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1.
J Dairy Sci ; 107(7): 4704-4713, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38310964

RESUMO

The large-scale recording of traits such as feed efficiency (FE) and methane emissions (ME) for use in genetic improvement programs is complex, costly, and time-consuming. Therefore, heritable traits that can be continuously recorded in dairy herds and are correlated with FE and ME traits could provide useful information for genetic evaluation. Rumination time has been suggested to be associated with FE, methane production (MeP; ME in g/d), and production traits at the phenotypic level. Therefore, the objective of this study was to investigate the genetic relationships among rumination time (RT), FE, methane and production traits using 7,358 records from 656 first-lactation Holstein cows. The estimated heritabilities were moderate for RT (0.45 ± 0.14), MeP (0.36 ± 0.12), milk yield (0.40 ± 0.08), fat yield (0.29 ± 0.06), protein yield (0.32 ± 0.07), and energy-corrected milk (0.28 ± 0.07), but were low and nonsignificant for FE (0.15 ± 0.07), which was defined as the residual of the multiple linear regression of DMI on energy-corrected milk and metabolic body weight. A favorable negative genetic correlation was estimated between RT and MeP (-0.53 ± 0.24), whereas a positive favorable correlation was estimated between RT and energy-corrected milk (0.49 ± 0.11). The estimated genetic correlation of RT with FE (-0.01 ± 0.17) was not significantly different from zero but showed a trend of a low correlation with dry matter intake (0.21 ± 0.13). These results indicate that RT is genetically associated with MeP and milk production traits, but high standard errors indicate that further analyses should be conducted to verify these findings when more data for RT, MeP, and FE become available.


Assuntos
Lactação , Metano , Leite , Animais , Bovinos/genética , Metano/biossíntese , Metano/metabolismo , Feminino , Lactação/genética , Leite/metabolismo , Leite/química , Ração Animal , Fenótipo , Dieta/veterinária
2.
J Child Lang ; : 1-23, 2023 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-37899270

RESUMO

Daily language interactions predict child outcomes. For multilingual families who rear neurodiverse children and who may be minoritized for their language use, a dearth of research examines families' daily language interactions. Utilizing a language socialization framework and a case study methodology, 4,991 English and Spanish utterances from a 5-year old autistic child and his family were collected during naturally occurring interactions over 10 days. Utterances were analyzed for patterns of code-switching by speaker, activity setting, English or Spanish initial language, and code-switch function. Spanish was spoken in most activities. For reading, both languages were equally employed by the father. While participants used both languages across all activity settings, significant variations in code-switching type and function were observed by activity setting and speaker. We discuss implications for how home language resources can be integrated into autism interventions.

3.
Trop Anim Health Prod ; 55(3): 189, 2023 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-37138172

RESUMO

This study aimed to determine the effect of growth rates on the hormonal status and puberty onset. Forty-eight Nellore heifers were weaned at 3.0 ± 0.1 (means ± standard error of the mean) months old were blocked according to body weight at weaning (84 ± 2 kg) and randomly assigned to treatments. The treatments were arranged in 2 × 2 factorial according to the feeding program. The first program was high (H; 0.79 kg/day) or control (C; 0.45 kg/day) average daily gain (ADG) from 3rd to 7th month of age (growing phase I). The second program was also high (H; 0.70 kg/day) or control (C; 0.50 kg/day) ADG from the 7th month until puberty (growing phase II), resulting in four treatments: HH (n = 13), HC (n = 10), CH (n = 13), and CC (n = 12). To achieve desired gains, heifers in high ADG program were fed ad libitum dry matter intake (DMI), and the control group was offered around 50% of ad libitum DMI of high group. All heifers received a diet with similar composition. Puberty was assessed weekly by ultrasound examination, and the largest follicle diameter was evaluated every month. Blood samples were collected to quantify leptin, insulin growth factor-1 (IGF1) and luteinizing hormone (LH). At 7 months of age, heifers in high ADG were 35 kg heavier than the control. Heifers in the HH had greater DMI compared with CH in phase II. The puberty rate at 19 months old was greater in the HH treatment (84%) than in the CC (23%), but there was no difference between HC (60%) and CH (50%) treatments. Heifers from HH treatment had greater serum leptin concentration than others at 13 months old, and serum leptin was greater in HH compared with CH and CC at 18 months old. High heifers in phase I had greater serum IGF1 concentration than the control. In addition, HH heifers had a greater diameter of the largest follicle than CC. There was no interaction between phases and age in any variable relative to the LH profile. However, the heifers' age was the main factor that increased the frequency of LH pulse. In conclusion, increasing ADG was associated with greater ADG, serum leptin and IGF-1 concentration, and puberty onset; however, LH concentration was affected mainly by age of the animal. The increasing growth rate at younger age made heifers more efficient.


