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1.
BMC Med Inform Decis Mak ; 22(1): 316, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36456974

RESUMO

BACKGROUND: When designing a treatment in orthodontics, especially for children and teenagers, it is crucial to be aware of the changes that occur throughout facial growth because the rate and direction of growth can greatly affect the necessity of using different treatment mechanics. This paper presents a Bayesian network approach for facial biotype classification to classify patients' biotypes into Dolichofacial (long and narrow face), Brachyfacial (short and wide face), and an intermediate kind called Mesofacial, we develop a novel learning technique for tree augmented Naive Bayes (TAN) for this purpose. RESULTS: The proposed method, on average, outperformed all the other models based on accuracy, precision, recall, [Formula: see text], and kappa, for the particular dataset analyzed. Moreover, the proposed method presented the lowest dispersion, making this model more stable and robust against different runs. CONCLUSIONS: The proposed method obtained high accuracy values compared to other competitive classifiers. When analyzing a resulting Bayesian network, many of the interactions shown in the network had an orthodontic interpretation. For orthodontists, the Bayesian network classifier can be a helpful decision-making tool.


Assuntos
Algoritmos , Conscientização , Criança , Adolescente , Humanos , Teorema de Bayes
2.
Acta Odontol Scand ; 80(1): 51-64, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34110967

RESUMO

OBJECTIVE: To describe and assess the available evidence of prediction methods of maxillary canine impaction (MCI). MATERIAL AND METHODS: A systematic search was conducted through PubMed, Cochrane Library, Embase, EBSCOhost, Scopus, ScienceDirect, Bireme and Scielo until December 2020. This systematic review was conducted according to the PRISMA statement. The methodology of the selected studies was assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). RESULTS: A total of 2391 articles were identified in the first approach and after a 2-phase selection, 11 studies were included in qualitative analysis. Prediction methods were constructed using equation-based models, geometric measurements and computational methods from clinical and imaging data to predict palatal/buccal MCI. The quality of evidence was low to moderate due to the presence of risk of bias in most of the studies included. Three cohort studies with the best methodological quality proposed prediction models based on geometric measurements, canine position and facial growth pattern that would allow predicting MCI from CBCT, lateral and panoramic radiographs. CONCLUSIONS: The evidence is limited and most of the studies present a low methodological quality. However, it is possible to suggest that some prediction methods based on the position of the canine and facial growth pattern could predict palatal/buccal MCI in mixed dentition. Cohort studies with better methodological quality and long-term follow-up are needed to better validate a prediction model.


Assuntos
Dente Canino , Dente Impactado , Humanos , Radiografia Panorâmica , Dente Impactado/diagnóstico por imagem
3.
BMC Med ; 19(1): 94, 2021 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-33849546

RESUMO

BACKGROUND: Balancing the control of SARS-CoV-2 transmission with the resumption of travel is a global priority. Current recommendations include mitigation measures before, during, and after travel. Pre- and post-travel strategies including symptom monitoring, antigen or nucleic acid amplification testing, and quarantine can be combined in multiple ways considering different trade-offs in feasibility, adherence, effectiveness, cost, and adverse consequences. METHODS: We used a mathematical model to analyze the expected effectiveness of symptom monitoring, testing, and quarantine under different estimates of the infectious period, test-positivity relative to time of infection, and test sensitivity to reduce the risk of transmission from infected travelers during and after travel. RESULTS: If infection occurs 0-7 days prior to travel, immediate isolation following symptom onset prior to or during travel reduces risk of transmission while traveling by 30-35%. Pre-departure testing can further reduce risk, with testing closer to the time of travel being optimal even if test sensitivity is lower than an earlier test. For example, testing on the day of departure can reduce risk while traveling by 44-72%. For transmission risk after travel with infection time up to 7 days prior to arrival at the destination, isolation based on symptom monitoring reduced introduction risk at the destination by 42-56%. A 14-day quarantine after arrival, without symptom monitoring or testing, can reduce post-travel risk by 96-100% on its own. However, a shorter quarantine of 7 days combined with symptom monitoring and a test on day 5-6 after arrival is also effective (97--100%) at reducing introduction risk and is less burdensome, which may improve adherence. CONCLUSIONS: Quarantine is an effective measure to reduce SARS-CoV-2 transmission risk from travelers and can be enhanced by the addition of symptom monitoring and testing. Optimal test timing depends on the effectiveness of quarantine: with low adherence or no quarantine, optimal test timing is close to the time of arrival; with effective quarantine, testing a few days later optimizes sensitivity to detect those infected immediately before or while traveling. These measures can complement recommendations such as social distancing, using masks, and hand hygiene, to further reduce risk during and after travel.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Quarentena/métodos , Doença Relacionada a Viagens , COVID-19/diagnóstico , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Modelos Estatísticos , SARS-CoV-2/isolamento & purificação
4.
Medicina (B Aires) ; 78(1): 50-53, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-29360079

