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1.
Braz. j. biol ; 83: e246803, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1339417

RESUMO

Abstract Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitant's age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.


Resumo A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados ​​por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das plantas da área para suas necessidades de saúde e outros usos como vegetal, lenha, forragem etc. O resultado atual de RFC, UV, ICF, FL e JI mostra que a flora medicinal precisa ser investigada farmacológica e fitoquimicamente para comprovar sua eficácia. A documentação do conhecimento medicinal é importante para preservar esse precioso conhecimento antigo antes que se perca para sempre, devido às mudanças tecnológicas e ambientais do mundo.


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Plantas Medicinais , Paquistão , Inquéritos e Questionários , Folhas de Planta , Etnobotânica , Fitoterapia , Medicina Tradicional
2.
Braz. j. biol ; 83: e249104, 2023. tab
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1339389

RESUMO

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.


Resumo O presente estudo foi desenhado para avaliar a força da associação da concentração elevada de homocisteína no plasma como um fator de risco para doença cardíaca coronária independente do fator de risco convencional. Foi um estudo de caso-controle realizado no Punjab Institute of Cardiology Lahore. Um total de 210 indivíduos com idade entre 25 e 60 anos, compreendendo 105 pacientes recém-admitidos de CHD como casos e 105 indivíduos saudáveis ​​pareados por idade e sexo sem histórico de CHD como controle, foi recrutado para o estudo. Amostras de sangue em jejum foram obtidas de casos e controles. A homocisteína plasmática foi analisada pelo método de imunoensaio de polarização de fluorescência (FPIA) em analisador de imunoensaio automatizado (Abbott IMX). Colesterol total, triglicerídeos e colesterol HDL foram analisados ​​usando métodos de kit calorimétrico. A concentração de colesterol LDL foi calculada pela fórmula de Friedewald. Os pacientes também foram avaliados para fatores de risco tradicionais, como idade, sexo, história familiar de DCV, hipertensão, tabagismo e atividade física, e foram comparados com indivíduos de controle. Os dados coletados foram inseridos no SPSS versão 24 para análise e interpretação. A média de idade nos grupos controles e experimentais foi de 43,00 ± 8,42 anos e 44,72 ± 8,59 anos com distribuição estatisticamente igual (p-valor = 0,144). A homocisteína plasmática média para os casos foi de 22,33 ± 9,22 µmol / L, enquanto no grupo controle foi de 12,59 ± 3,73 µmol / L. Diferença altamente significativa foi observada entre o nível plasmático médio de homocisteína em casos e controles (p ˂ 0,001). A regressão logística simples indica uma forte associação de doença cardíaca coronária com hiper-homocisteinemia (OR 7,45), que permaneceu significativamente associada com doença cardíaca coronária por multivariada regressão logística (OR 7,10, 95% C1 3,12-12,83, p = 0,000). O presente estudo conclui que níveis elevados de homocisteína plasmática são fator de risco independente para doença cardíaca coronária, independentemente dos fatores de risco convencionais, e pode ser usado como um indicador para prever a possibilidade futura de aparecimento de DCV.


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Doença das Coronárias/embriologia , Hiper-Homocisteinemia/diagnóstico , Hiper-Homocisteinemia/epidemiologia , Estudos de Casos e Controles , Fatores de Risco , Jejum
3.
Braz. j. biol ; 83: e246385, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1339384

RESUMO

Abstract Coronary heart disease (CHD) has been associated with significant morbidity and mortality worldwide. Although remain controversial, several studies have demonstrated the association of M. pneumoniae infections with atherosclerosis. We evaluated the possible association of mycoplasma infections in patients diagnosed with atherosclerosis by ELISA and PCR methods. Atherosclerotic tissue samples and blood samples were collected for the detection of mycoplasma antibodies (IgA) by ELISA from the 97 patients with coronary artery disease (CAD). M. pneumoniae specific IgA, IgG and IgM were measured by using the Anti-M. pneumoniae IgA/IgG/IgM ELISA. Detection of M. pneumoniae targeting the P1 adhesion gene was performed by PCR Acute infection of M. pneumoniae was diagnosed in 43.3% (42) of patients by PCR. The M. pneumoniae specific antibodies were detected in 36.1% (35) of patients. Twenty-five (25.8%) cases had IgG antibodies, 15 (15.5%) cases had IgM antibodies, 3 (3.1%) cases had IgA antibodies, 10 (10.3%) cases had both IgM + IgG antibodies and 1 (1%) case of each had IgM + IgA and IgG + IgA antibodies. None of the cases was positive for all three antibodies. A Pearson correlation coefficient analysis revealed an excellent correlation between the PCR and the serological results (r=0.921, p<0.001). A majority (17, 40.5%) of the M. pneumoniae positive patients are within the 41-50 years of age group, followed by 10 (23.8%) patients in the age group of 61-70 years and 2 (4.8%) patients were >70 years of age. Our study reported an unusually higher prevalence of M. pneumoniae by serological tests (36.1%) and PCR (43.3%). Although the hypothesis of the association of M. pneumoniae and CAD is yet to be proven, the unusually high prevalence of M. pneumoniae in CAD patients indicates an association, if not, in the development of atherosclerosis.