Assuntos
Leptina , Maturidade Sexual , Feminino , Bovinos , Animais , Desmame , Dieta/veterinária , Insulina , Ração Animal/análise
4.
Arch Biochem Biophys ; 731: 109424, 2022 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-36220378

RESUMO

As in most enveloped RNA viruses, the Respiratory Syncytial Virus Matrix (RSV-M) protein plays key roles in viral assembly and uncoating. It also plays non-structural roles related to transcription modulation through nucleo-cytoplasmic shuttling and nucleic acid binding ability. We dissected the structural and conformational changes underlying the switch between multiple functionalities, identifying Ca2+ binding as a key factor. To this end, we tackled the analysis of M's conformational stability and equilibria. While in silico calculations predict two potential calcium binding sites per protomer, purified RSV-M dimer contains only one strongly bound calcium ion per protomer. Incubation of RSV-M in the presence of excess Ca2+ leads to an increase in the thermal stability, confirming additional Ca2+ binding sites. Moreover, mild denaturant concentrations trigger the formation of higher order oligomers which are otherwise prevented under Ca2+ saturation conditions, in line with the stabilizing effect of the additional low affinity binding site. On the other hand, Ca2+ removal by chelation at pH 7.0 causes a substantial decrease in the thermal stability leading to the formation of amorphous, spherical-like aggregates, as assessed by TEM. Even though the Ca2+ content modulates RSV-M oligomerization propensity, it does affect its weak RNA binding ability. RSV-M undergoes a substantial conformational change at pHs 4.0 to 5.0 that results in the exposure of hydrophobic surfaces, an increase beta sheet content but burial of tryptophan residues. While low ionic strength promotes dimer dissociation at pH 4.0, physiological concentrations of NaCl lead to the formation of soluble oligomers smaller than 400 kDa at pH 4.0 or insoluble aggregates with tubular morphology at pH 5.0, supporting a fine tuning by pH. Furthermore, the dissociation constants estimated for the low- and high affinity calcium binding sites are 13 µM and 58 nM, respectively, suggesting an intracellular calcium sensing mechanism of RSV-M upon infection. We uncover a finely tuned interplay between calcium binding, ionic strength, and pH changes compatible with the different cellular compartments where M plays key roles, revealing diverse conformational equilibria, oligomerization, and high order structures, required to stabilize the virion particle by a layer of molecules positioned between the membrane and the nucleocapsid.


Assuntos
Cálcio , Vírus Sincicial Respiratório Humano , Subunidades Proteicas , Vírus Sincicial Respiratório Humano/química , Montagem de Vírus , Concentração Osmolar , Ligação Proteica
5.
Crit Rev Clin Lab Sci ; 58(3): 207-224, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33929278

RESUMO

In the clinical laboratory, knowledge of and the correct use of clot activators and anticoagulant additives are critical to preserve and maintain samples in optimal conditions prior to analysis. In 2017, the Latin America Confederation of Clinical Biochemistry (COLABIOCLI) commissioned the Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) to study preanalytical variability and establish guidelines for preanalytical procedures to be applied by clinical laboratories and health care professionals. The aim of this critical review, on behalf of COLABIOCLI WG-PRE-LATAM, is to provide information to understand the mechanisms of the interactions and reactions that occur between blood and clot activators and anticoagulant additives inside evacuated tubes used for laboratory testing. Clot activators - glass, silica, kaolin, bentonite, and diatomaceous earth - work by surface dependent mechanism whereas extrinsic biomolecules - thrombin, snake venoms, ellagic acid, and thromboplastin - start in vitro coagulation when added to blood. Few manufacturers of evacuated tubes state the type and concentration of clot activators used in their products. With respect to anticoagulant additives, sodium citrate and oxalate complex free calcium and ethylenediaminetetraacetic acid chelates calcium. Heparin potentiates antithrombin and hirudin binds to active thrombin, inactivating the thrombin irreversibly. Blood collection tubes have improved continually over the years, from the glass tubes containing clot activators or anticoagulant additives that were prepared by laboratory personnel to the current standardized evacuated systems that permit more precise blood/additive ratios. Each clot activator and anticoagulant additive demonstrates specific functionality, and both manufacturers of tubes and laboratory professional strive to provide suitable interference-free sample matrices for laboratory testing. Both manufacturers of in vitro diagnostic devices and laboratory professionals need to understand all aspects of venous blood sampling so that they do not underestimate the impact of tube additives on laboratory testing.


