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1.
J Endocrinol Invest ; 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38329608

RESUMO

AIM: Acromegaly is a rare chronic disease, caused by the over-secretion of growth hormone (GH), that creates a pro-inflammatory state, but the exact mechanisms by which GH or insulin-like growth factor 1 (IGF-1) act on inflammatory cells are not fully understood. Aim of the study was to evaluate Interleukin-33 (IL33) and the skin perfusion of hands in patients with acromegaly (AP) and healthy controls (HC). METHODS: IL33 have been assessed in 40 AP and 40 HC. IL 33 was determined and skin perfusion of hands was assessed by laser speckle contrast analysis (LASCA) in both populations. RESULTS: IL33 was significantly higher in AP compared to HC [45.72 pg/ml (IQR 28.74-60.86) vs 14 pg/ml (IQR 6.5535); p < 0.05]. At LASCA, peripheral blood perfusion (PBP) was significantly lower in AP compared to HC [53.39 pU (IQR 40.94-65.44) vs 87 pU (IQR 80-98) p < 0.001]. The median values of ROI1, ROI2 and ROI3 were significantly lower in AP compared to HC [97.32 pU (IQR 50.89-121.69) vs 131 pU (IQR 108-135); p < 0.001], [58.68 pU (IQR 37.72-84.92) vs 83 pU (IQR 70-89), p < 0.05] and HC [52.16 (34.47-73.78) vs 85 (78-98), p < 0.001], respectively. The proximal-distal gradient (PDG) was observed in 18 of 40 (45%) AP. CONCLUSION: Serum IL33 is higher in AP compared to HC; conversely a reduction of PBP of hands was present in AP compared to HC, probably due to endothelial dysfunction, strictly dependent on acromegaly and are not influenced by the choice of treatment.

2.
J Endocrinol Invest ; 47(1): 141-147, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37306894

RESUMO

PURPOSE: Sexual dysfunctions are often experienced by male patients with acromegaly, due to a combination of hypogonadism and other comorbidities, but are a scarcely investigated complication. Erectile dysfunction is also closely related to cardiovascular diseases through endothelial dysfunction. Therefore, this project aimed to assess the prevalence of erectile dysfunction in a population of acromegalic men and evaluate its association with cardio-metabolic disorders, also exploring associations with androgen and estrogen receptor gene polymorphisms. METHODS: Sexually active men aged 18-65 with previous diagnosis of acromegaly were recruited. Clinical and laboratory data were retrospectively collected. Each patient also provided a blood sample for AR and ERß gene polymorphisms analyses and filled out the IIEF-15 questionnaire. RESULTS: Twenty men with previous diagnosis of acromegaly (mean age 48.4 ± 10.0 years) were recruited. 13/20 subjects (65%) had erectile dysfunction, but only four had a concurrent biochemical hypogonadism, with no significant correlation with IIEF-15 scores. Total testosterone negatively correlated with sexual intercourse satisfaction domain (ρ = - 0.595; p = 0.019) and general satisfaction domain (ρ = - 0.651; p = 0.009). IGF-1 levels negatively correlated with biochemical hypogonadism (ρ = - 0.585; p = 0.028). The number of CAG and CA repeats in AR and ERß receptors genes was not significantly associated with IIEF-15 scores or with GH/IGF-1 levels, but a negative correlation between CA repeats and the presence of cardiomyopathy (ρ = - 0.846; p = 0.002) was present. CONCLUSIONS: Men with acromegaly have a high prevalence of erectile dysfunction, but it does not appear to be correlated with treatments, testosterone levels and AR/ER-beta signaling. Nonetheless, a shorter CA polymorphic trait (ERbeta) is associated with the presence of cardiomyopathy. If confirmed, these data may suggest an association between an incorrect hormonal balance and increased cardiovascular risk in acromegaly subjects.


Assuntos
Acromegalia , Cardiomiopatias , Disfunção Erétil , Hipogonadismo , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Androgênios , Disfunção Erétil/epidemiologia , Disfunção Erétil/genética , Acromegalia/complicações , Acromegalia/genética , Fator de Crescimento Insulin-Like I/genética , Estudos Retrospectivos , Receptor beta de Estrogênio/genética , Testosterona , Hipogonadismo/complicações , Hipogonadismo/epidemiologia , Hipogonadismo/genética , Polimorfismo Genético , Estrogênios
3.
Antimicrob Agents Chemother ; 67(4): e0146222, 2023 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-36892306

RESUMO

The clinical involvement and antifungal susceptibility of Aspergillus section Circumdati are poorly known. We analyzed 52 isolates, including 48 clinical isolates, belonging to 9 species inside the section Circumdati. The whole section exhibited, by the EUCAST reference method, a poor susceptibility to amphotericin B, but species/series-specific patterns were observed for azole drugs. This underlines the interest in getting an accurate identification inside the section Circumdati to guide the choice of antifungal treatment in clinical practice.


