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1.
Appetite ; 197: 107307, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38518867

RESUMO

Consumers are preferring more "natural" foods, made of "healthier" and "familiar" components - the "clean-label" trend. As the population ages, understanding the older adult consumer segment becomes increasingly important. This study aims to identify the factors influencing the acceptability and liking of clean-label products in older adults living in the community. A convenience sample of 100 older adults was used for this cross-sectional study. Socio-demographic data, health status, independence level, lifestyle characteristics, nutritional status, and food and nutrient intake data were collected. The acceptability and liking for clean-label products comprised two parts: Sensory analysis with overall liking evaluation of three pairs of products, using a 9-point hedonic scale and free comments; Willingness to eat and preference assessment of nine pairs of products using the Food Action scale and a simple preference test. The participants were 80% female with a mean age of 75 years old. The overall liking for clean-label versions of cookies and mayonnaise was lower than for traditional versions. However, participants were more willing to eat the clean-label versions of products, particularly ham and yogurt. Most of the participants would prefer buying the clean-label version of all nine pairs of products, especially for ham, loaf bread, sausages, and yogurt. In sum, older adults living in the community exhibit a lower liking but, a greater willingness to eat and a higher preference for buying clean-label products. Older adults who favor clean-label products have higher levels of education and are reported to have a more adequate diet.


Assuntos
Preferências Alimentares , Paladar , Humanos , Feminino , Idoso , Masculino , Estudos Transversais , Portugal , Pão/análise , Comportamento do Consumidor
2.
Aging Ment Health ; 28(2): 360-368, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37771115

RESUMO

OBJECTIVES: The abbreviated 16-item version of the Difficulties with Emotion Regulation Scale (DERS-16) is widely used to assess individuals' perceived challenges in regulating their emotions, a central aspect of psychological symptoms commonly experienced in old age. However, its psychometric properties have yet to be tested in this population. Furthermore, a shorter version of the DERS-16 could further minimize the assessment burden on older individuals. Thus, we aimed to test the DERS-16's psychometric performance and determine if any items were redundant to develop a psychometrically sound shorter version. METHODS: We enrolled 302 Portuguese older adults (Mage = 75.22; SD = 8.99 years) in a cross-sectional study. RESULTS: Exploratory factor analyses indicated a one-factor structure and a four-factor solution with eight items (69.3%-81.9% of the variance observed). The four-factor-8-item solution presented an interpretable structure and demonstrated good reliability values (> 0.70) and construct validity with the Twenty-Item Toronto Alexithymia Scale, Eight-Item Geriatric Depression Scale, and Geriatric Anxiety Inventory (r = 0.66, 0.40, 0.52; p < 0.001). CONCLUSION: The robust psychometric properties of DERS-8 make it a valuable tool for clinical and longitudinal studies, facilitating targeted interventions in older adults and allowing for precise emotion dysregulation screening.


Assuntos
Regulação Emocional , Humanos , Idoso , Reprodutibilidade dos Testes , Estudos Transversais , Emoções , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/psicologia , Psicometria/métodos , Inquéritos e Questionários
3.
Chem Biodivers ; : e202400680, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38748618

RESUMO

The study aimed to assess the chemical composition of Miconia ibaguensis leaves extracts and fractions obtained from the ethanolic extract (EE), along with evaluating their antifungal, antibacterial, antidiabetic, and antioxidant activities. The ethyl acetate fraction (EAF) exhibited potent antifungal activity against Candida spp (1.95 - 3.90 µg mL-1) and potent antioxidant activity in the DPPH (1.74 ± 0.07 µg mL-1), FRAP (654.01 ± 42.09 µmol ETrolox/gsample), and ORAC (3698.88 ± 37.28 µmol ETrolox/gsample) methods. The EE displayed inhibition against the α-amylase enzyme (8.42 ± 0.05 µg mL-1). Flavonoids, hydrolysable tannins, triterpenoids, and phenolic acids, identified in the EE and fractions via (-)-HPLC-ESI-MS/MS analysis, were found to contribute to the species' biological activity potentially. These findings suggest promising avenues for further research and potential applications in pharmacology and natural products, offering new possibilities in the fight against global health issues.

