol. Trinta gatos saudáveis foram distribuídos aleatoriamente em dois grupos (n=15/cada) e tratados com acepromazina (GA) ou acepromazina/tramadol (GAT). DP e PIO foram avaliadas antes (basal) e após 30 (PM1) e 40 minutos (PM2) dos tratamentos. A anestesia foi induzida com propofol, e a PIO e o DP foram registrados (A10) a cada 10 minutos até o final da anestesia com isoflurano (A40). Ao se compararem os valores obtidos no basal com PM1, a PIO diminuiu em GA e GAT; com PM2, a PIO reduziu apenas no GA. Durante a anestesia, a PIO não diferiu dentro e entre os grupos. Comparações entre os valores basais e os registrados em PM1 e em PM2 mostraram que a DP aumentou significativamente no GAT. Durante a anestesia, o DP diminuiu significativamente em GA e GAT. Ambos os protocolos mantêm a PIO dentro dos valores de referência para realizar cirurgias corneanas ou intraoculares em gatos saudáveis, mas não sustentam a dilatação pupilar pré-anestésica observada em GAT.(AU)
Assuntos
Animais , Gatos , Tramadol/administração & dosagem , Midríase/veterinária , Pupila/efeitos dos fármacos , Pressão Intraocular , Isoflurano/efeitos adversos , Acepromazina/administração & dosagem , Tonometria Ocular/veterinária , Anestésicos Gerais/administração & dosagemRESUMO
In view of increasing anthropogenic influences and global changes, quantification of carbon assimilation through photosynthesis has gained tremendous significance. Precise estimation of Gross Primary Productivity (GPP) is essential for several ecosystem models and is typically done using coarser scale satellite data. The mangrove ecosystem, which offers significant protection to the coastal environment, is one of the critical habitats from a global change point of view. Light use efficiency (LUE) was measured using diurnal in situ photosynthetic rate observations for 13 dominant mangrove species for 3 seasons at each of the three mangrove dominant test-sites situated along the east and west coast of India. Variations in photosynthetic rates among these species were studied for 3 seasons that indicated varying responses of mangrove ecosystem at each site. Among all species, Rhizophora mucronata and Sonneratia apetala indicated higher values at two of the test-sites. IRS Resourcesat-2 LISS-IV datasets were used for the estimation of GPP. Mean GPP for all the sites varied from 1.2 to 7.7 g C m-2 day-1 with maximum value of 14.4 g C m-2 day-1. Mean values of GPP varied across the sites, based on its maximum LUE values and available photosynthetically active radiation (PAR). The results provide GPP values at much better spatial resolution for a threatened habitat like mangroves that typically survive in a narrow habitat along the coasts.
Assuntos
Ecossistema , Áreas Alagadas , Monitoramento Ambiental , Índia , Fotossíntese , Estações do AnoRESUMO
The aim of present study was two-fold: i) to translate and adapt the Regulation of Eating Behavior Scale to Portuguese (REBSp), and ii) to analyze its psychometrics properties (factorial validity with gender invariance analyses, reliability and construct validity). The study sample was composed by 471 Portuguese participants (68.4% females) with a mean age of 30.5 years (SD = 11.2). Structural equation modeling was used to verify the psychometric properties of the scale using SPSS v. 23.0 and AMOS 24.0 software. The analysis showed that the Portuguese 24-item scale presented a good fit, achieving good reliability and convergent validity. Some issues arose with discriminant validity within autonomous and controlled regulations, discussed in light of the simplex pattern expected by self-determination theory literature. Additionally, the scale presented concurrent validity and evidence of gender measurement invariance. Latent mean analysis between genders showed that women presented higher means for intrinsic motivation and integrated regulation when compared to men. In conclusion, analyses suggest that the 24-item Portuguese version of REBS can be used safely to assess the eating regulation in both genders.
