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1.
Contemp Clin Trials Commun ; 39: 101301, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38711836

RESUMO

Cystic fibrosis (CF) is a multisystem, genetic disease with a significantly reduced life expectancy. Despite substantial progress in therapies in the last 10-15 years, there is still no cure. There are dozens of drugs in the development pipeline and multiple clinical trials are being conducted across the globe. The UK Cystic Fibrosis Trust's (CFT) Clinical Trials Accelerator Platform (CTAP) is a national initiative bringing together 25 UK based CF centres to support the CF community in accessing and participating in CF clinical trials. CTAP enables more CF centres to run a broader portfolio of trials and increases the range of CF studies available for UK patients. There are four large specialist CF centres based in London, all within a small geographical region as well as two smaller centres which deliver CF care. At the launch of CTAP, these centres formed a sub-network in a consortium-style collaboration. The purpose of the network was to ensure equity of access to trials for patients across the UK's capital, and to share experience and knowledge. Four years into the programme we have reviewed our practices through working group meetings and an online survey. We sought to identify strengths and areas for improvement. We share our findings here, as we believe they are relevant to others delivering research in regions outside of London and in other chronic diseases.

2.
J Clin Med ; 13(1)2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38202307

RESUMO

Evidence-informed interventions for stroke self-management support can influence functional capability and social participation. People with stroke should be offered self-management support after hospital discharge. However, in Portugal, there are no known programs of this nature. This study aimed to develop a person-centered and tailored blended care program for post-stroke self-management, taking into account the existing evidence-informed interventions and the perspectives of Portuguese people with stroke, caregivers, and health professionals. An exploratory sequential mixed methods approach was used, including qualitative methods during stakeholder consultation (stage 1) and co-production (stage 2) and quantitative assessment during prototyping (stage 3). After ethical approval, recruitment occurred in three health units. Results from a literature search led to the adaptation of the Bridges Stroke Self-Management Program. In stage one, 47 participants were interviewed, with two themes emerging: (i) Personalized support and (ii) Building Bridges through small steps. In stage two, the ComVida program was developed, combining in-person and digital approaches, supported by a workbook and a mobile app. In stage three, 56 participants evaluated prototypes, demonstrating a strong level of quality. Understandability and actionability of the developed tools obtained high scores (91-100%). The app also showed good usability (A-grade) and high levels of recommendation (5 stars).

3.
Appetite ; 192: 107084, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37875240

RESUMO

This study examined the relationship between weight stigma and disordered eating behaviors in university students during the COVID-19 pandemic, considering individuals with and without overweight. A national sample of 738 college students completed an online questionnaire at three time points between July 2020 and December 2021, reporting their experiences of weight stigma, perceived increase in weight stigma during the pandemic, internalized weight stigma, and disordered eating behaviors. The findings showed that the trajectories of disordered eating behaviors varied depending on participants' anthropometric status. Among those with overweight, there was a decrease over time in binge eating, food restriction, and purging. Conversely, the non-overweight group experienced a slight increase in binge eating from T2 to T3. Using the Generalized Estimating Equations model, the study revealed that weight stigma predicted disordered eating behaviors in both weight spectrums during the pandemic. Experiences of weight stigma and the perceived increase in weight stigma significantly increased the likelihood of engaging in binge eating, food restriction, and purging among individuals with overweight. Furthermore, the internalization of weight stigma was longitudinally associated with all examined eating behaviors, regardless of anthropometric status. These findings highlight the importance of addressing weight stigma to prevent disordered eating in college students.


Assuntos
Bulimia , COVID-19 , Transtornos da Alimentação e da Ingestão de Alimentos , Preconceito de Peso , Humanos , Sobrepeso/epidemiologia , Sobrepeso/prevenção & controle , Pandemias , Brasil/epidemiologia , Seguimentos , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Bulimia/epidemiologia , Estudantes
4.
Behav Sci (Basel) ; 13(11)2023 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-37998630

RESUMO

The aetiology of anorexia nervosa (AN) presents a puzzle for researchers. Recent research has sought to understand the behavioural and neural mechanisms of these patients' persistent choice of calorie restriction. This scoping review aims to map the literature on the contribution of habit-based learning to food restriction in AN. PRISMA-ScR guidelines were adopted. The search strategy was applied to seven databases and to grey literature. A total of 35 studies were included in this review. The results indicate that the habit-based learning model has gained substantial attention in current research, employing neuroimaging methods, scales, and behavioural techniques. Food choices were strongly associated with dorsal striatum activity, and habitual food restriction based on the self-report restriction index was associated with clinical impairment in people chronically ill with restricting AN. High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and Regulating Emotions and Changing Habits (REaCH) have emerged as potential treatments. Future research should employ longitudinal studies to investigate the time required for habit-based learning and analyse how developmental status, such as adolescence, influences the role of habits in the progression and severity of diet-related illnesses. Ultimately, seeking effective strategies to modify persistent dietary restrictions controlled by habits remains essential.

