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1.
An Acad Bras Cienc ; 96(suppl 1): e20231244, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39082591

RESUMEN

It was compared smartphone-based measurements of static balance control and mobility of elderly population with and without type 2 diabetes mellitus (DM2). The present cross-sectional study investigated 73 participants grouped in a control group (n = 36) and a DM2 group (n = 37). Smartphone's built in inertial sensors were used to record inertial changes of the participants during static balance and mobility (Timed Up and Go test - TUG) tasks. The inertial variations as a function of the time were analyzed and compared between groups. Both groups were matched in age, body mass index, male-female proportion, but DM2 group had significant larger fasting glucose than control group. Additionally, DM2 group had worst static balance control with open and closed eyes than the controls (p < 0.05) as well as they also had longer duration to execute the different events of the mobility test than the controls (p < 0.05). DM2 patients had decline of motor functions compared to controls and the use of bult-in sensors of smartphones was feasible to identify these functional impairments. The easy access of smartphones could be improving the screening of functional impairments in DM2 patients.


Asunto(s)
Diabetes Mellitus Tipo 2 , Equilibrio Postural , Teléfono Inteligente , Humanos , Diabetes Mellitus Tipo 2/fisiopatología , Masculino , Femenino , Estudios Transversales , Equilibrio Postural/fisiología , Anciano , Persona de Mediana Edad , Estudios de Casos y Controles
2.
Sensors (Basel) ; 24(9)2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38733024

RESUMEN

The Timed-Up and Go (TUG) test is widely utilized by healthcare professionals for assessing fall risk and mobility due to its practicality. Currently, test results are based solely on execution time, but integrating technological devices into the test can provide additional information to enhance result accuracy. This study aimed to assess the reliability of smartphone-based instrumented TUG (iTUG) parameters. We conducted evaluations of intra- and inter-device reliabilities, hypothesizing that iTUG parameters would be replicable across all experiments. A total of 30 individuals participated in Experiment A to assess intra-device reliability, while Experiment B involved 15 individuals to evaluate inter-device reliability. The smartphone was securely attached to participants' bodies at the lumbar spine level between the L3 and L5 vertebrae. In Experiment A, subjects performed the TUG test three times using the same device, with a 5 min interval between each trial. Experiment B required participants to perform three trials using different devices, with the same time interval between trials. Comparing stopwatch and smartphone measurements in Experiment A, no significant differences in test duration were found between the two devices. A perfect correlation and Bland-Altman analysis indicated good agreement between devices. Intra-device reliability analysis in Experiment A revealed significant reliability in nine out of eleven variables, with four variables showing excellent reliability and five showing moderate to high reliability. In Experiment B, inter-device reliability was observed among different smartphone devices, with nine out of eleven variables demonstrating significant reliability. Notable differences were found in angular velocity peak at the first and second turns between specific devices, emphasizing the importance of considering device variations in inertial measurements. Hence, smartphone inertial sensors present a valid, applicable, and feasible alternative for TUG assessment.


Asunto(s)
Teléfono Inteligente , Humanos , Masculino , Femenino , Adulto Joven , Adulto , Reproducibilidad de los Resultados , Accidentes por Caídas/prevención & control
3.
Clin Oral Investig ; 27(5): 2321-2333, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36515761

RESUMEN

OBJECTIVE: We performed a systematic review to investigate the appearance of imaging signs on magnetic resonance imaging (MRI), cone-beam computed tomography (CBCT), and conventional computed tomography (CT) scans of the temporomandibular joints (TMJs) of patients with juvenile idiopathic arthritis (JIA). MATERIALS AND METHODS: We performed electronic searches of the PubMed, Embase, Web of Science, Scopus, Lilacs, and the Cochrane Library databases to identify studies investigating JIA and its related imaging findings. Inclusion criteria were as follows: original article studies based on humans and systematic reviews, studies enrolling patients under 18 years of age with a diagnostic of JIA, the use of International League of Associations for Rheumatology (ILAR) criteria and one type of medical imaging (MRI, CBCT, or CT), and papers published in the English language. RESULTS: A total of six studies met the inclusion criteria, four involving MRI and two involving CBCT. Additionally, all six studies analyzed the imaging findings of pathological TMJ affected by JIA. The results showed that synovial membrane enhancement, condylar erosions, and condylar flattening were the most prevalent imaging findings in JIA. CONCLUSION: MRI examinations are more specific for detecting anomalies in the TMJ than CBCT and CT. Additionally, these results must be correlated with clinical signs to verify the correct diagnosis. CLINICAL RELEVANCE: This study identified the most prevalent imaging signs of JIA to provide an early and correct diagnosis of the disease.