Assuntos
Comportamento Alimentar , Adulto , Feminino , Humanos , Masculino , Portugal , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Melanoma is an aggressive malignant tumor, rarely observed in the oral cavity. The aim of this study was to describe the clinicopathologic features of a series of oral melanomas. MATERIAL AND METHODS: A retrospective descriptive study was performed. A total of 15,482 biopsy records from two oral and maxillofacial pathology services in Brazil were analyzed. All cases of oral melanomas were reviewed, and clinical, demographic, histopathological data, treatment, and follow-up status were collected. In addition, immunohistochemistry stains (pan-cytokeratin AE1/AE3, vimentin, α-SMA, CD45, S-100 protein, HMB-45, Melan A, and Ki-67) were performed. RESULTS: The series comprised of 5 males (71.4%) and 2 females (28.6%), with a mean age of 58.0 ± 9.2 years (range: 45-69 years) and a 2.5:1 male-to-female ratio. The gingiva (n = 3, 42.8%) and hard palate (n = 2, 28.6%) were the most common affected sites, presenting clinically as ulcerated swellings with a brown to black color. Cervical lymph node metastasis was detected in three patients during the first examination. Microscopically, 6 cases (85.7%) were melanotic, and one (14.3%) was amelanotic. Most cases (n = 4, 57.1%) presented a predominance of epithelioid cells. S-100 and HMB-45 were positive in all cases (n = 7, 100.0%). In contrast, only 4 cases (57.1%) were positive for Melan-A. The proliferative index with Ki-67 was high, with labeling index ranging from 70.0% to more than 90% of positive cells. Five patients died from complications of the tumors after a mean follow-up period of 7.8 months. CONCLUSIONS: Melanoma is an aggressive malignant tumor that rarely occurs in the oral cavity. It occurs mainly in adult and elderly patients and often is diagnosed in advanced stages. The current findings were similar to previous studies and reflected the characteristics of the services from where lesions were retrieved.
Assuntos
Melanoma , Neoplasias Bucais , Adulto , Idoso , Brasil/epidemiologia , Feminino , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/epidemiologia , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Estudos RetrospectivosRESUMO
Sandfly specimens from the subgenus Evandromyia (Aldamyia) Galati, 2003 (Diptera: Psychodidae: Phlebotominae) were collected between 2012 and 2019 from nine localities in seven Brazilian states, morphologically-identified, and then DNA barcoded by sequencing the mitochondrial cytochrome c oxidase subunit I (coi) gene. Forty-four new barcode sequences generated from 10 morphospecies were combined with 49 previously published sequences from the same subgenus and analysed using sequence-similarity methods (best-match criteria) to assess their ability at specimen identification, while four different species delimitation methods (ABGD, GMYC, PTP and TCS) were used to infer molecular operational taxonomic units (MOTUs). Overall, seven of the 11 morphospecies analysed were congruent with both the well-supported clades identified by phylogenetic analysis and the MOTUs inferred by species delimitation, while the remaining four morphospecies - E. carmelinoi, E. evandroi, E. lenti and E. piperiformis - were merged into a single well-supported clade/MOTU. Although E. carmelinoi, E. evandroi and E. lenti were indistinguishable using coi DNA barcodes, E. piperiformis did form a distinct phylogenetic cluster and could be correctly identified using best-match criteria. Despite their apparent morphological differences, we propose on the basis of the molecular similarity of their DNA barcodes that these latter four morphospecies should be considered members of a recently-diverged species complex.
Assuntos
Código de Barras de DNA Taxonômico/métodos , Psychodidae , Animais , Complexo IV da Cadeia de Transporte de Elétrons/genética , Filogenia , Psychodidae/classificação , Psychodidae/genéticaRESUMO
The market for biological control of insect pests in the world and in Brazil has grown in recent years due to the unwanted ecological and human health impacts of chemical insecticides. Therefore, research on biological control agents for pest management has also increased. For instance, insect viruses have been used to protect crops and forests around the world for decades. Among insect viruses, the baculoviruses are the most studied and used viral biocontrol agent. More than 700 species of insects have been found to be naturally infected by baculoviruses, with 90% isolated from lepidopteran insects. In this review, some basic aspects of baculovirus infection in vivo and in vitro infection, gene content, viral replication will be discussed. Furthermore, we provide examples of the use of insect viruses for biological pest control and recently characterized baculoviruses in Brazil.
