RESUMO
Este trabalho teve como o objetivo comparar dois Projetos Políticos Pedagógicos, descrever e analisar o desenvolvimento da visão humanística no curso de graduação em Odontologia da Universidade Federal Fluminense, a partir da ótica dos acadêmicos do referido curso. Realizou-se uma pesquisa descritivo-exploratória com enfoque quanti-qualitativo. A coleta de dados deu-se em 03 etapas, as duas primeiras por meio de categorização dos fatores selecionados pelos alunos e a terceira pelo método denominado grupo focal. As estratégias de análises utilizadas foram a categorização, operações estatísticas simples, análise temática e análise crítica com a literatura revisada. Entre os resultados da pesquisa têm-se: não existe diferença entre a visão humanística dos alunos no período inicial quando comparada com as dos alunos no final do período do ciclo profissional no Projeto Pedagógico Antigo, no Projeto Pedagógico Novo, em curso, os alunos demonstram em sua maioria estar voltados para uma visão mais humanística. Conclui-se que a humanização, do processo ensino-aprendizagem no contexto acadêmico pesquisado, apresenta ainda deficiências, constituindo-se, portanto, em um caminho a perseguir, onde o comprometimento de todos os envolvidos neste processo de transformação e formação tem um papel fundamental.
The aim of this paper was to compare two Pedagogical Political Projects, to describe and analyze the development of humanistic vision in the undergraduate course in Dentistry of the Federal University of Fluminense, from the perspective of the academics of this course. A descriptive-exploratory research with quantitative-qualitative approach was carried out. The data collection took place in 03 stages; the first two by categorizing the factors selected by the students and the third by the method called the focal group. The analysis strategies used were categorization, simple statistical operations, thematic analysis and critical analysis with the reviewed literature. The results of the research are: there is no difference between the humanistic view of the students in the initial period when compared to the students at the end of the professional cycle in the Pedagogical Project. In the New Pedagogical Project, in progress, students demonstrate, in majority, aimed at a more humanistic view. It is concluded that the humanization of the teaching-learning process in the researched academic context still presents deficiencies, constituting, therefore, a path to be pursued, where the commitment of all those involved in this process of transformation and formation plays a fundamental role.
Assuntos
Humanos , Masculino , Feminino , Estudantes de Odontologia , Ensino , Educação em Odontologia , Humanização da Assistência , AprendizagemRESUMO
O objetivo do presente estudo foi avaliar em tomografias computadorizadas as dimensões dos tecidos periodontais supracrestais (TPSC). Cem pacientes, 600 dentes anteriores da maxila (200 incisivos centrais, 200 incisivos laterais e 200 caninos), foram avaliados. A distância média da margem gengival até a crista óssea alveolar (COA) foi de 3.25mm (95% IC: 3.20-3.30), enquanto que da junção cemento-esmalte até a COA foi de 1.77mm (95% IC: 1.72-182mm). As medidas foram significativamente diferentes entre os grupos de dentes (ANOVA, p < 0.001). A tomografia, pode representar uma importante ferramenta para a avaliação das dimensões dos TPSC.
The aim of this study was to evaluate the dimensions of the supracrestal periodontal tissues (SPT) on tomographic scans. One hundred patients, 600 maxillary anterior teeth (200 central incisors, 200 lateral incisors and 200 canines), were evaluated. The average distance from the gingival margin to the alveolar bone crest (ABC) was 3.25mm (95% CI: 3.20-3.30), while the distance from the cemento-enamel junction to ABC was 1.77mm (95% CI: 1.72-182mm). The measurements were significantly different between the tooth groups (ANOVA, p < 0.001). When properly indicated, tomography can be an important tool for assessing the dimensions of TPSCs on a case-by-case basis.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Tecidos , Periodonto , Tomografia Computadorizada de Feixe Cônico , MaxilaRESUMO
Este estudo teve como objetivo avaliar o dimorfismo sexual em uma coleção de mandíbulas portuguesas através de uma metodologia métrica digital, utilizando análise estatística descritiva, inferencial e multivariada para identificar quais parâmetros são mais dimórficos e quais são os melhores preditores de sexo. Trinta e três mandíbulas (14 mulheres e 19 homens) e pertences pessoais foram fotograficamente registrados com código e sexo. Os dados foram coletados por tomografia e as medidas foram feitas pelo software Simplant Pro. Foram registrados a largura máxima e mínima do ramo mandibular, altura condilar, altura do processo coronoide, altura da sínfise mandibular, ângulo mandibular, distâncias bimentual, biantegonial, bigonial e bicondilar e comprimento máximo mandibular. A análise estatística foi realizada utilizando IBM® SPSS. Os resultados mostraram diferenças estatisticamente significativas para os seguintes parâmetros: altura do processo coronoide, altura do côndilo, comprimento máximo da mandíbula e largura mínima do ramo mandibular. Na análise estatística multivariada foi possível identificar a altura do processo coronoide como melhor preditor de sexo com precisão em 72,2% dos casos. Isto permite uma diferenciação mais fácil entre mandíbulas femininas e masculinas com uma precisão de 64,3% e 78,9%, respectivamente. Foi possível concluir que a altura do processo coronoide é o parâmetro mais dimórfico e o melhor preditor de sexo na amostra.