Asunto(s)
Artritis Juvenil , Tomografía Computarizada de Haz Cónico Espiral , Trastornos de la Articulación Temporomandibular , Humanos , Adolescente , Artritis Juvenil/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/patología , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/patología , Imagen por Resonancia Magnética/métodos
4.
Oncologist ; 27(11): e899-e907, 2022 11 03.
Artículo en Inglés | MEDLINE | ID: mdl-36099421

RESUMEN

BACKGROUND: Targeted and immunotherapies are currently moving toward early-stage settings for patients with non-small cell lung cancer (NSCLC). Predictive biomarkers data are scarce in this scenario. We aimed to describe the frequency of EGFR mutations and PD-L1 expression levels in early-stage non-squamous patients with NSCLC from a large, single Brazilian oncology center. METHODS: We retrospectively evaluated patients with NSCLC diagnosed at an early-stage (IB to IIIA-AJCC seventh edition) at Barretos Cancer Hospital (n = 302). EGFR mutational status was assessed in FFPE tumor tissues using distinct methodologies (NGS, Cobas, or Sanger sequencing). PD-L1 expression was evaluated by immunohistochemistry (clone 22C3) and reported as Tumor Proportion Score (TPS), categorized as <1%, 1-49%, and ≥50%. We evaluated the association between EGFR mutational status and PD-L1 expression with sociodemographic and clinicopathological parameters by Fisher's test, qui-square test, and logistic regression. Survival analysis was assessed by the Kaplan-Meier method and Cox regression model. RESULTS: EGFR mutations were detected in 17.3% (n = 48) of cases and were associated with female sex, never smokers, and longer overall and event-free survival. PD-L1 positivity was observed in 36.7% (n = 69) of cases [TPS 1-49% n = 44(23.4%); TPS ≥50% n = 25(13.3%)]. PD-L1 positivity was associated with smoking, weight loss, and higher disease stages (IIB/IIIA). CONCLUSION: The frequencies of EGFR mutations and PD-L1 positivity were described for early-stage non-squamous patients with NSCLC. These results will be essential for guiding treatment strategies with the recent approvals of osimertinib and immunotherapy in the adjuvant setting.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Carcinoma Pulmonar de Células Pequeñas , Humanos , Femenino , Antígeno B7-H1/genética , Antígeno B7-H1/metabolismo , Carcinoma de Pulmón de Células no Pequeñas/patología , Brasil/epidemiología , Neoplasias Pulmonares/patología , Estudios Retrospectivos , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/metabolismo , Mutación , Receptores ErbB/genética
5.
Sensors (Basel) ; 22(8)2022 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-35458920

RESUMEN

The evaluation of anticipatory postural adjustments (APAs) requires high-cost and complex handling systems, only available at research laboratories. New alternative methods are being developed in this field, on the other hand, to solve this issue and allow applicability in clinic, sport and hospital environments. The objective of this study was to validate an app for mobile devices to measure the APAs during gait initiation by comparing the signals obtained from cell phones using the Momentum app with measurements made by a kinematic system. The center-of-mass accelerations of a total of 20 healthy subjects were measured by the above app, which read the inertial sensors of the smartphones, and by kinematics, with a reflective marker positioned on their lumbar spine. The subjects took a step forward after hearing a command from an experimenter. The variables of the anticipatory phase, prior to the heel-off and the step phase, were measured. In the anticipatory phase, the linear correlation of all variables measured by the two measurement techniques was significant and indicated a high correlation between the devices (APAonset: r = 0.95, p < 0.0001; APAamp: r = 0.71, p = 0.003, and PEAKtime: r = 0.95, p < 0.0001). The linear correlation between the two measurement techniques for the step phase variables measured by ques was also significant (STEPinterval: r = 0.56, p = 0.008; STEPpeak1: r = 0.79, p < 0.0001; and STEPpeak2: r = 0.64, p < 0.0001). The Bland−Altman graphs indicated agreement between instruments with similar behavior as well as subjects within confidence limits and low dispersion. Thus, using the Momentum cell phone application is valid for the assessment of APAs during gait initiation compared to the gold standard instrument (kinematics), proving to be a useful, less complex, and less costly alternative for the assessment of healthy individuals.