RESUMO

Methotrexate is an antimetabolite analog to folic acid that competitively inhibits the enzyme dihydrofolate reductase and thymidylate synthetase, essential for the synthesis of DNA and RNA. It is widely used in dermatology and its adverse effects on the skin and mucous membranes are varied, including mild and severe reactions. The appearance of erosions and skin ulcers as a manifestation of methotrexate cytotoxicity are quite infrequent. These would represent an early cutaneous sign of pancytopenia due to marrow toxicity secondary to this drug. In most of the cases there are cutaneous diseases prior to ulceration, mainly psoriasis. In the absence of underlying dermatitis, the presence of ulcerations is very rare. We present eight cases of patients with cutaneous signs of methotrexate poisoning, with and without previous dermatoses. Most of them associated mucositis and bone marrow involvement. Treatment guidelines are recommended.


Assuntos
Toxidermias/etiologia , Imunossupressores/efeitos adversos , Metotrexato/efeitos adversos , Úlcera Cutânea/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Toxidermias/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Úlcera Cutânea/diagnóstico
5.
Best Pract Res Clin Rheumatol ; 37(1): 101850, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-37481369

RESUMO

Musculoskeletal ultrasonography has become an increasingly valuable tool as a complement to the physical exam in rheumatology practice. Its point-of-care access, low cost, safety, portability, and reliability in trained hands, make this technique especially useful in patients with inflammatory arthritis. Growing evidence has demonstrated the value of musculoskeletal ultrasound in the detection of inflammatory and structural changes in patients with joint pain without obvious joint swelling, in differentiating various inflammatory diagnoses, in the monitoring of inflammatory arthritis, and interventional procedures. The potential role of ultrasound guiding treat-to-target strategies or tapering treatment in inflammatory arthritis requires further research. However, musculoskeletal ultrasound can also have pitfalls and limitations that a clinician should be aware of.


Assuntos
Artrite , Reumatologia , Humanos , Reumatologia/métodos , Reprodutibilidade dos Testes , Artrite/diagnóstico por imagem , Artrite/terapia , Ultrassonografia
6.
Acta Medica (Hradec Kralove) ; 55(4): 165-71, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23631287

RESUMO

INTRODUCTION: Leptin is an adipokine which has a direct relationship to obesity. Our aim was to measure this hormone in pregnant women at three months intervals throughout their pregnancies to determine the serum value of those who developed preeclampsia. MATERIAL AND METHODS: We followed 19 women (median age 24.8 +/- 5.7 years) with pre-gestational Body Mass Index (BMI) less than 25 kg/m2, 21 (median age 26.1 +/- 4.6 years) with BMI higher than 25 kg/m2 and 16 (median age 30.9 +/- 5.8 years) with Gestational Diabetes Mellitus (GDM) (median age 30.9 +/- 5.8 years), recruited in the 1st trimester of pregnancy. Serum levels of leptin were measured with radioimmunoassay (RIA) technique. RESULTS: In the first trimester of pregnancy leptin levels showed statistically significant differences between normal weight and overweight-obese women (p < 0.001), diabetic women (p < 0.05) and the subgroup of preeclamptic women (p < 0.001). For those women with PGBMI > or = 40 kg/m2 and leptin > or = 40 ng/ml in the second trimester, the Odds Ratio (OR) to develop preeclampsia was of 47.95% CI (4.1-527.2). Analyzing leptin values with ROC curves, the greatest area under the curve (AUC) was for leptin in the second trimester (0.773, CI: 0.634-0.911). CONCLUSION: Women with morbid obesity (BMI > or = 40 kg/m2) had significantly higher levels of serum leptin (p < 0.01) and a value of 40 ng/ml of this hormone seems to be predictive of developing preeclampsia in this group of patients.