This study aimed to assess sex dimorphism in a collection of Portuguese mandibles through a digital metric methodology by using descriptive, inferential, and multivariate statistical analysis to identify which parameters are the most dimorphic and which are the best sex predictors. Thirty-three mandibles (14 females and 19 males) and personal belongings were photographically registered with code and sex. Data was collected using tomography, and measurements were made using the Simplant Pro software. The maximum and minimum width of the mandibular ramus, condylar height, coronoid process height, mandibular symphysis height, mandibular angle, bi-mental, bi-antegonial, bi-gonial and bi-condylar distances, and maximal mandibular length were registered. Statistical analysis was performed using IBM® SPSS. The results showed statistically significant differences for the following parameters: coronoid process height, condyle height, the maximum length of the mandible, and the minimum width of the mandibular ramus. In the multivariate statistical analysis, it was possible to identify the coronoid process height as the best sex predictor accurately in 72.2% of cases. This allows for easier differentiation between female and male mandibles with an accuracy of 64.3% and 78.9%, respectively. It was possible to conclude that the coronoid process height is the most dimorphic parameter and the best sex predictor in the sample.
Assuntos
Humanos , Masculino , Feminino , Caracteres Sexuais , Diagnóstico , Tomografia Computadorizada de Feixe Cônico , MandíbulaRESUMO
Introducción: Las enfermedades cerebrovasculares son consideradas un problema de salud pública que afectan muchas capacidades en el individuo, entre ellas la comunicación; de esta manera el cuidador cumple un papel fundamental en su recuperación. Objetivo: Describir el rol comunicativo del cuidador en la atención a pacientes con secuelas de accidente cerebrovascular en la ciudad de Sincelejo, Colombia. Materiales y métodos: Paradigma positivista, enfoque cuantitativo y estudio descriptivo de corte transversal realizado con 40 cuidadores, seleccionados según muestreo por criterios y reclutamiento en cadena. Se utilizó una encuesta sociodemográfica, una sobre favorecimiento y bienestar comunicativo y Escala Likert, se realizó análisis de fiabilidad y consistencia interna del instrumento. Resultados: Predominaron cuidadores de sexo femenino, sobresale el cuidador informal, con estudios de secundaria y estrato socioeconómico bajo. Se encontró una actitud favorable en la competencia del ser y saber hacer, prima el buen trato, justicia y respeto. La competencia del saber evidenció actitud desfavorable, caracterizada por un conocimiento limitado frente a la patología, insuficientes destrezas, técnicas y habilidades para cumplir sus funciones y estrategias empleadas. Conclusión: Es necesario cualificar al cuidador en la atención del paciente con accidente cerebrovascular, mediante programas de que dinamicen la competencia del ser, saber y saber hacer
Introduction: Cerebrovascular diseases are a public health problem affecting the different capabilities of patients, including communication. Thus, caregivers play a fundamental role in their recovery. Objective: To describe the communicative role of caregivers in the support of patients with stroke sequelae in the city of Sincelejo, Colombia. Materials and methods: A positivist paradigm, quantitative approach, and descriptive cross-sectional study was carried out with 40 caregivers, who were selected according to criteria sampling and chain recruitment. A sociodemographic survey about favorability and communicative well-being as well as the Likert Scale were applied. A reliability and internal consistency analysis was conducted. Results: The majority of caregivers were women. Informal caregivers, with high school education, and belonging to low socioeconomic status were also predominant. A positive attitude regarding competences such as being and knowing what to do; appropriate treatment of patients, with justice and respect, were observed as common features. The knowledge competence was considered unfavorable, which was characterized by limited understanding regarding pathology, strategies used, and insufficient skills, techniques, and abilities to fulfill their functions. Conclusions: Caregivers of stroke patients should be qualified through programs that improve the being, knowing, and knowing how to do competencies.
Introdução: As doenças cerebrovasculares são consideradas um problema de saúde pública que afeta diversas capacidades do indivíduo, incluindo a comunicação; desta forma, o cuidador desempenha um papel fundamental na sua recuperação. Objetivo: Descrever o papel comunicativo do cuidador no cuidado de pacientes com sequelas de acidente vascular cerebral na cidade de Sincelejo, Colômbia. Materiais e métodos: Paradigma positivista, abordagem quantitativa e estudo transversal descritivo realizado com 40 cuidadores, selecionados segundo critérios de amostragem e recrutamento em cadeia. Foi utilizado um inquérito sociodemográfico, um de favorabilidade e bem-estar comunicativo e uma Escala Likert, foi realizada uma análise da fiabilidade e consistência interna do instrumento. Resultados: Predominaram cuidadores do sexo feminino, destacando-se os cuidadores informais, com escolaridade média e baixo nível socioeconômico. Encontrou-se na competição uma atitude favorável por ser e saber fazer, prevalecendo o bom tratamento, a justiça e o respeito. A competência conhecimento apresentou atitude desfavorável, caracterizada por conhecimento limitado sobre a patologia, habilidades, técnicas e habilidades insuficientes para cumprir suas funções e estratégias utilizadas. Conclusões: É necessário qualificar o cuidador no cuidado ao paciente com AVC, por meio de programas que potencializem a competência de ser, saber e saber fazer.
Assuntos
Humanos , Masculino , FemininoRESUMO
Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.
Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.
Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Saúde , Emoções , Felicidade , HostilidadeRESUMO
BACKGROUND: Deaths from opioid overdose have increased dramatically in the past decade. For individuals with opioid use disorder (OUD), agonist medications such as methadone and buprenorphine reduce opioid-related morbidity and mortality. Historically, the provision of buprenorphine treatment in office-based settings has relied on frequent in-person contact, likely influencing patients' access to and retention in care. In response to the COVID-19 pandemic, providers of office-based buprenorphine treatment rapidly adapted their care processes, increasingly relying on telemedicine visits. To date, relatively few prior studies have combined patient and clinician perspectives to examine the implementation of telemedicine and related care adaptations, particularly in safety-net settings. METHODS: Qualitative methods were used to explore clinician and patient experiences with telemedicine in an office-based buprenorphine treatment clinic affiliated with an urban safety-net hospital. From this clinic, we conducted semi-structured interviews with 25 patients and 16 clinicians (including prescribers and non-prescribers). We coded all interview data and used a thematic analysis approach to understand how telemedicine impacted treatment quality and engagement in care, as well as preferences for using telemedicine moving forward. RESULTS: Five themes regarding the implementation of telemedicine and other COVID-19-related care adaptations arose from patient and clinician perspectives: (1) telemedicine integration precipitated openness to more flexibility in care practices, (2) concerns regarding telemedicine-related adaptations centered around safety and accountability, (3) telemedicine encounters required rapport and trust between patients and clinicians to facilitate open communication, (4) safety-net patient populations experienced unique challenges when using telemedicine, particularly in terms of the technology required and the need for privacy, and (5) there is an important role for telemedicine in office-based buprenorphine treatment moving forward, primarily through its use in hybrid models of care which integrate both in-person and virtual visits. CONCLUSIONS: Telemedicine implementation within office-based buprenorphine treatment has the potential to improve patients' engagement in care; however, our findings emphasize the need for tailored approaches to implementing telemedicine in office-based buprenorphine treatment, particularly within safety-net settings. Overall, this study supports the maintenance of changes to policy and practice that facilitate the use of telemedicine in office-based buprenorphine treatment beyond the COVID-19 public health emergency.
Assuntos
Buprenorfina , COVID-19 , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides , Pesquisa Qualitativa , Telemedicina , Humanos , Telemedicina/organização & administração , Buprenorfina/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Masculino , Feminino , Tratamento de Substituição de Opiáceos/métodos , Adulto , Pessoa de Meia-Idade , Antagonistas de Entorpecentes/uso terapêuticoRESUMO
BACKGROUND: Challenges with social functioning, which is a hallmark of opioid use disorder (OUD), are a drawback in treatment adherence and maintenance. Yet, little research has explored the underlying mechanisms of this impairment. Impulsivity and corresponding neural alterations may be at the center of this issue. Childhood adversity, which has been linked to both impulsivity and poorer treatment outcomes, could also affect this relationship. This study explores the relationship between impulsivity, social functioning, and their neural correlates in the prefrontal cortex, while examining the potential moderating effects of childhood trauma in individuals recovering from OUD. METHODS: Participants with (N = 16) and without (N = 19) social impairment completed a survey (e.g., social functioning, Barrat's Impulsivity Scale, Adverse Childhood Experiences (ACEs) and cognitive tasks while undergoing neuroimaging. Functional near infrared spectroscopy (fNIRS), a modern, portable, wearable and low-cost neuroimaging technology, was used to measure prefrontal cortex activity during a behavioral inhibition task (Go/No-Go task). RESULTS: Those who social functioning survey scores indicated social impairment (n = 16) scored significantly higher on impulsivity scale (t [33]= -3.4, p < 0.01) and reported more depressive symptoms (t [33] = -2.8, p < 0.01) than those reporting no social impairment (n = 19). Social functioning was negatively correlated with impulsivity (r=-0.7, p < 0.001), such that increased impulsivity corresponded to decreased social functioning. Childhood trauma emerged as a moderator of this relationship, but only when controlling for the effects of depression, B=-0.11, p = 0.023. Although both groups had comparable Go/No-Go task performance, the socially impaired group displayed greater activation in the dorsolateral (F(1,100.8) = 7.89, p < 0.01), ventrolateral (F(1,88.8) = 7.33, p < 0.01), and ventromedial (F(1,95.6) = 7.56, p < 0.01) prefrontal cortex duringthe behavioral inhibition task. CONCLUSION: In addition to being more impulsive, individuals with social impairment exhibited greater activation in the prefrontal cortex during the Go/No-Go task. Furthermore, the impact of impulsivity on social functioning varies depending on ACEs, such that higher levels of ACEs corresponded to a stronger negative relationship between impulsivity and social functioning, highlighting its importance in treatment approaches. These findings have implications for addressing social needs and impulsivity of those in recovery, highlighting the importance of a more personalized, integrative, and trauma-informed approach to intervention.
