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1.
Mol Cell ; 67(1): 55-70.e4, 2017 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-28673543

RESUMO

Ribosomal protein (RP) expression in higher eukaryotes is regulated translationally through the 5'TOP sequence. This mechanism evolved to more rapidly produce RPs on demand in different tissues. Here we show that 40S ribosomes, in a complex with the mRNA binding protein LARP1, selectively stabilize 5'TOP mRNAs, with disruption of this complex leading to induction of the impaired ribosome biogenesis checkpoint (IRBC) and p53 stabilization. The importance of this mechanism is underscored in 5q− syndrome, a macrocytic anemia caused by a large monoallelic deletion, which we found to also encompass the LARP1 gene. Critically, depletion of LARP1 alone in human adult CD34+ bone marrow precursor cells leads to a reduction in 5'TOP mRNAs and the induction of p53. These studies identify a 40S ribosome function independent of those in translation that, with LARP1, mediates the autogenous control of 5'TOP mRNA stability, whose disruption is implicated in the pathophysiology of 5q− syndrome.


Assuntos
Autoantígenos/metabolismo , Biossíntese de Proteínas , Sequência de Oligopirimidina na Região 5' Terminal do RNA , Estabilidade de RNA , RNA Mensageiro/metabolismo , Ribonucleoproteínas/metabolismo , Proteínas Ribossômicas/metabolismo , Ribossomos/metabolismo , Anemia Macrocítica/genética , Anemia Macrocítica/metabolismo , Autoantígenos/genética , Células da Medula Óssea/metabolismo , Deleção Cromossômica , Cromossomos Humanos Par 5/genética , Cromossomos Humanos Par 5/metabolismo , Células HCT116 , Humanos , Complexos Multiproteicos , Ligação Proteica , Interferência de RNA , RNA Mensageiro/genética , Ribonucleoproteínas/genética , Proteínas Ribossômicas/genética , Ribossomos/genética , Fatores de Tempo , Transfecção , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismo , Antígeno SS-B
2.
Am J Hum Biol ; : e24121, 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38938067

RESUMO

INTRODUCTION: Development policies have aimed to substitute subsistence agriculture for cash crops or other cash generating activities to encourage local farmers to depend on store-bought groceries available year-round instead of seasonal subsistence crops. In this paper, we test the hypothesis that increased dependence on store bought foods has decreased seasonal changes in nutritional status and fat mass in Maya Children from Yucatan, Mexico. METHODS: Weight for age (W/A), body mass index (BMI), and tricipital Skinfold z scores in children under the age of 10 years from 14 Maya rural towns with different degrees of development were compared longitudinally between scarcity and abundance seasons using a repeated measures analysis of variance. Height for age (H/A) z scores were also estimated. RESULTS: Origin of food consumed corresponded to the town's degree of development. Nutritional status (W/Az) and adiposity, BMI, and tricipital z scores were significantly lower during the scarcity season in every community. W/Az, tricipital skinfold z, and H/Az scores were significantly higher in developed than in traditional towns, yet in both types of town W/Az and H/Az scores were below the WHO standard mean. Tricipital skinfold z score was only below the WHO standard amongst traditional towns during the scarcity season. CONCLUSIONS: Increased dependence on store foods failed to eliminate significant losses in body fat during the scarcity season. This failure may be affecting linear growth and promoting a thrifty phenotype that is seen in short and stocky individuals with a tendency to accumulate fat during abundance seasons.