Assuntos
Leptina/sangue , Pré-Eclâmpsia/sangue , Adulto , Índice de Massa Corporal , Diabetes Gestacional/sangue , Feminino , Humanos , Obesidade/complicações , Sobrepeso/sangue , Pré-Eclâmpsia/etiologia , Gravidez , Complicações na Gravidez/sangue , Prognóstico , Fatores de Risco , Sensibilidade e Especificidade
7.
RMD Open ; 8(1)2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35074901

RESUMO

OBJECTIVE: To describe the prevalence of inflammatory and structural lesions using whole spine MRI in patients with psoriatic disease, and to assess their correlation with clinical features and with axial spondyloarthritis (axSpA) classification criteria. METHODS: This retrospective analysis included patients with whole spine and sacroiliac joints (SIJ) MRI, selected from 2 populations: (1) active psoriatic arthritis (PsA), irrespective of axial symptoms; (2) psoriasis with confirmed or suspected PsA and axSpA symptoms. MRI spondylitis and/or sacroiliitis (MRI-SpA) was defined according to Assessment of Spondyloarthritis International Society (ASAS) consensus and by radiologist impression. Agreement between MRI-SpA and different inflammatory back pain (IBP) definitions (Berlin/ASAS/rheumatologist criteria) and the axSpA classification criteria were calculated considering MRI as gold standard. Logistic regression determined MRI-SpA-associated factors. RESULTS: 93 patients were analysed (69.9% PsA; 30.1% psoriasis). Back pain was present in 81.7%, defined as IBP in 36.6%-57%. MRI-SpA was found in 9.7% of patients by ASAS definition and in 12.9% by radiologist impression, of which 25% had isolated spondylitis.Low agreement was found between the three IBP definitions and MRI-SpA. Rheumatologist criteria was the most sensitive (50%-55.6%) while ASAS and Berlin criteria were the most specific (61.9%-63%). axSpA criteria had poor sensitivity for MRI-SpA (22.2%-25%). Late onset of back pain or asymptomatic patients accounted for most cases with MRI-SpA not meeting axSpA or IBP criteria. Male sex was associated with MRI-SpA (OR 6.91; 95% CI 1.42 to 33.59) in multivariable regression analysis. CONCLUSION: Prevalence of MRI-defined axSpA was low and showed poor agreement with IBP and axSpA criteria.


Assuntos
Artrite Psoriásica , Sacroileíte , Artrite Psoriásica/diagnóstico por imagem , Artrite Psoriásica/epidemiologia , Estudos de Coortes , Humanos , Imageamento por Ressonância Magnética , Masculino , Estudos Retrospectivos , Sacroileíte/diagnóstico por imagem , Sacroileíte/epidemiologia
8.
J Rheumatol ; : 4-9, 2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35428726

RESUMO

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) held a trainee symposium at its 2021 virtual meeting. Dermatology and rheumatology trainees presented their work on psoriasis and psoriatic arthritis (PsA). This report briefly reviews 5 oral presentations: prediction of cardiovascular events in psoriatic disease (PsD), correlation between spine abnormalities and clinical findings, biomechanical stress as a trigger for PsA, differences in DNA methylation among twins with PsD, and critical proteins associated with induction of PsD. In addition, we highlight 22 posters broadly discussing clinical and molecular implications of PsD.