Assuntos
Anticoagulantes , Coleta de Amostras Sanguíneas , Anticoagulantes/farmacologia , Coagulação Sanguínea , Humanos , Flebotomia
6.
Mol Divers ; 25(1): 55-66, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31900682

RESUMO

Cancer is one of the leading causes of death worldwide and requires intense and growing research investments from the public and private sectors. This is expected to lead to the development of new medicines. A determining factor in this process is the structural understanding of molecules with potential anticancer properties. Since the major compounds used in cancer therapies fail to encompass every spectrum of this disease, there is a clear need to research new molecules for this purpose. As it follows, we have studied the class of quinolinones that seem effective for such therapy. This paper describes the structural elucidation of a novel dihydroquinoline by single-crystal X-ray diffraction and spectroscopy characterization. Topology studies were carried through Hirshfeld surfaces analysis and molecular electrostatic potential map; electronic stability was evaluated from the calculated energy of frontier molecular orbitals. Additionally, in silico studies by molecular docking indicated that this dihydroquinoline could act as an anticancer agent due to their higher binding affinity with human aldehyde dehydrogenase 1A1 (ALDH 1A1). Tests in vitro were performed for VERO (normal human skin keratinocytes), B16F10 (mouse melanoma), and MDA-MB-231 (metastatic breast adenocarcinoma), and the results certified that compound as a potential anticancer agent. A Dihydroquinoline derivative was tested against three cancer cell lines and the results attest that compound as potential anticancer agent.


Assuntos
Antineoplásicos/química , Antineoplásicos/farmacologia , Neoplasias/tratamento farmacológico , Quinolinas/química , Quinolinas/farmacologia , Animais , Linhagem Celular , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Chlorocebus aethiops , Cristalografia por Raios X/métodos , Ensaios de Seleção de Medicamentos Antitumorais/métodos , Compostos Heterocíclicos/química , Compostos Heterocíclicos/farmacologia , Humanos , Camundongos , Modelos Moleculares , Simulação de Acoplamento Molecular/métodos , Quinolonas/química , Quinolonas/farmacologia , Relação Estrutura-Atividade , Células Vero
7.
J Public Health (Oxf) ; 43(2): e204-e212, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-33367910

RESUMO

BACKGROUND: The purpose of the current study was to investigate the association between binge and heavy drinking and self-reported current depression (SRCD) in a representative population-based sample of adults residing in Brazil. METHODS: The sample for this study was based on the 2013 Brazilian National Health Survey. SRCD was accessed using the Patient Health Questionnaire (PHQ-8), a valid eight-item depression measure for population-based studies instrument. The association between binge/heavy drinking and SRCD was investigated using weighted and adjusted multivariable logistic regression models. RESULTS: Out of the final study sample of 59 399 Brazilians, 47.2% were young adults, 34.6% were middle age adults and 52.4% were females. The prevalence of binge drinking was 13.8%, of heavy drinking was 3.2% and SRCD was 7.6%. There was a significant weighted and adjusted association between binge drinking and SRCD among young and middle age females (OR = 1.5, 95% CI:1.1-2.0 and OR = 0.6, 95% CI:0.4-0.8, respectively) and between heavy drinking and SRCD among young and middle age males (OR = 1.8, 95% CI:1.2-2.8 and OR = 2.5, 95% CI:1.5-4.1, respectively). CONCLUSIONS: The possible protective factor of binge drinking for SRCD among middle-aged Brazilian females needs to be further investigated and understood. Longitudinal research is needed to provide further evidence of associations found in this study.