3.
Am J Primatol ; 86(6): e23620, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38506254

RESUMO

The progressive growth of urban environments has increasingly forced populations of nonhuman primates to coexist with humans in many cities, which has resulted in problems such as behavioral alterations, conflicts with humans, and threats to the health of the monkeys, due to their consumption of anthropogenic foodstuffs. These anthropogenic foods, which are rich in calories, are the principal driver of the proximity between humans and primates, even though the acquisition of these foods tends to be risky for the monkeys and involve a variety of challenges derived from specific features of the urban environment. The present study evaluated the success/risk relationship of foraging for anthropogenic food by tufted capuchins (Sapajus libidinosus) in Brasília National Park. The data were analyzed using a binary logistic regression, with the backward-stepwise Wald method, to investigate the factors related to the foraging success of the capuchins, considering variables such as their sex and age, the type of approach and its context, and interactions with humans. The capuchins were influenced by the anthropogenic context, which affected their foraging strategies and diet. Interactions with humans reduced the success of foraging for anthropogenic foods. Conflicts between humans and the capuchins were common, especially in the context of access to food. The capuchins thus preferred to access feeding resources directly, probably due to the reduced human interference, which resulted in greater foraging success for unattended food brought by park visitors and the raiding of trash cans. Based on the observed behavior patterns, a number of measures can be proposed to mitigate these conflicts. These recommendations include not bringing food into areas frequented by the capuchins, not reacting to approaching animals, and removing all trash generated during a visit. A cleaning team dedicated to the maintenance of the visitation area free of anthropogenic waste is also be recommended.


Assuntos
Cebinae , Comportamento Alimentar , Parques Recreativos , Animais , Brasil , Masculino , Feminino , Humanos , Cebinae/fisiologia , Interação Humano-Animal , Dieta/veterinária
4.
J Arthroplasty ; 38(4): 763-768.e2, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36328104

RESUMO

BACKGROUND: Ketamine is administered intraoperatively to treat pain associated with primary total hip (THA) and knee arthroplasty (TKA). The purpose of this study was to evaluate the efficacy and safety of ketamine in primary THA and TKA to support the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons (AAHKS), American Academy of Orthopaedic Surgeons (AAOS), Hip Society, Knee Society, and the American Society of Regional Anesthesia and Pain Management (ASRA). METHODS: The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched for studies published prior to 2020 on ketamine in THA and TKA. All included studies underwent qualitative assessment and quantitative homogeneity testing followed by a systematic review and direct comparison meta-analysis to assess the efficacy and safety of ketamine. After a critical appraisal of 136 publications, 7 high-quality studies were included for analyses. RESULTS: High-quality evidence demonstrates that intraoperative ketamine decreases postoperative opioid consumption. Four of 7 studies found that ketamine reduces postoperative pain. Intraoperative ketamine is not associated with an increase in adverse events and may reduce postoperative nausea and vomiting (relative risk [RR] 0.68; 95% CI 0.50-0.92). CONCLUSION: High-quality evidence supports the use of ketamine intraoperatively in THA and TKA to reduce postoperative opioid consumption. Most studies found ketamine reduces postoperative pain, nausea, and vomiting. Moderate quality evidence supports the safety of ketamine, but it should be used cautiously in patients at risk for postoperative delirium, such as the elderly.


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Ketamina , Humanos , Idoso , Ketamina/uso terapêutico , Analgésicos Opioides , Manejo da Dor , Artroplastia do Joelho/efeitos adversos , Dor Pós-Operatória/tratamento farmacológico , Artroplastia de Quadril/efeitos adversos
5.
Int J Mol Sci ; 24(12)2023 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-37373115

RESUMO

Currently available data on the involvement of neuropeptide Y (NPY), peptide YY (PYY), and pancreatic polypeptide (PP) and their receptors (YRs) in cancer are updated. The structure and dynamics of YRs and their intracellular signaling pathways are also studied. The roles played by these peptides in 22 different cancer types are reviewed (e.g., breast cancer, colorectal cancer, Ewing sarcoma, liver cancer, melanoma, neuroblastoma, pancreatic cancer, pheochromocytoma, and prostate cancer). YRs could be used as cancer diagnostic markers and therapeutic targets. A high Y1R expression has been correlated with lymph node metastasis, advanced stages, and perineural invasion; an increased Y5R expression with survival and tumor growth; and a high serum NPY level with relapse, metastasis, and poor survival. YRs mediate tumor cell proliferation, migration, invasion, metastasis, and angiogenesis; YR antagonists block the previous actions and promote the death of cancer cells. NPY favors tumor cell growth, migration, and metastasis and promotes angiogenesis in some tumors (e.g., breast cancer, colorectal cancer, neuroblastoma, pancreatic cancer), whereas in others it exerts an antitumor effect (e.g., cholangiocarcinoma, Ewing sarcoma, liver cancer). PYY or its fragments block tumor cell growth, migration, and invasion in breast, colorectal, esophageal, liver, pancreatic, and prostate cancer. Current data show the peptidergic system's high potential for cancer diagnosis, treatment, and support using Y2R/Y5R antagonists and NPY or PYY agonists as promising antitumor therapeutic strategies. Some important research lines to be developed in the future will also be suggested.