9.
J Org Chem ; 76(13): 5461-5, 2011 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-21612264

RESUMO

A chromium-mediated novel synthesis of carbohydrate-derived di- and trisubstituted (E)-α,ß-unsaturated esters or amides from a range of dichloroesters or amides and a variety of sugar aldehydes is reported. The process took place with total stereoselectivity and in high yields. A mechanism based on a sequential chromium-promoted aldol-type reaction and a completely stereoselective ß-elimination reaction is proposed to explain these results.


Assuntos
Amidas/síntese química , Carboidratos/química , Cromo/química , Ésteres/síntese química , Amidas/química , Ésteres/química , Estrutura Molecular , Estereoisomerismo
10.
Clin Exp Dent Res ; 7(2): 242-262, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33274551

RESUMO

OBJECTIVE: To evaluate the validity of craniofacial growth predictors in class II and III malocclusion. MATERIAL AND METHODS: An electronic search was conducted until August 2020 in PubMed, Cochrane Library, Embase, EBSCOhost, ScienceDirect, Scopus, Bireme, Lilacs and Scielo including all languages. The articles were selected and analyzed by two authors independently and the selected studies was assessed using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The quality of evidence and strength of recommendation was assessed by the GRADE tool. RESULTS: In a selection process of two phases, 10 articles were included. The studies were grouped according to malocclusion growth predictor in (1) class II (n = 4); (2) class III (n = 5) and (3) class II and III (n = 1). The predictors were mainly based on data extracted from cephalometries and characterized by: equations, structural analysis, techniques and computer programs among others. The analyzed studies were methodologically heterogeneous and had low to moderate quality. For class II malocclusion, the predictors proposed in the studies with the best methodological quality were based on mathematical models and the Fishman system of maturation assessment. For class III malocclusion, the Fishman system could provide adequate growth prediction for short- and long-term. CONCLUSIONS: Because of the heterogeneity of the design, methodology and the quality of the articles reviewed, it is not possible to establish only a growth prediction system for class II and III malocclusion. High-quality cohort studies are needed, well defined data extraction from cephalometries, radiographies and clinical characteristics are required to design a reliable predictor.


Assuntos
Má Oclusão Classe III de Angle , Má Oclusão Classe II de Angle , Má Oclusão , Cefalometria , Humanos , Má Oclusão Classe II de Angle/diagnóstico , Má Oclusão Classe III de Angle/diagnóstico
11.
Front Pharmacol ; 12: 644671, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33841163

RESUMO

Hermansky-Pudlak Syndrome (HPS) is a rare, genetic, multisystem disorder characterized by oculocutaneous albinism (OCA), bleeding diathesis, immunodeficiency, granulomatous colitis, and pulmonary fibrosis. HPS pulmonary fibrosis (HPS-PF) occurs in 100% of patients with subtype HPS-1 and has a similar presentation to idiopathic pulmonary fibrosis. Upon onset, individuals with HPS-PF have approximately 3 years before experiencing signs of respiratory failure and eventual death. This review aims to summarize current research on HPS along with its associated pulmonary fibrosis and its implications for the development of novel treatments. We will discuss the genetic basis of the disease, its epidemiology, and current therapeutic and clinical management strategies. We continue to review the cellular processes leading to the development of HPS-PF in alveolar epithelial cells, lymphocytes, mast cells, and fibrocytes, along with the molecular mechanisms that contribute to its pathogenesis and may be targeted in the treatment of HPS-PF. Finally, we will discuss emerging new cellular and molecular approaches for studying HPS, including lentiviral-mediated gene transfer, induced pluripotent stem cells (iPSCs), organoid and 3D-modelling, and CRISPR/Cas9-based gene editing approaches.

12.
J Org Chem ; 75(7): 2407-10, 2010 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-20196575

RESUMO

A novel, totally regioselective transformation of aromatic N-4-methoxyphenylaziridine 2-carboxamides into 2-aminoamides promoted by active manganese (Mn*) is reported. alpha-Amino ketones can be readily obtained by reaction of morpholine-derived 2-aminoamides with organolithium compounds.


