RESUMO
The aim of the present study was to analyze the effect of neuromuscular electrical stimulation (NMES) and photobiomodulation (PBMT) on the cardiovascular parameters, hemodynamic function, arterial baroreflex sensitivity (BRS), and autonomic balance (ANS) of rats with heart failure (HF). Male Wistar rats (220-290 g) were organized into five groups: Sham (n = 6), Control-HF (n = 5), NMES-HF (n = 6), PBMT-HF (n = 6), and NMES + PBMT-HF (n = 6). Myocardial infarction (MI) was induced by left coronary artery ligation. Animals were subjected to an eight-week NMES and PBMT protocol. Statistical analysis included the General Linear Model (GLM) followed by a Bonferroni post-hoc test. Rats of the NMES-HF group showed a higher MI area than the Control-HF (P = 0.003), PBMT-HF (P = 0.002), and NMES + PBMT-HF (P = 0.012) groups. NMES-HF and NMES + PBMT-HF showed higher pulmonary congestion (P = 0.004 and P = 0.02) and lower systolic pressure (P = 0.019 and P = 0.002) than the Sham group. NMES + PBMT-HF showed lower mean arterial pressure (P = 0.02) than the Sham group. Control-HF showed a higher heart rate than the NMES-HF and NMES + PBMT-HF (P = 0.017 and P = 0.013) groups. There was no difference in the BRS and ANS variables between groups. In conclusion, eight-week NMES isolated or associated with PBMT protocol reduced basal heart rate, systolic and mean arterial pressure, without influence on baroreflex sensibility and autonomic control, and no effect of PBMT was seen in rats with HF.
Assuntos
Insuficiência Cardíaca , Animais , Barorreflexo , Frequência Cardíaca , Hemodinâmica , Masculino , Ratos , Ratos WistarRESUMO
The Glittre ADL-test (TGlittre) is a multiple-task test designed to assess functional limitation in patients with chronic obstructive pulmonary disease (COPD). Although few studies have investigated the TGlittre learning effect, the results are still conflicting. This study aimed to investigate the test-retest reliability and learning effect on TGlittre and to identify predicting factors of the learning effect in patients with COPD. Patients performed the TGlittre twice with a 30-minutes resting period between trials. TGlittre consists in measuring the time to complete five laps of a multiple ADL-like activities circuit: walking stairs, carrying a backpack, lifting objects, bending down and rising from a seated position. 124 patients with COPD were assessed [81 men; 66 ± 8 years, forced expiratory volume in one second (FEV1) 37.1 ± 15.0%pred; TGlittre 120 ± 60%pred; six-minute walking test 75.5 ± 17.4%pred]. The time spent in TGlittre presented excellent reliability (ICC = 0.96; 95%CI 0.92 - 0.98; p < 0.001; SEM 0.46 min; MDC 1.28 min) and decreased in the retest (5.24 ± 2.31 min to 4.85 ± 2.02 min; p < 0.001). Patients presented a learning effect of 6.11 ± 11.1% in TGlittre. A lower FEV1 (r2=0.10; p < 0.001) and a worse performance in the first TGlittre (r2=0.28; p < 0.001) are related to the improvement in performance of the second TGlittre. Although the TGlittre is reliable, patients improve their performance when performing the second test probably because they underestimate their functional capacity. These results should encourage professionals to assess TGlittre twice when using this test as an outcome measure.
Assuntos
Atividades Cotidianas , Doença Pulmonar Obstrutiva Crônica , Teste de Esforço , Humanos , Masculino , Reprodutibilidade dos Testes , Teste de CaminhadaRESUMO
This study aimed to identify baseline variables predicting improvement in ADLs following an exercise training program in subjects with COPD. Sixty-seven patients with COPD underwent assessment of spirometry, modified Medical Research Council scale, COPD Assesment Test (CAT), Six Minute Walk Test (6MWT), London Chest Activity of Daily Living (LCADL) scale and Glittre-ADL test (TGlittre). After 24 sessions, they were reassessed for limitation in ADLs (LCADL and TGlittre). The main outcome was the achieving of minimal important difference (MID) of TGlittre, LCADL and both (ADLs). The cut-off points to discriminate the subjects who achieved the MID of TGlittre, LCADL and ADLs were established using the ROC curve. A cut-off point of 3.7 min in baseline TGlittre was able to discriminate subjects who achieved the MID of TGlittre (AUC = 0.77). Subjects with baseline TGlittre ≥3.7 min were 6.92 (95%CI 2.2-20.9) times more likely to achieve the MID of TGlittre post-exercise training. A cut-off point of 32% in LCADL was able to discriminate subjects who achieved the MID of LCADL (AUC = 0.81) and in ADLs (AUC = 0.78). Subjects with baseline LCADL ≥32% were 12.3 (95% CI 2.50 - 60.7) times more likely to achieve the MID of LCADL. In conclusion, the baseline variables that best predict the improvement of individuals after exercise training are TGlittre and LCADL, showing that subjects with significant functional impairment are more likely to clinically significantly improve their ADLs.