Assuntos
Neoplasias da Mama , Neoplasias Colorretais , Neoplasias Hepáticas , Neuroblastoma , Neoplasias Pancreáticas , Neoplasias da Próstata , Sarcoma de Ewing , Masculino , Humanos , Neuropeptídeo Y/metabolismo , Receptores de Neuropeptídeo Y/metabolismo , Recidiva Local de Neoplasia , Peptídeo YY , Neoplasias Pancreáticas
6.
Int J Mol Sci ; 24(10)2023 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-37240004

RESUMO

Harmful alcohol use is responsible for a group of disorders collectively named alcohol use disorders (AUDs), according to the DSM-5 classification. The damage induced by alcohol depends on the amount, time, and consumption patterns (continuous and heavy episodic drinking). It affects individual global well-being and social and familial environments with variable impact. Alcohol addiction manifests with different degrees of organ and mental health detriment for the individual, exhibiting two main traits: compulsive drinking and negative emotional states occurring at withdrawal, frequently causing relapse episodes. Numerous individual and living conditions, including the concomitant use of other psychoactive substances, lie in the complexity of AUD. Ethanol and its metabolites directly impact the tissues and may cause local damage or alter the homeostasis of brain neurotransmission, immunity scaffolding, or cell repair biochemical pathways. Brain modulator and neurotransmitter-assembled neurocircuitries govern reward, reinforcement, social interaction, and consumption of alcohol behaviors in an intertwined manner. Experimental evidence supports the participation of neurotensin (NT) in preclinical models of alcohol addiction. For example, NT neurons in the central nucleus of the amygdala projecting to the parabrachial nucleus strengthen alcohol consumption and preference. In addition, the levels of NT in the frontal cortex were found to be lower in rats bred to prefer alcohol to water in a free alcohol-water choice compared to wild-type animals. NT receptors 1 and 2 seem to be involved in alcohol consumption and alcohol effects in several models of knockout mice. This review aims to present an updated picture of the role of NT systems in alcohol addiction and the possible use of nonpeptide ligands modulating the activity of the NT system, applied to experimental animal models of harmful drinking behavior mimicking alcohol addiction leading to health ruin in humans.


Assuntos
Alcoolismo , Neurotensina , Camundongos , Humanos , Ratos , Animais , Neurotensina/metabolismo , Reforço Psicológico , Recompensa , Receptores de Neurotensina/metabolismo , Consumo de Bebidas Alcoólicas/metabolismo , Etanol , Animais Selvagens
7.
Int J Mol Sci ; 24(9)2023 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-37175568