5.
Eat Weight Disord ; 28(1): 78, 2023 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-37759035

RESUMO

OBJECTIVES: The purpose of this study is to investigate whether the relationship between weight stigma experiences and disordered eating behaviors during the COVID-19 pandemic is mediated by weight gain concern and psychological distress among university students with and without overweight. METHODS: A cross-sectional study was conducted with university students from five regions of Brazil who participated in the baseline assessment of the Online Cohort on Eating Behavior and Health (July/August 2020). Information on the frequency of binge eating episodes, food restriction, and purging, as well as experienced weight stigma, weight gain concern, and psychological distress, were recorded in an online questionnaire. Stratified structural equation modeling (SEM) analyses were performed to address the research questions of interest. RESULTS: Out of the total sample (n = 2511), 33.5% of participants reported experiencing weight stigma. The prevalence of binge eating episodes, food restriction, and purging was 43.7%, 24.1%, and 5.4%, respectively. These behaviors were more prevalent in individuals with overweight than in those without this condition. Furthermore, it was observed that weight gain concern and psychological distress mediated the relationship between weight stigma and disordered eating behaviors regardless of body weight status. CONCLUSIONS: Experiences of weight stigma and disordered eating behaviors were prevalent among Brazilian university students, especially among those with overweight. Weight gain concern and psychological distress appear to be important factors underlying the relationship between these constructs during the pandemic, and they can contribute to the development of targeted strategies for the prevention and management of disordered eating. LEVEL OF EVIDENCE: Level V, cross-sectional study.


Assuntos
Bulimia , COVID-19 , Transtornos da Alimentação e da Ingestão de Alimentos , Angústia Psicológica , Preconceito de Peso , Humanos , Sobrepeso/epidemiologia , Sobrepeso/psicologia , Pandemias , Estudos Transversais , Aumento de Peso , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Comportamento Alimentar/psicologia , Bulimia/epidemiologia
7.
J Eat Disord ; 10(1): 44, 2022 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-35351201

RESUMO

BACKGROUND: Weight stigma is a phenomenon associated with adverse behavioural and psychological consequences. Although experts suggest that its increase during the COVID-19 pandemic may be associated with worse health outcomes for people with obesity, a thorough analysis of the main findings and gaps is still needed when relating to this subject. OBJECTIVE: We aim to answer three questions: (1) How does weight stigma manifest in the COVID-19 pandemic? (2) How can weight stigma affect people with overweight or obesity in times of COVID-19? (3) What are the perceptions and experiences of weight stigma during the pandemic in individuals who experience overweight or obesity? METHODS: We conducted a scoping review of studies addressing weight stigma and the COVID-19 pandemic in electronic databases (Medline/PubMed, CINAHL, Embase, PsycInfo, BVS/Lilacs, Scopus, Web of Science, Google Scholar, and OpenGrey) published until 10th August 2021. All relevant studies were reviewed in full by two researchers. In addition, a narrative synthesis of the data was performed. RESULTS: The results included 35 studies out of 8,090 records and identified 13 original research publications, 14 text and opinion papers, and 6 narrative reviews. The results revealed the presence of weight stigma in the media, healthcare settings, interpersonal relationships, and public campaigns during the COVID-19 pandemic. The evidence of increasing weight stigma in the COVID-19 outbreak is limited, though. Many weight discrimination consequences were described during this time, such as impairment in accessing healthcare, worst COVID-19 outcomes, and maladaptive eating. However, only maladaptive behaviours and decline in mental health outcomes were demonstrated empirically in all age groups. This effect occurred regardless of body mass index, but people with high body weight were more likely to experience weight stigma. For some people with obesity, weight stigma in the pandemic has made activities of daily routine difficult. CONCLUSIONS: The results suggest that weight stigma in the COVID-19 pandemic occurs in several settings; moreover, although weight discrimination impacts mental health, whether before or during the pandemic, this influence between the pandemic and pre-pandemic scenario is still unclear. Therefore, more research is required in this field while the pandemic lasts, especially with people with obesity. Overall, people with overweight or obesity are more vulnerable to weight stigma than individuals without overweight. In addition, weight stigma refers to discrimination or prejudice based on a person's weight and relates to several consequences, for instance, poor healthcare treatment and mental health problems. In the COVID-19 outbreak, these weight stigma effects tend to become even more critical because they may be associated with unfavourable COVID-19 outcomes and eating disorder risks. Thus, it is crucial to investigate how weight stigma occurs during the pandemic and its impact on health, mainly for the most affected people. We investigated 35 studies published between 2019 and 2021 to map and explore how weight stigma was manifested and the related consequences for people with overweight or obesity in the COVID-19 pandemic. Only about a third of them were quantitative or qualitative, limiting the evidence of weight stigma in the COVID-19 context. The available evidence suggests that weight stigma manifests in several settings such as media, healthcare, public campaigns, and is more common in people with excess weight. However, weight discrimination experiences before or during the pandemic were associated with adverse psychological and behavioural consequences across all age groups, regardless of body weight. For some people with obesity, for instance, weight stigma made it difficult to accomplish their activities of daily routine. Nevertheless, it remains unclear whether weight stigma has increased in the pandemic, thus, more studies are required, especially about people with overweight or obesity.