4.
Compr Rev Food Sci Food Saf ; 23(1): e13247, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38284589

RESUMO

Low consumer acceptance of edible insects and insect-based products is one of the main barriers to the successful implementation of entomophagy in Western countries. This rejection is mainly caused by consumers' negative emotional responses, psychological/personality traits, and attitudes toward food choices. However, as the role of intrinsic product characteristics on such food choices has not been adequately studied, a systematic review was conducted following the PRISMA method, to analyze studies that have assessed hedonic evaluations, sensory profiling, or emotional responses to edible insects or insect-based products. The majority of studies performed with whole insects and insect flour highlight that insect-based products are more negatively evaluated than control products. Although the sensory properties of insects are affected by species and processing conditions, they are generally negative across sensory dimensions. In particular, insects and insect-based products are generally associated with odor and flavor/taste attributes that are related to old/spoiled food. These negative attributes can be linked to the fat fraction of edible insects, with insect oils being very negatively evaluated by consumers. On the other hand, defatted fractions and deodorized oils are not associated with these negative attributes, further supporting the hypothesis that the fat fraction is responsible for the negative odor and flavor/taste attributes. However, there is still a lack of studies assessing the sensory profile of edible insects and insect-based products, as well as consumers' emotional responses to their consumption. Future studies should focus on the effects of different processing conditions, products incorporating insect fractions (namely protein concentrates/isolates and defatted fractions), and evaluation by target consumer groups.


Assuntos
Insetos Comestíveis , Animais , Emoções , Farinha , Insetos , Óleos , Humanos
5.
Metabolomics ; 19(8): 68, 2023 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-37486581

RESUMO

INTRODUCTION: Lantana trifolia L. (Verbenaceae) is a shrubby plant. In folk medicine, its leaves are used in the form of infusions and syrups to treat angina, coughs, and colds; they are also applied as tranquilizer. Previous studies have reported the antimicrobial potential of the compounds present in L. trifolia leaves. OBJECTIVES: To report the anti-Candida activities of the fractions obtained from the fruits and leaves of two L. trifolia specimens. METHODS: The L. trifolia fractions were submitted to UFLC-DAD-(+)-ESI-MS/MS, and the data were analyzed by using multivariate statistical tools (PCA, PLS-DA) and spectral similarity analyses based on molecular networking, which aided dereplication of the bioactive compounds. Additionally, NMR analyses were performed to confirm the chemical structure of some of the major compounds in the fractions. RESULTS: The ethyl acetate fractions presented MIC values lower than 100 µg mL-1 against the three Candida strains evaluated herein (C. albicans, C. tropicalis, and C. glabrata). Fractions FrPo AcOEt, FrPe AcOEt, and FrPe nBut had MIC values of 1.46, 2.93, and 2.93 µg mL-1 against C. glabrata, respectively. These values resembled the MIC value of amphotericin B, the positive control (0.5-1.0 µg mL-1), against this same strain. Cytotoxicity was measured and used to calculate the selectivity index. CONCLUSION: On the basis of our data, the most active fractions in the antifungal assay were more selective against C. glabrata than against non-infected cells. The analytical approach adopted here allowed us to annotate 29 compounds, nine of which were bioactive (PLS-DA results) and belong to the class of phenolic compounds.


Assuntos
Antineoplásicos , Lantana , Antifúngicos/farmacologia , Antifúngicos/análise , Espectrometria de Massas em Tandem , Lantana/química , Frutas , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Metabolômica , Folhas de Planta/química
6.
Sensors (Basel) ; 23(2)2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36679414

RESUMO

In the near future, autonomous vehicles with full self-driving features will populate our public roads. However, fully autonomous cars will require robust perception systems to safely navigate the environment, which includes cameras, RADAR devices, and Light Detection and Ranging (LiDAR) sensors. LiDAR is currently a key sensor for the future of autonomous driving since it can read the vehicle's vicinity and provide a real-time 3D visualization of the surroundings through a point cloud representation. These features can assist the autonomous vehicle in several tasks, such as object identification and obstacle avoidance, accurate speed and distance measurements, road navigation, and more. However, it is crucial to detect the ground plane and road limits to safely navigate the environment, which requires extracting information from the point cloud to accurately detect common road boundaries. This article presents a survey of existing methods used to detect and extract ground points from LiDAR point clouds. It summarizes the already extensive literature and proposes a comprehensive taxonomy to help understand the current ground segmentation methods that can be used in automotive LiDAR sensors.