Assuntos
Doença Pulmonar Obstrutiva Crônica , Atividades Cotidianas , Exercício Físico , Teste de Esforço , Humanos , Doença Pulmonar Obstrutiva Crônica/terapia , Espirometria , Teste de CaminhadaRESUMO
To evaluate in vitro transenamel/transdentinal of penetration of H2O2 after microabrasive. Computational models were performed to verify peroxide penetration and evaluate if geometric modifications could affect in vitro results. Enamel/dentin blocks from bovine incisors were prepared and randomly divided into groups (n = 15) according with abrasive (35% phosphoric acid and pumice or 6.6% hydrochloric acid and silica) and bleaching agents (16% carbamide peroxide and 35% H2O2). From artificial pulp chambers, the H2O2 concentration was measured and SEM was used for surface morphology. Numerical models were performed (Abaqus® v6.12) modifying slightly enamel/dentin thickness based on experimental data. All groups presented H2O2 penetration, although no significant difference was noted between the control and experimental groups (p > 0.05). The numerical analysis demonstrated the role of dental tissue thickness in the H2O2 penetration. Microabrasion is recommended as its association with bleaching procedures and small modifications in thicknesses of enamel/dentin can cause substantial changes in HP penetration. Such diffusion aspect is clinically relevant for the bleaching procedures since very thin enamel could present more peroxide propagation through dental tissues.
Assuntos
Microabrasão do Esmalte , Peróxido de Hidrogênio , Animais , Peróxido de Carbamida , Bovinos , Esmalte Dentário , DentinaRESUMO
BACKGROUND: The chemical compounds in coffee are important indicators of quality. Its composition varies according to several factors related to the planting and processing of coffee. Thus, this study proposed to use near-infrared spectroscopy (NIR) associated with partial least squares (PLS) regression to estimate quickly some chemical properties (moisture content, soluble solids, and total and reducing sugars) in intact green coffee samples. For this, 250 samples produced in Brazil were analyzed in the laboratory by the standard method and also had their spectra recorded. RESULTS: The calibration models were developed using PLS regression with cross-validation and tested in a validation set. The models were elaborated using original spectra and preprocessed by five different mathematical methods. These models were compared in relation to the coefficient of determination, root mean square error of cross-validation (RMSECV), root mean square error of test set validation (RMSEP), and ratio of performance to deviation (RPD) and demonstrated different predictive capabilities for the chemical properties of coffee. The best model was obtained to predict grain moisture and the worst performance was observed for the soluble solids model. The highest determination coefficients obtained for the samples in the validation set were equal to 0.810, 0.516, 0.694 and 0.781 for moisture, soluble solids, total sugar, and reducing sugars, respectively. CONCLUSION: The statistics associated with these models indicate that NIR technology has the potential to be applied routinely to predict the chemical properties of green coffee, and in particular, for moisture analysis. However, the soluble solid and total sugar content did not show high correlations with the spectroscopic data and need to be improved. © 2020 Society of Chemical Industry.
Assuntos
Coffea/química , Café/química , Sementes/química , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Brasil , Controle de QualidadeRESUMO
BACKGROUND: Coffee is a raw material of global interest. Due to its relevance, this work evaluated the performance of calibration models constructed from spectral data obtained using near-infrared spectroscopy (FT-NIR) to determine the pH values and acidity in coffee beans in a practical and non-destructive way. Partial least squares regression was used during the calibration and the cross-validation to optimize the number of latent variables. The predictive capacity of the spectral pre-processing methods was also accessed. RESULTS: The results obtained showed that the best methods of pre-processing were the first derivative for the pH variable and the standard normal variate for the acidity, which produced models with correlations of 0.78 and 0.92, ratios of prediction to deviation of 2.061 and 2.966 and biases of -0.00011 and -0.152 to test set validation, respectively. The average errors between predicted and experimental values were lower than 7%. CONCLUSIONS: FT-NIR was successfully applied to predict properties related to the quality of coffee. The method was demonstrated to be a fast and non-destructive tool which allows the rapid inline evaluation of samples facilitating industrial and commercial processing. © 2020 Society of Chemical Industry.