Assuntos
Aziridinas/química , Cetonas/química , Manganês/química , Catálise , Ciclização , Compostos de Lítio/química , Espectroscopia de Ressonância Magnética , Estrutura Molecular , Morfolinas/química , Estereoisomerismo
13.
J Public Health Manag Pract ; 16(3): 189-200, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20357604

RESUMO

In Pennsylvania on February 16, 2006, a New York City resident collapsed with rigors and was hospitalized. On February 21, the Centers for Disease Control and Prevention and the New York City Department of Health and Mental Hygiene were notified that Bacillus anthracis had been identified in the patient's blood. Although the patient's history of working with dried animal hides to make African drums indicated the likelihood of a natural exposure to aerosolized anthrax spores, bioterrorism had to be ruled out first. Ultimately, this case proved to be the first case of naturally occurring inhalational anthrax in 30 years. This article describes the epidemiologic and environmental investigation to identify other cases and persons at risk and to determine the source of exposure and scope of contamination. Because stricter regulation of the importation of animal hides from areas where anthrax is enzootic is difficult, public healthcare officials should consider the possibility of future naturally occurring anthrax cases caused by contaminated hides. Federal protocols are needed to assist in the local response, which should be tempered by our growing understanding of the epidemiology of naturally acquired anthrax. These protocols should include recommended methods for reliable and efficient environmental sample collection and laboratory testing, and environmental risk assessments and remediation.


Assuntos
Antraz/transmissão , Exposição por Inalação , Exposição Ocupacional , Curtume , Antraz/diagnóstico , Bacillus anthracis/isolamento & purificação , Estudos de Casos e Controles , Infecções Comunitárias Adquiridas/epidemiologia , Humanos , Cidade de Nova Iorque/epidemiologia , Esporos Bacterianos
14.
J Matern Fetal Neonatal Med ; 33(24): 4049-4054, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30880554

RESUMO

Introduction: To assess the association of medical nutrition therapy (MNT) consultations and eating behavior with gestational weight gain (GWG) in Mexican women with type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM).Material and methods: Cross-sectional study conducted at (Blinded for Review) from 2013 to 2014. Fifty-seven patients with T2DM or GDM were invited to participate. The dependent variable was GWG and the main independent variables were MNT and eating behaviors. Data were obtained from medical records or interviews. Multiple linear regression models were used to assess associations.Results: Per each additional MNT consultation, GWG was reduced by 1.2 kg (ß = -1.2; 95% CI: -2, -0.3; p = .007). After adjusting for age, in women with normal pregestational weight, for each unit, increase in the EE behavior index, there was a GWG increase of 2.8 kg (ß = 2.8; 95% CI: 1.2, 4.4; p = .003).Conclusions: This study reinforces the need for additional research to determine how eating behaviors are related to GWG during pregnancy. ClinicalTrials.gov Identifier: NCT03767699.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Ganho de Peso na Gestação , Terapia Nutricional , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Comportamento Alimentar , Feminino , Humanos , Gravidez , Aumento de Peso
15.
Rev. bras. educ. espec ; 30: e0051, 2024. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1559425

RESUMO

RESUMEN: Los intérpretes en Lengua de Señas Chilena (ILSCh) constituyen un recurso para la inclusión, eliminando barreras de estudiantes sordos que manejan la modalidad visual-gestual para comunicarse. Chile tiene normativa que favorece la participación del ILSCh en distintos ámbitos, y este estudio se centró en los intérpretes en contexto escolar, considerando que existe un desconocimiento de los procesos, implementación, resultados, logros y situación laboral. Las interrogantes del estudio fueron: ¿cuál es el estado actual del ILSCh, las trayectorias formativas, el rol y los desafíos de su quehacer? El objetivo general fue describir la figura del ILSCh y los desafíos que enfrenta en su desempeño laboral en contexto escolar, situados en las regiones Metropolitana y Valparaíso, Chile. El enfoque fue cualitativo, interpretativo, diseño fenomenográfico, descriptivo y transeccional, la muestra intencionada por criterios de 24 intérpretes de nivel escolar. Las técnicas de recogida de información fueron: formulario de identificación, entrevista y grupo focal. Se analizaron las transcripciones con el software Atlas TI. Los resultados muestran la diversidad en la formación, centrada en el vocabulario de la lengua, con mínimas líneas del contexto educativo, desconocimiento del rol, solicitudes de tareas fuera de sus funciones y situaciones laborares sin regulación y diversidad de jefaturas.