Asunto(s)
Trastornos Neurológicos de la Marcha , Aplicaciones Móviles , Marcha , Humanos , Equilibrio Postural , Reproducibilidad de los Resultados , Teléfono Inteligente
6.
Water Sci Technol ; 84(10-11): 3257-3276, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34850726

RESUMEN

The increase in water demand in recent years led to the expansion of research and public policies on the reuse of water, especially greywater (GW). Given the diversity of research in the area, this paper proposes an analysis of the evolution of the area through an objectivity metric. Metadata of 1,524 publications indexed in the Scopus database between 1974 and 2021 were analyzed using the VOSviewer tool, and showed exponential growth in publications from 2013. Six different spelling variations were found for GW in the database. Despite the highly geographical scattering of academic production, developed countries, who began researching greywater earlier, had more connections and published more papers; except for Israel, which had the highest average of citations per article. While developed countries lead the research area, developing countries are emerging in GW reuse research. These aspects reveal both the dispersion of the research structure development and a trend of intellectual production in GW from developed to developing countries. Also, we noted that countries suffering from water scarcity stood out with the highest activity in paper publishing. Thus, we expect that future research on GW reuse will take place in developing countries that face water scarcity.


Asunto(s)
Purificación del Agua , Bibliometría , Israel , Agua , Abastecimiento de Agua
7.
J Oral Implantol ; 47(1): 31-35, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32662834

RESUMEN

The perforation of the Schneiderian membrane (SM) is a common surgical complication during the sinus floor augmentation (SFA) procedure. Different approaches have been proposed to completely closer the SM perforation and to avoid graft contamination or migration and postoperative sinus infection. In this context, the leukocyte and platelet-rich fibrin (L-PRF) membranes have been proposed for SM perforation treatment because of their natural adhesive property and resistance. Thus, this case series aims to evaluate the effectiveness of L-PRF in the treatment of SM large perforations during SFA. A total of 9 SM perforations were treated in this case series. The L-PRF membranes were interposed on the perforated SM until the rupture could not be visualized. The maxillary sinus cavities were filled with deproteinized bovine mineral bone (Bio-oss, Geistlich, Switzerland), and a collagen membrane was positioned to cover the lateral access window. After 8 months, 13 implants were placed, achieving satisfactory primary stability. The osseointegration of all implants and absence of infection signs/mucus in the maxillary sinus were observed in cone beam computed tomography or panoramic radiography qualitative analysis after 3-5 years of follow-up. It can be concluded that the use of L-PRF can be considered a viable alternative for the repair of large SM perforations.


Asunto(s)
Fibrina Rica en Plaquetas , Elevación del Piso del Seno Maxilar , Animales , Bovinos , Estudios de Seguimiento , Humanos , Leucocitos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Mucosa Nasal
8.
J Surg Oncol ; 121(5): 848-856, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31773747

RESUMEN

The mainstays of treatment for colorectal liver metastases (CRLMs) are surgery and chemotherapy. Chemotherapeutic benefits of tumor shrinkage and systemic control of micrometastases are in part counterbalanced by chemotoxicity that can modify the liver parenchyma, jeopardizing the detection of CRLM. This review addresses the clinical decision-making process in the context of radiographic and pathologic responses, the preoperative imaging workup, and the approaches to the liver for CRLM, which disappear after systemic chemotherapy.