Assuntos
Coffea/química , Concentração de Íons de Hidrogênio , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Calibragem , Análise dos Mínimos Quadrados , Sementes/químicaRESUMO
The objective of this study was to evaluate the effect of the simplified ethanol wet-bonding technique on luting of posts to intraradicular dentin. The effect was assessed by push-out bond strength testing and confocal laser scanning microscopic analysis. Thirty endodontically treated roots were distributed into 3 groups (n = 10): water wet-bonding; stepwise ethanol wet-bonding; and simplified ethanol wet-bonding. After cementation of the posts, the roots were sectioned. Specimens were stored for 24 hours or 1 year before they were stressed to failure. Specimens from each group were processed for microscopic analysis. Data were analyzed using a 2-way analysis of variance and the Tukey test (α = 0.05). Statistically significant differences in push-out bond strength values were observed between the technique groups (P < 0.001) and between the storage periods (P = 0.009). The bond strength results in the group bonded using the simplified ethanol wet-dehydration approach did not differ from those in the group bonded using the stepwise ethanol technique at either storage time interval (P > 0.05). From 24 hours to 1 year, there was a similar decrease in bond strength for specimens prepared with the simplified and stepwise techniques. The microscopic results confirmed that ethanol wet-bonding technique improved the quality of the interface. The simplified ethanol wet-dehydration protocol achieved bond strengths and stability over time that were similar to those obtained with the stepwise ethanol technique and may be considered an alternative strategy to accomplish resin cement-root dentin bonding.
Assuntos
Colagem Dentária , Cavidade Pulpar , Adesivos Dentinários , Técnica para Retentor Intrarradicular , Dentina , Etanol , Teste de Materiais , Cimentos de ResinaRESUMO
The mosquito Aedes aegypti is the main vector of several arthropod-borne diseases that have global impacts. In a previous meta-analysis, our group identified a vector gene set containing 110 genes strongly associated with infections of dengue, West Nile and yellow fever viruses. Of these 110 genes, four genes allowed a highly accurate classification of infected status. More recently, a new study of Ae. aegypti infected with Zika virus (ZIKV) was published, providing new data to investigate whether this "infection" gene set is also altered during a ZIKV infection. Our hypothesis is that the infection-associated signature may also serve as a proxy to classify the ZIKV infection in the vector. Raw data associated with the NCBI/BioProject were downloaded and re-analysed. A total of 18 paired-end replicates corresponding to three ZIKV-infected samples and three controls were included in this study. The nMDS technique with a logistic regression was used to obtain the probabilities of belonging to a given class. Thus, to compare both gene sets, we used the area under the curve and performed a comparison using the bootstrap method. Our meta-signature was able to separate the infected mosquitoes from the controls with good predictive power to classify the Zika-infected mosquitoes.
Assuntos
Aedes/virologia , Mosquitos Vetores/virologia , Transcriptoma , Zika virus/genética , Animais , Zika virus/isolamento & purificação , Infecção por Zika virus/transmissãoRESUMO
BACKGROUND AND AIMS: Being goalkeepers of liver homeostasis, gap junctions are also involved in hepatotoxicity. However, their role in this process is ambiguous, as gap junctions can act as both targets and effectors of liver toxicity. This particularly holds true for drug-induced liver insults. In the present study, the involvement of connexin26, connexin32 and connexin43, the building blocks of liver gap junctions, was investigated in acetaminophen-induced hepatotoxicity. METHODS: C57BL/6 mice were overdosed with 300mg/kg body weight acetaminophen followed by analysis of the expression and localization of connexins as well as monitoring of hepatic gap junction functionality. Furthermore, acetaminophen-induced liver injury was compared between mice genetically deficient in connexin43 and wild type littermates. Evaluation of the toxicological response was based on a set of clinically relevant parameters, including protein adduct formation, measurement of alanine aminotransferase activity, cytokines and glutathione. RESULTS: It was found that gap junction communication deteriorates upon acetaminophen intoxication in wild type mice, which is associated with a switch in mRNA and protein production from connexin32 and connexin26 to connexin43. The upregulation of connexin43 expression is due, at least in part, to de novo production by hepatocytes. Connexin43-deficient animals tended to show increased liver cell death, inflammation and oxidative stress in comparison with wild type counterparts. CONCLUSION: These results suggest that hepatic connexin43-based signaling may protect against acetaminophen-induced liver toxicity.