ABSTRACT: The interpreters in Chilean Sign Language (ILSCh) constitute a resource for inclusion, eliminating the barriers of deaf students who use the visual-gestural modality to communicate. Chile has regulations that favor the participation of the ILSCh in different áreas, and this study focused on interpreters in the school context, considering that there is a lack of knowledge of the processes, implementation, results, achievements and employment situation. The questions of the study were: What is the current state of the ILSCh, its formative trajectories, its role and the challenges of its work? The general objective was to describe the figure of the ILSCh and the challenges it faces in its work performance in the school context, located in the Metropolitan and Valparaíso regions, Chile. The approach was qualitative, interpretative, phenomenographic, descriptive and transactional design, the sample intentional by criteria of 24 school level interpreters. The information collection techniques were: identification form, interview and focus group. The transcripts were analyzed with the Atlas TI software. The results show the diversity in the training, focused on the vocabulary of the language, with minimal lines of the educational context, lack of knowlegde of the role, requests for tasks outside their functions and work situations without regulation and diversity of leadership.

16.
Nutr Hosp ; 36(4): 834-839, 2019 Aug 26.
Artigo em Espanhol | MEDLINE | ID: mdl-31192689

RESUMO

INTRODUCTION: Introduction: obesity and DM-2 decrease trabecular bone mass even though cortical bone increase may coexist. Another common finding is presarcopenia/sarcopenia, possibly due to insulin resistance and oxidative stress. It remains to be clarified whether these changes depend on either early (prediabetes) or late (established DM) glucidic alterations, or rather they would be linked predominantly by excess fat mass in obese patients Objectives: to evaluate and compare body composition parameters (bone, muscle and adipose-visceral tissues) in overweight/obese patients grouped by whether or not they present glucidic metabolism disorders. Analyze if there are differences between FRAX vs FRAX adjusted to trabecular bone score TBS in both groups. Methods: sixteen overweight/obese patients were included. In all of them clinical-anthropometric evaluation, bioimpedance, DXA and analysis were performed. They were grouped by glycemia as: a) normal; b) impaired fasting glycemia (IFG); and c) DM-2. Non-parametric tests were performed. Results: no statistically significant differences were found among groups regarding bone microarchitecture, muscle mass or visceral fat. The IFG group showed the highest average muscle mass and visceral fat. Then, patients were reclassified in only two groups, normal glycemia in group 1 and altered glycemia in group 2 (IFG and DM-2), and statistically significant differences were found at the expense of lower trabecular bone microarchitecture in group 2 (p = 0.031) and phosphorus lower levels in group 1 (p = 0.042). Conclusions: in our study, the bone microarchitecture is impaired in patients with altered glycemia and obesity. Studies with larger sample size are needed to establish when these changes take place in the natural evolution of diabetes.