Assuntos
Antifúngicos , Aspergillus , Antifúngicos/farmacologia , Testes de Sensibilidade Microbiana , Anfotericina B/farmacologia , Azóis/farmacologia
4.
Encephale ; 49(6): 557-563, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36253185

RESUMO

INTRODUCTION: The French day hospital program specialized in eating disorders (ED) opened in January 2018. Our study presents preliminary data on clinical profiles of patients with anorexia nervosa (AN). We describe more specifically clinical characteristics of patients with early onset AN and according to their therapeutics orientations. Then, we compare the weight gain of patients managed only in day-patient (DP) treatment with those managed initially inpatient (IP) treatment and relays in DP. METHODS: Ninety-two patients with AN, aged between 8 and 18 years, were evaluated with several questionnaires (EDI-2, EDE-Q, BSQ, EDS-R, CDI, STAI-Y, VSP-A, EPN-13). RESULTS: Patients with early onset AN, n = 23 (25.3%), presented more restrictive behaviors, less marked dietary symptomatology, a lower degree of clinical perfectionism and a less marked feeling of ineffectiveness than adolescent patients with AN. Regarding the choice of hospitalization modality (DP alone or IP-DP), the only difference highlighted was the severity of patient undernutrition. Among the patients who were treated (IP-DP n = 27 vs DP alone n = 25), the weight evolution after one month and at discharge was favorable for both groups. CONCLUSION: These preliminary data suggest the effectiveness of DP in the care of AN in children and adolescents.


Assuntos
Anorexia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos , Humanos , Adolescente , Criança , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/terapia , Hospitalização , Alta do Paciente , Hospitais
5.
AIDS Care ; 34(7): 832-838, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-34082616

RESUMO

Studies describing characteristics and outcomes of COVID-19 among people living with HIV are currently limited, lacking detailed evaluation of the interplay among demographics, HIV-related variables, and comorbidities on COVID-19 outcomes. This retrospective cohort study describes mortality rates overall and according to demographic characteristics and explores predictors of admission to intensive care unit and death among 255 persons living with HIV with severe acute respiratory syndrome and confirmed SARS-CoV-2 infection in the State of Sao Paulo, Brazil. We found that the overall mortality rate was 4.1/1,000 person-days, with a case-fatality of 34%. Higher rates occurred among older adults, Black/Mixed skin color/race patients, and those with lower schooling. In a multivariable analysis adjusted for age, sex, CD4 count, viral load and number of comorbidities, skin color/race, and schooling remained significantly associated with higher mortality. Although tenofovir use was more frequent among survivors in the univariable analysis, we failed to find a statistically significant association between tenofovir use and survival in the multivariable analysis. Our findings suggest that social vulnerabilities related to both HIV and COVID-19 significantly impact the risk of death, overtaking traditional risk factors such as age, sex, CD4 count, and comorbidities.


Assuntos
Síndrome da Imunodeficiência Adquirida , COVID-19 , Infecções por HIV , Idoso , Brasil/epidemiologia , Estudos de Coortes , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Tenofovir
6.
Nanotechnology ; 34(5)2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36322965

RESUMO

Experimental realizations of two-dimensional materials are hardly free of structural defects such as e.g. vacancies, which, in turn, modify drastically its pristine physical defect-free properties. In this work, we explore effects due to point defect clustering on the electronic and transport properties of bilayer graphene nanoribbons, for AA and AB stacking and zigzag and armchair boundaries, by means of the tight-binding approach and scattering matrix formalism. Evident vacancy concentration signatures exhibiting a maximum amplitude and an universality regardless of the system size, stacking and boundary types, in the density of states around the zero-energy level are observed. Our results are explained via the coalescence analysis of the strong sizeable vacancy clustering effect in the system and the breaking of the inversion symmetry at high vacancy densities, demonstrating a similar density of states for two equivalent degrees of concentration disorder, below and above the maximum value.