Assuntos
Consumo de Bebidas Alcoólicas , Depressão , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Depressão/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Autorrelato , Adulto Jovem
8.
J Eur Acad Dermatol Venereol ; 35(11): 2128-2142, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34263958

RESUMO

Keloids (K) and hypertrophic scars (HS) are abnormal responses to wound healing that occur as the result of dermal inflammation. Despite the advances on their treatment, many patients still suffer from the negative effects of excessive scarring; its approach is impaired by the lack of objective data on different treatments and the large genetic variability among patients and the difficulties in producing multicentre studies. Their incidence among the Brazilian population is high, as the result of an admixture of Amerindians, Europeans and Africans ancestral roots. With the aim of producing multicentre studies on K and HS, a panel of senior Brazilian dermatologists focused on their treatment was invited to contribute with the K and HS Treatment Brazilian Guidelines. In the first part of this study, different treatment modalities for keloids and HS are fully reviewed by the panel. The second part of the study presents a consensus recommendation of treatment for different types of lesions. More than a literature review, this article aims to show the pitfalls and pearls of each therapeutic option, as well as a therapeutic approach by the Panel of Experts on keloids and Scars on a highly mixed population, providing simple guidelines.


Assuntos
Cicatriz Hipertrófica , Queloide , Brasil , Cicatriz Hipertrófica/genética , Cicatriz Hipertrófica/patologia , Cicatriz Hipertrófica/terapia , Humanos , Queloide/genética , Queloide/patologia , Queloide/terapia
9.
Proc Biol Sci ; 287(1923): 20192922, 2020 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-32183629

RESUMO

The role of cognitive factors in triggering the stress response is well established in humans and mammals (aka cognitive appraisal theory) but very seldom studied in other vertebrate taxa. Predictability is a key factor of the cognitive evaluation of stimuli. In this study, we tested the effects of stressor predictability on behavioral, physiological and neuromolecular responses in the European sea bass (Dicentrarchus labrax). Groups of four fish were exposed to a predictable (signalled) or unpredictable (unsignalled) stressor. Stressor predictability elicited a lower behavioural response and reduced cortisol levels. Using the expression of immediate early genes (c-fos, egr-1, bdnf and npas4) as markers of neuronal activity, we monitored the activity of three sea bass brain regions known to be implicated in stressor appraisal: the dorsomedian telencephalon, Dm (putative homologue of the pallial amygdala); and the dorsal (Dld) and ventral (Dlv) subareas of the dorsolateral telencephalon (putative homologue of the hippocampus). The activity of both the Dm and Dlv significantly responded to stressor predictability, suggesting an evolutionarily conserved role of these two brain regions in information processing related to stressor appraisal. These results indicate that stressor predictability plays a key role in the activation of the stress response in a teleost fish, hence highlighting the role of cognitive processes in fish stress.


Assuntos
Bass/fisiologia , Estresse Fisiológico/fisiologia , Animais , Cognição/fisiologia , Estresse Psicológico
10.
Photochem Photobiol Sci ; 19(11): 1548-1558, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33146219

RESUMO

Firefly luciferases display a typical change in bioluminescence color to red at acidic pH, high temperatures and in the presence of heavy metals. Recently, the proton and metal sensing site responsible for the pH-sensitivity of firefly luciferases, which involves the salt bridges between E311-R337 and H310-E354, was identified. However, it is unclear what other residues contribute to the distinct degrees of pH-sensitivity observed in other firefly luciferases. A multialignment of primary structures of a large set of pH-sensitive and pH-insensitive beetle luciferases showed that the conserved E270 among adult firefly luciferases is substituted by Gly (railroad worms)/Gln (click-beetles) in pH-insensitive ones. Site-directed mutagenesis studies using Macrolampis sp2 and Amydetes vivianii firefly luciferases indeed showed that E270 is important for the pH-dependent activity and spectral profiles: the substitution E270A/G drastically decreases the spectral pH-sensitivity, and extends the activity profile above pH 9.0. These mutations also decrease the sensitivity to metals such as zinc, mercury and cadmium. Modelling studies showed that the residue E270 is located in a three-glutamate motif (269EEE271) at the N-terminal of α-helix-10. The results suggest that at acidic pH, the protonation of E270 carboxylate may extend a turn of the helix at the N-terminal, misaligning the pH-sensor and luciferin phenolate binding site residues: S286, I288 and E311. In contrast, the substitution of E270A/G may unwind a turn of the α-helix-10, indirectly increasing the interaction of the pH-sensor and other residues at the bottom of the luciferin binding site, stabilizing the green light emitting conformation.


