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1.
Nature ; 610(7933): 693-698, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36224389

RESUMO

Soils are the foundation of all terrestrial ecosystems1. However, unlike for plants and animals, a global assessment of hotspots for soil nature conservation is still lacking2. This hampers our ability to establish nature conservation priorities for the multiple dimensions that support the soil system: from soil biodiversity to ecosystem services. Here, to identify global hotspots for soil nature conservation, we performed a global field survey that includes observations of biodiversity (archaea, bacteria, fungi, protists and invertebrates) and functions (critical for six ecosystem services) in 615 composite samples of topsoil from a standardized survey in all continents. We found that each of the different ecological dimensions of soils-that is, species richness (alpha diversity, measured as amplicon sequence variants), community dissimilarity and ecosystem services-peaked in contrasting regions of the planet, and were associated with different environmental factors. Temperate ecosystems showed the highest species richness, whereas community dissimilarity peaked in the tropics, and colder high-latitudinal ecosystems were identified as hotspots of ecosystem services. These findings highlight the complexities that are involved in simultaneously protecting multiple ecological dimensions of soil. We further show that most of these hotspots are not adequately covered by protected areas (more than 70%), and are vulnerable in the context of several scenarios of global change. Our global estimation of priorities for soil nature conservation highlights the importance of accounting for the multidimensionality of soil biodiversity and ecosystem services to conserve soils for future generations.


Assuntos
Biodiversidade , Conservação dos Recursos Naturais , Mapeamento Geográfico , Microbiologia do Solo , Solo , Animais , Conservação dos Recursos Naturais/métodos , Solo/parasitologia , Invertebrados , Archaea
2.
Glob Chang Biol ; 30(5): e17295, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38804108

RESUMO

Plant-soil biodiversity interactions are fundamental for the functioning of terrestrial ecosystems. Yet, the existence of a set of globally distributed topsoil microbial and small invertebrate organisms consistently associated with land plants (i.e., their consistent soil-borne microbiome), together with the environmental preferences and functional capabilities of these organisms, remains unknown. We conducted a standardized field survey under 150 species of land plants, including 58 species of bryophytes and 92 of vascular plants, across 124 locations from all continents. We found that, despite the immense biodiversity of soil organisms, the land plants evaluated only shared a small fraction (less than 1%) of all microbial and invertebrate taxa that were present across contrasting climatic and soil conditions and vegetation types. These consistent taxa were dominated by generalist decomposers and phagotrophs and their presence was positively correlated with the abundance of functional genes linked to mineralization. Finally, we showed that crossing environmental thresholds in aridity (aridity index of 0.65, i.e., the transition from mesic to dry ecosystems), soil pH (5.5; i.e., the transition from acidic to strongly acidic soils), and carbon (less than 2%, the lower limit of fertile soils) can result in drastic disruptions in the associations between land plants and soil organisms, with potential implications for the delivery of soil ecosystem processes under ongoing global environmental change.


Assuntos
Embriófitas , Microbiota , Microbiologia do Solo , Biodiversidade , Solo/química
3.
Memory ; 32(2): 143-155, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38166650

RESUMO

In response to the COVID-19 pandemic, face masks became required attire. Face masks obstruct the bottom portion of faces, restricting face processing. The present study examined the influence face masks have on memory predictions and memory performance for new face-name associations. Participants studied face-name pairs presented for 8 s (Experiment 1) or 10 s (Experiment 2). Half of the face-name pairs included a face mask obstructing the nose and mouth of the pictured face, counterbalanced across participants. Participants provided item-by-item judgements of learning (JOLs) and completed subsequent cued recall and associative recognition memory tests. Both experiments demonstrated that face masks impaired memory for newly-learned names, however, the magnitude of the mask impact was under-predicted by JOLs. The presence of a face mask negatively influenced memory performance to a greater degree than participants' JOLs predicted. Results have implications for name learning during pandemics, as well as in settings where face masks are common (e.g., medical field).