7.
Appl Environ Microbiol ; 87(3)2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33187998

RESUMO

Biofilms are increasingly implicated as playing a major role in waterborne cryptosporidiosis. This review aims to synthesize all currently available data on interactions between Cryptosporidium oocysts and biofilms. Initially described following a waterborne outbreak, the integration of Cryptosporidium oocysts in biofilm has been well demonstrated. Biofilms appear important in the dissemination/protection of oocysts in the environment. Consequently, it has been suggested that substrate-associated biofilms should be systematically considered in oocyst water quality assessment. The influence of physicochemical parameters has been studied on oocyst biofilm retention. Biofilm surface roughness, ionic concentration (especially Ca2+), laminar/turbulent flow, shear stress, and electrostatic repulsion forces appear important to consider regarding oocyst release from biofilm. However, data analysis carried out during this review also revealed important gaps in biological interactions within biofilms, offering many perspectives for future work.


Assuntos
Biofilmes , Cryptosporidium , Oocistos
8.
Phys Rev Lett ; 127(10): 106801, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34533367

RESUMO

The moiré pattern observed in stacked noncommensurate crystal lattices, such as heterobilayers of transition metal dichalcogenides, produces a periodic modulation of their band gap. Excitons subjected to this potential landscape exhibit a band structure that gives rise to a quasiparticle dubbed the moiré exciton. In the case of MoS_{2}/WSe_{2} heterobilayers, the moiré trapping potential has honeycomb symmetry and, consequently, the moiré exciton band structure is the same as that of a Dirac-Weyl fermion, whose mass can be further tuned down to zero with a perpendicularly applied field. Here we show that, analogously to other Dirac-like particles, the moiré exciton exhibits a trembling motion, also known as Zitterbewegung, whose long timescales are compatible with current experimental techniques for exciton dynamics. This promotes the study of the dynamics of moiré excitons in van der Waals heterostructures as an advantageous solid-state platform to probe Zitterbewegung, broadly tunable by gating and interlayer twist angle.

9.
Br J Nutr ; 126(5): 790-800, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-33161915

RESUMO

The consumption of energy-dense sugar-sweetened beverages (SSB) and its low satiating effects may influence the development of child eating behaviours. We aimed to investigate the association of SSB consumption at 4 years on appetitive behaviours at age 7 years. Children from the Generation XXI birth cohort were included (n 3880). SSB consumption was evaluated through a FFQ and appetitive behaviours were evaluated through the Children's Eating Behaviour Questionnaire, which includes eight subscales. Two composite factors, derived by principal component analysis (Appetite Restraint - related to Food Fussiness, Enjoyment of Food, Slowness in Eating and Satiety Responsiveness - and Appetite Disinhibition - related to Food Responsiveness, Emotional Under- and Overeating and Desire to Drink), were also investigated. The dose-response relationship between SSB consumption and appetitive behaviours was examined using multivariable linear regression (continuous eating behaviour scores) and multinomial logistic regression (tertile categories of eating behaviour scores). Child SSB consumption at 4 years was associated with higher Appetite Disinhibition and Desire to Drink and lower Food Fussiness and Slowness in Eating at 7 years. Consuming SSB ≥1 times/d (compared with a lower intake) was associated with 29 % increase in the odds of Desire to Drink (3rd v. 1st tertile). Pre-schoolers' SSB consumption was associated with higher food approach and less food avoidant behaviours later in childhood. Family characteristics, particularly maternal SSB consumption, explained part of these associations. It is essential to promote the intake of water, instead of sugary drinks, and make parents and caregivers aware of the importance of this exposure, since they have a pivotal role in shaping children's eating behaviours.


Assuntos
Comportamento Apetitivo , Comportamento Infantil , Comportamento Alimentar , Bebidas Adoçadas com Açúcar , Apetite , Coorte de Nascimento , Criança , Pré-Escolar , Humanos , Inquéritos e Questionários
10.
Mol Biol Rep ; 48(2): 1383-1391, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33599950