Assuntos
Experiências Adversas da Infância , Comportamento Impulsivo , Transtornos Relacionados ao Uso de Opioides , Córtex Pré-Frontal , Humanos , Córtex Pré-Frontal/fisiopatologia , Córtex Pré-Frontal/diagnóstico por imagem , Comportamento Impulsivo/fisiologia , Masculino , Feminino , Adulto , Transtornos Relacionados ao Uso de Opioides/fisiopatologia , Transtornos Relacionados ao Uso de Opioides/psicologia , Experiências Adversas da Infância/psicologia , Espectroscopia de Luz Próxima ao Infravermelho , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Serum uric acid (SUA), the final product of purine metabolism, is an independent risk factor for cardiovascular (CV) disease. Since SUA levels depend on renal function, SUA to serum creatinine ratio (SUA/sCr) is emerging as a more specific biomarker of CV risk. AIM: To evaluate in hospitalized patients with cardiorenal multimorbidity (CRM) if the SUA/sCr ≥ 5.35 is associated with clinical outcomes. The primary outcome was in-hospital mortality. The secondary outcome was the composite of all-cause of mortality and adverse clinical events. METHODS: We conducted a retrospective review of medical records from consecutive CRM inpatients admitted to the medical ward. The composite endpoint was calculated as all-cause mortality and adverse clinical events such as acute coronary syndrome, stroke, infections, and renal replacement therapy. RESULTS: In our cohort, 141 patients (mean age of 75.6 ± 10.2 years) were identified with CRM. In-hospital mortality occurred in 17 patients (16%), and 64 patients (60.4%) experienced adverse clinical outcomes. Among the 106 patients, 20 (18.9%) had an SUA/sCr ≥ 5.35, while 86 (81.1%) had an SUA/sCr < 5.35. Male gender was significantly associated with SUA/sCr ≥ 5.35 (p = 0.007). In-hospital mortality was significantly higher in patients with SUA/sCr ≥ 5.35 (p = 0.010), and a positive correlation with adverse clinical outcomes was documented in this subgroup (p = 0.012). CONCLUSION: in patients with CRM, SUA/sCr ≥ 5.35 is associated with increased in-hospital mortality and worse clinical outcomes. The ratio and related cut-off value of SUA/sCr could represent a useful biomarker to assess in-hospital complications in CRM patients.
Assuntos
Biomarcadores , Creatinina , Mortalidade Hospitalar , Multimorbidade , Valor Preditivo dos Testes , Ácido Úrico , Humanos , Masculino , Feminino , Biomarcadores/sangue , Idoso , Estudos Retrospectivos , Ácido Úrico/sangue , Creatinina/sangue , Idoso de 80 Anos ou mais , Medição de Risco , Prognóstico , Fatores de Tempo , Pessoa de Meia-Idade , Fatores de Risco , Hiperuricemia/sangue , Hiperuricemia/diagnóstico , Hiperuricemia/epidemiologia , Hiperuricemia/mortalidade , Causas de MorteRESUMO
An integrated frozen elephant trunk with a four-branched vascular graft may shorten the circulatory arrest time during open distal anastomosis. We report a case of acute type A aortic dissection where postoperative graft kinking led to acute liver failure, kidney injury and lower limb ischaemia corrected by thoracic endovascular aortic repair.
Assuntos
Aneurisma da Aorta Torácica , Dissecção Aórtica , Implante de Prótese Vascular , Prótese Vascular , Procedimentos Endovasculares , Humanos , Dissecção Aórtica/cirurgia , Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Aneurisma da Aorta Torácica/cirurgia , Procedimentos Endovasculares/métodos , Procedimentos Endovasculares/efeitos adversos , Masculino , Desenho de Prótese , Resultado do Tratamento , Isquemia/etiologia , Isquemia/cirurgia , Pessoa de Meia-Idade , Injúria Renal Aguda/etiologia , Fatores de Tempo , Falência Hepática Aguda/cirurgiaRESUMO
Lactation represents a critical evolutionary adaptation in mammals, imposing heightened nutritional demands that drive shifts in foraging behavior and intestinal microbiota to optimize nutrient acquisition. In the sexually dimorphic Pratt's leaf-nosed bat (Hipposideros pratti), males exhibit enlarged transverse lobes posterior to the nasal leaf, a morphological trait may influence echolocation dynamics and dietary niche partitioning. This provides an opportunity to examine dietary and microbiota differences between genders and across various reproductive states. Using high-throughput sequencing of fecal samples from male (HPM), non-lactating female (HPF), and lactating female (HPFL) H. pratti collected in late June, we identified gender- and physiology-linked ecological strategies. While dietary diversity indices showed no significant intergroup differences, compositional analysis revealed distinct prey preferences: both HPM and HPFL predominantly consumed Coleoptera, whereas HPF favored Diptera. Coleoptera's larger size and nutrient profile-rich in leucine, isoleucine, and chitin-likely optimize energy efficiency for HPFL, reducing foraging effort while supplying amino acids critical for mammary gland function and immunity. Gender-based differences were observed in intestinal microbiota diversity, with females demonstrating higher diversity indices compared to males. Males showed a notable abundance of Clostridium sensu stricto 1, a proteolytic genus associated with Coleoptera digestion but linked to inflammatory risks via pathogenic strains. The HPFL group exhibited microbiota enriched in Lactococcus (chitinolytic taxa) and lactation-adapted symbionts: Lachnoclostridium may suppress pro-inflammatory responses via acetate production, while Pseudonocardia may enhance calcium homeostasis and antimicrobial defense. This study advances understanding of host-microbe coadaptation in mitigating life-history trade-offs and highlights ecological drivers of microbiota plasticity in insectivorous bats.