Assuntos
Condução de Veículo , Automóveis , Veículos Autônomos , Análise Espectral Raman
7.
J Appl Clin Med Phys ; 23(4): e13542, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35166027

RESUMO

PURPOSE: Development of an independent MU calculator (StereoCalc) with and without heterogeneity corrections for stereotactic treatments, in a Varian TrueBeam STx LINAC using stereotactic cones, with flattening filter-free photon energies. METHODS: Multiple depth curves and output factors were measured, following the dosimetry formalism for small fields proposed by the TRS-483. The developed StereoCalc imports and processes the beam data files and calculates the patient plans with and without heterogeneity correction. Validation of the developed software was carried out using phantoms. The accuracy of the StereoCalc software was verified in stereotactic patient plans. RESULTS: A maximum difference of 2.47% and 2.07% was obtained in the phantom validation tests with and without heterogeneity correction, respectively. The mean percentual difference of StereoCalc from cone dose calculation (CDC) in the clinical testing was 2.86% ±1.27% and 0.78% ±0.48% with and without heterogeneity correction, respectively. The largest differences found were 7.34% and 1.98%, respectively. CONCLUSIONS: The results obtained in this work show that the MU calculated with StereoCalc software is in good agreement with the values calculated by the treatment planning systems, both in static fields and arcs. We have also improved the software to consider heterogeneity corrections calculations. As expected, and as a major achievement of this work, some differences were observed when heterogeneities were considered. StereoCalc proved to be a powerful tool that can be integrated into the specific quality assurance program in a medical physics department for independent verification in stereotactic treatment with cones.


Assuntos
Radiocirurgia , Radioterapia de Intensidade Modulada , Humanos , Aceleradores de Partículas , Imagens de Fantasmas , Radiometria , Radiocirurgia/métodos , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia de Intensidade Modulada/métodos , Software
8.
N Engl J Med ; 378(23): 2191-2201, 2018 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-29766772

RESUMO

BACKGROUND: Embolic strokes of undetermined source represent 20% of ischemic strokes and are associated with a high rate of recurrence. Anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, may result in a lower risk of recurrent stroke than aspirin. METHODS: We compared the efficacy and safety of rivaroxaban (at a daily dose of 15 mg) with aspirin (at a daily dose of 100 mg) for the prevention of recurrent stroke in patients with recent ischemic stroke that was presumed to be from cerebral embolism but without arterial stenosis, lacune, or an identified cardioembolic source. The primary efficacy outcome was the first recurrence of ischemic or hemorrhagic stroke or systemic embolism in a time-to-event analysis; the primary safety outcome was the rate of major bleeding. RESULTS: A total of 7213 participants were enrolled at 459 sites; 3609 patients were randomly assigned to receive rivaroxaban and 3604 to receive aspirin. Patients had been followed for a median of 11 months when the trial was terminated early because of a lack of benefit with regard to stroke risk and because of bleeding associated with rivaroxaban. The primary efficacy outcome occurred in 172 patients in the rivaroxaban group (annualized rate, 5.1%) and in 160 in the aspirin group (annualized rate, 4.8%) (hazard ratio, 1.07; 95% confidence interval [CI], 0.87 to 1.33; P=0.52). Recurrent ischemic stroke occurred in 158 patients in the rivaroxaban group (annualized rate, 4.7%) and in 156 in the aspirin group (annualized rate, 4.7%). Major bleeding occurred in 62 patients in the rivaroxaban group (annualized rate, 1.8%) and in 23 in the aspirin group (annualized rate, 0.7%) (hazard ratio, 2.72; 95% CI, 1.68 to 4.39; P<0.001). CONCLUSIONS: Rivaroxaban was not superior to aspirin with regard to the prevention of recurrent stroke after an initial embolic stroke of undetermined source and was associated with a higher risk of bleeding. (Funded by Bayer and Janssen Research and Development; NAVIGATE ESUS ClinicalTrials.gov number, NCT02313909 .).