RESUMO

Yellow vein mosaic disease is the major biotic constraint of okra cultivation in Sri Lanka. Identification and detailed molecular characterization of associated pathogen is needed for effective disease management. The genome of the begomovirus and betasatellite were amplified in symptomatic plant samples using specific degenerate primers. DNA-A genome of twelve isolates representing different locations in Sri Lanka were cloned, sequenced and deposited in GenBank database (Accession No- KX698087- KX698092 and MH455207- MH455212). Size of the complete nucleotide sequences ranged from 2735 to 2786 bp. The genome organization showed characteristics of begomoviruses. The pairwise sequence identity revealed the association of two different begomovirus species. Five of the isolates showed > 91% of sequences identity with Bhendi yellow vein mosaic virus, and the rest of the seven isolates were around 92% of identity with Okra enation leaf curl virus. This is further supported by phylogenetic analysis where both of these group of isolates were in different cluster. Recombination analysis showed the presence of recombinant fragments in the virus isolates associated with okra yellow vein mosaic disease (OYVMD) in Sri Lanka. Attempts to amplify DNA- B were failed in any of the samples tested. However, both type of the begomovirus species associated with betasatellite species, Bhendi yellow vein mosaic betasatellite. The present study has revealed the association of two distinct monopartite begomovirus species, Bhendi yellow vein mosaic virus or Okra enation leaf curl virus, with OYVMD in Sri Lanka.


Assuntos
Abelmoschus/virologia , Begomovirus/genética , Doenças das Plantas/virologia , Abelmoschus/genética , Begomovirus/isolamento & purificação , Begomovirus/patogenicidade , Análise por Conglomerados , DNA Viral/genética , DNA Viral/isolamento & purificação , Variação Genética/genética , Genoma Viral/genética , Filogenia , Doenças das Plantas/genética , Análise de Sequência de DNA , Software
11.
Bull Entomol Res ; 111(5): 568-578, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33858528

RESUMO

The Mediterranean fruit fly, Ceratitis capitata (Wiedemann), is one of the main pests of fruit, worldwide, and the use of population suppression method with low environmental impact is an increasingly strong requirement of the consumer market. The aim of this study was to evaluate the effect of mineral and natural films on the physical-chemical properties of grapes (Vitis vinifera L.), cultivar Itália, and oviposition behaviour of C. capitata. Fruits were immersed in suspensions (100 and 200 g L-1) of mineral (kaolin Surround®WP, kaolin 607, kaolin 608, kaolin 611 and talc) and natural films (chitosan, cassava starch, potato starch and guar gum 5.0 g L-1) and distilled water (control). After drying, fruits were exposed to C. capitata pairs of males and females for 24 h in choice and non-choice tests; the number of punctures with and without eggs, eggs per fruit and behavioural response of fly to treated and untreated fruits were recorded. Results obtained in this study are promising, given the scientific evidence that films of mineral particles such as kaolin (Surround®, 607, 608 and 611) changed the firmness, luminosity, chroma and hue angle of grapes and reduced the oviposition of C. capitata. In addition, our results also showed that natural polymers do not deter C. capitata females, but rather seem to stimulate oviposition.


Assuntos
Ceratitis capitata/fisiologia , Filmes Cinematográficos , Oviposição , Vitis , Animais , Feminino , Frutas , Caulim , Masculino , Polímeros , Talco
12.
Proc Natl Acad Sci U S A ; 115(12): 3072-3077, 2018 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-29483242

RESUMO

The extent of increasing anthropogenic impacts on large marine vertebrates partly depends on the animals' movement patterns. Effective conservation requires identification of the key drivers of movement including intrinsic properties and extrinsic constraints associated with the dynamic nature of the environments the animals inhabit. However, the relative importance of intrinsic versus extrinsic factors remains elusive. We analyze a global dataset of ∼2.8 million locations from >2,600 tracked individuals across 50 marine vertebrates evolutionarily separated by millions of years and using different locomotion modes (fly, swim, walk/paddle). Strikingly, movement patterns show a remarkable convergence, being strongly conserved across species and independent of body length and mass, despite these traits ranging over 10 orders of magnitude among the species studied. This represents a fundamental difference between marine and terrestrial vertebrates not previously identified, likely linked to the reduced costs of locomotion in water. Movement patterns were primarily explained by the interaction between species-specific traits and the habitat(s) they move through, resulting in complex movement patterns when moving close to coasts compared with more predictable patterns when moving in open oceans. This distinct difference may be associated with greater complexity within coastal microhabitats, highlighting a critical role of preferred habitat in shaping marine vertebrate global movements. Efforts to develop understanding of the characteristics of vertebrate movement should consider the habitat(s) through which they move to identify how movement patterns will alter with forecasted severe ocean changes, such as reduced Arctic sea ice cover, sea level rise, and declining oxygen content.