Assuntos
Luciferases de Vaga-Lume/metabolismo , Metais Pesados/metabolismo , Animais , Vaga-Lumes , Concentração de Íons de Hidrogênio , Cinética , Luciferases de Vaga-Lume/química , Luciferases de Vaga-Lume/genética , Metais Pesados/química , Mutagênese Sítio-Dirigida
11.
Pediatr Surg Int ; 36(5): 563-568, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32232550

RESUMO

PURPOSE: This study evaluates the capacity of ultrasonography as a diagnostic method to confirm the proper positioning of central venous catheter (CVC) when compared to the current gold standard, chest radiography (CR). METHODS: A prospective study was performed including children from 0 to 14 incomplete years, who underwent CVC placement between March and May 2018 at a teaching hospital in Brazil. A four-chamber view of the heart was performed with ultrasound during a rapid injection of saline solution to identify hyperechoic images and confirm the central position of the catheter. After that, a CR was performed. The diagnostic quality of ultrasound was evaluated based on accuracy, sensitivity, specificity, positive and negative predictive values. RESULTS: A total of 21 patients were analyzed. The mean age was 3.95 ± 4.01 years. The preferred puncture site was the right internal jugular vein (71.4%). Ultrasound accuracy to detect CVC positioning was 81%. Sensitivity, specificity and positive and negative predictive values were 33%, 100%, 100% and 79%, respectively. CONCLUSION: Ultrasound is a reliable method for detection of CVC positioning. Even so, with the four-chamber cardiac view, this method is unable to identify catheters inside heart chambers, therefore, needing to confirm the positioning with CR.


Assuntos
Cateterismo Venoso Central/métodos , Cateteres Venosos Centrais , Veias Jugulares/diagnóstico por imagem , Radiografia Torácica/métodos , Ultrassonografia/métodos , Adolescente , Veias Braquiocefálicas , Criança , Pré-Escolar , Desenho de Equipamento , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Punções
12.
Arch Biochem Biophys ; 671: 77-86, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31229488

RESUMO

Virus from the Mononegavirales order share common features ranging from virion structure arrangement to mechanisms of replication and transcription. One of them is the way the nucleoprotein (N) wraps and protects the RNA genome from degradation by forming a highly ordered helical nucleocapsid. However, crystal structures from numerous Mononegavirales reveal that binding to the nucleoprotein results in occluded nucleotides that hinder base pairing necessary for transcription and replication. This hints at the existence of alternative conformations of the N protein that would impact on the protein-RNA interface, allowing for transient exposure of the nucleotides without complete RNA release. Moreover, the regulation between the alternative conformations should be finely tuned. Recombinant expression of N from the respiratory syncytial virus form regular N/RNA common among all Mononegavirales, and these constitute an ideal minimal unit for investigating the mechanisms through which these structures protect RNA so efficiently while allowing for partial accessibility during transcription and replication. Neither pH nor high ionic strength could dissociate the RNA but led to irreversible aggregation of the nucleoprotein. Low concentrations of guanidine chloride dissociated the RNA moiety but leading to irreversible aggregation of the protein moiety. On the other hand, high concentrations of urea and long incubation periods were required to remove bound RNA. Both denaturants eventually led to unfolding but converged in the formation of an RNA-free ß-enriched intermediate species that remained decameric even at high denaturant concentrations. Although the N-RNA rings interact with the phosphoprotein P, the scaffold of the RNA polymerase complex, this interaction did not lead to RNA dissociation from the rings in vitro. Thus, we have uncovered complex equilibria involving changes in secondary structure of N and RNA loosening, processes that must take place in the context of RNA transcription and replication, whose detailed mechanisms and cellular and viral participants need to be established.


Assuntos
Proteínas do Nucleocapsídeo/metabolismo , RNA Viral/metabolismo , Concentração de Íons de Hidrogênio , Simulação de Dinâmica Molecular , Conformação de Ácido Nucleico , Proteínas do Nucleocapsídeo/química , Concentração Osmolar , Ligação Proteica , Estrutura Secundária de Proteína , Estabilidade de RNA , RNA Viral/química , Vírus Sincicial Respiratório Humano/química , Temperatura , Termodinâmica
13.
Biofouling ; 35(8): 819-831, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31558046