Resumo A doença coronariana (DCC) tem sido associada a significativa morbidade e mortalidade em todo o mundo. Embora ainda sejam controversos, vários estudos têm demonstrado a associação de infecções por M. pneumoniae com aterosclerose. Avaliamos a possível associação de infecções por micoplasma em pacientes com diagnóstico de aterosclerose pelos métodos ELISA e PCR. Amostras de tecido aterosclerótico e amostras de sangue foram coletadas para a detecção de anticorpos contra micoplasma (IgA) por ELISA de 97 pacientes com doença arterial coronariana (DAC). IgA, IgG e IgM específicos para M. pneumoniae foram medidos usando o Anti-M. pneumoniae IgA / IgG / IgM ELISA. A detecção de M. pneumoniae visando o gene de adesão P1 foi realizada por PCR. A infecção aguda por M. pneumoniae foi diagnosticada em 43,3% (42) dos pacientes pela PCR. Os anticorpos específicos para M. pneumoniae foram detectados em 36,1% (35) dos pacientes. Vinte e cinco (25,8%) casos tinham anticorpos IgG, 15 (15,5%) casos tinham anticorpos IgM, 3 (3,1%) casos tinham anticorpos IgA, 10 (10,3%) casos tinham anticorpos IgM + IgG e 1 (1%) caso de cada um tinha anticorpos IgM + IgA e IgG + IgA. Nenhum dos casos foi positivo para os três anticorpos. A análise do coeficiente de correlação de Pearson revelou uma excelente correlação entre o PCR e os resultados sorológicos (r = 0,921, p < 0,001). A maioria (17, 40,5%) dos pacientes positivos para M. pneumoniae está na faixa etária de 41-50 anos, seguida por 10 (23,8%) pacientes na faixa etária de 61-70 anos e 2 (4,8%) pacientes tinham > 70 anos de idade. Nosso estudo relatou uma prevalência incomumente maior de M. pneumoniae por testes sorológicos (36,1%) e PCR (43,3%). Embora a hipótese da associação de M. pneumoniae e DAC ainda não tenha sido comprovada, a prevalência incomumente alta de M. pneumoniae em pacientes com DAC indica uma associação, se não, no desenvolvimento de aterosclerose.


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Doença da Artéria Coronariana/epidemiologia , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/epidemiologia , Imunoglobulina M , Prevalência , Anticorpos Antibacterianos , Mycoplasma pneumoniae
4.
Clin Rehabil ; 37(1): 86-97, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35786028

RESUMO

OBJECTIVE: To determine the effect of foot orthoses on pain, disability and foot functionality in patients with Systemic Lupus Erythematosus. DESIGN: Randomized clinical trial. SETTING: University Podiatric Clinical Area. SUBJECTS: Patients with systemic lupus erythematosus. INTERVENTIONS: Patients were randomly assigned to either group A, which received custom-made functional foot orthoses, or group B, which received flat cushioning insoles, for three months. MAIN MEASURES: The primary outcome was foot pain, measured by 11-point numeric pain rating scale. Foot functionality and foot-related disability were evaluated using the foot function index, the Manchester foot pain and disability, at the beginning and at days 90. RESULTS: Sixty-six participants (age 47.3 ± 11.9 years) suffering from foot pain, received either the custom-made foot orthoses (N = 33) or the flat cushioning insoles (N = 33). For the analysis of the data, only participants who had finished the follow-up period (90 days) were included. None statistically significant difference between groups were found. In group A, all variables showed statistically significant differences when comparing the initial and final measurements. Pain showed 6.8 ± 1.6 and 4.2 ± 2.9 in group A, at baseline and at 90 days, respectively, group B showed 6.5 ± 1.5 and 4.7 ± 3.0 at baseline and at 90 days, respectively. CONCLUSION: Both groups showed a reduction in foot pain. This study suggests that not only controlling the foot function, but providing cushioning to the foot, may have positive effects to manage foot pain in patients with systemic lupus erythematosus.