Asunto(s)
Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioterapia Adyuvante , Toma de Decisiones Clínicas , Neoplasias Colorrectales/patología , Humanos , Neoplasias Hepáticas/secundario , Terapia Neoadyuvante
9.
BMC Cancer ; 19(1): 382, 2019 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-31023257

RESUMEN

BACKGROUND: Lung cancer patients undergoing palliative chemotherapy exhibit many symptoms related to the disease, such as adverse events and infectious complications during treatment, which impacts directly their health-related quality of life (HRQOL). Nutritional status is a relevant aspect among advanced cancer patients under palliative care and food supplementation has the potential to reduce treatment-related adverse effects and improve the nutritional status. The product named AferBio® is a fermented supplement that has been described as able to provide some benefits, including the capacity to potentiate the effects of anticancer drugs, by promoting the reduction of side effects and ultimately improving HRQOL. METHODS/DESIGN: A Phase II double-blind placebo-controlled randomized clinical trial to assess the use of food supplementation with AferBio® in Stage IIIB or IV non-small cell lung cancer (NSCLC) patients beginning a second-line palliative mono-chemotherapy. The primary goal is to compare HRQOL scores between the arms of the study over time. The ten first patients included in the present study will undergo an AferBio®toxicity-testing (non-randomized phase). If no significant toxicity is found, the study will move on to the randomized phase. All patients will be randomized in blocks at a 1:1 ratio using the online tool REDCap. ECOG-PS (0-1 versus 2) criteria will be used for stratification. All patients included in the trial will be evaluated at baseline and at each chemotherapy cycle. Each evaluation will include the following: HRQOL (EORTC QLQ-C30, LC13 and IQualiV-Lung), ECOG-PS, anthropometric measurements, clinical and laboratory toxicity assessment and response evaluation. DISCUSSION: During palliative systemic therapy in advanced cancer patients, one of the main goals is the improvement and maintenance of HRQOL, which can be negatively affected by cancer symptoms, cancer- or treatment-related psychosocial difficulties, and chemotherapy toxicity. Thus, much research has been dedicated to the development of new and more effective and/or less toxic cancer therapies. The present study is justified by the testing of a novel food supplement that may reduce some toxicities, thus, having a potential positive impact on the HRQOL of lung cancer patients. The product in question (AferBio®) is already available for sale in Brazil, but has not yet been fully tested in cancer patients. TRIAL REGISTRATION: This Trial was registered on March 19, 2018 with ClinicalTrials.gov , NCT03469063. Protocol version: 2.0 from March 26, 2018. Trial status: Patient enrollment in the study began in April, 2018.


Asunto(s)
Antineoplásicos/administración & dosificación , Docetaxel/administración & dosificación , Neoplasias Pulmonares/tratamiento farmacológico , Adolescente , Adulto , Anciano , Antineoplásicos/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Brasil , Docetaxel/efectos adversos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/patología , Femenino , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Cuidados Paliativos , Calidad de Vida , Adulto Joven
10.
BMC Cancer ; 18(1): 1026, 2018 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-30352576