Assuntos
Acetaminofen/efeitos adversos , Analgésicos não Narcóticos/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/genética , Conexina 43/genética , Fígado/efeitos dos fármacos , Regulação para Cima/efeitos dos fármacos , Animais , Células Cultivadas , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/patologia , Conexina 43/análise , Conexina 43/metabolismo , Hepatócitos/efeitos dos fármacos , Hepatócitos/metabolismo , Hepatócitos/patologia , Fígado/metabolismo , Fígado/patologia , Masculino , Camundongos Endogâmicos C57BL , RNA Mensageiro/análise , RNA Mensageiro/genéticaRESUMO
Dairy goats were fed a total mixed ration with or without the inclusion of castor oil [40 g/kg of dry matter (DM)] to study the metabolism of ricinoleic acid (12-OH,cis-9-18:1). Ten goats, at 39.7 ± 4.0 d in milk, were individually penned and allocated at random to the 2 experimental diets. Goats were manually milked twice a day. Milk fatty acids (FA) were analyzed as methyl esters and hydroxyl groups were derivatized in trimethylsilyl ethers. Apart from ricinoleic acid, 6 FA were only detected in the milk of the castor oil group. Ricinoleic acid composed 0.3% of total FA in milk of the castor oil group, whereas the hydroxy-FA (8-OH-14:0, 10-OH-16:0, and 12-OH-18:0) and oxo-FA (8-oxo-14:0, 10-oxo-16:0, and 12-oxo-18:0) reached 7.5% of total FA in milk. We anticipate that these FA were derived from the metabolism of ricinoleic acid, although it was not clear if they were produced in the rumen or in the tissues. To confirm that, we conducted in vitro batch incubations repeated for 3 consecutive weeks with castor oil (40 g/kg of DM) and strained rumen fluid from 2 fistulated sheep. To examine the products formed over time, incubation tubes were stopped at 0, 6, 12, 24, 48, and 72 h. The results of the in vitro experiment showed that ricinoleic acid was metabolized in the rumen at a slow rate and the main products formed were 12-OH-18:0 and 12-oxo-18:0, by hydrogenation of the cis-9 double bond, followed by oxidation of the hydroxyl group, respectively. Our results suggest that the 12-OH-18:0 and 12-oxo-18:0 escape rumen and are further metabolized through partial ß-oxidation in ruminant tissues. We propose that the 10-OH-16:0 and 8-OH-14:0 found in goat milk of the castor oil group are successive products of the ß-oxidation of 12-OH-18:0, and the 10-oxo-16:0 and 8-oxo-14:0 are successive products of the 12-oxo-18:0 in tissues. Overall, our results indicate that ricinoleic acid is extensively metabolized in the rumen and tissues, producing mainly oxo- and hydroxy-FA that are further excreted in milk.
Assuntos
Ácidos Graxos/metabolismo , Leite/química , Ácidos Ricinoleicos/metabolismo , Animais , Óleo de Rícino/administração & dosagem , Dieta , Ácidos Graxos/análise , Feminino , Cabras , Lactação , Leite/metabolismo , Distribuição Aleatória , Ácidos Ricinoleicos/análise , RúmenRESUMO
The Atlantic Forest biome is recognized for its biodiversity and is one of the most threatened biomes on the planet, with forest fragmentation increasing due to uncontrolled land use, land occupation, and population growth. The most serious aspect of the forest fragmentation process is the edge effect and the loss of biodiversity. In this context, the aim of this study was to evaluate the dynamics of forest fragmentation and select potential forest fragments with a higher degree of conservation for seed harvesting in the Itapemirim river basin, Espírito Santo State, Brazil. Image classification techniques, forest landscape ecology, and multi-criteria analysis were used to evaluate the evolution of forest fragmentation to develop the landscape metric indexes, and to select potential forest fragments for seed harvesting for the years 1985 and 2013. According to the results, there was a reduction of 2.55% of the occupancy of the fragments in the basin between the years 1985 and 2013. For the years 1985 and 2013, forest fragment units 2 and 3 were spatialized with a high potential for seed harvesting, representing 6.99% and 16.01% of the total fragments, respectively. The methodology used in this study has the potential to be used to support decisions for the selection of potential fragments for seed harvesting because selecting fragments in different environments by their spatial attributes provides a greater degree of conservation, contributing to the protection and conscious management of the forests. The proposed methodology can be adapted to other areas and different biomes of the world.