Assuntos
Baculoviridae/classificação , Agentes de Controle Biológico , Insetos/virologia , Animais , Baculoviridae/patogenicidade , Brasil , Controle Biológico de VetoresRESUMO
OBJECTIVE: To analyze the impact of different classes of lupus nephritis as risk variables for maternal and fetal adverse outcomes in a cohort of pregnant lupus patients. METHODS: This is a cohort study with retrospective and prospective data collection, conducted at the University Hospital of State University of Rio de Janeiro, Brazil, from 2011 to 2016. A total of 147 pregnancies of 137 systemic lupus erythematosus patients of whom 66 had lupus nephritis were included. Demographic and clinical features, as well as maternal and fetal outcomes were observed for each nephritis histological class among systemic lupus erythematosus patients and compared with those without nephritis. Categorical variables were expressed as absolute and relative frequencies and numerical variables as means and standard deviation. The chi-square test with Fisher's correction and Student's t-test were used for statistical analysis. A pvalue < 0.05 was considered statistically significant. RESULTS: Systemic lupus erythematosus patients with proliferative nephritis (classes III/IV, n = 54) presented more frequent disease flares ( p = 0.02), continuous active disease during pregnancy and puerperium ( p = 0.006), hospitalization due to systemic lupus erythematosus ( p < 0.001), hospitalization not directly associated to systemic lupus erythematosus ( p = 0.04), higher frequency of cesarean delivery ( p = 0.03) and preeclampsia ( p = 0.01) than patients without nephritis. Permanent damage measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was more frequent in classes III/IV than among the other patients. The frequency of adverse fetal outcomes such as prematurity and admission to neonatal intensive care unit were not different among systemic lupus erythematosus patients with or without nephritis. However, perinatal deaths were more frequent in patients with all classes of nephritis ( p = 0.003). CONCLUSION: Systemic lupus erythematosus patients with proliferative nephritis (classes III/IV) have a higher frequency of adverse maternal outcomes. This is probably due to the major impact of proliferative forms of nephritis on women's global heath, which is corroborated by the higher Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index findings, although we cannot exclude the negative influence of disease activity for the maternal adverse events. The findings indicate a need for further lupus nephritis classification beyond the nonspecific term nephritis in the context of lupus pregnancy as the impact on maternal and fetal outcomes varies according to histological class.
Assuntos
Nefrite Lúpica/classificação , Nefrite Lúpica/epidemiologia , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Adulto , Brasil/epidemiologia , Cesárea/estatística & dados numéricos , Estudos de Coortes , Feminino , Hospitalização/estatística & dados numéricos , Hospitais Universitários , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Terapia Intensiva Neonatal/estatística & dados numéricos , Morte Perinatal , Pré-Eclâmpsia/epidemiologia , Gravidez , Adulto JovemRESUMO
Inflammatory processes and cardiovascular autonomic imbalance are very relevant characteristic of the enormous dynamic process that is a myocardial infarction (MI). In this sense, some studies are investigating pharmacological therapies using acetylcholinesterase inhibitors, such as pyridostigmine bromide (PYR), aiming to increase parasympathetic tone after MI. Here we hypothesized that the use of PYR before the MI might bring an additional positive effect to the autonomic function, and consequently, in the inflammatory response and cardiac function. The present study aimed to evaluate left ventricular function, baroreflex sensitivity, autonomic modulation, and inflammatory profile in PYR-treated rats previously to MI. METHODS: Male Wistar rats (250-300 g) were treated for 60 days with PYR. After treatment, they were submitted to the MI. After the MI, the autonomic and ventricular function were evaluated, as well as the systemic, left ventricle, and adipose tissue inflammatory profile. RESULTS: PYR, performed before MI, prevented HR increase, systolic function impairment, baroreflex sensitivity drop, as well as pulse interval variance, RMSSD, blood pressure and parasympathetic modulation reduction in treated rats compared to untreated rats. Also, this positive functional changes may have been a result of the reduced inflammatory parameters in the left ventricle (IFN-γ, IL-6, and IL-1ß), as well as increased IL-10 expression and IL-10/TNF-α ratio in treated animals before MI. CONCLUSION: Prior treatment with PYR prevents impairment of the autonomic nervous system after MI, which may be associated with the attenuated expression of inflammatory factors and heart dysfunction.