Assuntos
Migração Animal , Bases de Dados Factuais , Oceanos e Mares , Vertebrados , Animais , Ecossistema
13.
Med Oral Patol Oral Cir Bucal ; 26(1): e114-e117, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33037804

RESUMO

BACKGROUND: Odontology practice has been severely compromised by the pandemic caused by COVID-19 and Spain is one of the countries with higher incidence. Our aim with this study is to find out the number of cases and type of odonto-stomatological emergencies (OSE) treated in four dental clinics of the Madrid capital area and region (CAM) in the period covered between March 17th and 4th of May. MATERIAL AND METHODS: We search the cases in the demographic/epidemiological databases of the CAM regional government and the Illustrious Official College of Dentists and Stomatologists of the First Region (Madrid). RESULTS: We found that the most prevalent pathology was acute apical periodontitis whereas odontogenic abscess showed the lowest frequency. Prosthetic-orthodontic OSE represented 14% of cases. CONCLUSIONS: In this period of time, the most prevalent pathology acute apical periodontitis, odontogenic abscess reported the lowest frequency and prosthetic-orthodontic treatments were the third in number of cases. Most of OSE were resolved, without referring the patient to a hospital emergency department.


Assuntos
COVID-19 , Emergências , Clínicas Odontológicas , Humanos , SARS-CoV-2 , Espanha
14.
Antimicrob Agents Chemother ; 64(12)2020 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-32900686

RESUMO

The antifungal susceptibility of Aspergillus cryptic species is poorly known. We assessed 51 isolates, belonging to seven Fumigati cryptic species, by the EUCAST reference method and the concentration gradient strip (CGS) method. Species-specific patterns were observed, with high MICs for azole drugs, except for Aspergillus hiratsukae and Aspergillus tsurutae, and high MICs for amphotericin B for Aspergillus lentulus and Aspergillus udagawae Essential and categorical agreements between EUCAST and CGS results were between 53.3 and 93.3%.


Assuntos
Antifúngicos , Aspergillus , Antifúngicos/farmacologia , Aspergillus/efeitos dos fármacos , Testes de Sensibilidade Microbiana
15.
Br J Dermatol ; 182(4): 860-868, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-30965384

RESUMO

BACKGROUND: People with melanoma want and need effective interventions for living with fear of cancer recurrence (FCR). OBJECTIVES: This study reports the 12-month outcomes of a brief, psychological intervention designed to reduce FCR in people at high risk of developing another primary melanoma compared with usual care. METHODS: In this two-arm randomized controlled trial, adults previously diagnosed with stage 0, I or II melanoma were randomly allocated to the intervention (n = 80) or control (usual care) arm (n = 84). The trial was registered with the Australian and New Zealand Clinical Trials Registry on 19 March 2013 (registration: ACTRN12613000304730). The intervention comprised a 76-page psychoeducational resource and three individually tailored, telephone-based sessions with a psychologist, scheduled at specific time points around participants' dermatological appointments. The primary outcome was the level of self-reported fear of new or recurrent melanoma assessed at 12 months postintervention using the severity subscale of the Fear of Cancer Recurrence Inventory. RESULTS: Compared with the control arm, the intervention group reported significantly lower FCR at 12 months postintervention; the between-group mean difference was -1·41 for FCR severity [95% confidence interval (CI) -2·6 to -0·2; P = 0·02] and -1·32 for FCR triggers (95% CI -2·6 to -0·02; P = 0·04). The odds ratio for FCR severity scores ≥13 (54% intervention, 63% control) was 0·59 (95% CI 0·30-1·14, P = 0·12). There were no differences between groups in secondary outcomes, such as anxiety, depression or health-related quality of life. CONCLUSIONS: The previously reported 6-month benefits of this brief, patient-centred psychological intervention in reducing FCR were found to continue 12 months postintervention, with no known adverse effects, supporting implementation as part of routine melanoma care.