Assuntos
Quirópteros , Dieta , Microbioma Gastrointestinal , Animais , Quirópteros/microbiologia , Quirópteros/fisiologia , Feminino , Masculino , Dieta/veterinária , Lactação , Reprodução , Fezes/microbiologia , Caracteres SexuaisRESUMO
The liver performs essential functions critical to overall health. This study evaluated the efficacy of berberine-loaded albumin nanoparticles (BRB-BSA NPs) and cisplatin in mitigating hepatic damage caused by diethylnitrosamine (DEN) and carbon tetrachloride (CCl4) in male albino rats. Molecular modeling was conducted to explore BRB interactions with Sirt1, a NAD+-dependent protein deacetylase involved in key cellular pathways. BRB-BSA NPs showed superior results to cisplatin in reducing liver enzymes, oxidative stress, and proinflammatory markers while enhancing antioxidant activities. Cisplatin, however, was more effective in restoring mitochondrial pathway regulators. Additionally, BRB-BSA NPs improved liver tissue histoarchitecture and ultrastructure, bringing them closer to normal. In conclusion, BRB-BSA NPs demonstrated potent efficacy in alleviating DEN/CCl4-induced liver injury in male rats.
Assuntos
Berberina , Nanopartículas , Animais , Berberina/farmacologia , Berberina/administração & dosagem , Masculino , Ratos , Nanopartículas/química , Retículo Endoplasmático/metabolismo , Retículo Endoplasmático/efeitos dos fármacos , Biogênese de Organelas , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/patologia , Doença Hepática Induzida por Substâncias e Drogas/tratamento farmacológico , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Estresse Oxidativo/efeitos dos fármacos , Albuminas/metabolismo , Albuminas/química , Sirtuína 1/metabolismoRESUMO
INTRODUCTION: The high prevalence of patients with embolic stroke of undetermined source (ESUS), the considerable risk of ischemic stroke, and the need for novel antithrombotic strategies highlight ESUS as an important priority in stroke research in the coming years. This study is designed to investigate the effectiveness and safety of rivaroxaban along with aspirin in reducing stroke recurrence in patients with ESUS. MATERIALS AND METHODS: The present study is a parallel-group, placebo-controlled, randomized, outcome-assessor blind, on patients in whom ESUS has recently (7-60 days) identified and had one risk factor of a potential embolic source. The recruited patients were randomly assigned to: rivaroxaban 2.5â¯mg two times daily plus ASA 80â¯mg once daily (intervention) or ASA 80â¯mg once daily plus placebo (control) (1:1 ratio). All patients were followed up every 3 months until 12 months. Any side effects or outcome events were recorded. The primary outcome was clarified as the rate of stroke recurrence and major bleeding occurrence. RESULTS: Forty-two patients with ESUS were recruited in this study (21 in each group). Stroke recurred in 3 patients in the comparator group and 1 patient in the intervention group (OR: 0.30; 95â¯% CI = 0.02-3.14, Pâ¯=â¯0.31; RR= 0.33; 95â¯% CI = 0.03-2.95, Pâ¯=â¯0.32). No major hemorrhagic event occurred in either group. CONCLUSIONS: It seems reasonable to test, in a larger study, the effect of rivaroxaban (2.5â¯mg BID) plus aspirin on the prevention of stroke recurrence in patient with ESUS and a potential embolic source.
Assuntos
Aspirina , Quimioterapia Combinada , AVC Embólico , Estudos de Viabilidade , Rivaroxabana , Humanos , Rivaroxabana/uso terapêutico , Rivaroxabana/efeitos adversos , Aspirina/uso terapêutico , Aspirina/administração & dosagem , Aspirina/efeitos adversos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , AVC Embólico/prevenção & controle , AVC Embólico/etiologia , AVC Embólico/tratamento farmacológico , Resultado do Tratamento , Inibidores do Fator Xa/uso terapêutico , Inibidores do Fator Xa/efeitos adversos , Método Simples-Cego , Inibidores da Agregação Plaquetária/uso terapêutico , Inibidores da Agregação Plaquetária/administração & dosagem , Inibidores da Agregação Plaquetária/efeitos adversos , Prevenção Secundária/métodosRESUMO
OBJECTIVE: To evaluate changes in the thickness of the crystalline lens components in children with different refractive errors before and after cycloplegia. METHODS AND ANALYSIS: This prospective study recruited 132 right eyes from 132 children (age 5-15 years) with different spherical equivalent (SE) ranging from -6.00 diopters (D) to +6.75 D. We categorized these eyes into non-myopia (N = 30), low-myopia (N = 77), and moderate-myopia (N = 25) groups. The thickness parameters of the crystalline lens components, including lens thickness (LT), lens nucleus thickness (LNT), anterior cortex thickness (ACT), and posterior cortex thickness (PCT), were assessed using optical coherence tomography before and after 0.5 % tropicamide-induced cycloplegia. RESULTS: After cycloplegia, LT significantly decreased from 3.47 ± 0.20 to 3.41 ± 0.20 mm in non-myopia eyes (P < 0.05), and from 3.30 ± 0.17 to 3.27 ± 0.16 mm in low-myopia eyes (P < 0.05), with no significant changes in moderate-myopia eyes (P < 0.05). LNT decreased from 3.15 ± 0.19 to 3.09 ± 0.19 mm in non-myopia eyes (P < 0.05), and from 3.02 ± 0.20 to 2.99 ± 0.17 mm in low-myopia eyes (P < 0.01), with no reduction observed in moderate-myopia eyes (P > 0.05). Cycloplegia-induced changes in ACT and PCT (all P > 0.05) did not differ significantly between the groups. SE was positively correlated with LT and LNT before (Pearson's r = 0.353 and 0.272, respectively; both P < 0.05) and after cycloplegia (r = 0.285 and 0.198, respectively; both P < 0.05). CONCLUSIONS: LT and LNT significantly decreased after cycloplegia induced by 0.5 % tropicamide in children with non-myopia and low-myopia, while neither ACT nor PCT changed significantly. SE was positively correlated with LT and LNT.