INTRODUCCIÓN: Introducción: la obesidad y la diabetes mellitus tipo 2 (DM-2) disminuyen el entramado trabecular óseo aun cuando puede coexistir aumento del hueso cortical. Otro hallazgo en común es la presarcopenia/sarcopenia secundaria posiblemente a la insulinorresistencia y el estrés oxidativo. Queda por aclarar si estos cambios dependen fundamentalmente de las alteraciones glucídicas precoces (pre DM-2) o tardías (DM-2 establecida), o más bien estarían vinculadas de forma predominante por el exceso de masa grasa en individuos obesos. Objetivos: evaluar y comparar parámetros de composición corporal (compartimentos óseo, muscular y adiposo-visceral) en pacientes con sobrepeso/obesidad agrupados según presenten o no alteraciones glucídicas. Analizar si existen diferencias comparando FRAX vs. FRAX ajustado a trabecular bone score (TBS) en ambos grupos. Métodos: se incluyeron 16 pacientes con sobrepeso/obesidad. A todos se les realizó evaluación clínica-antropométrica, bioimpedanciometría, absorciometría de rayos X de energía dual o densitometría ósea (DXA) y análisis, y se les agrupó según glucemia en tres grupos: a) normal; b) glucemia basal alterada en ayunas (GBA); y c) DM-2. Para el análisis estadístico empleamos pruebas no paramétricas. Resultados: no se encontraron diferencias estadísticamente significativas en los grupos respecto a microarquitectura ósea, masa muscular o grasa visceral. El grupo GBA mostró el mayor promedio de masa muscular y grasa visceral. Tras reclasificar en solo dos grupos, glucemia normal en el grupo 1 y glucemia alterada en el grupo 2 (GBA y DM-2), encontramos diferencias estadísticamente significativas con detrimento de la microarquitectura ósea trabecular en el grupo 2 (p = 0,031) y cifras de fósforo con niveles inferiores en el grupo 1 (p = 0,42). Conclusiones: en nuestro estudio, la microarquitectura ósea está deteriorada en pacientes con glucemia alterada y obesos. Hacen falta estudios con mayor tamaño muestral para establecer en qué momento se instauran estos cambios en la evolución natural de la diabetes.


Assuntos
Composição Corporal , Osso e Ossos/patologia , Transtornos do Metabolismo de Glucose/patologia , Obesidade/patologia , Absorciometria de Fóton , Análise de Variância , Glicemia , Densidade Óssea , Osso e Ossos/ultraestrutura , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Jejum/sangue , Feminino , Transtornos do Metabolismo de Glucose/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/anatomia & histologia , Obesidade/sangue , Sobrepeso/sangue , Sobrepeso/patologia , Estudos Prospectivos , Estatísticas não Paramétricas
17.
Org Biomol Chem ; 6(16): 2934-40, 2008 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-18688486

RESUMO

A Mn*-promoted sequential process directed toward the synthesis of (Z)-alpha-halo-alpha,beta-unsaturated esters or amides is described. In both cases, the process takes place with complete Z-stereoselectivity. In addition, (Z)-alpha-chloro-alpha,beta-unsaturated ketones and carboxylic acids, and (Z)-haloallylic alcohols were readily prepared from (Z)-alpha-halo-alpha,beta-unsaturated amides derived from morpholine, or esters. A mechanism has been proposed to explain the sequential process and the stereoselectivity observed.

18.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1528743

RESUMO

El canino maxilar permanente corresponde al segundo diente más frecuentemente impactado en el arco dental. La etiología de esta patología aún no está totalmente definida, sin embargo, investigadores plantean la deficiencia del ancho del hueso maxilar como una posible causa. Objetivo: Investigar la evidencia que asocia menores dimensiones transversales del maxilar a la ocurrencia de la impactación de caninos superiores y esclarecer la posible relación. Materiales y métodos: Se realizó una revisión sistemática exploratoria a partir de una búsqueda amplia de la literatura en bases de datos PubMed, Cochrane, EBSCO y Multibuscador UNAB. Los artículos fueron recopilados, identificados y filtrados según el diagrama de flujo de declaración PRISMA. Resultados: La búsqueda identificó 755 estudios, de los cuales 14 fueron incluidos. Los estudios varían en diseño, edad de estudio y métodos de diagnóstico. La mitad de los estudios reporta una asociación positiva entre compresión maxilar e impactación canina superior, mientras que la otra mitad una asociación negativa. Conclusiones: No hay evidencia suficiente para poder asociar compresión maxilar con impactación de caninos superiores. Estudios con métodos de diagnóstico rigurosos son necesarios para una mejor comprensión. No obstante, se enfatiza la importancia de un diagnóstico precoz, para garantizar mejores resultados y pronóstico más favorable.