Assuntos
Melanoma , Qualidade de Vida , Adulto , Austrália , Medo , Seguimentos , Humanos , Melanoma/prevenção & controle , Recidiva Local de Neoplasia/prevenção & controle , Nova Zelândia , Intervenção Psicossocial
16.
Lupus ; 29(1): 83-91, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31801041

RESUMO

OBJECTIVE: We analyzed baseline and follow-up characteristics related to poorer renal outcomes in a Brazilian cohort of admixture race patients with lupus nephritis. METHODS: Overall, 280 outpatients with a diagnosis of systemic lupus erythematosus and previous kidney biopsy of lupus nephritis were recruited from August 2015 to December 2018 and had baseline laboratory and histologic data retrospectively analyzed; patients were then followed-up and data were recorded. The main outcome measure was the estimated glomerular filtration rate at last follow-up. Secondary analyses assessed the impact of initial kidney histology and treatment in long-term kidney survival. RESULTS: Median duration of lupus nephritis was 60 months (interquartile range: 27-120); 40 (14.3%) patients presented progressive chronic kidney disease (estimated glomerular filtration rate <30 and ≥10 ml/min/1.73 m2) or end-stage kidney disease at last visit. Adjusted logistic regression analysis showed that class IV lupus nephritis (odds ratio 14.91; 95% confidence interval 1.77-125.99; p = 0.01) and interstitial fibrosis ≥25% at initial biopsy (odds ratio 5.87; 95% confidence interval 1.32-26.16; p = 0.02), lack of complete or partial response at 12 months (odds ratio 16.3; 95% confidence interval 3.74-71.43; p < 0.001), and a second renal flare (odds ratio 4.49; 95% confidence interval 1.10-18.44; p = 0.04) were predictors of progressive chronic kidney disease. In a Kaplan-Meier survival curve we found that class IV lupus nephritis and interstitial fibrosis ≥25% were significantly associated with end-stage kidney disease throughout follow-up (hazard ratio 2.96; 95% confidence interval 1.3-7.0; p = 0.036 and hazard ratio 4.96; 95% confidence interval 1.9-12.9; p < 0.0001, respectively). CONCLUSION: In this large cohort of admixture race patients, class IV lupus nephritis and chronic interstitial damage at initial renal biopsy together with non-response after 1 year of therapy and relapse were associated with worse long-term renal outcomes.


Assuntos
Progressão da Doença , Falência Renal Crônica/etiologia , Nefrite Lúpica/fisiopatologia , Adulto , Brasil , Estudos de Coortes , Feminino , Taxa de Filtração Glomerular , Humanos , Nefrite Lúpica/classificação , Nefrite Lúpica/complicações , Masculino , Pessoa de Meia-Idade
17.
BMC Gastroenterol ; 20(1): 338, 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054847

RESUMO

BACKGROUND: A defecation disorder (DD) is a difficulty in evacuation documented by physiological exams. However, this physiological evaluation can be cumbersome, inaccessible and costly. Three "low-cost" tools to evaluate DD-a clinical DD score, the balloon expulsion test (BET) and a digital rectal examination (DRE) score were evaluated as separate or combined tests for DD screening. METHODS: This prospective study occurred between January 2015 and March 2019 in the Gastroenterology Department of a tertiary hospital. Besides the gold standard physiological tests, constipated patients answered the clinical DD score and were evaluated by DRE and BET [standard and variable volume (VV)]. RESULTS: From 98 constipated patients, 35 (38.9%) were diagnosed with DD according to Rome IV criteria, mainly female (n = 30, 86%) with a median age of 60 years old. The clinical DD score revealed an AUC of 0.417 (SE = 0.07, p = 0.191). The DRE score displayed an AUC of 0.56 (SE = 0.063, p = 0.301). The standard BET displayed a sensitivity of 86%, specificity of 58%, positive predictive value (PPV) of 57% and negative predictive value (NPV) of 86%. The sequential VVBET followed by standard BET improved the BET performance regarding the evaluation of DD, with a sensitivity of 86%, specificity of 67%, PPV of 63% and NPV of 87%. The sequential BET had an OR 8.942, p > 0.001, CI 3.18-25.14, revealing to be the most significant predictor for DD screening. CONCLUSION: The sequential BET is a low cost, well-performing DD screening tool, appropriate to the Primary Care Setting.