RESUMO

Intrinsic radiosensitivity is a major determinant of radiation response. Despite the extensive amount of radiobiological data available, variability among different studies makes it very difficult to produce high-quality radiosensitivity biomarkers or predictive models. Here, we characterize a panel of 27 human cell lines, including those derived from lung cancer, prostate cancer, and normal tissues. In addition, we used CRISPR-Cas9 to generate a panel of lines with known DNA repair defects. These cells were characterised by measuring a range of biological features, including the induction and repair of DNA double-strand breaks (DSBs), cell cycle distribution, ploidy, and clonogenic survival following X-ray irradiation. These results offer a robust dataset without inter-experimental variabilities for model development. In addition, we used these results to explore correlations between potential determinants of radiosensitivity. There was a wide variation in the intrinsic radiosensitivity of cell lines, with cell line Mean Inactivation Doses (MID) ranging from 1.3 to 3.4 Gy for cell lines, and as low as 0.65 Gy in Lig4-/- cells. Similar substantial variability was seen in the other parameters, including baseline DNA damage, plating efficiency, and ploidy. In the CRISPR-modified cell lines, residual DSBs were good predictors of cell survival (R2 = 0.78, p = 0.009), as were induced levels of DSBs (R2 = 0.61, p = 0.01). However, amongst the normal and cancerous cells, none of the measured parameters correlated strongly with MID (R2 < 0.45), and the only metrics with statistically significant associations are plating efficiency (R2 = 0.31, p = 0.01) and percentage of cell in S phase (R2 = 0.37, p = 0.005). While these data provide a valuable dataset for the modelling of radiobiological responses, the differences in the predictive power of residual DSBs between CRISPR-modified and other subgroups suggest that genetic alterations in other pathways, such as proliferation and metabolism, may have a greater impact on cellular radiation response. These pathways are often neglected in response modelling and should be considered in the future.


Assuntos
Neoplasias Pulmonares , Tolerância a Radiação , Masculino , Humanos , Tolerância a Radiação/genética , Reparo do DNA/genética , Linhagem Celular , Dano ao DNA , Sobrevivência Celular/genética , Sobrevivência Celular/efeitos da radiação , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/radioterapia , Relação Dose-Resposta à Radiação
8.
Int J Mol Sci ; 24(21)2023 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-37958914

RESUMO

The substance P (SP)/neurokinin-1 receptor (NK-1R) system is involved in cancer progression. NK-1R, activated by SP, promotes tumor cell proliferation and migration, angiogenesis, the Warburg effect, and the prevention of apoptosis. Tumor cells overexpress NK-1R, which influences their viability. A typical specific anticancer strategy using NK-1R antagonists, irrespective of the tumor type, is possible because these antagonists block all the effects mentioned above mediated by SP on cancer cells. This review will update the information regarding using NK-1R antagonists, particularly Aprepitant, as an anticancer drug. Aprepitant shows a broad-spectrum anticancer effect against many tumor types. Aprepitant alone or in combination therapy with radiotherapy or chemotherapy could reduce the sequelae and increase the cure rate and quality of life of patients with cancer. Current data open the door to new cancer research aimed at antitumor therapeutic strategies using Aprepitant. To achieve this goal, reprofiling the antiemetic Aprepitant as an anticancer drug is urgently needed.


Assuntos
Antineoplásicos , Neoplasias , Humanos , Aprepitanto/farmacologia , Aprepitanto/uso terapêutico , Antagonistas dos Receptores de Neurocinina-1/farmacologia , Antagonistas dos Receptores de Neurocinina-1/uso terapêutico , Reposicionamento de Medicamentos , Qualidade de Vida , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Receptores da Neurocinina-1/metabolismo , Substância P/farmacologia , Substância P/metabolismo , Neoplasias/tratamento farmacológico
9.
J Environ Manage ; 344: 118493, 2023 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-37494872

RESUMO

The southern rivers of Peru originate in the Andes Mountains and flow in a southwestern direction to the Pacific Ocean through one of the most hyper-arid regions of the world. During each sub-equatorial summer from December to February, rains and snow melt in the Andes increase the streamflow in these rivers, even as they pass through the 100 km arid zone to the ocean. This study quantified seasonal dynamics of 34 trace metal elements (TM) and other constituent concentrations in four southern river basins of Peru (Chili-Quilca, Tambo, Camana-Majes-Colca, and Ocoña) during 2019-2020. Consistent with previous studies, we observed that: (1) the river water in the southern basins had relatively high concentrations of B, As, Fe, Al, Mn, P, Pb and Ni, with As the most ubiquitous toxic TM in all the basins, often detected at concentrations surpassing Peruvian and USEPA regulated concentrations; and (2) basins with the most to least toxic TM contamination were the Tambo > Chili-Quilca > Camana-Majes-Colca > Ocoña. Seasonal streamflow strongly influenced the concentrations of twenty TM, with 15 TM (Al, Au, Ba, Cd, Co, Cu, Fe, Gd, Mn, Ni, P, Pb, Ti, Yb and Zr) consistently higher in the wet season, and with As, B, Ge, Li, and Pd higher in the dry season. Our results improve the understanding of seasonal variability and vulnerability in western Andes superficial water sources, which are highly influenced by both local geogenic and anthropogenic conditions. A Spanish translation of this paper is available in the online Supplementary Material.