Assuntos
Julgamento , Máscaras , Humanos , Pandemias , Aprendizagem , Rememoração Mental/fisiologia
4.
Eur Arch Otorhinolaryngol ; 281(2): 817-826, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38055045

RESUMO

INTRODUCTION: To validate the Group for Learning Useful and Performant Swallowing (GLUPS), a clinical tool dedicated to videofluoroscopy swallowing study (VFSS). METHODS: Forty-five individuals were recruited from January 2022 to March 2023 from the Department of Otolaryngology Head and Neck Surgery of University Hospital Saint-Pierre (Brussels, Belgium). Subjects underwent VFSS, which was rated with GLUPS tool by two blinded otolaryngologists and one speech-therapist. VFSS were rated twice with GLUPS within a 7-day period to assess test-retest reliability. RESULTS: Twenty-four patients and twenty-one controls completed the evaluations. The internal consistency (α = 0.745) and the test-retest reliability (rs = 0.941; p = 0.001) were adequate. GLUPS reported a high external validity regarding the significant correlation with the Penetration-Aspiration Scale (rs = 0.551; p = 0.001). Internal validity was adequate, because GLUPS score was significant higher in patients compared to controls (6.21 ± 4.42 versus 2.09 ± 2.00; p = 0.001). Interrater reliability did not report significant differences in the GLUPS sub- and total score among the independent judges. The mean GLUPS score of individuals without any evidence of VFSS abnormalities was 2.09/23 (95% CI 1.23-2.95), which supported that a GLUPS score ≥ 3.0 is suggestive of pathological VFSS. CONCLUSIONS: GLUPS is a clinical instrument documenting the abnormal findings of oral and pharyngeal phases at the VFSS. GLUPS demonstrated high reliability and excellent criterion-based validity. GLUPS may be used in clinical practice for the swallowing evaluation at the VFSS.


Assuntos
Transtornos de Deglutição , Deglutição , Humanos , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Reprodutibilidade dos Testes , Fluoroscopia , Aspiração Respiratória/etiologia , Aspiração Respiratória/complicações
5.
Health Promot Pract ; : 15248399241228831, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38374701

RESUMO

OBJECTIVES: In recent years, increasing efforts have been made to apply arts- and culture-based strategies to public health concerns. Accumulating studies point to the value of these strategies for addressing social determinants of health in ways that center communities, cultures, and lived experiences. However, this work has lacked a common framework to support application and advancement. The objectives of this study were to examine knowledge, experience, and evidence related to the uses of arts and culture in public health in the United States and to develop a pilot version of an evidence-based framework to guide cross-sector development and research. METHODS: Using a convergent mixed-methods design with sequential elements, this study drew upon findings from a national field survey, seven focus groups, eight structured working-group dialogues, and a five-day structured dialogue and writing process with 12 interdisciplinary thought leaders. Data were integrated to develop a pilot evidence-based framework. RESULTS: The study identified six broad ways in which arts and culture can be used in public health and 59 specific outcomes that can be addressed through arts and cultural strategies. The framework identifies evidence supporting the effects of arts and culture on each outcome, along with mechanisms that may mediate or moderate these effects. CONCLUSION: The pilot framework clearly links arts and culture practices with public health outcomes. In doing so, it provides both a resource for current practice and a model for the continued development of interdisciplinary tools that support health researchers and practitioners in utilizing arts and culture resources to advance community health and health equity.