Assuntos
Constipação Intestinal , Defecação , Constipação Intestinal/diagnóstico , Exame Retal Digital , Feminino , Humanos , Manometria , Pessoa de Meia-Idade , Estudos Prospectivos
18.
BMC Infect Dis ; 20(1): 257, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228484

RESUMO

BACKGROUND: Cryptosporidium sp. are common intracellular parasites responsible of severe diarrhea in T-cell-immunocompromised patients. We report the first case of a woman who contracted cryptosporidiosis after treatment with fingolimod, a drug labeled for multiple sclerosis and responsible for marked lymphopenia. CASE PRESENTATION: A 60-year-old woman was admitted for abdominal pain diarrhea and fever. The patient suffered from multiple sclerosis and had been treated with fingolimod from august 2017 to september 2018 time of occurrence of the first digestive symptoms. Stool culture was negative but parasitological examination was positive for Cryptosporidium sp. Blood biological examination profound lymphopenia of 240/mm3 [17 CD4/mm3 (7%) and 32 CD8/mm3 (14%)]. Fingolimod was stopped, and the patient was put on nitazoxanide 500 mg bid for 7 days. The diarrhea resolved and no relapse was observed. Six other cases were found in the Pharmacovigilance database. CONCLUSION: Physicians should be aware of this association and screen for Cryptosporidium in cases of diarrhea in patients treated with fingolimod. Patients should be aware of this risk and advise to take appropriate measures to avoid such contamination.


Assuntos
Criptosporidiose/tratamento farmacológico , Diarreia/parasitologia , Cloridrato de Fingolimode/efeitos adversos , Dor Abdominal/parasitologia , Animais , Antiparasitários/uso terapêutico , Criptosporidiose/parasitologia , Diarreia/etiologia , Fezes/parasitologia , Feminino , Febre/parasitologia , Cloridrato de Fingolimode/uso terapêutico , Humanos , Hospedeiro Imunocomprometido , Pessoa de Meia-Idade , Esclerose Múltipla/tratamento farmacológico , Nitrocompostos , Farmacovigilância , Tiazóis/uso terapêutico
19.
J Occup Rehabil ; 30(1): 93-104, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31346923

RESUMO

Purpose To evaluate whether a protocol for early intervention addressing the psychosocial risk factors for delayed return to work in workers with soft tissue injuries would achieve better long-term outcomes than usual (stepped) care. Methods The study used a controlled, non-randomised prospective design to compare two case management approaches. For the intervention condition, workers screened within 1-3 weeks of injury as being at high risk of delayed returned to work by the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) were offered psychological assessment and a comprehensive protocol to address the identified obstacles for return to work. Similarly identified injured workers in the control condition were managed under usual (stepped) care arrangements. Results At 2-year follow-up, the mean lost work days for the Intervention group was less than half that of the usual care group, their claim costs were 30% lower, as was the growth trajectory of their costs after 11 months. Conclusions The findings supported the hypothesis that brief psychological risk factor screening, combined with a protocol for active collaboration between key stakeholders to address identified psychological and workplace factors for delayed return to work, can achieve better return on investment than usual (stepped) care.


Assuntos
Acidentes de Trabalho/economia , Administração de Caso/organização & administração , Pessoas com Deficiência/psicologia , Retorno ao Trabalho/psicologia , Indenização aos Trabalhadores/economia , Acidentes de Trabalho/estatística & dados numéricos , Adulto , Austrália , Avaliação da Deficiência , Emprego/economia , Feminino , Humanos , Masculino , Estudos Prospectivos , Retorno ao Trabalho/economia , Inquéritos e Questionários , Fatores de Tempo , Indenização aos Trabalhadores/estatística & dados numéricos
20.
Ecol Appl ; 29(6): e01947, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31183944

RESUMO

Telemetry is a key, widely used tool to understand marine megafauna distribution, habitat use, behavior, and physiology; however, a critical question remains: "How many animals should be tracked to acquire meaningful data sets?" This question has wide-ranging implications including considerations of statistical power, animal ethics, logistics, and cost. While power analyses can inform sample sizes needed for statistical significance, they require some initial data inputs that are often unavailable. To inform the planning of telemetry and biologging studies of marine megafauna where few or no data are available or where resources are limited, we reviewed the types of information that have been obtained in previously published studies using different sample sizes. We considered sample sizes from one to >100 individuals and synthesized empirical findings, detailing the information that can be gathered with increasing sample sizes. We complement this review with simulations, using real data, to show the impact of sample size when trying to address various research questions in movement ecology of marine megafauna. We also highlight the value of collaborative, synthetic studies to enhance sample sizes and broaden the range, scale, and scope of questions that can be answered.


Assuntos
Ecologia , Ecossistema , Animais , Tamanho da Amostra , Telemetria
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