Assuntos
Metais Pesados , Poluentes Químicos da Água , Rios , Estações do Ano , Peru , Chumbo , Poluentes Químicos da Água/análise , Monitoramento Ambiental , Água , Metais Pesados/análise
10.
Entropy (Basel) ; 25(1)2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36673292

RESUMO

We study a stochastic version of the dynamical Casimir effect, computing the particle creation inside a cavity produced by a random motion of one of its walls. We first present a calculation perturbative in the amplitude of the motion. We compare the stochastic particle creation with the deterministic counterpart. Then, we go beyond the perturbative evaluation using a stochastic version of the multiple scale analysis, that takes into account stochastic parametric resonance. We stress the relevance of the coupling between the different modes induced by the stochastic motion. In the single-mode approximation, the equations are formally analogous to those that describe the stochastic particle creation in a cosmological context, that we rederive using multiple scale analysis.

11.
Entropy (Basel) ; 25(9)2023 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-37761548

RESUMO

Shortcuts to adiabaticity (STA) are relevant in the context of quantum systems, particularly regarding their control when they are subjected to time-dependent external conditions. In this paper, we investigate the completion of a nonadiabatic evolution into a shortcut to adiabaticity for a quantum field confined within a one-dimensional cavity containing two movable mirrors. Expanding upon our prior research, we characterize the field's state using two Moore functions that enables us to apply reverse engineering techniques in constructing the STA. Regardless of the initial evolution, we achieve a smooth extension of the Moore functions that implements the STA. This extension facilitates the computation of the mirrors' trajectories based on the aforementioned functions. Additionally, we draw attention to the existence of a comparable problem within nonrelativistic quantum mechanics.

12.
Omega (Westport) ; : 302228231187013, 2023 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-37384882

RESUMO

Cultural snapshots may be a didactic resource that promotes the understanding of death and provides teachers with tools that can be used to work with students. This study aims to analyse pre-service teachers' attitudes towards death education. A quantitative longitudinal panel design with pre-test and post-test measures was applied, with descriptive, inferential, and predictive approaches. The sample consisted of 161 pre-service primary teachers from a Spanish university who responded to the validated questionnaire "Death Education Attitudes Scale-Teachers" (DEAS-T). The results reveal an improvement in their attitudes towards death education after implementing cultural snapshots in class, producing significant differences between the pre-test and post-test according to gender, in favour of the male participants. The variables of death anxiety and adequate training are relevant for predicting the attitudes of both genders, in addition to the motivation variable in male participants and the variable of interest towards the topic in female participants.

13.
Educ Inf Technol (Dordr) ; : 1-21, 2023 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-37361788

RESUMO

All spheres of our life are being affected using technology, particularly its integration in the research processes carried out by teachers. The success of the integration of specific digital resources in research work can be affected by several factors, such as: digital skills for finding information, managing it, analyzing it, and communicating results; digital flow; anxiety in the use of ICT; digital ethics; quality of digital resources; and finally, the behavioral intention to integrate ICT. The purpose of this study is to examine the factors that influence the integration of ICT in the research process of the Higher Education teacher, and the relation between them. An online survey was used to collect data, and 1740 participants. This study used a causal model through partial least squares structural equations modeling (PLS-SEM). With this, the hypotheses established between the integration of ICT and its possible incident factors were verified. The findings revealed a significant influence path from factor integration to digital skills, ethics, flow digital, and behavior intention. Although, resource quality and ICT anxiety had significant effects on the causal model, they did not have a large impact on teachers' integration of digital resources. The total of these factors corresponded to 48.20% of the variance in the integration of the researcher of the specific digital resources to be used in the research process. These results confirm that this model is effective in explaining the technological integration of teachers to use ICT in research work.