Assuntos
Órtoses do Pé , Lúpus Eritematoso Sistêmico , Humanos , Adulto , Pessoa de Meia-Idade , Manejo da Dor , Dor , Sapatos , Lúpus Eritematoso Sistêmico/complicações , Resultado do Tratamento
5.
Med Educ Online ; 28(1): 2141602, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36333902

RESUMO

BACKGROUND & OBJECTIVES: In 2021, the USA recorded 100,000 annual deaths from drug overdose, representing the most frequent cause of death in adults under age 55. The integration of care for substance use disorders (SUDs) into undergraduate medical education is not well established. It is unclear whether a short course on management of opioid use disorder (OUD) offered to fourth year medical students could increase graduating students' knowledge and preparedness to treat these disorders. METHODS: We designed a 2-hour interactive case-based session on patient care for OUD and delivered it virtually as part of a Transition to Residency course. A retrospective pre-/post-test assessment instrument determined the impact of this session on students' perceived knowledge, confidence, and intention to seek further educational opportunities for OUD. RESULTS: Of 144 participants, 58 students (40.3%) completed the retrospective pre-/post- survey. There were statistically significant improvements in perceived knowledge and attitudes on the 12-item survey. The largest gains in perceived knowledge on a 5-point scale occurred in the categories regarding buprenorphine induction (pre 2.9; post 4.22; p < 0.001), managing inpatient opioid withdrawal (pre 2.84; post 4.27; p < 0.001), and the role of methadone in treating withdrawal (pre 3.16; post 4.29; p < 0.001). All (n = 58) survey respondents would recommend the training to a colleague and felt that the session would benefit their professional practice. Over 90% (93.1%) of respondents planned on seeking additional SUD learning opportunities during residency. CONCLUSIONS: A 2-hour interactive case-based teaching session delivered to medical students improved perceived knowledge, attitudes, and future interest in obtaining education around OUD. As the opioid epidemic shows no sign of abating, we would advocate for the inclusion SUD education as part of Transition to Residency courses.


Assuntos
Internato e Residência , Transtornos Relacionados ao Uso de Opioides , Estudantes de Medicina , Adulto , Humanos , Pessoa de Meia-Idade , Intenção , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico
6.
Arch Gerontol Geriatr ; 104: 104801, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36081231

RESUMO

BACKGROUND: Some research suggests social isolation and loneliness are important risk factors for reduced successful aging and cognitive health. However, findings are inconsistent and no prior systematic review has investigated whether social isolation and loneliness are associated with the memory domain of cognition. This review examined whether social isolation and loneliness individually and jointly affected the memory of middle- and older-aged adults. METHODS: We used PubMed, PsycInfo, and Scopus to search for comparative studies that examined the impact of both loneliness and social isolation (e.g., social activity, social networks) on memory (including all subtypes) in populations aged ≥ 45 years. Three raters performed data extraction and risk of bias assessment using the Joanna Briggs Institute checklist. Data were synthesized narratively following the Synthesis without Meta-Analysis guideline. RESULTS: In 12 included articles, higher levels of loneliness and social isolation (combining a range of different indicators) were associated with lower memory performance, where the interaction between loneliness and social isolation had the largest adverse effect on memory, followed by social isolation alone, and followed by loneliness alone. However, substantial heterogeneity was observed in the composition of the two most common indicators of social isolation (social network size, social activity participation), with the magnitude of most results being clinically non-important. Most articles had moderate risk of bias. CONCLUSION: This review found an inverse association between social isolation/loneliness and memory, and outlines future steps to systematically combine the two constructs and measure social isolation in a consistent, multi-modal format.


Assuntos
Solidão , Isolamento Social , Humanos , Adulto , Pessoa de Meia-Idade , Solidão/psicologia , Isolamento Social/psicologia , Fatores de Risco , Envelhecimento , Cognição
7.
J Infect Chemother ; 29(1): 7-14, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36089256