RESUMEN

BACKGROUND: The evolution of radiotherapy over recent decades has reintroduced the hypofractionation for many tumor sites with similar outcomes to those of conventional fractionated radiotherapy. The use of hypofractionation in locally advanced head and neck cancer (LAHNC) has been already used, however, its use has been restricted to only a few countries. The aim of this trial was to evaluate the safety and feasibility of moderate hypofractionated radiotherapy (HYP-RT) with concomitant cisplatin (CDDP). METHODS: This single-arm trial was designed to evaluate the safety and feasibility of HYP-RT with concomitant CDDP in LAHNC. Stage III and IV patients withnonmetastatic disease were enrolled. Patients were submitted to intensity modulatedradiation therapy, which comprised 55 Gy/20 fractions to the gross tumor and44-48 Gy/20 fractions to the areas of subclinical disease. Concomitant CDDPconsisted of 4 weekly cycles of 35 mg/m2. The primary endpoints were the treatment completion rate and acute toxicity. RESULTS: Twenty patients were enrolled from January 2015 to September 2016, and 12 (60%) were classified as unresectable. All patients completed the total dose of radiotherapy, and 19 patients (95%) received at least 3 of 4 cycles of chemotherapy. The median overall treatment time was 29 days (27-34). Grade 4 toxicity was reported twice (1 fatigue and 1 lymphopenia). The rates of grade 3 dermatitis and mucositis were 30% and 40%, respectively, with spontaneous resolution. Nasogastric tubes were offered to 15 patients (75%) during treatment; 4 patients (20%) needed feeding tubes after 2 months, and only 1 patient needed a feeding tube after 12 months. CONCLUSION: HYP-RT with concomitant CDDP was considered feasible for LAHNC, and the rate of acute toxicity was comparable to that of standard concomitant chemoradiation. A feeding tube was necessary for most patients during treatment. Further investigation of this strategy is warranted. TRIAL REGISTRATION: ClinicalTrials, NCT03194061 . Registered 21 Jun 2017 - Retrospectively registered.


Asunto(s)
Carcinoma de Células Escamosas , Quimioradioterapia/efectos adversos , Cisplatino , Neoplasias de Cabeza y Cuello , Anciano , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/radioterapia , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Femenino , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Masculino , Persona de Mediana Edad , Hipofraccionamiento de la Dosis de Radiación
11.
Implant Dent ; 27(3): 375-380, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29461999

RESUMEN

PURPOSE: The aim of this case report was to demonstrate the repair of a large sinus membrane perforation related to a sinus floor augmentation procedure, using leukocyte platelet-rich fibrin (L-PRF), for subsequent rehabilitation of a partially edentulous patient. MATERIALS AND METHODS: The patient presented the absence of teeth numbers 18, 17, and 16, associated with insufficient bone height because of the maxillary sinus pneumatization. A maxillary inlay bone graft was proposed, however, during the sinus floor augmentation procedure, a large portion of the sinus membrane was ruptured. To avoid interruption of the surgical procedure, membrane mending was proposed using L-PRF and collagen membranes. RESULTS: After 8 months, 2 external hexagon connection dental implants were placed in the 16 and 17 teeth regions, and a screw-retained implant-supported prosthesis was installed. CONCLUSION: The use of L-PRF associated with collagen membrane was efficient for the sealing of the sinus membrane perforation and enabled bone formation for subsequent implant installation.


Asunto(s)
Mucosa Nasal/lesiones , Fibrina Rica en Plaquetas/fisiología , Elevación del Piso del Seno Maxilar/efectos adversos , Cicatrización de Heridas/fisiología , Anciano , Humanos , Arcada Parcialmente Edéntula/rehabilitación , Leucocitos , Masculino
12.
Gen Dent ; 65(2): 23-27, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28253178

RESUMEN

In this study, the influence of different irrigant solutions applied before cementation on the bond strength (BS) of glass fiber posts to root dentin was evaluated. Thirty endodontically treated maxillary canines of similar length were selected and divided into 3 groups (n = 10) according to the irrigant solution used before post cementation: 1% sodium hypochlorite (NaOCl; control), 2% chlorhexidine (CHX), or a 6.5% grape seed extract (GSE) cross-linking agent. After cementation of the posts, the roots were transversely sectioned to create 2 discs (2 mm) for each of the root thirds: coronal, middle, and apical. These discs were submitted to push-out tests (0.5 mm/min) to evaluate the BS between the glass fiber posts and the root dentin. Statistical analysis was performed by a 2-way analysis of variance and a Tukey test (P < 0.05). The failure mode was evaluated in all specimens. Both the CHX and GSE groups presented significantly higher BS values than the control group in all root thirds (P < 0.05). The values of the GSE group were significantly higher than those of the CHX group in all thirds except the apical third (P < 0.05). In the control group, the BS value was highest in the cervical third. There was no significant difference in the BS values between the cervical and middle thirds when CHX was used (P > 0.05); however, the BS value diminished significantly in the apical third (P < 0.05). The highest BS value in the GSE group was found in the middle third. The results showed that the use of either GSE or CHX before adhesive cementation improved the BS of glass fiber posts to root dentin.