14.
Mol Biol Evol ; 38(12): 5782-5805, 2021 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-34469576

RESUMO

Drosophila melanogaster is a leading model in population genetics and genomics, and a growing number of whole-genome data sets from natural populations of this species have been published over the last years. A major challenge is the integration of disparate data sets, often generated using different sequencing technologies and bioinformatic pipelines, which hampers our ability to address questions about the evolution of this species. Here we address these issues by developing a bioinformatics pipeline that maps pooled sequencing (Pool-Seq) reads from D. melanogaster to a hologenome consisting of fly and symbiont genomes and estimates allele frequencies using either a heuristic (PoolSNP) or a probabilistic variant caller (SNAPE-pooled). We use this pipeline to generate the largest data repository of genomic data available for D. melanogaster to date, encompassing 271 previously published and unpublished population samples from over 100 locations in >20 countries on four continents. Several of these locations have been sampled at different seasons across multiple years. This data set, which we call Drosophila Evolution over Space and Time (DEST), is coupled with sampling and environmental metadata. A web-based genome browser and web portal provide easy access to the SNP data set. We further provide guidelines on how to use Pool-Seq data for model-based demographic inference. Our aim is to provide this scalable platform as a community resource which can be easily extended via future efforts for an even more extensive cosmopolitan data set. Our resource will enable population geneticists to analyze spatiotemporal genetic patterns and evolutionary dynamics of D. melanogaster populations in unprecedented detail.


Assuntos
Drosophila melanogaster , Metagenômica , Animais , Drosophila melanogaster/genética , Frequência do Gene , Genética Populacional , Genômica
15.
J Arthroplasty ; 37(10): 1898-1905.e7, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36162922

RESUMO

BACKGROUND: Corticosteroids are commonly used intraoperatively to treat pain and reduce opioid consumption and nausea associated with primary total joint arthroplasty (TJA). The purpose of this study was to evaluate the efficacy and safety of corticosteroids in primary TJA to support the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and the American Society of Regional Anesthesia and Pain Management. METHODS: The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched for studies published before February 2020 on corticosteroids in TJA. All included studies underwent qualitative and quantitative homogeneity testing followed by a systematic review and direct comparison meta-analysis to assess the efficacy and safety of corticosteroids. RESULTS: Critical appraisal of 1,581 publications revealed 23 studies regarded as the best available evidence for analysis. Intraoperative dexamethasone reduces postoperative pain, opioid consumption, and nausea and vomiting. Multiple doses lead to further reduction in pain, opioid consumption, nausea and vomiting. There is insufficient evidence on the risk of adverse events with perioperative dexamethasone in TJA. CONCLUSION: Strong evidence supports the use of a single dose or multiple doses of intravenous dexamethasone to reduce postoperative pain, opioid consumption, nausea and vomiting after primary TJA. There is insufficient evidence on perioperative dexamethasone in primary TJA to determine the optimal dose, number of doses, or risk of postoperative adverse events.


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Corticosteroides/efeitos adversos , Analgésicos Opioides/efeitos adversos , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Dexametasona/efeitos adversos , Humanos , Náusea , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Vômito/tratamento farmacológico , Vômito/etiologia
16.
J Arthroplasty ; 37(10): 1928-1938.e9, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36162925