Assuntos
Sistema Nervoso Autônomo/efeitos dos fármacos , Inibidores da Colinesterase/administração & dosagem , Infarto do Miocárdio/prevenção & controle , Brometo de Piridostigmina/administração & dosagem , Função Ventricular Esquerda/efeitos dos fármacos , Animais , Sistema Nervoso Autônomo/fisiopatologia , Pressão Sanguínea/efeitos dos fármacos , Inibidores da Colinesterase/farmacologia , Modelos Animais de Doenças , Regulação da Expressão Gênica/efeitos dos fármacos , Interferon gama/metabolismo , Interleucina-10/metabolismo , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Masculino , Infarto do Miocárdio/imunologia , Infarto do Miocárdio/fisiopatologia , Brometo de Piridostigmina/farmacologia , Ratos , Ratos WistarRESUMO
O presente trabalho objetivou avaliar os resultados de 34 olhos submetidos ao enxerto conjuntival pediculado (ECP) em ceratites ulcerativas profundas (n=5), em ceratites ulcerativas com colagenólise (n=2), descemetocele (n=7), perfuração corneal (n=15) e prolapso de íris (n=5). Os impactos do grau de uveíte e da integridade da córnea foram correlacionados com presença e ausência de visão por tabelas de contingência. Raças braquicefálicas foram acometidas em 91,11% dos casos. O número de córneas consideradas perfuradas [20/34 (58,82%)] foi maior que o de córneas íntegras [14/34 (41,17%)]. Ao 50º dia de pós-operatório, o número de olhos visuais que apresentavam córneas íntegras previamente às cirurgias (n=13) não diferiu significativamente dos olhos com córneas perfuradas (n=12) (P=0,05). Avaliações relativas ao grau de uveíte, revelaram que a metade dos casos foi considerada severa [17/34 (50%)] e na outra metade as uveítes foram consideradas discretas. Dos 17 casos que apresentaram uveíte severa, oito recuperaram a visão. Já nos 17 olhos onde a uveíte foi considerada leve, 15 mantiveram a visão ao final do período de avaliação. Apesar de a integridade da córnea não se correlacionar com a severidade da uveíte (P=0,48), constatou-se que o número de olhos visuais com uveíte discreta foi significativamente maior que os olhos com uveíte severa (P=0,006). Neste estudo, a taxa geral de sucesso visual após ECP foi de 73,52% e a integridade da córnea não exerceu impacto significativo sobre a manutenção da visão. Todavia, olhos acometidos por uveítes severas apresentaram menor chance de recuperar a visão.(AU)
The present study aimed to evaluate the results of 34 eyes of dogs presenting deep corneal ulcer (n=5), colagenolytic corneal ulcer (n=2), descemetocele (n=7), corneal perforation (n=15), and iris prolapse (n=5) that were corrected by the bulbar conjuntival pedicle graft (CPG). The uveitis score and the corneal integrity were correlated with the presence or absence of vision by contingency tables. Brachycephalic breeds accounted for 91.11% of all cases. The number of perforated corneas [20/34 (58.82%)] were higher than the non-perforated ones [14/34 (41.17%)]. At post-operative day 50, the number of visual eyes with non-perforated corneas before surgery (n=13) did not differ significantly from the eyes with perforated corneas (n=12) (P = 0.05). In half of the cases, uveitis score was considered severe [17/34 (50%)], and in the other half, mild. Eight out of 17 eyes classified with severe uveitis regained vision. In 17 eyes where uveitis score was considered mild, 16 regained vision at the end of the study. Although corneal integrity was non-correlated with the uveitis score (P = 0.48), the number of visual eyes scored with mild uveitis were significantly larger than the eyes with severe uveitis (P = 0.006). In this study, the overall success visual rate after CPG was 73,52% % and the corneal integrity did not play an important role regarding maintenance of vision. However, eyes presenting severe uveitis score had less chance to regain vision.(AU)
Assuntos
Animais , Cães , Úlcera da Córnea/complicações , Iridociclite/cirurgia , Uveíte/complicações , Túnica ConjuntivaRESUMO
Las personas pasan por un proceso de envejecimiento, que está manifestado en los cambios biológicos y en la declinación fisiológica, lo cual, tiene un impacto significativo en el desarrollo de las actividades básicas de la vida diaria. En ese sentido, se hace necesario determinar cuáles son los instrumentos de medición más empleados para la evaluación de la condición física, capacidad funcional y niveles de actividad física de esta población. A través de una revisión sistemática de publicaciones científicas, se logró establecer que, para la medición de la condición física, la batería más utilizada es la SPPB (Short Physical Performance Battery); respecto al nivel de actividad física, la acelerometría es uno de los métodos directos más empleados, junto a los cuestionarios de autoreporte y para identificar la capacidad funcional, el índice de katz es el reportado con mayor frecuencia.
People go through a process of aging that is manifested in biological changes and physiological decline, which has a significant impact on the development of basic activities of daily living. In this sense, it is necessary to determine which are the most used measurement instruments for the evaluation of the physical condition, functional capacity and levels of physical activity of this population. Through a systematic review of scientific publications, it was possible to establish that for the measurement of the physical condition the battery most used is the SPPB (Short Physical Performance Battery); Regarding the level of physical activity, accelerometry is one of the direct methods most used together with self-report questionnaires and to identify functional capacity, the katz index is the most frequently reported.