RESUMO

BACKGROUND: Cefmetazole is used as the first-line treatment for intra-abdominal infections. However, only a few studies have investigated the risk factors for cefmetazole treatment failure. AIMS: This study aimed to develop a decision tree-based predictive model to assess the effectiveness of cefmetazole in initial intra-abdominal infection treatment to improve the clinical treatment strategies. METHODS: This retrospective cohort study included adult patients who were unexpectedly hospitalized due to intra-abdominal infections between 2003 and 2020 and initially treated with cefmetazole. The primary outcome was clinical intra-abdominal infection improvement. The chi-square automatic interaction detector decision tree analysis was used to create a predictive model for clinical improvement after cefmetazole treatment. RESULTS: Among 2,194 patients, 1,807 (82.4%) showed clinical improvement post-treatment; their mean age was 48.7 (standard deviation: 18.8) years, and 1,213 (55.3%) patients were men. The intra-abdomせinal infections were appendicitis (n = 1,186, 54.1%), diverticulitis (n = 334, 15.2%), and pancreatitis (n = 285, 13.0%). The chi-square automatic interaction detector decision tree analysis identified the intra-abdominal infection type, C-reactive protein level, heart rate, and body temperature as predictive factors by categorizing patients into seven groups. The area under the receiver operating characteristic curve was 0.71 (95% confidence interval: 0.68-0.73). CONCLUSION: This predictive model is easily understandable visually and may be applied in clinical practice.


Assuntos
Cefmetazol , Infecções Intra-Abdominais , Adulto , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Cefmetazol/uso terapêutico , Estudos Retrospectivos , Árvores de Decisões , Infecções Intra-Abdominais/tratamento farmacológico , Curva ROC
8.
J Steroid Biochem Mol Biol ; 225: 106198, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36181990

RESUMO

To evaluate the effects of long-term vitamin D supplementation on metabolic profiles in middle-aged to elderly patients with type 2 diabetes (T2D), a randomized controlled trial was conducted among patients with T2D aged 50-70 years. A total of 270 patients underwent randomization with 135 being allocated to the vitamin D group and 135 to the control group, and participants in the vitamin D group received oral vitamin D3 (800 IU/day) for 30 months. Serum 25(OH)D and metabolic variables were measured at baseline, and after 6, 12, 18, and 30 months of intervention. After 30 months, the vitamin D group showed a greater increase in serum 25(OH)D than the control group (12.39 ± 6.99 vs 5.35 ± 5.29 ng/ml, P < 0.001). Meanwhile, changes in the levels of fasting insulin, HOMA-IR, non-high-density-lipoprotein cholesterol (non-HDL-C), high-sensitivity C-reactive protein (hs-CRP), and uric acid differed significantly between the two groups (all P < 0.05). Stratified analysis indicated that change in uric acid differed significantly between the two groups in subgroup with baseline 25(OH)D ≥ 20 ng/ml (P = 0.042) or subgroup with female patients (P = 0.034). And the change in fasting blood glucose (FBG) differed significantly between the vitamin D group (-0.30 ± 2.52 mmol/L) and the control group (0.49 ± 1.78 mmol/L, P = 0.049) among patients achieving 25(OH)D concentrations of 30 ng/ml at the end of this trial. A significant difference in the change of triglyceride was observed between the two groups among patients with obesity at baseline [0.05(-0.59, 0.23) vs 0.41(-0.01, 0.80) mmol/L, P = 0.023]. These findings suggested that long-term vitamin D supplementation significantly reduced fasting insulin, HOMA-IR, and serum concentrations of non-HDL-C, hs-CRP, and uric acid among middle-aged to elderly patients with T2D. And vitamin D status, gender, and baseline obesity may modify the effects of vitamin D supplementation.


Assuntos
Diabetes Mellitus Tipo 2 , Resistência à Insulina , Pessoa de Meia-Idade , Idoso , Humanos , Feminino , Vitamina D/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/metabolismo , Proteína C-Reativa/metabolismo , Ácido Úrico , Glicemia/metabolismo , Suplementos Nutricionais , Vitaminas/uso terapêutico , Insulina/metabolismo , Obesidade , Metaboloma , Método Duplo-Cego
9.
Arch Gerontol Geriatr ; 104: 104827, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36191493

RESUMO

BACKGROUND/OBJECTIVE: Diabetes mellitus (DM) is associated with walking performance, but potential underlying mechanisms of this association remain unclear. The present study aims to disentangle the pathways linking DM to gait and falls through the serial mediation effect of vision and cognition among the older population. METHODS: Data were taken from wave 9 (2018-2019) of the English Longitudinal Study of Aging (ELSA), including 5496 participants aged 60 years and older. DM was identified based on medical diagnosis and laboratory tests. Vision and falls were self-reported. Cognition was evaluated using questionnaire. Gait speed was measured by the "timed walking test". Serial mediation analysis was performed using Mplus 8.3. RESULTS: DM was associated with impaired gait speed (c = 0.085, P < 0.05) and falls (c = 0.061, P < 0.05). The serial mediation model revealed that vision and cognition significantly mediated the association of DM with impaired gait speed, with 17.97% and 23.60% of the total effects explained by vision and cognition respectively, and 3.37% explained by the path through vision and then cognition. Similarly, vision and cognition significantly mediated the association of DM with falls, with 14.99% and 6.67% of the total effects explained by vision and cognition respectively, and 1.67% explained by the path through vision and then cognition. CONCLUSIONS: These findings contribute to deeper understanding of the mechanism underlying the association of DM with walking performance. Evaluation and intervention targeted at vision and the cognition may be beneficial for improving gait or reducing falls in older adults with DM.