RESUMO

BACKGROUND: Periarticular injection (PAI) is administered intraoperatively to help reduce postoperative pain and opioid consumption after primary total joint arthroplasty (TJA). The purpose of this study was to evaluate the efficacy and safety of PAI in primary TJA to support the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and American Society of Regional Anesthesia and Pain Medicine. METHODS: The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched for studies published prior to March 2020 on PAI in TJA. All included studies underwent qualitative and quantitative homogeneity testing followed by a systematic review and direct comparison meta-analysis to assess the efficacy and safety of PAI. RESULTS: Three thousand six hundred and ninety nine publications were critically appraised to provide 60 studies regarded as the best available evidence for an analysis. The meta-analysis showed that intraoperative PAI reduces postoperative pain and opioid consumption. Adding ketorolac or a corticosteroid to a long-acting local anesthetic (eg, ropivacaine or bupivacaine) provides an additional benefit. There is no difference between liposomal bupivacaine and other nonliposomal long-acting local anesthetics. Morphine does not provide any additive benefit in postoperative pain and opioid consumption and may increase postoperative nausea and vomiting. There is insufficient evidence to draw conclusions on the use of epinephrine and clonidine. CONCLUSION: Strong evidence supports the use of a PAI with a long-acting local anesthetic to reduce postoperative pain and opioid consumption. Adding a corticosteroid and/or ketorolac to a long-acting local anesthetic further reduces postoperative pain and may reduce opioid consumption. Morphine has no additive effect and there is insufficient evidence on epinephrine and clonidine.


Assuntos
Anestésicos Locais , Artroplastia do Joelho , Analgésicos Opioides/uso terapêutico , Artroplastia do Joelho/efeitos adversos , Bupivacaína , Clonidina/uso terapêutico , Epinefrina/uso terapêutico , Humanos , Injeções Intra-Articulares , Cetorolaco/uso terapêutico , Morfina/uso terapêutico , Manejo da Dor , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Ropivacaina/uso terapêutico
17.
J Arthroplasty ; 37(10): 1906-1921.e2, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36162923

RESUMO

BACKGROUND: Regional nerve blocks are widely used in primary total knee arthroplasty (TKA) to reduce postoperative pain and opioid consumption. The purpose of our study was to evaluate the efficacy and safety of regional nerve blocks after TKA in support of the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and American Society of Regional Anesthesia and Pain Management. METHODS: We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for studies published before March 24, 2020 on femoral nerve block, adductor canal block, and infiltration between Popliteal Artery and Capsule of Knee in primary TKA. All included studies underwent qualitative and quantitative homogeneity testing followed by a systematic review and direct comparison meta-analysis to assess the efficacy and safety of the regional nerve blocks compared to a control, local peri-articular anesthetic infiltration (PAI), or between regional nerve blocks. RESULTS: Critical appraisal of 1,673 publications yielded 56 publications representing the best available evidence for analysis. Femoral nerve and adductor canal blocks are effective at reducing postoperative pain and opioid consumption, but femoral nerve blocks are associated with quadriceps weakness. Use of a continuous compared to single shot adductor canal block can improve postoperative analgesia. No difference was noted between an adductor canal block or PAI regarding postoperative pain and opioid consumption, but the combination of both may be more effective. CONCLUSION: Single shot adductor canal block or PAI should be used to reduce postoperative pain and opioid consumption following TKA. Use of a continuous adductor canal block or a combination of single shot adductor canal block and PAI may improve postoperative analgesia in patients with concern of poor postoperative pain control.


Assuntos
Anestésicos , Artroplastia do Joelho , Bloqueio Nervoso , Analgésicos Opioides , Anestésicos Locais , Nervo Femoral , Humanos , Dor Pós-Operatória/prevenção & controle
18.
J Arthroplasty ; 37(10): 1922-1927.e2, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36162924

RESUMO

BACKGROUND: Regional nerve blocks may be used as a component of a multimodal analgesic protocol to manage postoperative pain after primary total hip arthroplasty (THA). The purpose of our study was to evaluate the efficacy and safety of regional nerve blocks after THA in support of the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and American Society of Regional Anesthesia and Pain Management. METHODS: We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for studies published prior to March 24, 2020 on fascia iliaca, lumbar plexus, and quadratus lumborum blocks in primary THA. All included studies underwent qualitative and quantitative homogeneity testing followed by a systematic review and direct comparison meta-analysis to assess the efficacy and safety of the regional nerve blocks. RESULTS: An initial critical appraisal of 3,382 publications yielded 11 publications representing the best available evidence for an analysis. Fascia iliaca, lumbar plexus, and quadratus lumborum blocks demonstrate the ability to reduce postoperative pain and opioid consumption. Among the available comparisons, no difference was noted between a regional nerve block or local periarticular anesthetic infiltration regarding postoperative pain and opioid consumption. CONCLUSION: Local periarticular anesthetic infiltration should be considered prior to a regional nerve block due to concerns over the safety and cost of regional nerve blocks. If a regional nerve block is used in primary THA, a fascia iliaca block is preferred over other blocks due to the differences in technical demands and risks associated with the alternative regional nerve blocks.