RESUMO
The purpose of this review was to summarize the current knowledge on the utilization of magnetic resonance imaging (MRI) and ultrasound (US) for assessing arthropathy in children and adolescents with haemophilia and to recognize the limitations of each imaging modality and pitfalls in the diagnosis of soft tissue and osteochondral abnormalities. Awareness of MRI and US limitations and pitfalls in the assessment of joints in persons with haemophilia is essential for accurate diagnosis and optimal management of haemophilic arthropathy.
Assuntos
Hemartrose/diagnóstico por imagem , Hemartrose/etiologia , Hemofilia A/complicações , Hemofilia B/complicações , Hemartrose/patologia , Humanos , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/normas , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Ultrassonografia/normasRESUMO
This study analyzed maternal and fetal outcomes of pregnancies of neuropsychiatric systemic lupus erythematosus patients followed in a reference unit. This retrospective cohort study included 26 pregnancies of patients seen between 2011 and 2015 included with history and/or active neuropsychiatric systemic lupus erythematosus among 135 pregnancies. Three patients had active neuropsychiatric systemic lupus erythematosus at conception, but only one remained with neurological activity during gestation, characteristically related to the inadvertent suspension of medications. Twenty six percent of the newborns were small for gestational age and 40% of live births were premature, with no neonatal death or early complications of prematurity. Preeclampsia was diagnosed in nine pregnancies, with two cases of early severe form that resulted in intrauterine fetal death. Patients with neuropsychiatric systemic lupus erythematosus had more prematurity and preeclampsia compared to patients without neuropsychiatric disease. However, when concomitant lupus nephritis was excluded, the gestational results of neuropsychiatric systemic lupus erythematosus patients were more favorable.
Assuntos
Nefrite Lúpica/epidemiologia , Vasculite Associada ao Lúpus do Sistema Nervoso Central/complicações , Pré-Eclâmpsia/epidemiologia , Complicações na Gravidez/epidemiologia , Adulto , Feminino , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Complicações na Gravidez/classificação , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Natimorto/epidemiologia , Adulto JovemRESUMO
PURPOSE: Little is known about the informativeness of initial patient reports before they are reviewed by a pharmacovigilance centre (PVC). We aim to describe the patterns of patient adverse drug reaction (ADR) reporting in France and estimate the contribution of a review by a PVC assessor on the informativeness of these reports. METHODS: A retrospective study was conducted on patient reports between July 2011 and July 2015. Informativeness of 16 key elements of information (including drug start and end date, duration of treatment, time to onset and duration of the ADR, outcome, medical history and concomitant medication) was assessed in initial reports before and after review by a pharmacovigilance assessor. RESULTS: Overall, 240 reports concerning 522 ADR and involving 278 drugs were reported over this 4-year period. Mean number of available key elements of information in initial reports was increased from 11/16 to 15/16 after review of reports by the PVC. Time to onset and duration of the ADR were respectively available in only 51 and 58% of the reports before review compared to 83 and 90% after review. Medical history and concomitant medication were missing in 75% of the initial reports compared to less than 30% of the reports after review. Contacting the reporter enabled an increase of informativeness of most elements of information for more than 90% of the reports. CONCLUSION: Patient reports often need to be completed on key elements of information that are required to assess reports. Both upstream education of patients and downstream intervention of a pharmacovigilance assessor to complete missing information could help to enhance the informativeness of such reports.
Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Autorrelato/normas , Adulto , Idoso , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , FarmacovigilânciaRESUMO
Interventional cardiology requires complex procedures and can result in high doses and dose rates to the patient and medical staff. The many variables that influence the dose to the patient and staff include the beam position and angle, beam size, kVp, filtration, kerma-area product and focus-skin distance. A number of studies using the Monte Carlo method have been undertaken to obtain prospective dose assessments. In this paper, detailed irradiation scenarios were simulated mathematically and the resulting dose estimates were compared with real measurements made previously under very similar irradiation conditions and geometries. The real measurements and the calculated doses were carried out using or simulating an interventional cardiology system with a flat monoplane detector installed in a dedicated room with an Alderson phantom placed on the procedure table. The X-ray spectra, beam angles, focus-skin distance, measured kerma-area product and filtration were simulated, and the real dose measurements and calculated doses were compared. It was shown that the Monte Carlo method was capable of reproducing the real dose measurements within acceptable levels of uncertainty.