RESUMO

Biofilms can be formed on the surfaces of dairy processing equipment and are a potential source of product contamination. This study evaluated the diversity of multispecies biofilms formed on stainless steel (SS) due to the contaminating microbiota in raw milk. Samples of raw milk were used: one was fresh milk and the other maintained in refrigerated bulk tanks for up to 48 h. The mesophilic aerobic contamination was ∼104 CFU ml-1 in fresh milk and 106 CFU ml-1 in bulk milk. SS coupons were kept immersed in the milk at 7 ±2 °C for 10 days, and every two days, the raw milk was changed for samples of the same origin collected on the current day. After incubation for 10 days, sessile cells in the biofilm reached 105 CFU cm-2 in the presence of fresh milk, and 106 CFU cm-2 in the presence of bulk milk. The genetic diversity analysis showed that Gammaproteobacteria and Bacilli predominated in the biofilms throughout the incubation of both milk samples and these biofilms showed a reduction in diversity over time. The main classes of bacteria found in these biofilms have representatives of great importance since many of them have spoilage potential.


Assuntos
Biofilmes/crescimento & desenvolvimento , Contaminação de Equipamentos , Manufaturas/microbiologia , Microbiota , Leite/microbiologia , Aço Inoxidável , Animais , Contagem de Colônia Microbiana , Indústria de Laticínios/normas , Microbiologia de Alimentos
14.
Public Health ; 171: 31-40, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31082758

RESUMO

OBJECTIVES: The aims of this study were (1) to identify attributes for patient safety at a primary healthcare level and (2) to analyze conceptions of patients, professionals, and managers about how these attributes are being addressed. STUDY DESIGN: This was a qualitative study. METHODS: Participants were recruited from three primary care settings in Brazil. A total of 37 subjects (four physicians, three nurses, three dentists, three managers, five community assistants, and 19 patients) participated on interviews about their perceptions of safety attributes at the primary care settings involved in the study. Some of these participants attended a focus group meeting. A thematic categorical analysis was carried out to interpret the interviews. RESULTS: The main attributes for patient safety were valued by the participants. However, barriers such as discontinuity of care, interruptions during consultations, breakdowns in the communication, and ineffective teamwork were reported as frequent sources of patient safety issues. Reports of patients left unattended for excessive time because of the lack of accurate information and disruptions that took up to 35 min show that there is still a long way to go for primary care to be safe and effective in the study settings. CONCLUSIONS: It is necessary that the strategies meet the patient safety needs more effectively and efficiently. Further research is needed to understand the complex nature of the problems that affect patient safety in these settings so that appropriate decisions can be made.


Assuntos
Avaliação das Necessidades , Segurança do Paciente , Atenção Primária à Saúde/organização & administração , Pessoal Administrativo/psicologia , Pessoal Administrativo/estatística & dados numéricos , Adulto , Brasil , Comunicação , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
15.
Br J Anaesth ; 120(2): 317-322, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29406181

RESUMO

BACKGROUND: The knowledge regarding appropriate dosage of local anaesthetics for peripheral nerve blocks in children is very scarce. The main objective of the current investigation was to evaluate dosing patterns of local anaesthetics in children receiving peripheral nerve blocks across multiple paediatric hospitals in the USA. We also sought to estimate the incidence of local anaesthetic systemic toxicity. METHODS: This is an observational study using the Pediatric Regional Anesthesia Network (PRAN) database. Data on every peripheral nerve block in patients aged <18 years placed from April 1, 2007 to May 31, 2015 were examined as a subset of the PRAN protocol. Data were examined for the type and dose of local anaesthetic and for the presence of local anaesthetic systemic toxicity. RESULTS: In total, 40 121 peripheral nerve blocks in children were analysed. Individual analyses of block type demonstrated large local anaesthetic dose variability with a five- to 10-fold spread depending on the block type. Two patients developed local anaesthetic systemic toxicity, resulting in an estimated incidence (95% CI) per blocks performed of 0.005% (0.001-0.015%). None of the patients had any short- or long-term complications or sequelae. CONCLUSIONS: We detected a large variability in the local anaesthetic dosing practices for peripheral nerve blocks in children across multiple hospitals in the USA. Nonetheless, the risk of local anaesthetic systemic toxicity was very low. Due to the lack of dose findings studies, our results suggest the need to develop practice guidelines to minimize variability of regional anaesthesia practices in children.