Assuntos
Acidentes por Quedas , Diabetes Mellitus , Humanos , Pessoa de Meia-Idade , Idoso , Vida Independente , Estudos Longitudinais , Marcha , Cognição , Velocidade de Caminhada , Diabetes Mellitus/epidemiologia
10.
Addict Behav ; 136: 107493, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36137447

RESUMO

OBJECTIVE: We examined the direct and indirect effects of older siblings' substance use behaviors (i.e., cannabis and e-cigarettes) on younger siblings' later substance use intentions via their substance use expectations. MATERIAL AND METHODS: Data were collected from 682 families (N = 2,046) with two adolescent siblings (older siblings: M age = 15.67 years, 51% female; younger siblings: M age = 13.14 years, 48% female) and one parent (M age = 45.15 years; 85% female). Participants completed annual online surveys at two occasions. Older siblings reported on their cannabis and e-cigarette use frequencies (Time 1) and younger siblings reported on their substance use expectations (Time 1) and intentions (Time 1 and 2); parents reported on adolescents' sociodemographic characteristics and their own substance use (Time 2). RESULTS: Structural equation modeling results suggested that older siblings' cannabis and e-cigarette use was indirectly related to younger siblings' later intentions to use these substances through their positive expectations about substances, after accounting for younger siblings' earlier intentions to use substances and control variables including parents' and friends' use. There were no significant direct relations between older siblings' cannabis or e-cigarette use and younger siblings' intentions to use them. CONCLUSIONS: Findings indicate that older siblings are critical and unique socialization agents of younger siblings' expectations and intentions to use substances. Intervention and prevention programs that target adolescents' substance use should consider the ways in which siblings shape each other's substance use.


Assuntos
Comportamento do Adolescente , Cannabis , Sistemas Eletrônicos de Liberação de Nicotina , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Feminino , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Motivação , Relações entre Irmãos , Irmãos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
11.
Addict Behav ; 136: 107469, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36055058

RESUMO

INTRODUCTION: According to the recent adaptation of the I-PACE model, desire thinking and craving might be closely related to problematic Internet pornography use. The overall aim of the present study was to investigate the role of two components of desire thinking (imaginal prefiguration and verbal perseveration) and craving in problematic Internet pornography use. Furthermore, we examined gender differences in the underlying mechanism linking desire thinking to problematic Internet pornography use. METHOD: A total of 414 Italian adults (mean age = 27.55 years, SD = 6.13; age range = 18-58; 53.6 % men) participated in this study. Participants completed an online survey to assess problematic Internet pornography use, pornography craving, desire thinking and problematic Internet use. Path analyses and a multi-group approach were used to test the relationships among variables and to explore gender differences. RESULTS: Imaginal prefiguration was associated to pornography craving which, in turn, was associated to verbal perseveration as proximal antecedent of problematic Internet pornography use, above and beyond the effect of age, relationship status, and problematic Internet use. Two paths significantly differed between men and women: the path between verbal perseveration and problematic Internet pornography, which for women was weaker and did not reach significance; and the path between problematic Internet use and problematic Internet pornography use that was not significant for women. CONCLUSIONS: In line with the I-PACE model, the present study provided support for the potential role of desire thinking in problematic Internet pornography use as a specific Internet-use disorder and expanded the literature in the field by testing unexplored gender differences. Preventive and clinical implications are discussed.


Assuntos
Fissura , Literatura Erótica , Adolescente , Adulto , Feminino , Humanos , Internet , Uso da Internet , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Pensamento , Adulto Jovem
12.
J Biomech Eng ; 145(2)2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36082471