6.
Eur Arch Otorhinolaryngol ; 280(5): 2411-2419, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36525078

RESUMO

OBJECTIVES: To establish a consensus protocol for telerehabilitation in speech therapy for voice disorders. METHODS: The study was conducted according to a modified Delphi method. Twenty speech therapist or laryngologist experts of the French Society of Phoniatrics and Laryngology assessed 24 statements of voice telerehabilitation with a 10-point visual analog scale ranging from 1 (totally disagree) to 10 (totally agree). The statements were accepted if more than 80% of the experts rated the item with a score of ≥ 8/10. The statements with ≥ 8/10 score by 60-80% of experts were improved and resubmitted to voting until they were validated or rejected. RESULTS: The French Society of Phoniatrics and Laryngology experts validated 10, 6, and 2 statements after the first, second and third voting round, respectively. Seven statements did not reach agreement threshold and were rejected. The validated statements included recommendations for setting (N = 4), medical/speech history (N = 2), subjective voice evaluations (N = 3), objective voice quality measurements (N = 3), and voice rehabilitation (N = 5). The experts agreed for a follow-up consisting of combined telerehabilitation and in-office rehabilitation. The final protocol may be applied in context of pandemic but could be assessed out of pandemic period for patients located in rural regions. CONCLUSIONS: This Delphi study established the first telerehabilitation protocol of the French Society of Phoniatrics and Laryngology for patients with voice disorders. Future controlled studies are needed to assess its feasibility, reliability, and the patient perception about telerehabilitation versus in-office rehabilitation.


Assuntos
Otolaringologia , Telerreabilitação , Distúrbios da Voz , Humanos , Consenso , Reprodutibilidade dos Testes , Pandemias , Técnica Delphi
7.
Int J Mol Sci ; 24(10)2023 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-37240194

RESUMO

Mitochondrial dysfunction is a hallmark of numerous diseases, including neurodegenerative disorders, metabolic disorders, and cancer. Mitochondrial transfer, the transfer of mitochondria from one cell to another, has recently emerged as a potential therapeutic approach for restoring mitochondrial function in diseased cells. In this review, we summarize the current understanding of mitochondrial transfer, including its mechanisms, potential therapeutic applications, and impact on cell death pathways. We also discuss the future directions and challenges in the field of mitochondrial transfer as a novel therapeutic approach in disease diagnosis and treatment.


Assuntos
Doenças Metabólicas , Neoplasias , Doenças Neurodegenerativas , Humanos , Mitocôndrias/metabolismo , Doenças Metabólicas/metabolismo , Doenças Neurodegenerativas/diagnóstico , Doenças Neurodegenerativas/terapia , Doenças Neurodegenerativas/metabolismo , Estresse Oxidativo , Neoplasias/diagnóstico , Neoplasias/terapia , Neoplasias/metabolismo
8.
Int J Mol Sci ; 24(13)2023 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-37445852

RESUMO

Endocrine homeostasis and metabolic diseases have been the subject of extensive research in recent years. The development of new techniques and insights has led to a deeper understanding of the mechanisms underlying these conditions and opened up new avenues for diagnosis and treatment. In this review, we discussed the rise of metabolic diseases, especially in Western countries, the genetical, psychological, and behavioral basis of metabolic diseases, the role of nutrition and physical activity in the development of metabolic diseases, the role of single-cell transcriptomics, gut microbiota, epigenetics, advanced imaging techniques, and cell-based therapies in metabolic diseases. Finally, practical applications derived from this information are made.


Assuntos
Microbioma Gastrointestinal , Doenças Metabólicas , Humanos , Doenças Metabólicas/terapia , Doenças Metabólicas/metabolismo , Epigênese Genética
9.
Health Promot Pract ; : 15248399231183388, 2023 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-37458132

RESUMO

Arts participation has been linked to positive health outcomes around the globe. As more research is taking place on this topic, there is heightened need for definitions for the complex concepts involved. While significant work to define "arts participation" has taken place in the arts sector, less work has been undertaken for the purpose of researching the arts in public health. This study developed a definition for "arts participation" to guide a national arts in public health research agenda and to advance and make more inclusive previous work to define the term. A convergent mixed-methods study design with sequential elements was used to iteratively develop a definition that integrated the perspectives of field experts as well as the general public. Literature review was followed by four iterative phases of data collection, analysis, and integration, and a proposed definition was iteratively revised at each stage. The final definition includes modes, or ways, in which people engage with the arts, and includes examples of various art forms intended to frame arts participation broadly and inclusively. This definition has the potential to help advance the quality and precision of research aimed at evaluating relationships between arts participation and health, as well as outcomes of arts-based health programs and interventions in communities. With its more inclusive framing than previous definitions, it can also help guide the development of more inclusive search strategies for evidence synthesis in this rapidly growing arena and assist researchers in developing more effective survey questions and instruments.