Assuntos
Anestesia por Condução/estatística & dados numéricos , Anestésicos Locais/administração & dosagem , Bloqueio Nervoso/métodos , Nervos Periféricos , Adolescente , Anestésicos Locais/efeitos adversos , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Bloqueio Nervoso/efeitos adversos , Pediatria , Ultrassonografia de Intervenção , Estados Unidos/epidemiologia
16.
Br J Anaesth ; 120(4): 705-711, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29576111

RESUMO

BACKGROUND: Maximising patient comfort during and after surgery is a primary concern of anaesthetists and other perioperative clinicians, but objective measures of what constitutes patient comfort in the perioperative period remain poorly defined. The Standardised Endpoints in Perioperative Medicine initiative was established to derive a set of standardised endpoints for use in perioperative clinical trials. METHODS: We undertook a systematic review to identify measures of patient comfort used in the anaesthetic, surgical, and other perioperative literature. A multi-round Delphi consensus process that included up to 89 clinician researchers was then used to refine a recommended list of outcome measures. RESULTS: We identified 122 studies in a literature search, which were the basis for a preliminary list of 24 outcome measures and their definitions. The response rates for Delphi Rounds 1, 2, and 3 were 100% (n=22), 90% (n=79), and 100% (n=13), respectively. A final list of six defined endpoints was identified: pain intensity (at rest and during movement) at 24 h postoperatively, nausea and vomiting (0-6 h, 6-24 h, and overall), one of two quality-of-recovery (QoR) scales (QoR score or QoR-15), time to gastrointestinal recovery, time to mobilisation, and sleep quality. CONCLUSIONS: As standardised outcomes will support benchmarking and pooling (meta-analysis) of trials, one or more of these recommended endpoints should be considered for inclusion in clinical trials assessing patient comfort and pain after surgery.


Assuntos
Conforto do Paciente/métodos , Assistência Perioperatória/métodos , Consenso , Técnica Delphi , Humanos , Guias de Prática Clínica como Assunto , Projetos de Pesquisa
17.
Public Health ; 161: 36-42, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29870833

RESUMO

OBJECTIVES: The proportion of deaths attributed to hypertensive diseases (HYPDs) was only 50% of that registered for cerebrovascular diseases (CBVDs) in 2013 in Brazil. This article aims to evaluate mortality related to HYPDs and CBVDs as multiple causes of death, in Brazil from 2004 to 2013. STUDY DESIGN: Analysis of historical series of secondary data obtained from Brazilian official registries. METHODS: Data about the deaths were obtained from the Mortality Information System of the Brazilian Ministry of Health, available on the DATASUS website. CBVDs and HYPDs were evaluated according to their mentions as the underlying cause of death or entry in any line of the death certificates (DCs), according to their International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes. RESULTS: When CBVDs were the underlying causes of death, HYPDs were mentioned in 40.9% of the DCs. When HYPDs were the underlying causes of death, CBVDs were mentioned in only 5.0%. When CBVDs were mentioned without HYPDs, they were selected as the underlying cause of death 74.4% of the time. When HYPDs were mentioned in DCs without CBVDs, HYPDs were selected 30.0% of the time. In 2004, the frequency of any mention of HYPDs relative to the frequency of HYPDs cited as underlying causes increased fourfold and was followed by a plateau until 2013. In contrast, the frequency of any mention of CBVDs relative to the frequency of CBVDs as underlying causes decreased in the same period. Because this study was based on DC records, it was limited by the way these documents were completed, which may have included lack of record of the causes related to the sequence that culminated in death. CONCLUSION: When deaths related to HYPDs were evaluated as multiple causes of death, they were mentioned up to four times more often than when they were selected as underlying causes of death. This reinforces the need for better control of hypertension to prevent deaths.


Assuntos
Transtornos Cerebrovasculares/mortalidade , Hipertensão/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Causas de Morte/tendências , Atestado de Óbito , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
18.
Clin Exp Immunol ; 187(3): 383-398, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28008595