RESUMO

In vivo characteristics of palmar soft tissue can be used to improve the accuracy of human models to explore and simulate a range of contact scenarios. Tissue characteristics can help to assess injury prevention strategies and designing technologies that depend on quantified physical contacts such as prosthetics, wearables, and assistive devices. In this study, a simplified quasi-linear viscoelastic (QLV) model was developed to quantify large deformation, in vivo soft tissue relaxation characteristics of the palm. We conducted relaxation tests on 11 young adults (6 males, 5 females, 18 < age < 30, mean age: 25 ± 4 yr) and 9 older adults (6 males, 3 females, age > 50, mean age: 61.5 ± 11.5 yr) using a 3 mm indenter to a depth of 50% of each participant's soft tissue thickness. The relaxation parameters of the QLV model were found to differ with age and sex, emphasizing the importance of using targeted material models to represent palmar soft tissue mechanics. Older adults showed on average 2.3-fold longer relaxation time constant compared to younger adults. It took 1.2-fold longer for young males to reach equilibrium than for young females; however, young females had a higher level of relaxation (36%) than young males (33%). Differences in specific QLV model parameters, P1, P2, and α were also found between age and sex groups. QLV characteristics differentiated by age and sex, add biofidelity to computational models which can provide a better representation of the diversity of tissue properties in the population.


Assuntos
Modelos Biológicos , Adulto , Idoso , Elasticidade , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Estresse Mecânico , Viscosidade , Adulto Jovem
13.
Addict Behav ; 136: 107475, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36081247

RESUMO

BACKGROUND: Although the data on racial/ethnic associations with gambling disorder are limited, studies suggest that ethnicity may have associations with both symptom severity and psychosocial impairment linked to gambling disorder. Based on the current literature, we hypothesized that there would be a difference in gambling symptom severity, and co-occurring disorders, as a function of racial-ethnic group. METHODS: 475 adults (mean age = 47.6 (±11.6) years; 54.3 % females) with gambling disorder who had participated in clinical trials on pharmacotherapy or psychotherapy were included. Participants were assessed for gambling severity, comorbidities, health issues, quality of life and psychosocial functioning. Participants who self-identified as Black, Asian or Minority Ethnic (BAME) were compared to those who self-identified as white Caucasian (non-BAME). Significance was defined as p < 0.01. RESULTS: The BAME group had significantly earlier age of first gambling. The two groups did not differ significantly in terms of age when gambling first became problematic, disability, current gambling disorder symptom severity, previous suicide attempt(s), quality of life, percent of salary in past year lost to gambling, or likelihood of having received treatment for gambling disorder in the past, nor in terms of having used Gamblers Anonymous. CONCLUSIONS: These data show that having gambling disorder and being from a minority racial-ethnic group was associated with significantly earlier age at first gambling, in clinical trial settings. Future work should further examine differences in the clinical features of gambling disorder in different minority groups in larger sample sizes, ideally also longitudinally, across a range of settings. Identification of the reasons/mechanisms for differences in earlier age of first gambling may lead to new public health and treatment targets to minimize gambling harms.


Assuntos
Jogo de Azar , Adulto , Ensaios Clínicos como Assunto , Etnicidade , Feminino , Jogo de Azar/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Qualidade de Vida , Brancos
14.
Ann Otol Rhinol Laryngol ; 132(1): 41-49, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35114808

RESUMO

OBJECTIVES: To explore the usefulness of vestibular tests including "vestibular evoked myogenic potentials" (VEMPs) and the video head impulse test (vHIT) in the early diagnosis of "idiopathic Parkinson's disease" (PD). MATERIALS AND METHODS: The study involved 80 participants including 40 patients (24 males, 16 females; age average 63.20 ± 7.94 years) with PD and 40 healthy individuals (18 males and 22 females; age average of 60.36 ± 7.68 years). The Modified Hoehn and Yahr (H&Y) scale was used to measure how Parkinson's symptoms progress and the level of disability. Patients with PD underwent cVEMPs, oVEMPs, and vHIT and the results were compared with those of 40 age-matched healthy control (HC) subjects. vHIT results and VEMP responses were registered in all patients and HCs. RESULTS: One-sided absent cVEMP responses were found in 6 (15%) patients with PD and 8 (20%) patients had bilaterally absent responses. Five (12.5%) patients had 1-sided absent oVEMP responses and it was bilateral in 6 (15%). Patients with PD had significantly shorter cVEMP P1, N1 latency, lower cVEMP amplitudes, and oVEMP amplitudes than the HC group. The cVEMP and oVEMP amplitude asymmetry ratio was significantly higher in the PD group (P < .05). Evaluation of vHIT results and vestibular-ocular reflex (VOR) gain between the groups revealed that anterior canal and posterior canal VOR gains results were remarkably lower in the PD group than in the HCs (P < .05). There was no difference in right and left lateral canal VOR gains between the groups (P > .05). CONCLUSION: The results of this study suggest that cVEMP and vHIT can be used to evaluate the vestibular system in patients with early-stage Parkinson's disease.