Asunto(s)
Cementación , Clorhexidina/farmacología , Técnica de Perno Muñón , Proantocianidinas/farmacología , Irrigantes del Conducto Radicular/farmacología , Raíz del Diente , Cementación/métodos , Recubrimiento Dental Adhesivo/métodos , Análisis del Estrés Dental , Recubrimientos Dentinarios/uso terapéutico , Vidrio , Humanos , Hipoclorito de Sodio/farmacología
13.
J Food Sci Technol ; 52(6): 3689-93, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26028752

RESUMEN

Cashew apple bagasse is a byproduct of cashew peduncle juice processing. Such waste is a source of carotenoids, but it is usually discarded after the juice extraction. The objective of this work was to study the influence of pectinolytic and cellulolytic enzyme complexes on cashew bagasse maceration in order to obtain carotenoids. It was observed that maceration with the enzymatic complex Pectinex Batch AR showed a higher content of carotenoids, with an overall gain of 79 % over the control carried out without enzyme complex addition.

14.
Qual Life Res ; 23(8): 2247-56, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24627088

RESUMEN

PURPOSE: Many maintenance hemodialysis patients do not feel well after the hemodialysis session and need a time to recover. The main objective of the study was to investigate whether a simple question about the need of some time to recover from hemodialysis was associated with scores of comprehensive tools of depression symptoms and health-related quality of life (HRQOL). METHODS: Cross-sectional evaluation of 800 Brazilian patients enrolled in the Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO). The KDQOL-SF was used for HRQOL and the 20-item CES-D and BDI for depression symptoms. Linear and logistic models were used for multivariable adjustments. RESULTS: Patients who reported some time to recover (30%) had significantly (P < 0.001) higher depression symptoms scores (mean difference = 4.75 for CES-D and 4.48 for BDI). HRQOL scores were, in general, lower for patients who referred a time to recover, with mean differences larger than 4.0 (P < 0.05) both for physical and mental components. Strong associations of needing a time to recover and lower scores of several kidney disease-targeted HRQOL components were also observed. Differences in depression symptoms and HRQOL were largely reduced after adjustments for symptoms (muscle pain/cramps, faintness, fatigue, nausea/vomiting). CONCLUSIONS: The results support the validity of a simple question on post-hemodialysis recovery as a proxy for scores of complex instruments for depression symptoms and HRQOL. The results suggest that the poorer HRQOL and higher depression probability in patients who need a time to recover from hemodialysis could be partially explained by the presence of hemodialysis-related symptoms.


Asunto(s)
Depresión/psicología , Calidad de Vida/psicología , Diálisis Renal/psicología , Brasil , Estudios Transversales , Depresión/diagnóstico , Depresión/etiología , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Diálisis Renal/efectos adversos , Encuestas y Cuestionarios
15.
Front Med (Lausanne) ; 11: 1302710, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38482527

RESUMEN

Background: Currently, integrase inhibitors (INIs)-based ART regimens are the preferred initial therapy for AIDS patients. There is scarce information on the use of dolutegravir (DTG) among late-presenter people living with HIV (PLHIV). Objectives: To compare the effect of DTG- or efavirenz (EFV)-based regimens on the outcomes of patients with advanced AIDS. Methods: We compared two cohorts of consecutive symptomatic AIDS patients (WHO stage 4, CD4 count<50 cells/mL) starting therapy with DTG-based (2018-2021, prospective cohort) or EFV-based regimens (2013-2016, retrospective cohort) from five Brazilian cities. The main endpoints were early (all-cause) mortality, viral suppression at 24 and 48 weeks, changes in CD4 count, and changes in initial therapy (for any reason). Results: We included all eligible patients in a consecutive way (in both groups) until we reached 92 individuals per arm. The median baseline CD4 count (20 vs. 21 cells/mL) and the median HIV plasma viral load (5.5 copies/mL log10) were identical across the groups. Viral suppression rates were higher in the DTG group than in the EFV group at 24 (67.4% vs. 42.4%,) and 48 weeks (65.2% vs. 45.7%, p < 0.001 for both comparisons). More patients in the DTG group presented with CD4 > 200 cells/mL compared to the EFV group at 48 weeks (45% vs. 29%, p = 0.03). Treatment changes (ITT, M = F) were significantly more frequent in the EFV group (1% vs. 17%, p < 0.0001). The relative mortality rate was 25% lower in the DTG group, but without statistical significance. Conclusion: We detected a higher rate of virological suppression and greater treatment durability in patients with advanced AIDS treated with DTG than in those treated with EFV.