Assuntos
Cardiologia , Doses de Radiação , Radiografia Intervencionista , Radiometria/métodos , Fluoroscopia , Humanos , Método de Monte Carlo , Exposição Ocupacional/análise , Imagens de FantasmasRESUMO
Researchers have been looking for modifying surfaces of polymeric biomaterials approved by FDA to obtain nanofeatures and bactericidal properties. If modified, it would be very interesting because the antibiotic administration could be reduced and, therefore, the bacterial resistance. Here, we report the electrospinning of poly (lactic acid) (PLA) with high loadings of titanium dioxide nanoparticles (TiO2, 1-5wt%) and their bactericidal properties. TiO2 nanoparticles have been recognized for a long time for their antibacterial, low cost and self-cleaning properties. However, their ability to reduce bacteria functions when used in polymers has not been well studied to date. In this context, we aimed here to generate nanostructured PLA electrospun fiber-TiO2 nanoparticle composites for further evaluation of their bactericidal activity and cell viability. TEM and SEM micrographs revealed the successful electrospinning of PLA/TiO2 and the generation of polymer-TiO2 nanostructures. When increasing the TiO2 concentration, we observed a proportional increase in the nanoparticle density along the fiber and surface. The nanostructured PLA/TiO2 nanofibers showed no mammalian cell toxicity and, most importantly, possessed bactericidal activity with higher TiO2 loads. Such results suggest that the present PLA electrospun fiber-TiO2 nanoparticle composites should be further studied for a wide range of biomedical applications.
Assuntos
Antibacterianos , Nanofibras/química , Nanopartículas/química , Poliésteres , Staphylococcus aureus/crescimento & desenvolvimento , Titânio , Animais , Antibacterianos/química , Antibacterianos/farmacologia , Linhagem Celular , Humanos , Poliésteres/química , Poliésteres/farmacologia , Ratos , Titânio/química , Titânio/farmacologiaRESUMO
Nowadays, bioethanol production is one of the most important technologies by the necessity to identify alternative energy resources, principally when based on inexpensive renewable resources. However, the costs of 2nd-generation bioethanol production using current biotechnologies are still high compared to fossil fuels. The feasibility of bioethanol production, by obtaining high yields and concentrations of ethanol, using low-cost medium, is the primary goal, leading the research done today. Batch Saccharomyces cerevisiae fermentation of high-density sugar from carob residues with different organic (yeast extract, peptone, urea) and inorganic nitrogen sources (ammonium sulfate, ammonium nitrate) was performed for evaluating a cost-effective ethanol production, with high ethanol yield and productivity. In STR batch fermentation, urea has proved to be a very promising nitrogen source in large-scale production of bioethanol, reaching an ethanol yield of 44 % (w/w), close to theoretical maximum yield value and an ethanol production of 115 g/l. Urea at 3 g/l as nitrogen source could be an economical alternative with a great advantage in the sustainability of ethanol production from carbohydrates extracted from carob. Simulation studies, with experimental data using SuperPro Design software, have shown that the bioethanol production biorefinery from carob wastes could be a very promising way to the valorization of an endogenous resource, with a competitive cost.
Assuntos
Reatores Biológicos/microbiologia , Etanol/metabolismo , Galactanos/metabolismo , Resíduos Industriais/prevenção & controle , Mananas/metabolismo , Compostos de Nitrogênio/metabolismo , Gomas Vegetais/metabolismo , Saccharomyces cerevisiae/fisiologia , Proliferação de Células/fisiologia , Sobrevivência Celular/fisiologia , Etanol/isolamento & purificaçãoRESUMO
BACKGROUND: The natural history of multiple sclerosis (MS) in Brazil has been available in different regions of country. There is no nationwide population-based studies that express general data in Brazil. OBJECTIVE: To review and synthesize available data about MS in Brazil. MATERIAL AND METHODS: Systematic review was performed through a search of medical literature databases to identify Brazilian studies published during 1990-2012. DATA SOURCES: PubMed, SciELO, and Lilacs. KEYWORDS: "Brazil" or "Brazilian" combined with the following terms: "multiple sclerosis", "clinical profile", "demographic profile", "natural history", "clinical course", "pediatric", or "familial form". RESULTS: In total of 45 pediatric and 1922 adult patients, the median age at onset was 10 years in pediatric patients and 32 years in adult patients. Women were more affected. Motor-control complaints and relapsing-remitting phenotype at onset were the most common. Predictors to disability and progression were number of relapses during the first year of disease, older age, male gender and African ancestry. CONCLUSIONS: The profile of the MS in Brazilian seems to correspond to that observed in high-MS-prevalence areas. African ancestry is a risk factor to disability and progression early. In Brazil, factors that limit MS incidence do not interfere with the clinical pattern and outcomes.