Assuntos
Conservação dos Recursos Naturais/métodos , Técnicas de Apoio para a Decisão , Agricultura Florestal/métodos , Florestas , Sementes , Biodiversidade , Brasil , Ecologia/métodos , ÁrvoresRESUMO
Connexin32 is the building block of hepatocellular gap junctions, which control direct intercellular communication and thereby act as goalkeepers of liver homeostasis. This study was set up to investigate whether connexin32 is involved in hepatotoxicity induced by the analgesic and antipyretic drug acetaminophen. To this end, whole body connexin32 knock-out mice were overdosed with acetaminophen followed by sampling at different time points within a 24-h time frame. Evaluation was done based upon a series of clinically and mechanistically relevant read-outs, including protein adduct formation, histopathological examination, measurement of alanine aminotransferase activity, cytokine production, levels of reduced and oxidized glutathione and hepatic protein amounts of proliferating cell nuclear antigen. In essence, it was found that genetic ablation of connexin32 has no influence on several key events in acetaminophen-induced hepatotoxicity, including cell death, inflammation or oxidative stress, yet it does affect production of protein adducts as well as proliferating cell nuclear antigen steady-state protein levels. This outcome is not in line with previous studies, which are contradicting on their own, as both amplification and alleviation of this toxicological process by connexin32 have been described. This could question the suitability of the currently available models and tools to investigate the role of connexin32 in acetaminophen-triggered hepatotoxicity.
Assuntos
Acetaminofen/toxicidade , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Conexinas/metabolismo , Fígado/efeitos dos fármacos , Acetaminofen/administração & dosagem , Acetaminofen/metabolismo , Alanina Transaminase/sangue , Animais , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Doença Hepática Induzida por Substâncias e Drogas/patologia , Conexinas/genética , Citocinas/sangue , Dissulfeto de Glutationa/metabolismo , Fígado/imunologia , Fígado/metabolismo , Fígado/patologia , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Antígeno Nuclear de Célula em Proliferação/metabolismo , Ligação Proteica , Proteína beta-1 de Junções ComunicantesRESUMO
The aim of this in vitro study was to evaluate the nanoleakage of fiber posts luted using different adhesive strategies and to investigate the effect of 2% chlorhexidine (CHX) on nanoleakage at the resin-dentin interfaces of self-adhesive cements. The self-adhesive and etch-and-rinse adhesive groups tested demonstrated similar results with regard to nanoleakage. Pretreatment with CHX promoted an adequate seal at the resin-dentin interface for self-adhesive cements.
Assuntos
Clorexidina/farmacologia , Resinas Compostas/uso terapêutico , Cimentos Dentários/uso terapêutico , Infiltração Dentária/induzido quimicamente , Dentina/metabolismo , Animais , Bis-Fenol A-Glicidil Metacrilato/uso terapêutico , Bovinos , Polietilenoglicóis/uso terapêutico , Ácidos Polimetacrílicos/uso terapêutico , Cimentos de Resina/uso terapêuticoRESUMO
OBJECTIVES: To assess the influence of light-curing unit tip distance on the microtensile bond strength (µTBS) and nanoleakage of self-etching adhesives to enamel and dentin. MATERIALS AND METHODS: Flat buccal surfaces were prepared on 198 bovine incisors. The teeth were randomly assigned into nine groups for µTBS (n = 8) and nanoleakage (n = 3) testing according to the adhesive system (Clearfil Protect Bond, Clearfil Tri-S Bond or One Up Bond F Plus) and distance from the light-curing tip (0, 3 or 6 mm). The bonded samples were tested in tension (0.5 mm/min) and nanoleakage was analyzed using SEM. RESULTS: Clearfil Protect Bond exhibited the highest tensile strength on both enamel and dentin. Leakage was higher in samples exposed at a distance of 6 mm on enamel and 0 mm on dentin. One Up Bond F Plus experienced the greatest amount of nanoleakage on both substrates. CONCLUSIONS: Light-curing unit distance did not influence the µTBS of the adhesives, but nanoleakage increased on enamel samples when photoactivation occurred at a distance of 6 mm.