16.
Materials (Basel) ; 16(8)2023 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-37109776

RESUMEN

Microscale abrasion has been intensively used to study the wear behavior o several hard coatings, enabling the observation of different wear mechanisms. Recently, a study arguing whether the surface texture of the ball could influence the dynamics of abrasive particles throughout the contact was presented. In this work, the influence of the abrasive particles concentration able to change the texture of the ball was studied to understand its influence on the wear modes-rolling or grooving. Thus, tests were carried out using samples with a thin coating of TiN, deposited using the Physical Vapor Deposition (PVD) technique, and AISI 52100 steel balls etched over 60 s to induce a change in their texture and roughness were used. Three abrasive slurries were prepared with black silicon carbide (SiC) particles (average particle size of 4 µm) with different concentrations, 0.25, 0.35, and 0.45 g/cm3. The rotation speed used in the tests was 80 rpm and the normal loads applied in the study were 0.2 N and 0.5 N, and 1 N. After the wear tests, the coated samples and tracks on the surface of the balls were observed by SEM and 3D microscopy to understand the abrasive particle dynamics, evaluating the wear mode transition as well as the function of both applied load and slurry concentration. The tracks in the balls showed particles embedded on their surface. A lower concentration of abrasion was conducted to higher specific wear rate. Moreover, a predominant two-body wear mechanism was induced when the abrasive concentration was increased. There was an increase in the roughness of the scar and the surface of the balls with an increase in the abrasive particles' concentration.

17.
Epileptic Disord ; 25(5): 724-730, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37518897

RESUMEN

OBJECTIVE: Identify the predictive variables of genetic pathogenic results and the impact of test results on epilepsy diagnosis and management. METHODS: Analytical observational design evaluated 130 patients with epilepsy that had performed genetic testing over January 2017 to July 2022. RESULTS: There was a gradual increase in the number of exams performed over the years. The frequency of pathogenic results was 34% (n = 44/130), 8 altered genes with 54% (n = 24/44) of the results. The tests were more positive in patients with developmental delay and/or regression (p = .01). None of the other factors analyzed were associated with higher diagnostic yield. The age at onset of epilepsy brought diagnostic yield to the test (p = .041). Patients with negative genetic test had a reduction in the number of electroencephalograms performed before and after the test (respectively, 3.80 ± 6.37 and .84 ± 1.67; p < .001). SIGNIFICANCE: Facing a large proportion of patients with unexplained epilepsy have a genetic cause a genetic test has the potential to reduce the use of unnecessary diagnostic tests, improve patient outcomes by identifying targeted treatments, and provide families with genetic counseling and risk assessment. But an early genetic testing can be crucial to reach these goals. Even in cases where the genetic test is negative, the study suggests that it still has important implications for patient care and management.