10.
Medicina (Kaunas) ; 59(8)2023 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-37629765

RESUMO

Background and Objective: To examine the effects of the lockdown on diet adherence and stress levels in patients with laryngopharyngeal reflux (LPR). Materials and Methods: Patients with a positive LPR diagnosis at the hypopharyngeal-esophageal impedance-pH monitoring were treated from a pre- to lockdown period with a 3-month high-protein, low-fat, alkaline, plant-based diet, with behavioral changes, and an association of pantoprazole (20 MG/d) and alginate (Gaviscon 3/d). The following patient-reported outcomes questionnaire and findings instrument were used: Reflux Symptom Score-12 (RSS-12) and Reflux Sign Assessment (RSA). At the posttreatment time, patients were invited to evaluate the impact of lockdown on diet adherence and stress management with a predefined grid of foods and beverages and the perceived stress scale (PSS), respectively. Results: Thirty-two patients completed the evaluations. RSS-12 and RSA significantly improved from baseline to 3-month posttreatment. Most patients experienced mild-to-severe stress levels at the end of the lockdown. The level of stress substantially increased in 11 patients (34%) due to the lockdown, while it did not change in 11 patients (44%). In 11 cases (34%), patients reported that the adherence to the anti-reflux diet was better than initially presumed thanks to the lockdown period, while 44% (N = 14) reported that the lockdown did not impact the adherence to a diet. PSS and RSS-12 were significantly correlated at the end of the pandemic (rs = 0.681; p < 0.001). The increase in stress level was positively associated with the lack of adherence to diet (rs = 0.367; p = 0.039). Conclusions: During the lockdown, the diet habits of LPR patients were improved in one-third and unchanged in 44% of cases. The stress level was increased in one-third of patients, which was associated with an increase in symptom scores.


Assuntos
COVID-19 , Refluxo Laringofaríngeo , Humanos , Quarentena , Controle de Doenças Transmissíveis , Bebidas
11.
Eur Arch Otorhinolaryngol ; 279(7): 3543-3549, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35212775

RESUMO

OBJECTIVES: The objective is to study the usefulness of acoustic measurements as therapeutic outcomes for patients with dysphonia related to laryngopharyngeal reflux (LPR). METHODS: From September 2019 to April 2021, 120 patients with LPR at the hypopharyngeal-esophageal multichannel intraluminal impedance pH-monitoring (HEMII-pH) were prospectively recruited from three University Hospitals. They were divided in two groups regarding the presence of dysphonia. The treatment consisted of a combination of diet, proton-pump inhibitors, magaldrate and alginate for 3-6 months. The following clinical and acoustic evaluations were studied regarding groups at baseline, 3- and 6-month posttreatment: reflux symptom score (RSS), reflux sign assessment (RSA), percent jitter, percent shimmer and noise-to-harmonic ratio (NHR). RESULTS: A total of 109 patients completed the evaluations, accounting for 49 dysphonic and 60 non-dysphonic individuals. HEMII-pH, gastrointestinal endoscopy, baseline clinical and acoustic features were comparable between groups. RSS and RSA significantly improved from pre- to 3-month posttreatment in both groups. Jitter, Shimmer and NHR significantly improved from pre- to 3-month posttreatment in dysphonic patients, without additional 3- to 6-month posttreatment changes. Acoustic parameters did not change throughout treatment in patients without dysphonia. CONCLUSION: Acoustic measurements may be an interesting indicator of treatment in LPR patients who reported dysphonia. In this group of individuals, the evolution of acoustic parameters was consistent with the evolution of symptoms and findings.