Assuntos
Doença de Parkinson , Potenciais Evocados Miogênicos Vestibulares , Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Teste do Impulso da Cabeça/métodos , Doença de Parkinson/diagnóstico , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia
15.
Ann Otol Rhinol Laryngol ; 132(1): 100-104, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35130751

RESUMO

OBJECTIVE: Carotid sinus syndrome (CSS) is a rare yet serious presentation of head and neck malignancy. To our knowledge, syncope and seizure-like episodes as a manifestation of carotid sinus syndrome secondary to laryngeal cancer has not been reported to date. We report a case of laryngeal cancer causing convulsive syncope masquerading as seizures due to CSS. METHODS: Case report. The patient's medical record was reviewed for demographic and clinical information. RESULTS: A 62-year-old male presented with multiple episodes of syncope and hoarseness of voice. On nasoendoscopic examination, left vocal cord palsy and left aryepiglottic fold tumor were visualized. Computerized tomography (CT) neck showed a large 2.4 × 3.6 cm left supraglottic tumor with local invasion and extensive cervical lymphadenopathy compressing the carotid sinus. CT guided biopsy of the tumor revealed invasive squamous cell carcinoma. While undergoing evaluation, the patient developed seizure-like episodes. Inpatient telemetry monitoring revealed significant bradycardia and hypotension during these episodes. A permanent pacemaker was inserted which resulted in resolution of the syncopal and seizure-like episodes. CONCLUSION: In patients with unexplained syncope or seizure-like episodes and a background of head and neck cancer, clinicians should consider the diagnosis of CSS. CSS is a poor prognostic factor due to the associated higher stage of disease.


Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias Laríngeas , Masculino , Humanos , Pessoa de Meia-Idade , Neoplasias Laríngeas/complicações , Neoplasias Laríngeas/diagnóstico , Seio Carotídeo , Síncope/diagnóstico , Síncope/etiologia , Neoplasias de Cabeça e Pescoço/complicações , Convulsões/etiologia , Convulsões/complicações
16.
Ann Otol Rhinol Laryngol ; 132(1): 110-114, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35156399

RESUMO

OBJECTIVE: To report a novel case of tracheal reconstruction using a serratus anterior-rib composite flap. METHODS: Case report and literature review. RESULTS: A 46-year-old male with a 4 cm anterior tracheal wall defect underwent reconstruction with a serratus anterior-rib composite flap. The patient experienced excellent results regarding phonation, swallowing, and cosmesis. CONCLUSION: The serratus anterior-rib composite flap appears to be a suitable candidate for tracheal reconstruction and merits further analysis in this context. The flap's intrinsic incorporation of a perfused rib segment allows for reliable reconstruction of the neotrachea and maintenance of proximal dynamic airway support.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Retalhos Cirúrgicos , Masculino , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos/métodos , Traqueia/cirurgia , Tórax , Costelas
17.
J Palliat Care ; 38(1): 62-70, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35171062

RESUMO

OBJECTIVES: To identify classes of heart failure (HF) caregivers based upon indicators of coping resources and stress, and then, to examine the relationships between the identified caregiver classes and depression, caregiver burden, and life changes. METHODS: Cross-sectional data from 530 HF caregivers were analyzed in this secondary analysis using a three-step latent class mixture model to classify caregivers based on level of resources and examine the relationship between the identified classes and depression, caregiver burden, and life changes. Using an online survey, caregivers reported on social support, problem-solving, family function, depression, caregiver burden, and life changes. RESULTS: Caregivers were 41.39 (± 10.38) years of age, 49.1% women, 78.3% white, 77.6% urban-dwelling, and 61.7% college/postgraduate educated. Three classes of caregivers (42.3% Adequately Resourced, 25.1% At Risk for Decompensation, 32.6% Inadequately Resourced) were identified. Inadequately Resourced caregivers had the lowest levels of social support, problem-solving, and family function and the highest levels of depression and caregiver burden. Caregivers At Risk for Decompensation had the best family function and reported the most positive perceptions of life changes despite low levels of social support and problem-solving. CONCLUSION: Social support, problem-solving, and family function are modifiable coping resources which may buffer stress and influence stress indicators. Caregivers with few coping resources may experience higher degrees of depression and burden, and less positive perceptions of life changes. More research is needed to examine the influence of these coping resources on caregiver adaptation to facilitate the development of targeted interventions which support caregiver mental health.