Assuntos
Colagem Dentária , Cimentos Dentários , Esmalte Dentário/química , Dentina/química , Nanotecnologia , Tensão Superficial , Resistência à TraçãoRESUMO
Discrepancies in tooth size and shape can interfere with smile harmony. Composite resin can be used to improve the esthetics of the smile at a low cost while offering good clinical performance. This article presents an approach for restoring and correcting functional, anatomic, and esthetic discrepancies with minimal intervention, using composites and a direct adhesive technique. This conservative restorative procedure provided the patient with maximum personal esthetic satisfaction.
Assuntos
Resinas Compostas/uso terapêutico , Colagem Dentária/métodos , Estética Dentária , Cimentos de Resina/uso terapêutico , Adulto , Humanos , Masculino , Clareamento Dental/métodos , Preparo Prostodôntico do Dente/métodosRESUMO
INTRODUCTION: Brazil is one of the countries with the largest population of people with hemophilia (PwH) worldwide. In this scoping review, we aim to investigate the Brazilian context for hemophilia regarding three predefined concepts: (i) clinical-epidemiological profile, (ii) burden of disease and (iii) patient journey and unmet needs. METHODS: Three questions in each concept guided the screening of references retrieved by systematic searches carried out in MEDLINE, LILACS and the Digital Library of Theses and Dissertations. Quantitative and qualitative studies conducted in Brazil from 2002 onwards were assessed for eligibility. MAIN RESULTS: Ninety-two studies were included. A total of 66 studies addressed the concept "Clinical-epidemiological profile", 31 investigated the concept of "Burden of disease" and 26 addressed the concept "Patient journey and unmet needs". Based on these studies, pain and arthropathy affect a substantial proportion of the PwH, with physical functioning, pain and school or work being the domains of quality of life with the greatest impact. About 43 % to 82.6 % of the PwH are unemployed. Rates of inhibitor development are highly variable across studies, especially in hemophilia A. Adherence to prophylactic treatment ranges from 25 % to 72 %. The annualized bleeding rate is estimated at 2.4 ± 4.1. The barriers to treatment identified include distance to reference centers, lack of coordination of specialized and emergency care and restricted access to rehabilitation. CONCLUSIONS: Hemophilia poses a considerable burden on the PwH. Despite the available modalities of treatment, there are remaining unmet needs that should be addressed by researchers and policy makers in the future.
RESUMO
BACKGROUND AND OBJECTIVE: The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach is a systematic method for assessing the certainty of evidence (CoE) and strength of recommendations in health care. We aimed to verify the effects of an online-based GRADE course on multirater consistency in the evaluation of the CoE in systematic reviews (SRs) analysis. STUDY DESIGN AND SETTINGS: Sixty-five Brazilian methodologists and researchers participated in an online course over 8 weeks. Asynchronous lessons and weekly synchronous meetings addressed the GRADE system in the context of CoE assessment. We asked participants to evaluate the CoE of random SRs (two before and another two after the course). Analyzes focused on the multirater agreement with a standard response, in the interrater agreement, and before-after changes in the proportion of participants that rated down the domains. RESULTS: 48 individuals completed the course. Participants presented improvements in the raters' assessment of the CoE using the GRADE approach after the course. The multirater consistency of indirectness, imprecision, and the overall CoE increased after the course, as well as the agreement between raters and the standard response. Furthermore, interrater reliability increased for risk of bias, inconsistency, indirectness, publication bias, and overall CoE, indicating progress in between-raters consistency. After the course, approximately 78% of individuals rated down the overall CoE to a low/very low degree, and participants presented more explanations for the judgment of each domain. CONCLUSION: An online GRADE course improved the consistency and agreement of the CoE assessment by Brazilian researchers. Online training courses have the potential to improve skills in guideline methodology development.