Assuntos
Disfonia , Esofagite Péptica , Refluxo Laringofaríngeo , Acústica , Disfonia/diagnóstico , Disfonia/etiologia , Disfonia/terapia , Monitoramento do pH Esofágico , Rouquidão , Humanos , Refluxo Laringofaríngeo/complicações , Refluxo Laringofaríngeo/diagnóstico , Refluxo Laringofaríngeo/tratamento farmacológico , Estudos Prospectivos
12.
Eur Arch Otorhinolaryngol ; 279(12): 5951-5953, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35904632

RESUMO

INTRODUCTION: Olfactory dysfunction (OD) is a well know symptom of coronavirus disease 2019 (COVID-19), accounting for 48 to 85% of patients. In 1 to 10% of cases, patients develop a chronic olfactory dysfunction (COD), lasting more than 6 months. Recently, platelet-rich plasma (PRP) was used in patients with non-COVID-19 COD and authors reported encouraging results. METHODS: In the present study, we investigated the usefulness and safety of PRP injection in 56 patients with COVID-19 COD by the Sniffing Stick test (TDI score) and a linker-scale from 0 (none) to 3 (strong) and we compare the result to a control group. RESULTS: At 1 month post-PRP injection, the mean TDI scores significantly improved by 6.7 points in the PRP group (p < 0,001), the mean self-assessment of improvement in smell function was 1.8 (mild-to-moderate) in the PRP group, which was significantly higher than the score (0.3) in the control group (p < 0,001). CONCLUSION: Our results showed that PRP in the olfactory cleft can increase the olfactory threshold 1 month after the injection. Moreover, our results suggest that timing of treatment may be an important factor and that PRP is a safe treatment, because no adverse effects were reported throughout the study. TRIAL REGISTRATION NUMBER: NCT05226546.


Assuntos
COVID-19 , Transtornos do Olfato , Plasma Rico em Plaquetas , Humanos , COVID-19/complicações , Olfato , Injeções , Transtornos do Olfato/etiologia , Transtornos do Olfato/terapia
13.
Eur Arch Otorhinolaryngol ; 279(8): 4103-4111, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35099595

RESUMO

PURPOSE: The neutrophil-to-lymphocyte ratio (NLR) is the most widely biomarker used to assess the inflammatory system in various solid cancers. An elevated NLR has been reported to be associated with worse outcomes in head and neck squamous cell cancers (HNSCC). However, questions remain about the prognostic value of these findings in HNSCC patients with lung metastasis. This study aims to quantify the prognostic impact of NLR on HNSCC patients with lung metastasis. METHODS: A retrospective chart review of 169 HNSCC patients was performed at the Otorhinolaryngology and the Stomatology and Maxillofacial Surgery Department (Saint-Pierre Hospital), between 2000 and 2017. All patients were divided into two subgroups. Patients who developed lung involvement were assigned to the lung-metastasis-group (LM-group) in contrast to no-lung-metastasis-group patients (NLM-group). The prognostic significance of NLR was evaluated using multivariable analysis adjusting for overall-survival (OS) and lung-metastasis-free-survival (LMFS). RESULTS: 95 patients were enrolled in the NLM-group while 74 were in the LM-group. Multivariable analysis highlights that patients with a higher NLR value had shortened OS in the NLM subgroup (HR 1.3; p = 0.024). However, this association was not found in the LM subgroup. When considering both subgroups, an elevated NLR was reported as a prognostic factor of poor LMFS (HR 1.65; p = 0.047). CONCLUSION: Our data revealed that pretreatment NLR is an independent prognostic factor of mortality and lung metastasis development. However, the prognostic value of NLR is not confirmed in patients who suffered from lung metastasis. Physicians should integrate these findings in their treatment algorithm approach.


Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias Pulmonares , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Neoplasias Pulmonares/patologia , Contagem de Linfócitos , Linfócitos/patologia , Neutrófilos/patologia , Prognóstico , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia
14.
Eur J Appl Physiol ; 121(6): 1567-1577, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33638689

RESUMO

PURPOSE: Pentraxin 3 (PTX3) has been shown to be a predictor of endothelial dysfunction in patients with increased risk of cardiovascular disease (CVD) (e.g., obesity). Circulating PTX3 concentrations are dysregulated in obese individuals and are elevated following acute aerobic exercise. High-intensity interval exercise (HIIE) has been demonstrated to be as effective as continuous moderate-intensity exercise in improving endothelial function, as indicated by brachial artery flow-mediated dilation (BAFMD), in patients with CVD. Therefore, the purpose of this study was to examine the effect of acute HIIE on plasma PTX3 and BAFMD responses in obese individuals. METHODS: Eight obese and six normal-weight young males participated in acute HIIE (4 intervals of 4 min at 80-90% of VO2max; 3 min of active recovery at 50-60% VO2max). Plasma PTX3 and BAFMD were measured prior to, immediately following exercise, and one and 2 hours into recovery. RESULTS: Plasma PTX3 concentrations significantly increased following HIIE, yet the PTX3 response to HIIE was significantly blunted in obese compared to normal-weight participants. While the kinetic responses of BAFMD were also significantly different in obese compared to normal-weight participants, similar increases above the baseline were observed 2 hours into recovery in both groups. Finally, plasma PTX3 concentrations were not associated with BAFMD at baseline or in response to HIIE. CONCLUSION: The utilization of HIIE may serve as a time-efficient exercise prescription strategy to transiently improve endothelial function, independent of elevated plasma PTX3 concentrations, in obese individuals.


Assuntos
Artéria Braquial/fisiologia , Proteína C-Reativa/metabolismo , Endotélio Vascular/fisiologia , Treinamento Intervalado de Alta Intensidade , Obesidade/sangue , Obesidade/fisiopatologia , Componente Amiloide P Sérico/metabolismo , Humanos , Masculino , Projetos Piloto , Adulto Jovem
15.
Eur J Anaesthesiol ; 38(5): 524-533, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33259449

RESUMO

BACKGROUND: The effect of dexmedetomidine on Nociception Level Index-guided (Medasense, Israel) antinociception to reduce intra-operative opioid requirements has not been previously investigated. OBJECTIVE: We aimed to determine if low-dose dexmedetomidine would reduce remifentanil requirements during Nociception Level Index-guided antinociception without increasing complications associated with dexmedetomidine. DESIGN: Double-blind randomised controlled trial. SETTING: Two university teaching hospitals in Brussels, Belgium. PATIENTS: American Society of Anesthesiologists 1 and 2 patients (n = 58) undergoing maxillofacial or cervicofacial surgery under propofol--remifentanil target-controlled infusion anaesthesia. INTERVENTIONS: A 30 min infusion of dexmedetomidine, or equal volume of 0.9% NaCl, was infused at 1.2 µg kg-1 h-1 immediately preceding induction and then decreased to 0.6 µg kg-1 h-1 until 30 min before ending surgery. Nociception Level Index and frontal electroencephalogram guided the remifentanil and propofol infusions, respectively. MAIN OUTCOMES: The primary outcome was the remifentanil requirement. Other outcomes included the propofol requirement, cardiovascular status and postoperative outcome. RESULTS: Mean ±â€ŠSD remifentanil (3.96 ±â€Š1.95 vs. 4.42 ±â€Š2.04 ng ml-1; P = 0.0024) and propofol (2.78 ±â€Š1.36 vs. 3.06 ±â€Š1.29 µg ml-1; P = 0.0046) TCI effect site concentrations were lower in the dexmedetomidine group at 30 min postincision and remained lower throughout surgery. When remifentanil (0.133 ±â€Š0.085 vs. 0.198 ±â€Š0.086 µg kg-1 min-1; P = 0.0074) and propofol (5.7 ±â€Š2.72 vs. 7.4 ±â€Š2.80 mg kg-1 h-1; P = 0.0228) requirements are represented as infusion rates, this effect became statistically significant at 2 h postincision. CONCLUSION: In ASA 1 and 2 patients receiving Nociception Level Index-guided antinociception, dexmedetomidine decreases intra-operative remifentanil requirements. Combined frontal electroencephalogram and Nociception Level Index monitoring can measure dexmedetomidine's hypnotic and opioid-sparing effects during remifentanil-propofol target-controlled infusion anaesthesia. TRIAL REGISTRATIONS: Clinicaltrials.gov: NCT03912740, EudraCT: 2018-004512-22.