18.
J Bras Nefrol ; 45(2): 144-151, 2023.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-36200884

RESUMEN

INTRODUCTION: Chronic kidney disease (CKD) has been increasing significantly. There is evidence that a large part of the population does not have enough knowledge on the subject. OBJECTIVE: To investigate the level of knowledge about CKD in the general population, its risk factors and means of prevention. METHODS: We ran a cross-sectional study in the population of Fortaleza, Ceará - Brazil, between 2017 and 2020, with the application of a questionnaire on CKD, risk factors and prevention. RESULTS: we interviewed 735 volunteers, with a mean age of 38 years, of which 55% were female. Only 17.2% correctly responded to the concept of CKD, and 5.8% knew the concept of creatinine. Low water intake was the most cited risk factor by respondents (79.3%). The main risk factors and direct causes of CKD (diabetes and hypertension) were mentioned less frequently (13.2% and 15.1%, respectively). Men were more correct regarding risk factors and ways to prevent CKD. Older respondents answered more correctly the questions about the definition of CKD (n = 22; 28.6%) and creatinine (n = 7; 9.0%). With regards to education there was a statistically significant correlation in all the questions (p < 0.05). CONCLUSION: There is little knowledge about CKD in the general population. Higher level of education is associated with better knowledge. More health education actions are needed so that the population becomes better acquainted with CKD and, consequently, can adopt more adequate prevention and control measures.

19.
Braz Dent J ; 34(3): 66-72, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37466527

RESUMEN

The aim of this study was to evaluate the osseointegration of a hydrophilic surface (blasting + acid etching + immersion in isotonic solution) in comparison with that of a control surface (blasting + acid etching) using an experimental model of low-density bone. To perform the study, 24 rabbits were submitted to the installation of 4 implants in the iliac bone bilaterally: 2 implants with a control surface and 2 implants with a hydrophilic surface. The rabbits were euthanized at 2, 4, and 8 weeks after implant installation. After euthanasia, one implant from each surface was used to perform the removal torque analysis, and the other implant was used for the execution of non-decalcified histological sections and evaluation of the bone implant contact (% BIC) as well as the fraction of bone tissue area between the implant threads (% BBT). The implants with a hydrophilic surface presented higher %BIC (42.92 ± 2.85% vs. 29.49 ± 10.27%) and % BBT (34.32 ± 8.52% vs. 23.20 ± 6.75%) (p < 0.05) in the 2-week period. Furthermore, the hydrophilic surface presented higher removal torque in the 8-week period (76.13 ± 16.00 Ncm2 vs. 52.77 ± 13.49 Ncm2) (p<0.05). Implants with a hydrophilic surface exhibited acceleration in the process of osseointegration, culminating in greater secondary stability in low-density bone than in implants with a control surface.


Asunto(s)
Implantes Dentales , Oseointegración , Animales , Conejos , Propiedades de Superficie , Interacciones Hidrofóbicas e Hidrofílicas , Huesos , Titanio , Torque
20.
J Stomatol Oral Maxillofac Surg ; 124(6S2): 101657, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37866505

RESUMEN

OBJECTIVE: This cross-sectional study aimed to evaluate the presence of bone changes on magnetic resonance imaging (MRI) scans of patients with temporomandibular joint (TMJ) anterior disc displacement (ADD) with reduction (ADDWR) and without reduction (ADDWoR). METHODS: TMJ-MRI scans were screened for the presence of ADD. 285 scans presented ADD, being further divided into ADDWR (n = 188) and ADDWoR (n = 97). Bone changes on the mandibular condyle and articular eminence were also assessed and computed. The chi-square test compared the association of these bone changes with the presence of ADDWR and ADDWoR, with a significance level of 5 %. Also, the prevalence ratio (PR) was calculated. RESULTS: In the mandibular condyle, subchondral cyst (p = 0.035, PR = 1.08) and bone edema (p = 0.044, PR = 2.40), more prevalent on ADDWR, and generalized sclerosis (p = 0.015, PR = 1.04), more prevalent on ADDWoR, presented significant association with ADD. On the articular eminence, generalized sclerosis (p = 0.015, PR = 1.04) and articular surface flattening (p = 0.003, PR = 1.19) presented significant association with ADD, both more prevalent on ADDWoR. CONCLUSION: Bone changes are usual findings in TMJ with ADD diagnosis. The real influence of ADD is not fully clear, although clinicians should be aware of patients with this condition, to provide an early diagnosis and improve patient´s prognosis.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Articulación Temporomandibular , Humanos , Estudios Transversales , Esclerosis/patología , Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/epidemiología , Imagen por Resonancia Magnética
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