Assuntos
Cristalino , Midriáticos , Tomografia de Coerência Óptica , Tropicamida , Humanos , Criança , Feminino , Estudos Prospectivos , Masculino , Midriáticos/administração & dosagem , Pré-Escolar , Adolescente , Cristalino/patologia , Cristalino/diagnóstico por imagem , Tropicamida/administração & dosagem , Tropicamida/farmacologia , Refração Ocular/fisiologia , Erros de Refração/fisiopatologia , Pupila/efeitos dos fármacos , Pupila/fisiologiaRESUMO
Maple syrup urine disease is a rare metabolic disorder that results in neurodevelopmental injury despite dietary therapy. While structural neuroimaging has shown a characteristic pattern of edema and white matter injury, no functional neuroimaging studies of maple syrup urine disease have been performed. Using widefield optical imaging, we investigated resting-state functional connectivity in two brain-specific mouse models of maple syrup urine disease (an astrocyte-specific knockout and a whole-brain knockout). At 8 weeks, mouse functional neuroimaging was performed using a custom-built widefield optical imaging system. Imaging was performed before and after initiation of a high-protein diet for 1 week to mimic metabolic crisis, which we hypothesized would result in decreased functional connectivity strength. Data were analyzed using seed-based functional connectivity and cluster-based inference. Astrocyte-specific knockout mice developed increased contralateral functional connectivity within the posteromedial somatosensory cortex after diet initiation. Whole-brain knockout mice had a similar pattern present at baseline, which persisted after diet initiation. Thus, contrary to expectations, maple syrup urine disease resulted in increased functional connectivity strength, especially after diet initiation. While the underlying etiology of these changes is unclear, these results demonstrate that inborn errors of metabolism result in changes to functional connectivity networks. Further research may demonstrate functional neuroimaging biomarkers that could be translated to clinical care.
Assuntos
Encéfalo , Modelos Animais de Doenças , Doença da Urina de Xarope de Bordo , Camundongos Knockout , Animais , Doença da Urina de Xarope de Bordo/diagnóstico por imagem , Doença da Urina de Xarope de Bordo/fisiopatologia , Doença da Urina de Xarope de Bordo/genética , Camundongos , Encéfalo/diagnóstico por imagem , Camundongos Endogâmicos C57BL , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Masculino , Astrócitos/metabolismo , Astrócitos/patologia , FemininoRESUMO
OBJECTIVES: AI/ML advancements have been significant, yet their deployment in clinical practice faces logistical, regulatory, and trust-related challenges. To promote trust and informed use of ML predictions in real-world scenarios, reliable assessment of individual predictions is essential. We propose RelAI, a tool for pointwise reliability assessment of ML predictions that can support the identification of prediction errors during deployment. MATERIALS AND METHODS: RelAI utilizes Autoencoders (AEs) to detect distributional shifts (Density principle) and a proxy model to encode local performance (Local Fit principle). We validated RelAI on a synthetic dataset and a real-world scenario involving Multiple Sclerosis (MS) patient outcomes. RESULTS: On a synthetic dataset, RelAI effectively identified unreliable predictions, outperforming alternative approaches. In the MS case study, reliable predictions exhibited higher accuracy and were associated with specific demographic features, such as sex, residence, and eye symptoms. DISCUSSION AND CONCLUSION: RelAI can support ML deployment in clinical settings by providing pointwise reliability assessments, ensuring regulatory compliance, and fostering user trust. Its model-agnostic nature and its compatibility with Python-based ML pipelines enhance its potential for widespread adoption.
Assuntos
Esclerose Múltipla , Humanos , Reprodutibilidade dos Testes , Feminino , Masculino , Aprendizado de Máquina , AlgoritmosRESUMO
OBJECTIVE: Analyze the impact of ventricular opening during surgery for High-Grade Glioma (HGG) on surgical, functional outcomes, and survival rates. MATERIALS AND METHODS: Retrospective, single-center, analytical study of a cohort of patients who underwent surgery for HGG in an Argentine center between 2013 and 2023. Patients with Grade IV supratentorial gliomas, 3 months of minimum follow-up, studied with pre and postoperative volumetric MRI were included. Subsequently, ventricular opening during surgery and its influence on prognosis were analyzed. RESULTS: A total 263 patients met the inclusion criteria, with a mean follow-up of 24.8 months. Mean age was 58.5 years with a predominance of male patients (63â¯%) and preoperative mean KPS was 80 (range 40-100). Eighty-eight percent of tumors corresponded to Glioblastomas and the mean preoperative volume was 27.2â¯cm3. Ventricular opening was identified in 80 patients (30.4â¯%) in correlation with the number of patients with ependymal invasion. This factor was associated with worse survival rates and risk of multicentricity in univariate analysis. However, when adjusted for covariables, there was a trend towards higher survival and slight increase in resection rates. Opening the ventricles was associated with a higher risk of leptomeningeal spread and complications such as hydrocephalus and CSF leak. CONCLUSION: Ventricular opening during surgery for HGG did not show to represent an independent prognostic factor for survival rates. It could be considered when ependymal invasion is observed in favor of maximizing EOR. Conversely, it should be avoided as it carries a higher risk for complications and tumor spread.