8.
Motriz (Online) ; 28: e10220017721, 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1375935

RESUMO

Abstract Aim: To investigate if treadmill exercise (Ex) associated with fish oil (FO) supplementation during lactation would influence the biochemical profile as well as the oxidative balance in the hearts of male juvenile rats. Methods: Fifteen days-old rats were submitted to a daily moderate Ex training (based on their maximal running capacity) and FO supplementation for 4 weeks. Forty-eight hours after the last exercise session, blood fasting glucose and lipid profile were assessed according to the manufacturer's recommendations, while the oxidative status of the hearts was evaluated via colorimetric and absorbance-based assays. Results: FO associated with Ex decreased triglycerides (TG-79.27 ± 5.75 to 60.24 ± 6.25 mg/dL) and very-low-density lipoprotein cholesterol levels (VLDL-15.85 ± 1.15 to 12.05 ± 1.25 mg/dL) when compared to sedentary animals. FO, alone, reduced atherogenic index (AI- 1.14 ± 0.03 vs. 1.01 ± 0.04 a.u) while increased high-density lipoprotein cholesterol (HDL-43.90 ± 2.50 vs. 59.43 ± 3.15 mg/dL) of sedentary animals. Additionally, both Ex (67.3 ± 13.5 nmol/mg prot) and FO supplementation (56.6 ± 5.5 nmol/mg prot) decreased the oxidative damage to lipids in non-trained animals (105.8 ± 10.8 nmol/mg prot). The interventions also protected the protein content from oxidative stress (Ex- 5.15 ± 0.46; FO- 4.5 ± 0.5; and vehicle sedentary-7.3 ± 0.6 µmol/mg prot), while increasing the antioxidant defense and oxidative metabolism. Conclusion: Our findings suggest that intervention in juvenile rats can improve cardiac metabolism. These are the first findings to show the positive effects of the association between FO and moderate treadmill Ex during the critical period of development. We believe these results can drive early-life origins of heart disease through different avenues and, possibly, assist the development of a heart disease prevention program as well as an adjunctive therapeutic resource.


Assuntos
Animais , Ratos , Óleos de Peixe/administração & dosagem , Exercício Físico , Suplementos Nutricionais , Crescimento e Desenvolvimento , Ratos Wistar
9.
J Contemp Dent Pract ; 22(8): 876-881, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34753838

RESUMO

AIM AND OBJECTIVE: This study aimed to evaluate the effect of ozonated water used as an irrigant and dentin-cleaning solution on the bond strength of fiberglass pins in vitro, comparing it with the commonly used solutions. MATERIAL AND METHODS: Seventy-seven bovine roots were randomly divided into seven groups according to the irrigant and dentin-cleaning solution to be used: HP/HP, 2.5% sodium hypochlorite; DA/DA, distilled water; CHX/CHX, 2% chlorhexidine; OA/OA, 4 ppm ozonated water; HP/DA; HP/CHX; and HP/OA. In each group, the root canals were endodontically prepared by using the corresponding irrigant and stored in DA; after 7 days, they were cleared and cleaned with the corresponding cleaning solution. The fiberglass pins were cemented by using self-adhesive cement. After 7 days, the roots were sectioned (six discs each) and submitted to the push-out test. The type of fracture was analyzed with a 4.5x stereoscopic magnifying glass. The data were analyzed by the analysis of variance and the Tukey test at a 5% significance level. RESULTS: The OA/OA (11.67), HP/HP (11.21), and HP/OA (9.71) groups showed the highest mean push-out bond strength (MPa) in the cervical third. The same trend was maintained in the middle and apical thirds. CONCLUSION: Ozonated water and 2.5% sodium hypochlorite are the most relevant solutions for root dentin treatment. CLINICAL RELEVANCE: Teeth treated with ozonated water, sodium hypochlorite, and a combination of the two showed greater bond strength than those treated with other solutions.