Assuntos
Cuidadores , Insuficiência Cardíaca , Feminino , Humanos , Pessoa de Meia-Idade , Masculino , Cuidadores/psicologia , Adaptação Psicológica , Análise de Classes Latentes , Estudos Transversais
18.
Meat Sci ; 195: 109004, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36272313

RESUMO

Demographics, anthropometrics, oral responsiveness to sensory stimuli and psycho-attitudinal traits were collected from a representative Italian population sample (n = 2384; 58% women, age 18-60 years) and considered as possible explanatory variables affecting meat liking. Differences in motives underlying individual variation in liking for meat were independently investigated by gender. Three groups of subjects were identified based on liking ratings: Slightly Likers, Likers and Lovers. Both common and gender-specific variables affecting liking for meat were identified. The interest in food (including its rewarding function) and eating experience, low food neophobia and relatively high Body Mass Index characterized meat Lovers irrespective to gender. The careful food selection and the food comforting function further characterized women meat Lovers. Men Slightly Likers were characterized by the interest for health-related food aspects, importance assigned to naturalness and restrained eating. Markers of oral responsiveness were ineffective for describing variation in liking for meat.


Assuntos
Produtos da Carne , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Preferências Alimentares , Personalidade , Índice de Massa Corporal , Demografia
19.
J Hazard Mater ; 443(Pt A): 130147, 2023 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-36283217

RESUMO

Hypertension is the most common chronic non-infectious disease and a severe problem for public health in China. There were 244.5 million people aged over 18 years in China who had hypertension in 2015, and hypertension-related death accounted for more than 25 % of all causes of death in China every year. To monitor the hypertension prevalence in near real-time, a wastewater-based epidemiology (WBE) approach by using metoprolol acid as a biomarker was conducted in 164 cities in China. LC-MS/MS was utilized to quantify metoprolol acid in sewage, and satisfactory method validation results were achieved. The average concentration of metoprolol acid in sewage was 943.1 ± 671.1 ng/L, and the back-calculated consumption of metoprolol based on metoprolol acid was 932.0 ± 390.5 mg/day/1000inh on average, ranging from 76.7 to 3275.7 mg/day/1000inh. The prevalence of metoprolol was estimated to be 0.83 % ± 0.35 %, and the estimated hypertension prevalence in the population aged over 15 years was ultimately assessed to be 28.56 % ± 10.44 % ranging from 14.28 % to 44.28 % and was consistent with the China Hypertension Survey result of 27.9 %. This research demonstrated that estimating hypertension prevalence by WBE with metoprolol acid as a biomarker is feasible in Chinese cities.


Assuntos
Hipertensão , Vigilância Epidemiológica Baseada em Águas Residuárias , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Cidades/epidemiologia , Cromatografia Líquida , Esgotos , Prevalência , Metoprolol , Águas Residuárias/análise , Espectrometria de Massas em Tandem , China/epidemiologia , Hipertensão/epidemiologia , Biomarcadores
20.
Genes Chromosomes Cancer ; 62(1): 47-51, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35906852

RESUMO

Neurotropic tropomyosin receptor kinase (NTRK) gene rearrangements have been reported in limited cases of sarcomas; however, to date, there has been only one report of such rearrangements in malignant peripheral nerve sheath tumors (MPNSTs). Herein, we describe a 51-year-old male patient with a buttock tumor arising from the sciatic nerve, which was diagnosed as MPNST with positive S-100 staining, negative SOX10 staining, and loss of trimethylation at lysine 27 of histone H3 (H3K27me3) confirmed by immunohistochemistry. Soon after the resection of the primary tumor, the patient was found to have pulmonary and lymph node metastases. Chemotherapy with eribulin and trabectedin showed limited effects. However, the patient responded rapidly to pazopanib, but severe side effects caused discontinuation of the treatment. RNA panel testing revealed a novel fusion gene between Small Nuclear Ribonucleoprotein U1 Subunit 70 (SNRNP70) gene and NTRK3 gene. Furthermore, loss of NF1, SUZ12, and CDKN2A genes was confirmed by DNA panel testing, which is compatible with a histological diagnosis of MPNST. SNRNP70 possesses a coiled-coiled domain and seems to induce constitutive activation of NTRK3 through dimerization. In fact, immunohistochemistry revealed diffuse staining of pan-TRK within tumor cells. Treatment with entrectinib, which is an NTRK inhibitor, showed a quick and durable response for 10 months. Although NTRK rearrangements are very rare in MPNST, this case highlights the importance of genetic testing in MPNST, especially using an RNA panel for the detection of rare fusion genes.


Assuntos
Neurofibrossarcoma , Masculino , Humanos , Pessoa de Meia-Idade , Neurofibrossarcoma/tratamento farmacológico , Neurofibrossarcoma/genética , Biomarcadores Tumorais/genética , Imuno-Histoquímica , RNA , Ribonucleoproteína Nuclear Pequena U1
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