Assuntos
Aspirina/uso terapêutico , Inibidores do Fator Xa/uso terapêutico , Embolia Intracraniana/tratamento farmacológico , Inibidores da Agregação Plaquetária/uso terapêutico , Rivaroxabana/uso terapêutico , Acidente Vascular Cerebral/prevenção & controle , Idoso , Aspirina/efeitos adversos , Isquemia Encefálica/prevenção & controle , Inibidores do Fator Xa/efeitos adversos , Feminino , Hemorragia/induzido quimicamente , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/efeitos adversos , Rivaroxabana/efeitos adversos , Prevenção Secundária/métodos , Acidente Vascular Cerebral/etiologia
9.
Glob Chang Biol ; 27(19): 4575-4591, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34118093

RESUMO

Amazonian rainforests, once thought to be pristine wilderness, are increasingly known to have been widely inhabited, modified, and managed prior to European arrival, by human populations with diverse cultural backgrounds. Amazonian Dark Earths (ADEs) are fertile soils found throughout the Amazon Basin, created by pre-Columbian societies with sedentary habits. Much is known about the chemistry of these soils, yet their zoology has been neglected. Hence, we characterized soil fertility, macroinvertebrate communities, and their activity at nine archeological sites in three Amazonian regions in ADEs and adjacent reference soils under native forest (young and old) and agricultural systems. We found 673 morphospecies and, despite similar richness in ADEs (385 spp.) and reference soils (399 spp.), we identified a tenacious pre-Columbian footprint, with 49% of morphospecies found exclusively in ADEs. Termite and total macroinvertebrate abundance were higher in reference soils, while soil fertility and macroinvertebrate activity were higher in the ADEs, and associated with larger earthworm quantities and biomass. We show that ADE habitats have a unique pool of species, but that modern land use of ADEs decreases their populations, diversity, and contributions to soil functioning. These findings support the idea that humans created and sustained high-fertility ecosystems that persist today, altering biodiversity patterns in Amazonia.


Assuntos
Ecossistema , Solo , Agricultura , Biodiversidade , Humanos , Microbiologia do Solo
10.
Public Health Nutr ; 24(13): 4277-4285, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33183385

RESUMO

OBJECTIVE: To determine nutritional adequacy of school lunch and to assess the impact of food waste on nutrient intake of primary schoolchildren. DESIGN: The weighing method was used for evaluating initial servings and plate waste for lunch. Energy and nutritional contents of meals served, consumed and wasted were estimated using the software Food Processor Plus. The mean nutritional value of food served and consumed was compared with dietary guidelines. SETTING: Portuguese public primary schools in the city of Porto. PARTICIPANTS: All 525 fourth-grade children, aged from 9 to 10 years old, attending to twenty-one public primary schools. RESULTS: Overall, school lunches served did not meet the dietary guidelines for energy and nutrients, as only 12·5 % of the evaluated meals were adequate for energy, 33·5 % for proteins, 11·9 % for carbohydrates and 57·1 % for lipids. The majority of meals served were below the age-specific lower limit, namely for energy (83·7 %) and carbohydrates (86·8 %). The only exception, also unbalanced, was observed for proteins, as 42·4 % of lunches served exceeded the recommended upper limit. Furthermore, lunches served and consumed by children did not meet the dietary guidelines for fibre and for the micronutrients evaluated. Children wasted 26 % of the energy content provided in lunches, corresponding to 91·5 kcal, 25 % of proteins and 29 % of carbohydrates supplied. CONCLUSIONS: The lunches served and consumed by children at school canteens failed to meet nutritional standards. These results are not only a consequence of inadequate food portions served but also a result of the high plate waste values observed.


Assuntos
Serviços de Alimentação , Eliminação de Resíduos , Idoso , Criança , Ingestão de Alimentos , Humanos , Almoço , Instituições Acadêmicas
11.
Environ Res ; 176: 108507, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31203050