Assuntos
Medicina Baseada em Evidências , Humanos , Brasil , Medicina Baseada em Evidências/normas , Variações Dependentes do Observador , Feminino , Masculino , Internet , Adulto , Educação a Distância/normas , Educação a Distância/métodos , Reprodutibilidade dos TestesRESUMO
AIM: This study aimed to investigate the acute effects of dietary nitrate ingestion through l-arginine supplementation or dehydrated beet consumption on endothelial function in chronic obstructive pulmonary disease (COPD) patients. The secondary outcome was to analyze arterial stiffness, plasma nitrate, and nitrate/protein concentration. METHODS: In this randomized crossover study, subjects with COPD underwent three series of supplementation: (1) l-arginine, (2) dehydrated beetroot, and (3) a placebo that appeared like the other supplements. Each intervention lasted 14 days, with a 7-day washout period between series. Participants underwent endothelial function assessment using flow-mediated dilatation (FMD), and plasma nitrate levels were measured at the end of each supplementation series. RESULTS: Seventeen subjects (twelve male) completed the study protocol. Only five subjects presented endothelial dysfunction (RHI ≤0.51) at baseline. The mean baseline characteristics included age 66.5 ± 9.4 years, BMI 27.5 ± 4.5 kg/m2, FEV1, 0.79 (0.67-1.06) L. There were no differences (p > 0.05) between the groups or from pre-to post-interventions for RHI and arterial stiffness index (AIx) values, as well as parameters of endothelium-dependent vasodilation, such as blood flow velocity (BFV), shear stress, shear rate, FMD (mm), and FMD%. There was also no differences (p > 0.05) between the groups or from pre-to post-interventions plasma nitrate levels. CONCLUSIONS: Acute dietary supplementation with nitrates, at the doses provided, did not show a significant improvement in endothelial function assessed by FMD, EndoPAT, or plasma nitrate levels in COPD. These findings suggest that a higher dose or prolonged supplementation might be required to achieve a therapeutic effect.
Assuntos
Beta vulgaris , Estudos Cross-Over , Suplementos Nutricionais , Endotélio Vascular , Nitratos , Doença Pulmonar Obstrutiva Crônica , Rigidez Vascular , Humanos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Masculino , Idoso , Feminino , Nitratos/administração & dosagem , Nitratos/sangue , Nitratos/uso terapêutico , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiopatologia , Pessoa de Meia-Idade , Rigidez Vascular/efeitos dos fármacos , Rigidez Vascular/fisiologia , Arginina/administração & dosagem , Arginina/sangue , Vasodilatação/efeitos dos fármacosRESUMO
BACKGROUND: The incidence of olfactory disorders has increased in recent years, mainly related to COVID-19 infection. In Brazil, over 37 million cases of COVID-19 have been reported, and approximately 10 % of those cases continue to experience olfactory disorders for more than one month. Despite the significant negative impact on well-being, there is currently no validated instrument to assess how olfactory disorders impact the quality of life in Brazil. OBJECTIVES: This study aimed to validate the Questionnaire of Olfactory Disorders (QOD) for Brazilian Portuguese. METHODS: The authors first performed translation, back-translation, expert review, pre-testing, psychometric evaluation and cultural adaptation of the English version of the questionnaire. To assure linguistic and conceptual equivalence of the translated questionnaire, 126 participants from two Brazilian states and varying degrees of olfactory loss answered the QOD and the World Health Organization Quality of Life bref (WHOQOL-bref) questionnaires. The University of Pennsylvania Smell Identification Test (UPSIT®) was used to quantify the olfactory loss. Furthermore, to evaluate the reliability of the Portuguese version a test-retest was performed on a subgroup of patients. The authors observed a high Cronbach's alpha (α = 0.86) for internal consistency of the quality of Life (QOD-QOL) statements. FINDINGS: As expected, there was a negative correlation between QOD-QOL and UPSIT® (Spearman's ρ = -0.275, p = 0.002), since QOL score increases and UPSIT® score decreases with worsening of olfactory function. Correlations were moderate between QOD-QOL and WHOQOL-bref mean (Spearman's ρ = -0.374, p < 0.001) and weak to moderate between the QOD-QOL and Visual Analog Scale of the QOD regarding professional life, leisure, and private life (Spearman's ρ = -0.316, p = 0.000; Spearman's ρ = -0.293, p = 0.001; Spearman's ρ = -0.261, p = 0.004; respectively). CONCLUSION: In conclusion, the authors have demonstrated a high internal consistency and validity of the Brazilian Portuguese version of the QOD for evaluating the quality of life in individuals with olfactory disorders.