Assuntos
Colagem Dentária , Técnica para Retentor Intrarradicular , Animais , Bovinos , Cavidade Pulpar , Dentina , Vidro , Teste de Materiais , Cimentos de Resina , Irrigantes do Canal Radicular , Água
10.
Thorax ; 76(10): 1036-1039, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33632768

RESUMO

Bronchiectasis is a well-recognised complication of primary antibody deficiency (PAD) syndromes. Previous data suggest that mortality in common variable immune deficiency (CVID) is not associated with isolated bronchiectasis. A retrospective analysis of patients with CVID and specific antibody deficiency in two tertiary referral centres with lung disease was conducted. Severity of bronchiectasis at presentation was associated with mortality. Lower FEV1, colonisation with Pseudomonas aeruginosa and a diagnosis of COPD were also associated with mortality. Bronchiectasis is an important driver of mortality in patients with PAD syndromes.


Assuntos
Bronquiectasia , Imunodeficiência de Variável Comum , Pneumopatias , Doenças da Imunodeficiência Primária , Humanos , Estudos Retrospectivos
11.
ERJ Open Res ; 7(1)2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33575312

RESUMO

BACKGROUND: A standardised approach to assessing COVID-19 survivors has not been established, largely due to the paucity of data on medium- and long-term sequelae. Interval chest radiography is recommended following community-acquired pneumonia; however, its utility in monitoring recovery from COVID-19 pneumonia remains unclear. METHODS: This was a prospective single-centre observational cohort study. Patients hospitalised with severe COVID-19 pneumonia (admission duration ≥48 h and oxygen requirement ≥40% or critical care admission) underwent face-to-face assessment at 4-6 weeks post-discharge. The primary outcome was radiological resolution of COVID-19 pneumonitis (Radiographic Assessment of Lung Oedema score <5). Secondary outcomes included clinical outcomes, symptom questionnaires, mental health screening (Trauma Screening Questionnaire, seven-item Generalised Anxiety Disorder assessment and nine-item Patient Health Questionnaire) and physiological testing (4-m gait speed (4MGS) and 1-min Sit-to-Stand (STS) tests). RESULTS: 119 patients were assessed between June 3, 2020 and July 2, 2020 at median (interquartile range (IQR)) 61 (51-67) days post-discharge: mean±sd age 58.7±14.4 years, median (IQR) body mass index 30.0 (25.9-35.2) kg·m-2, 62% male and 70% ethnic minority. Despite radiographic resolution of pulmonary infiltrates in 87%, modified Medical Research Council Dyspnoea (breathlessness) scale grades were above pre-COVID-19 baseline in 44%, and patients reported persistent fatigue (68%), sleep disturbance (57%) and breathlessness (32%). Screening thresholds were breached for post-traumatic stress disorder (25%), anxiety (22%) and depression (18%). 4MGS was slow (<0.8 m·s-1) in 38% and 35% desaturated by ≥4% during the STS test. Of 56 thoracic computed tomography scans performed, 75% demonstrated COVID-19-related interstitial and/or airways disease. CONCLUSIONS: Persistent symptoms, adverse mental health outcomes and physiological impairment are common 2 months after severe COVID-19 pneumonia. Follow-up chest radiography is a poor marker of recovery; therefore, holistic face-to-face assessment is recommended to facilitate early recognition and management of post-COVID-19 sequelae.

12.
United European Gastroenterol J ; 7(7): 881-888, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31428412

RESUMO

Background: People with cystic fibrosis (CF) report a variety of gastrointestinal (GI) symptoms, independent of pancreatic enzyme insufficiency (PEI), reminiscent of other chronic GI disorders. There are currently no accepted or validated assessment tools and neither the range, frequency nor severity of GI symptoms has been systematically described in CF. We present results of a cross-sectional study using established tools and compare them to current measures of quality of life (QOL). Methods: Consecutive patients attending specialist CF appointments were asked to complete questionnaires including the GI Symptom Rating Scale (GSRS); Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS) and Cystic Fibrosis Questionnaire (CFQ-R). Questionnaire terminology was altered to replace references to 'IBS' with 'GI symptoms'. Results: In total, 107 patients were recruited (mean age, 27.8 ± 9.6 years; 60 female), and 94 (88%) had PEI. Body mass index was 22.1 ± 3.6 kg/m2, forced expiratory volume in one second was 59 + 27.7% predicted. Fifty-three (49.5%) were p.Phe508del homozygous. Overall 69/107 (65%) reported significant GI symptoms independent of PEI or adherence to pancreatic enzyme replacement therapy (PERT), with the four most frequent being attributable to the lower GI tract: bloating/distension, flatulence, abdominal pain and borborygmi (gurgling). There was no numerical correlation between any CFQ-R domain (particularly Digestion domain) and GSRS or SSS. Conclusion: This is the first systematic study measuring GI symptoms in CF using validated GI tools. Symptoms are not related to PERT or genotype and appear to be captured well by the GSRS. Further research will study longitudinal changes with treatment, and therapeutic trials in CF may use these tools to demonstrate a positive impact on 'non-respiratory' symptoms and QOL.