The permanent maxillary canine is the second most frequently impacted tooth in the dental arch. The etiology of this disease is not completely defined, yet some researchers propose the deficiency of the width from the maxilla as a possible cause. Objective: To investigate available evidence correlating smaller transverse maxilla dimensions with the occurrence of potential impaction of upper canines and clarify the possible relation. Materials and methods: A systematic exploratory review was carried out based on comprehensive search of the literature in databases such as PubMed, Cochrane, EBSCO and UNAB multi search engine. The articles were compiled, identified and filtered systematically according to the PRISMA flow diagram. Results: Our search identified 755 studies, 14 of which were included. These studies vary in design, patients age, and methods for detection. Half of the studies show a positive correlation between maxillary compression and potential upper canine impaction, whereas the other half show a negative correlation. Conclusions: There is not enough evidence to link maxillary compression to upper canine impaction. Studies with rigorous diagnostic methods for detection are necessary for a better understanding of this relation. Nonetheless, the importance of early diagnosis must be emphasized to guarantee better results and a more favorable prognosis.

19.
J Abnorm Child Psychol ; 35(3): 393-404, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17295064

RESUMO

This study evaluated the validity and classification utility of the Conners' Continuous Performance Test (CCPT) in the assessment of inattentive and hyperactive-impulsive behaviors in children. Significant, positive correlations between the CCPT parameters and behavioral ratings of ADHD behaviors were hypothesized. In addition, it was hypothesized that the CCPT parameters would perform better than a random test (chance) and show fair to moderate utility of classification across the different indices. Participants were 104 children between 6 and 12 years of age who were referred for evaluation of attention problems. The first hypothesis was not supported. There were no significant, positive correlations between the CCPT parameters and parent and teacher ratings of inattentive and hyperactive-impulsive behaviors. The second hypothesis was only partially supported. The CCPT Overall Index and the Omission Errors (84th percentile cutoff) performed better than a random test; however, the utility of the CCPT Overall Index only ranged from poor to slight. Receiver operating characteristic analyses showed the accuracy of the CCPT to be low. The implications and limitations of this study and future research directions are discussed.


Assuntos
Testes Neuropsicológicos/estatística & dados numéricos , Atenção , Transtorno do Deficit de Atenção com Hiperatividade/classificação , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Atitude , Criança , Comportamento Infantil/psicologia , Diagnóstico por Computador , Manual Diagnóstico e Estatístico de Transtornos Mentais , Estudos de Avaliação como Assunto , Feminino , Humanos , Comportamento Impulsivo/classificação , Comportamento Impulsivo/diagnóstico , Comportamento Impulsivo/psicologia , Masculino , Testes Neuropsicológicos/normas , Pais/psicologia , Escalas de Graduação Psiquiátrica , Psicometria , Curva ROC , Ensino
20.
Dermatol. argent ; 27(1): 28-30, ene.-mar. 2021. il
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1361644

RESUMO

El apremilast es un fármaco inhibidor de la fosfodiesterasa-4 que modula, a nivel intracelular, la expresión de citoquinas involucradas en la patogenia inflamatoria de la psoriasis. Su uso está indicado en la psoriasis en placas moderada y severa, con buenos resultados clínicos. Los principales efectos adversos son gastrointestinales y, en menos del 2% de los pacientes, dermatológicos, con exantema y foliculitis. Se presenta el caso de un paciente de 42 años que, luego de tomar el apremilast, desarrolló lesiones faciales que correspondieron clínica e histopatológicamente a una reacción acneiforme, con evolución favorable y resolución total del cuadro posterior a la suspensión del medicamento.


Apremilast is a phosphodiesterase-4 inhibitor that modulates the intracellular expression of cytokines, which are involved in the pathogenesis of psoriasis. Apremilast is indicated in moderate to severe plaque psoriasis, and it has shown good clinical results. The main adverse effects occur at a gastrointestinal level, and in less than 2% at the dermatologic level with exanthema and folliculitis. We present a 42-year-old patient that developed facial lesions after taking apremilast. The facial lesions were clinically and histopathologically correspond to an acneiform eruption. The patient evolved favorably and fully recovered after suspending apremilast.


Assuntos
Humanos , Masculino , Adulto , Psoríase/tratamento farmacológico , Talidomida/efeitos adversos , Talidomida/análogos & derivados , Erupções Acneiformes , Diarreia , Minociclina/administração & dosagem
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