Assuntos
Dexmedetomidina , Propofol , Anestésicos Intravenosos , Bélgica , Humanos , Nociceptividade , Remifentanil
16.
Eur Arch Otorhinolaryngol ; 278(1): 101-108, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32754871

RESUMO

PURPOSE: To evaluate the evolution of chemosensation via extended psychophysical testing in patients who suffered from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19). Additionally, this study sought to determine whether odor threshold testing provided additional information on olfactory loss due to COVID-19 compared to the more common odor identification testing. METHODS: Prospective cohort study of patients with sudden chemosensory loss since February 2020 and confirmed COVID-19 infection via RT-PCR or serology testing. Olfactory function was tested extensively using the "Sniffin Sticks" test battery. In addition, we screened gustatory perception and nasal cooling sensations using psychophysical tests. RESULTS: Seventy-two patients completed the study. After a mean of 37 days, 37% of patients showed olfactory dysfunction, 7% were dysgeusic, and 48% showed signs of low sensitivity for cooling sensation. A longer duration of anosmia before smell improvement was correlated with lower olfactory function at 5 weeks. Odor threshold detection was more affected by COVID-19 compared to odor identification. CONCLUSION: Five weeks after developing sudden chemosensory loss due to COVID-19, a high proportion of patients were dysosmic and showed signs of low nasal cooling sensitivity, whereas most of them had normal taste function. SARS-CoV-2 affected mainly odor thresholds, possibly suggesting that the major cause of loss of smell lies at the level of the olfactory neuroepithelium, rather than in the central nervous system.


Assuntos
Anosmia/etiologia , COVID-19/diagnóstico , COVID-19/psicologia , Transtornos do Olfato/etiologia , Olfato/fisiologia , Adulto , Anosmia/psicologia , COVID-19/complicações , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Odorantes , Estudos Prospectivos , SARS-CoV-2 , Avaliação de Sintomas/métodos
17.
Artigo em Inglês | MEDLINE | ID: mdl-33643395

RESUMO

OBJECTIVE: Estimate the acceptability and adoption by health care workers of clinical practice guidelines and treatment protocols for women with preeclampsia/eclampsia and identify the facilitating factors and barriers to their implementation. METHODS: A qualitative study was conducted, using semi-structured interviews and focus groups in five maternity hospitals. Interviews were compiled for analysis, and barriers and facilitators were characterized. RESULTS: Seventy health professionals (52 female and 18 male) participated, representing different levels of the health system. The majority of workers and managers were aware of the existence and content of clinical practice guidelines (CPGs) for preeclampsia/eclampsia, especially the participants with more time in the health service. With respect to facilitating factors, both medical and nursing staff were positive about continued development and implementation of high-quality CPGs. There was consensus that limitations exist, especially with respect to a lack of the necessary medicines, supplies, and equipment to meet and implement the established recommendations. DISCUSSION: The results of the study show the need to strengthen strategies that help close the gap between research and public policy. Studies suggest that research should focus on users, policymakers, and decisionmakers in the health system. The actors in the Dominican health system recognize the GRADE methodology as an appropriate instrument for the development and implementation of CPGs. Implementation barriers require systemic and comprehensive approaches.