RESUMO

During the last few years, there has been an alarming increase in the amount of nickel (Ni) being released into the environment, primarily due to its use in the production of stainless steel but also from other sources such as batteries manufacturing and consequent disposal. The established biotic ligand models provide precise estimates for Ni bioavailability, in contrast, studies describing the mechanisms underpinning toxicological effect of Ni are scarce. This study exploits RNA-seq to determine the transcriptomic responses of isopods using Porcellionides pruinosus as an example of a terrestrial metal-resistant woodlouse. Furthermore, the recently proposed model for Ni adverse outcome pathways (Ni-AOP) presents an unprecedented opportunity to fit isopod responses to Ni toxicity and define Porcellionides pruinosus as a metalomic model. Prior to this study, P. pruinosus represented an important environmental sentinel, though lacking genetic/omic data. The reference transcriptome generated here thus represents a major advance and a novel resource. A detailed annotation of the transcripts obtained is presented together with the homology to genes/gene products from Metazoan and Arthropoda phylum, Gene Ontology (GO) classification, clusters of orthologous groups (COG) and assignment to KEGG metabolic pathways. The differential gene expression comparison was determined in response to nickel (Ni) exposure and used to derive the enriched pathways and processes. It revealed a significant impact on ion trafficking and storage, oxidative stress, neurotoxicity, reproduction impairment, genetics and epigenetics. Many of the processes observed support the current Ni-AOP although the data highlights that the current model can be improved by including epigenetic endpoints, which represents key chronic risks under a scenario of Ni toxicity.


Assuntos
Poluentes Ambientais , Isópodes , Níquel , Animais , Poluentes Ambientais/farmacocinética , Poluentes Ambientais/toxicidade , Níquel/farmacocinética , Níquel/toxicidade , Estresse Oxidativo , Reprodução , Transcriptoma
12.
Appetite ; 139: 26-34, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-30974180

RESUMO

The knowledge of the food pattern of a population is crucial for establishing nutritional and epidemiological profiles, as well as for controlling the market of foodstuffs and to help in the management of stock of staple foods. This study aims to evaluate food consumption and its association with the underlying motives for consumers' food choices, through the application of a Food Frequency Questionnaire (FFQ) followed by a Food Choice Questionnaire (FCQ). Face to face interviews were conducted with 503 participants, recruited at their homes, workplaces, health centers and other central locations in Cape Verde, only including subjects aged ≥18 years, without a self-reported history of chronic diseases. Food frequency analysis, as well as exploratory factorial analysis (EFA) were used to determine dietary patterns and nonparametric statistical tests for comparisons and associations of variables. The EFA yielded 4 patterns termed as: "Traditional", "Western", "Balanced" and "Energetic". Using an FCQ structure of 9 factors, three different groups were obtained from hierarchical clustering. (Cabral, de Almeida, & Cunha, 2017). The results show that Cape Verdean inhabitants follow global diet trends (towards the so-called "westernization"), however, in a more moderate rate if compared to other developing country populations. Consuming "junk food" is infrequent in Cape Verde, which appears to be due to limited availability and accessibility of this type of food. The rural coastal population remains more attached to traditional foods, consuming local products and traditional dishes, whereas in the urban population, one may notice the "westernization" of consumption. The application of an FFQ in combination with the FCQ provided in-depth information on eating attitudes and behaviors.


Assuntos
Dieta/estatística & dados numéricos , Preferências Alimentares/psicologia , Adolescente , Adulto , Cabo Verde , Comportamento de Escolha , Dieta/psicologia , Inquéritos sobre Dietas , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , População Rural/estatística & dados numéricos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto Jovem
13.
J Appl Clin Med Phys ; 20(2): 63-70, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30628154

RESUMO

In-phantom and in-vivo three dimensional conformal radiation therapy (3DCRT) and volumetric modulated arc therapy (VMAT) skin doses, measured with and without bolus in a female anthropomorphic phantom RANDO and in patients, were compared against treatment planning system calculated values. A thorough characterization of the metal oxide semiconductor field effect transistor measurement system was performed prior to the measurements in phantoms and patients. Patients with clinical indication for postoperative external radiotherapy were selected. Skin dose showed higher values with 3DCRT technique compared with VMAT. The increase in skin dose due to the use of bolus was quantified. It was observed that, in the case of VMAT, the bolus effect on the skin dose was considerable when compared with 3DCRT. From the point of view of treatment time, bolus cost, and positioning reproducibility, the use of bolus in these situations can be optimized.