Assuntos
Anestésicos , Artroplastia de Quadril , Bloqueio Nervoso , Analgésicos , Analgésicos Opioides , Humanos , Bloqueio Nervoso/métodos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle
19.
Entropy (Basel) ; 25(1)2022 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-36673159

RESUMO

The development of quantum technologies present important challenges such as the need for fast and precise protocols for implementing quantum operations. Shortcuts to adiabaticity (STAs) are a powerful tool for achieving these goals, as they enable us to perform an exactly adiabatic evolution in finite time. In this paper, we present a shortcut to adiabaticity for the control of an optomechanical cavity with two moving mirrors. Given reference trajectories for the mirrors, we find analytical expressions that give us effective trajectories which implement an STA for the quantum field inside the cavity. We then solve these equations numerically for different reference protocols, such as expansions, contractions and rigid motions, thus confirming the successful implementation of the STA and finding some general features of these effective trajectories.

20.
J Neurosci ; 40(13): 2633-2643, 2020 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-31996455

RESUMO

An increasing number of studies supports the view that transcutaneous electrical stimulation of the spinal cord (TESS) promotes functional recovery in humans with spinal cord injury (SCI). However, the neural mechanisms contributing to these effects remain poorly understood. Here we examined motor-evoked potentials in arm muscles elicited by cortical and subcortical stimulation of corticospinal axons before and after 20 min of TESS (30 Hz pulses with a 5 kHz carrier frequency) and sham-TESS applied between C5 and C6 spinous processes in males and females with and without chronic incomplete cervical SCI. The amplitude of subcortical, but not cortical, motor-evoked potentials increased in proximal and distal arm muscles for 75 min after TESS, but not sham-TESS, in control subjects and SCI participants, suggesting a subcortical origin for these effects. Intracortical inhibition, elicited by paired stimuli, increased after TESS in both groups. When TESS was applied without the 5 kHz carrier frequency both subcortical and cortical motor-evoked potentials were facilitated without changing intracortical inhibition, suggesting that the 5 kHz carrier frequency contributed to the cortical inhibitory effects. Hand and arm function improved largely when TESS was used with, compared with without, the 5 kHz carrier frequency. These novel observations demonstrate that TESS influences cortical and spinal networks, having an excitatory effect at the spinal level and an inhibitory effect at the cortical level. We hypothesized that these parallel effects contribute to further the recovery of limb function following SCI.SIGNIFICANCE STATEMENT Accumulating evidence supports the view that transcutaneous electrical stimulation of the spinal cord (TESS) promotes recovery of function in humans with spinal cord injury (SCI). Here, we show that a single session of TESS over the cervical spinal cord in individuals with incomplete chronic cervical SCI influenced in parallel the excitability cortical and spinal networks, having an excitatory effect at the spinal level and an inhibitory effect at the cortical level. Importantly, these parallel physiological effects had an impact on the magnitude of improvements in voluntary motor output.


Assuntos
Córtex Cerebral/fisiopatologia , Plasticidade Neuronal/fisiologia , Quadriplegia/terapia , Recuperação de Função Fisiológica/fisiologia , Traumatismos da Medula Espinal/terapia , Estimulação da Medula Espinal/métodos , Adulto , Córtex Cerebral/diagnóstico por imagem , Medula Cervical/diagnóstico por imagem , Medula Cervical/fisiopatologia , Eletromiografia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Córtex Motor/fisiopatologia , Quadriplegia/diagnóstico por imagem , Quadriplegia/fisiopatologia , Traumatismos da Medula Espinal/diagnóstico por imagem , Traumatismos da Medula Espinal/fisiopatologia , Adulto Jovem
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