Assuntos
Ventrículos Cerebrais , Glioma , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Glioma/cirurgia , Glioma/mortalidade , Idoso , Adulto , Estudos Retrospectivos , Taxa de Sobrevida , Ventrículos Cerebrais/cirurgia , Ventrículos Cerebrais/diagnóstico por imagem , Resultado do Tratamento , Neoplasias Encefálicas/cirurgia , Neoplasias Encefálicas/mortalidade , Procedimentos Neurocirúrgicos/métodos , Neoplasias Supratentoriais/cirurgia , Neoplasias Supratentoriais/mortalidade , Adulto JovemRESUMO
BACKGROUND: Alzheimer's disease (AD) is a complex neurodegenerative disorder with substantial genetic influence. While genome-wide association studies (GWAS) have identified numerous risk loci for late-onset AD (LOAD), the functional mechanisms underlying most of these associations remain unresolved. Large genomic rearrangements, known as structural variants (SVs), represent a promising avenue for elucidating such mechanisms within some of these loci. METHODS: By leveraging data from two ongoing cohort studies of aging and dementia, the Religious Orders Study and Rush Memory and Aging Project (ROS/MAP), we performed genome-wide association analysis testing 20,205 common SVs from 1088 participants with whole genome sequencing (WGS) data. A range of Alzheimer's disease and other common age-related clinical and neuropathologic traits were examined. RESULTS: First, we mapped SVs across 81 AD risk loci and discovered 22 SVs in linkage disequilibrium (LD) with GWAS lead variants and directly associated with the phenotypes tested. The strongest association was a deletion of an Alu element in the 3'UTR of the TMEM106B gene, in high LD with the respective AD GWAS locus and associated with multiple AD and AD-related disorders (ADRD) phenotypes, including tangles density, TDP-43, and cognitive resilience. The deletion of this element was also linked to lower TMEM106B protein abundance. We also found a 22-kb deletion associated with depression in ROS/MAP and bearing similar association patterns as GWAS SNPs at the IQCK locus. In addition, we leveraged our catalog of SV-GWAS to replicate and characterize independent findings in SV-based GWAS for AD and five other neurodegenerative diseases. Among these findings, we highlight the replication of genome-wide significant SVs for progressive supranuclear palsy (PSP), including markers for the 17q21.31 MAPT locus inversion and a 1483-bp deletion at the CYP2A13 locus, along with other suggestive associations, such as a 994-bp duplication in the LMNTD1 locus, suggestively linked to AD and a 3958-bp deletion at the DOCK5 locus linked to Lewy body disease (LBD) (P = 3.36 × 10-4). CONCLUSIONS: While still limited in sample size, this study highlights the utility of including analysis of SVs for elucidating mechanisms underlying GWAS loci and provides a valuable resource for the characterization of the effects of SVs in neurodegenerative disease pathogenesis.
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Doença de Alzheimer , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Doença de Alzheimer/genética , Doença de Alzheimer/patologia , Feminino , Masculino , Idoso , Desequilíbrio de Ligação , Envelhecimento/genética , Variação Estrutural do Genoma , Idoso de 80 Anos ou mais , Fenótipo , Polimorfismo de Nucleotídeo Único , Proteínas do Tecido Nervoso/genética , Proteínas de Membrana/genéticaRESUMO
BACKGROUND: Despite success in treating childhood acute lymphoblastic leukemia and lymphoma (ALL), modern multiagent chemotherapy regimens containing high-dose corticosteroids can result in osteonecrosis afflicting survivors, frequently involving the knee. Thus, we describe the usage of fresh osteoarticular allograft (FOAG) to treat steroid-induced osteonecrosis of the femoral condyle in pediatric cancer survivors. We assessed the efficacy of FOAGs to heal necrotic bone, provide long-term pain relief, while retrospectively reviewing quality of life and functional status. METHODS: We recorded patient demographics, pain, and functional scores preoperatively, postoperatively, and at the most recent follow-up, additional surgical procedures, and radiographic outcomes at each timepoint. Anatomic locations and sizes of the grafts were noted using operative reports and intraoperative photographs. Function and pain scores were collected by direct patient communication or through survey, with data scored using the KOOS (Knee Injury and Osteoarthritis Outcome Score), PROMIS (Patient-Reported Outcomes Measurement Information System), and CTCAE (Common Terminology Criteria for Adverse Events) scoring tools. RESULTS: Eighteen patients, (12 females) over a period of 8 years, underwent the procedure. One patient was excluded due to death before 12 months follow-up. The average age at diagnosis of femoral condyle osteonecrosis was 14.5 years. The average age at the time of surgery was 18.5 years (range, 13 to 25 y). All patients had at least 16 months follow-up (average 60 mo; range 16 to 99 mo). Grafts ranged in size from 18 to 27.5 mm. All patients reported a return to normal function of the knees with KOOS scores approaching normal, PROMIS scores averaging 46, and CTCAE outcomes improving at an average of 34 months post-surgery. Two patients experienced a partial graft failure, which was repaired with new allografts. CONCLUSIONS: Although historical reviews indicated unsatisfactory results, our experience highlights the successful usage of FOAG for the management of patients treated for childhood leukemia who develop steroid-induced osteonecrosis of the femoral condyle. This procedure proved effective in managing pain and improving function and quality of life, with good bone ingrowth despite large necrotic lesions. LEVELS OF EVIDENCE: Therapeutic Level IV.