RESUMO

Defective apoptosis might be involved in the pathogenesis of multiple sclerosis (MS). We evaluated apoptosis-related molecules in MS patients before and after autologous haematopoietic stem cell transplantation (AHSCT) using BCNU, Etoposide, AraC and Melphalan (BEAM) or cyclophosphamide (CY)-based conditioning regimens. Patients were followed for clinical and immunological parameters for 2 years after AHSCT. At baseline, MS patients had decreased proapoptotic BAD, BAX and FASL and increased A1 gene expression when compared with healthy counterparts. In the BEAM group, BAK, BIK, BIMEL , FAS, FASL, A1, BCL2, BCLXL , CFLIPL and CIAP2 genes were up-regulated after AHSCT. With the exception of BIK, BIMEL and A1, all genes reached levels similar to controls at day + 720 post-transplantation. Furthermore, in these patients, we observed increased CD8+ Fas+ T cell frequencies after AHSCT when compared to baseline. In the CY group, we observed increased BAX, BCLW, CFLIPL and CIAP1 and decreased BIK and BID gene expressions after transplantation. At day + 720 post-AHSCT, the expression of BAX, FAS, FASL, BCL2, BCLXL and CIAP1 was similar to that of controls. Protein analyses showed increased Bcl-2 expression before transplantation. At 1 year post-AHSCT, expression of Bak, Bim, Bcl-2, Bcl-xL and cFlip-L was decreased when compared to baseline values. In summary, our findings suggest that normalization of apoptosis-related molecules is associated with the early therapeutic effects of AHSCT in MS patients. These mechanisms may be involved in the re-establishment of immune tolerance during the first 2 years post-transplantation.


Assuntos
Apoptose/genética , Proteína 5 Relacionada à Autofagia/genética , Esclerose Múltipla/genética , Adulto , Linfócitos T CD8-Positivos/efeitos dos fármacos , Ciclofosfamida/uso terapêutico , Feminino , Expressão Gênica/genética , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/tratamento farmacológico , Condicionamento Pré-Transplante/métodos , Transplante Autólogo/métodos , Adulto Jovem
19.
Mol Ecol ; 26(20): 5541-5551, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28802076

RESUMO

Acid mine drainage (AMD) is characterized by an acid and metal-rich run-off that originates from mining systems. Despite having been studied for many decades, much remains unknown about the microbial community dynamics in AMD sites, especially during their early development, when the acidity is moderate. Here, we describe draft genome assemblies from single cells retrieved from an early-stage AMD sample. These cells belong to the genus Hydrotalea and are closely related to Hydrotalea flava. The phylogeny and average nucleotide identity analysis suggest that all single amplified genomes (SAGs) form two clades that may represent different strains. These cells have the genomic potential for denitrification, copper and other metal resistance. Two coexisting CRISPR-Cas loci were recovered across SAGs, and we observed heterogeneity in the population with regard to the spacer sequences, together with the loss of trailer-end spacers. Our results suggest that the genomes of Hydrotalea sp. strains studied here are adjusting to a quickly changing selective pressure at the microhabitat scale, and an important form of this selective pressure is infection by foreign DNA.


Assuntos
Bacteroidetes/classificação , Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas , Genoma Bacteriano , Mineração , Ácidos , Bacteroidetes/genética , DNA Bacteriano/genética , Ecossistema , Evolução Molecular , Filogenia , Análise de Sequência de DNA , Análise de Célula Única
20.
Haemophilia ; 23(5): e436-e443, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28750474

RESUMO

INTRODUCTION: von Willebrand disease (VWD) reflects a loss or dysfunction in von Willebrand factor (VWF), while haemophilia represents a loss or dysfunction of clotting factors such as factor VIII (FVIII) or FIX. Their diagnosis requires laboratory testing, with this potentially compromised by preanalytical events, including poor sample quality. This study assessed the effect of inadequate mixing as a potential cause of VWD and haemophilia misdiagnosis. METHODS: After completion of requested testing, 48 consecutive patient samples comprising separate aliquots from single collections were individually pooled, appropriately mixed, then frozen in separate aliquots, either at -20°C or -80°C for 2-7 days. Each sample set was then thawed and the separate aliquots subjected to separate mixing protocols (several inversions, blood roller, vortex) vs a non-mix sample, and all aliquots then tested for various VWF and factor assays. RESULTS: Non-mixing led to substantial reduction in VWF and factors in about 25% of samples, that in some cases could lead to misdiagnosis of VWD or haemophilia. Interestingly, there were also some differences observed with respect to different mixing protocols. CONCLUSIONS: Our study identified ineffective or variable mixing of thawed plasma samples as potential causes of misdiagnosis of VWD or haemophilia. Further education regarding the importance of appropriate mixing appears warranted.


Assuntos
Testes de Coagulação Sanguínea/normas , Hemofilia A/sangue , Hemofilia A/diagnóstico , Doenças de von Willebrand/sangue , Doenças de von Willebrand/diagnóstico , Fatores de Coagulação Sanguínea , Testes de Coagulação Sanguínea/métodos , Erros de Diagnóstico , Fator VIII , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Manejo de Espécimes/métodos , Manejo de Espécimes/normas , Fator de von Willebrand
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