Assuntos
Neoplasias da Mama/radioterapia , Imagens de Fantasmas , Radiometria/instrumentação , Planejamento da Radioterapia Assistida por Computador/normas , Radioterapia Conformacional/métodos , Radioterapia de Intensidade Modulada/métodos , Pele/efeitos da radiação , Feminino , Humanos , Órgãos em Risco/efeitos da radiação , Prognóstico , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador/métodos , Semicondutores
14.
ScientificWorldJournal ; 2019: 9423658, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30853865

RESUMO

The species Inga laurina is native to the Brazilian Cerrado. There are no studies about the chemical composition and biological activities of extracts of this endangered species. The ethanolic extract and its successive fractions are rich in phenolic compounds and presented good antifungal activities. HPLC/MS-MS/MS and H1/C13 analysis led to the identification of seventeen compounds, most of which are gallic acid derivatives, myricetin and quercetin glycosides. The ethyl acetate fraction (EAF) contained high levels of total phenolics, expressed in milligrams of gallic acid equivalents per gram of extract (475.3 ± 1.9 mg GAE gextract -1) and flavonoids expressed in milligrams of quercetin equivalents per gram of extract (359.3 ± 10.6 mg QE gextract -1). This fraction was active against fungi of the Candida genus. The EAF showed MIC value 11.7 µg mL-1 against C. glabrata and a selectivity index of 1.6 against Vero cells. The flavonol glycoside myricetin-3-O-rhamnoside was isolated for the first time from the Inga laurina. These results make I. laurina a promising plant as a source of pharmaceutical and biological active antifungal compounds.


Assuntos
Antifúngicos/farmacologia , Citotoxinas/farmacologia , Fabaceae/química , Extratos Vegetais/farmacologia , Antifúngicos/química , Antifúngicos/isolamento & purificação , Cromatografia Líquida de Alta Pressão , Citotoxinas/química , Citotoxinas/isolamento & purificação , Flavonoides/química , Flavonoides/isolamento & purificação , Fenóis/química , Fenóis/isolamento & purificação , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Folhas de Planta/química , Proantocianidinas/química , Proantocianidinas/isolamento & purificação , Espectrometria de Massas em Tandem
15.
Hum Brain Mapp ; 39(4): 1712-1720, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29334156

RESUMO

We investigated the relationship between retinal layers and normal-appearing white matter (WM) integrity in the brain of patients with relapsing-remitting multiple sclerosis (MS), using a combined diffusion tensor imaging and high resolution optical coherence tomography approach. Fifty patients and 62 controls were recruited. The patients were divided into two groups according to presence (n = 18) or absence (n = 32) of optic neuritis. Diffusion tensor data were analyzed with a voxel-wise whole brain analysis of diffusion metrics in WM with tract-based spatial statistics. Thickness measurements were obtained for each individual retinal layer. Partial correlation and multivariate regression analyses were performed, assessing the association between individual retinal layers and diffusion metrics across all groups. Region-based analysis was performed, by focusing on tracts associated with the visual system. Receiver operating characteristic (ROC) curves were computed to compare the biomarker potential for the diagnosis of MS, using the thickness of each retinal layer and diffusion metrics. In patients without optic neuritis, both ganglion cell layer (GCL) and inner plexiform layer thickness correlated with the diffusion metrics within and outside the visual system. GCL thickness was a significant predictor of diffusion metrics in the whole WM skeleton, unlike other layers. No association was observed for either controls or patients with a history of optic neuritis. ROC analysis showed that the biomarker potential for the diagnosis of MS based on the GCL was high when compared to other layers. We conclude that GCL integrity is a predictor of whole-brain WM disruption in MS patients without optic neuritis.


Assuntos
Imagem de Tensor de Difusão , Esclerose Múltipla Recidivante-Remitente/diagnóstico por imagem , Retina/diagnóstico por imagem , Células Ganglionares da Retina , Tomografia de Coerência Óptica , Substância Branca/diagnóstico por imagem , Adulto , Estudos Transversais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Esclerose Múltipla Recidivante-Remitente/complicações , Neurite Óptica/complicações , Neurite Óptica/diagnóstico por imagem , Tamanho do Órgão , Retina/patologia , Células Ganglionares da Retina/patologia
16.
Eur Neurol ; 79(1-2): 21-26, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29131095