Assuntos
Transplante Ósseo , Fêmur , Osteonecrose , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , Feminino , Masculino , Adolescente , Estudos Retrospectivos , Criança , Osteonecrose/cirurgia , Fêmur/cirurgia , Transplante Ósseo/métodos , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/cirurgia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Aloenxertos , Qualidade de Vida , Articulação do Joelho/cirurgia , Resultado do Tratamento , Sobreviventes de Câncer , Adulto JovemRESUMO
BACKGROUND: The G2019S mutation of LRRK2, which enhances kinase activity of the protein, confers a substantial risk of developing Parkinson's disease (PD). However, the mutation demonstrates incomplete penetrance, suggesting the involvement of other genetic or environmental modulating factors. Here, we investigated whether LRRK2 G2019S knock-in (KI) mice treated with the inflammogen lipopolysaccharide (LPS) could model LRRK2 PD. RESULTS: We found that short-term (2 weeks) treatment with LPS did not result in the loss of dopaminergic neurons in either LRRK2 G2019S KI or wild-type (WT) mice. Compared with WT mice, LRRK2 G2019S-KI mice showed incomplete recovery from LPS-induced weight loss. In LRRK2 G2019S KI mice, LPS treatment led to upregulated phosphorylation of LRRK2 at the autophosphorylation site Serine 1292, which is known as a direct readout of LRRK2 kinase activity. LPS treatment caused a greater increase in the activated astrocyte marker glial fibrillary acidic protein (GFAP) in the striatum and substantia nigra of LRRK2 G2019S mice than in those of WT mice. The administration of caffeine, which was recently identified as a biomarker of resistance to developing PD in individuals with LRRK2 mutations, attenuated LPS-induced astrocyte activation specifically in LRRK2 G2019S KI mice. CONCLUSIONS: Our findings suggest that 2 weeks of exposure to LPS is not sufficient to cause dopaminergic neuronal loss in LRRK2 G2019S KI mice but rather results in increased astrocyte activation, which can be ameliorated by caffeine.
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Astrócitos , Neurônios Dopaminérgicos , Técnicas de Introdução de Genes , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina , Lipopolissacarídeos , Animais , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina/genética , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina/metabolismo , Lipopolissacarídeos/farmacologia , Neurônios Dopaminérgicos/efeitos dos fármacos , Neurônios Dopaminérgicos/metabolismo , Astrócitos/metabolismo , Astrócitos/efeitos dos fármacos , Camundongos Transgênicos , Camundongos , Camundongos Endogâmicos C57BL , Fosforilação/efeitos dos fármacos , Masculino , Proteína Glial Fibrilar Ácida/metabolismo , Modelos Animais de Doenças , Corpo Estriado/metabolismo , Corpo Estriado/efeitos dos fármacos , MutaçãoRESUMO
INTRODUCTION: Non-Hispanic Black (Black) colorectal cancer (CRC) patients have a higher risk of mortality than most other racial/ethnic groups. Limited studies examine the contribution of socioeconomic (SES), clinicopathologic, or treatment variations to mortality disparities. This retrospective cohort investigation examined the extent to which SES, clinicopathologic, and treatment factors explain racial/ethnic differences in CRC mortality. METHODS: We studied 146,515 individuals, 18+ years old, with a confirmed diagnosis of CRC within 2010-2017, identified from the Surveillance, Epidemiology, and End Results (SEER) database. We performed Cox regression analyses to examine the association of race and ethnicity, surgery type, and tumor site with all-cause mortality and CRC-specific mortality. We then performed mediation analysis to quantify the extent to which mortality differences were mediated by SES, clinicopathologic, and treatment factors. RESULTS: Black patients had a significantly higher hazard of all-cause mortality than non-Hispanic White (White) patients. The White versus Black patients' comparison demonstrated that variations in SES and clinicopathologic factors significantly explained 46.63% (indirect effect HR: 0.92, 95% CI 0.91-0.93) and 10.87% (indirect effect HR: 0.98, 95% CI 0.97-0.99) of the excess all-cause mortality among Black patients, respectively. The Hispanic versus Black comparisons identified SES as the most influential mediator, explaining 19.68% of the excess all-cause mortality. The proportions mediating for CRC-specific mortality showed comparable outcomes to all-cause mortality. CONCLUSION: Black patients had a greater risk for all-cause mortality and CRC-specific mortality attributed to SES and clinicopathologic variations compared to other racial/ethnic groups. Future studies should investigate equity in healthcare through interventions addressing SES-related disparities.