18.
Clin Otolaryngol ; 46(2): 311-317, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33190393

RESUMO

OBJECTIVES: The purpose of this study was to determine the outcome of head and neck squamous cell carcinoma (HNSCC) patients developing lung metastasis. DESIGN: Retrospective study. PARTICIPANTS: HNSCC patients with lung metastasis treated between 2001 and 2018 were included. MEAN OUTCOMES MEASURES: Statistical analyses described the relationship between patient survival, treatment efficacy and pulmonary metastasis occurrence. RESULTS: One hundred HNSCC patients were included in the study. The median overall survival (OS) was 21 months. The median recurrence-free survival (RFS) was seven months. Patient survival with only lung metastases was significantly longer compared to patients with lung metastases and lymph nodes involvement or other metastases. Moreover, patients with a single metastasis had longer post-RFS and OS than patients with multiple metastases. The local control of metastasis was better when patients presented only lung metastases, and it was more effective in single metastasis. The surgery allowed better metastases local control than supportive care or radio and/or chemotherapy. In case of specific therapy, pulmonary resection was associated with a longer post-RFS and a longer OS compared to supportive care or radio and/or chemotherapy. CONCLUSIONS: We confirmed, in the current study, the significant survival benefit for HNSCC patients treated by surgery for their pulmonary metastasis. While treatment of multiple metastases required palliative chemotherapy or best supportive care in most of the cases, specific surgical treatment in selected HNSCC patients should be considered.


Assuntos
Carcinoma de Células Escamosas/secundário , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias Pulmonares/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/terapia , Feminino , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/terapia , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Taxa de Sobrevida
19.
Adapt Phys Activ Q ; 38(4): 702-710, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34453022

RESUMO

This study aimed to assess the internalization of sociocultural attitudes and appearance comparison among U.S. athletes with physical disabilities. Female (n = 19) and male (n = 25) athletes between the ages of 18 and 73 years completed a quantitative survey along with two exploratory open-ended questions related to body appearance and influencers. Results showed significant correlations between internalization of the thin and low-body-fat ideal and appearance comparison (r = .55, p < .05) and internalization of the muscular ideal and appearance comparison (r = .76, p < .05) among women. For men, results showed a significant association between internalization of the muscular ideal and appearance comparison (r = .52, p < .05). The findings prompt further investigation of whether appearance comparison and internalization influence body dissatisfaction and disordered eating among athletes with physical disabilities.


Assuntos
Imagem Corporal , Transtornos da Alimentação e da Ingestão de Alimentos , Adolescente , Adulto , Idoso , Atletas , Atitude , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
20.
Eur Arch Otorhinolaryngol ; 277(11): 3111-3119, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32488380

RESUMO

OBJECTIVE: To assess the internal consistency, reliability, and clinical validity of a French version of the M.D. Anderson Dysphagia Inventory (Fr-MDADI). METHODS: Patients addressed in the Swallowing Clinics of CHU Saint-Pierre Hospital (Brussels) and EpiCURA hospital (Ath, Belgium) for dysphagia completed Fr-MDADI, eating assessment tool-10 (EAT-10), dysphagia handicap index (DHI), and benefited from fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy. Seventy-two asymptomatic individuals composed the control group. The reliability of Fr-MDADI was assessed through a test-retest procedure. The validity was assessed by comparing Fr-MDADI with EAT-10 scores. Normative value of Fr-MDADI was calculated through the receiver operating characteristic (ROC) curve. RESULTS: Forty-two patients and 77 healthy individuals completed the evaluations (33 males). The main etiology of dysphagia was head and neck cancers. The internal consistency was high regarding the Cronbach's alpha (0.864). The test-retest reliability was high for Fr-MDADI total scores (rs = 0.849). The Fr-MDADI emotional, functional and physical subscores, and the total score exhibited high positive correlations with EAT-10 (rs = 0.770) and DHI (rs = 0.811), exhibiting high external validity. Patients had significant higher item and total score of Fr-MDADI compared with healthy individuals (control group), which indicated an adequate internal validity. About normative data, a Fr-MDADI > 13 was considered to be reflective of abnormalities. The 'swallowing-induced cough' item of the Fr-MDADI was significantly associated with the occurrence of aspirations regarding objective examinations (FEES or videofluoroscopy; p = 0.001). CONCLUSION: The Fr-MDADI is a reliable and valid self-administered tool in the evaluation of the dysphagia of French-speaking patients.


Assuntos
Transtornos de Deglutição , Bélgica , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Humanos , Masculino , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários
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