RESUMO

BACKGROUND: Calcifications are an important element of atherosclerotic plaques and have been used as a marker of atherosclerosis and clinical outcome predictor in different vascular territories. CT-scan, performed in the acute ischemic stroke setting, can reliably detect intracranial arterial calcifications. OBJECTIVES: To investigate the association between intracranial internal carotid artery calcification and functional outcome, symptomatic intracerebral hemorrhage (sICH), recanalization, and death. METHODS: We included 396 consecutive ischemic stroke patients submitted to recombinant tissue plasminogen activator treatment between January 2011 and September 2014. Admission CT-scans were reviewed to calculate the Total Carotid Syphon Calcification score. Patients were followed for up to at least 6 months post-stroke or until death. Outcome measures included evaluation of recanalization on the first 24 h (transcranial color coded Doppler or angio-CT), sICH, and assessment of functional outcome at 3 months after stroke (using modified Rankin scale). RESULTS: Carotid artery wall calcification did not predict sICH, recanalization or any good outcome. However, it was a statistically significant predictor of death (OR 1.102, 95% CI [1.004-1.211], p = 0.042). DISCUSSION: Intracranial carotid artery calcification does not increase the risk of thrombolysis-induced sICH. Patients with higher grade of carotid artery wall calcification may have a higher mortality rate.


Assuntos
Calcinose/patologia , Doenças das Artérias Carótidas/patologia , Artéria Carótida Interna/patologia , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos , Idoso , Idoso de 80 Anos ou mais , Calcinose/mortalidade , Doenças das Artérias Carótidas/tratamento farmacológico , Hemorragia Cerebral/etiologia , Feminino , Fibrinolíticos/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acidente Vascular Cerebral/mortalidade , Terapia Trombolítica/efeitos adversos , Ativador de Plasminogênio Tecidual/efeitos adversos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
17.
Eur Neurol ; 79(1-2): 108-112, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29421803

RESUMO

INTRODUCTION: Clinical trials and subsequent meta-analyses showed advantages of non-vitamin K antagonists oral anticoagulants (NOACs) over vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation. The impact of preadmission anticoagulation in acute ischaemic stroke (AIS) has not been established. OBJECTIVE: To compare functional outcome of patients with AIS with preadmission NOACs vs. VKAs. METHODS: A retrospective analysis was conducted on consecutive AIS patients under oral anticoagulation (VKAs or NOACs) admitted in 4 Portuguese hospitals within a period of 30 months. Two primary outcomes were defined and compared between VKA and NOAC groups: symptomatic intracerebral hemorrhage transformation (sICH) and modified Rankin Scale (mRS) at 3 months. RESULTS: Four hundred sixty-nine patients were included, of whom 332 (70.8%) were treated with VKA and 137 (29.2%) with NOAC. Patients' median age was 78.0 and 234 (49.9%) were male. NOAC-treated patients had a higher median CHA2DS2-VASc score than those under VKA (5.0 vs. 4.0, p = 0.023). The two primary outcomes showed no statistical differences between the VKAs' group and the NOACs' group (sICH: 5.4 vs. 5.4% [p = 0.911]; mRS at 3 months: 3.0 vs. 3.0 [p = 0.646], respectively). CONCLUSION: Preadmission anticoagulation with NOACs in AIS has a functional impact similar to that of VKAs.


Assuntos
Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Acidente Vascular Cerebral/prevenção & controle , Vitamina K/antagonistas & inibidores , Administração Oral , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Estudos Retrospectivos , Resultado do Tratamento
18.
Eur Neurol ; 80(1-2): 63-67, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30227441

RESUMO

We performed a retrospective study with the aim of investigating the association between blood pressure (BP) variability in the first 24 h after ischemic stroke and functional outcome, regarding arterial recanalization status. A total of 674 patients diagnosed with acute stroke and treated with revascularization therapies were enrolled. Systolic and diastolic BP values of the first 24 h after stroke were collected and their variation quantified through standard deviation. Recanalization state was evaluated at 6 h and clinical outcome at 3 months was assessed by modified Rankin Scale. In multivariate analyses systolic BP variability in the first 24 h post-stroke showed an association with 3 months clinical outcome in the whole population and non-recanalyzed patients. In recanalyzed patients, BP variability did not show a significant association with functional outcome.


Assuntos
Pressão Sanguínea/fisiologia , Procedimentos Endovasculares/métodos , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , Resultado do Tratamento , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recuperação de Função Fisiológica , Estudos Retrospectivos
19.
J Appl Clin Med Phys ; 19(1): 250-258, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29193644

RESUMO

PURPOSE: The purpose of this study was to evaluate the efficacy of needle holders in reducing staff hand exposure during biopsies guided by computed tomography fluoroscopy (CTF), through the analysis of data acquired during a detailed monitoring study, undertaken in parallel with an ongoing optimization process to reduce hand irradiation. METHODS: Hand monitoring was performed with 11 extremity detectors, two per finger (base and tip) and one on the back of the wrist, for the left (dominant) hand, during two series of biopsies with comparable characteristics. The first series (47 biopsies) were performed with only quick-check method (QC) and occasional side-handle (SH) manipulation of the needle. The second series (63 biopsies) were performed after introducing needle holders (NH) in the course of an optimization process. RESULTS: Choice of technique (QC, QC + NH, QC + SH) by the interventional radiologist (IR) was related to biopsy difficulty. Measured hand exposure was low (< 1 mSv) for all QC-only procedures, and for most of the QC + NH procedures. Occasional side-handle manipulation still occurred during challenging biopsies, so that 8% of biopsies in the second series accounted for ~70% of total fingertip dose (~90 mSv). The methodology used allowed a detailed insight into the dose reduction achievable with needle holders during real procedures, without the limitations of phantom measurements. CONCLUSIONS: Needle holders proved effective in reducing mean hand exposure during clinical procedures where real-time manipulation was necessary. Occasional side-handle manipulation was found to contribute disproportionately to hand exposure. This highlights the importance of individual hand monitoring during CTF guided procedures.


Assuntos
Fluoroscopia/instrumentação , Mãos/efeitos da radiação , Exposição Ocupacional/análise , Imagens de Fantasmas , Proteção Radiológica/métodos , Radiografia Intervencionista/instrumentação , Tomografia Computadorizada por Raios X/instrumentação , Biópsia por Agulha , Humanos , Doses de Radiação , Tomografia Computadorizada por Raios X/métodos
20.
J Stroke Cerebrovasc Dis ; 27(7): 1890-1896, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29571758

RESUMO

BACKGROUND: Stroke is one of the leading causes of disability worldwide. Early prediction of poststroke disability using clinical models is of great interest, especially in the rehabilitation field. Although some biomarkers and neuroimaging techniques have shown potential predictive value, there are still insufficient data to support their clinical utility in predicting poststroke functional recovery. We aimed to assess the value of serum biomarkers (C-reactive protein [CRP], D-dimer, fibrinogen, and S100ß protein) in predicting medium-term (12 weeks) functional outcome in patients with acute ischemic stroke. METHODS: This is an observational, prospective study in a sample of patients hospitalized for ischemic stroke (N = 131). Peripheral blood levels of biomarkers of interest were determined at admission (CRP, D-dimer, and fibrinogen) or at 48 hours poststroke (S100ß protein). Functional status was accessed at 48 hours and 12 weeks poststroke using the modified Rankin Scale (mRS). RESULTS: S100ß protein levels measured at 48 hours were significantly associated with mRS scores at 12 weeks (odds ratio = 1.005, 95% confidence interval [CI] [1.005-1.007]; P <.001). This association was not seen for the remaining biomarkers of interest. The S100ß cutoff for poor functionality at 12 weeks was 140.5 ng/L or more (sensibility 83.8%; specificity 71.4%; area under the curve = .80, 95% CI [.722, .879]). CONCLUSIONS: S100ß levels in peripheral blood at 48 hours poststroke reflect acute stroke severity and predict functional outcome at 12 weeks with a cutoff value of 140.5 ng/dL. The value of S100ß as predictor of functional recovery after stroke should be emphasized in further clinical research and clinical practice.


Assuntos
Isquemia Encefálica/sangue , Subunidade beta da Proteína Ligante de Cálcio S100/sangue , Acidente Vascular Cerebral/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Fibrinogênio/metabolismo , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Curva ROC , Recuperação de Função Fisiológica , Índice de Gravidade de Doença
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