Assuntos
Fibrose Cística/complicações , Gastroenteropatias/diagnóstico , Gastroenteropatias/etiologia , Adolescente , Adulto , Doença Crônica , Estudos Transversais , Fibrose Cística/tratamento farmacológico , Fibrose Cística/enzimologia , Terapia de Reposição de Enzimas , Insuficiência Pancreática Exócrina/tratamento farmacológico , Feminino , Humanos , Masculino , Estudos Prospectivos , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto Jovem
13.
Paediatr Respir Rev ; 31: 32-34, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31288987

RESUMO

As the life expectancy of patients with cystic fibrosis has increased, greater attention has been paid towards the diagnosis and management of the longer term consequences of the condition. A recognised but rare complication of the disease is the development of secondary amyloidosis. Whilst deposition of amyloid protein has been reported in a high proportion of patients with cystic fibrosis at post-mortem [1] and Serum Amyloid A protein has been shown to correlate with disease activity and response to antibiotics [2], the manifestation of clinical disease remains extremely uncommon. The prognosis for patients with amyloid secondary to cystic fibrosis in published reports has been historically bleak [3-6], however there may be novel approaches in the era of biological therapies. The theoretical potential for an increase in the incidence of secondary amyloid amongst the population of cystic fibrosis patients who are experiencing much longer lifespans means that it is worthwhile to consider the condition and its possible treatments in more detail. We report a case and a review of the literature.


Assuntos
Amiloidose/metabolismo , Fibrose Cística/metabolismo , Síndrome Nefrótica/metabolismo , Proteína Amiloide A Sérica/metabolismo , Amiloidose/etiologia , Amiloidose/fisiopatologia , Fibrose Cística/complicações , Fibrose Cística/fisiopatologia , Feminino , Humanos , Síndrome Nefrótica/etiologia , Adulto Jovem
14.
Nutr Neurosci ; 21(10): 753-760, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28784045

RESUMO

OBJECTIVES: To evaluate how safflower oil (SFO) influences brain electrophysiology and cortical oxidative status in the offspring, mothers received a diet with SFO during brain development period. METHODS: Beginning on the 14th day of gestation and throughout lactation, rats received safflower (safflower group - SG) or soybean oil (control group - CG) in their diet. At 65 days old, cortical spreading depression (CSD) and cortex oxidative status were analyzed in the offspring. RESULTS: SG presented reduction of the CSD velocity as compared to the CG (SG: 3.24 ± 0.09; CG: 3.37 ± 0.07 mm/min). SFO reduced levels of lipid peroxidation by 39.4%. SG showed the following increases: glutathione-S-transferase, 40.8% and reduced glutathione, 34.3%. However, SFO decreased superoxide dismutase by 40.4% and catalase by 64.1%. To control for interhemispheric effects, since CSD was recorded only in the right cortex, we evaluated the oxidative status in both sides of the cortex; no differences were observed. DISCUSSION: Data show that when SFO is consumed by the female rats during pregnancy and lactation, the offspring present long-term effects on brain electrophysiology and cortical oxidative state. The present study highlights the relevance of understanding the SFO intake of pregnant and lactating mammals.


Assuntos
Encéfalo/efeitos dos fármacos , Carthamus tinctorius/química , Lactação , Óleo de Cártamo/farmacologia , Animais , Encéfalo/metabolismo , Catalase/metabolismo , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/metabolismo , Depressão Alastrante da Atividade Elétrica Cortical/efeitos dos fármacos , Feminino , Glutationa/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Oxirredução/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Gravidez , Ratos , Ratos Wistar , Superóxido Dismutase/metabolismo
15.
Paediatr Respir Rev ; 26: 24-26, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28539256

RESUMO

This article explores the challenges associated with diagnosing and managing eating disorders such as anorexia nervosa amongst adolescents and adults with cystic fibrosis. It reviews the known risk factors, generic verses disease specific eating disorder risk screening tools and considers the ethical dilemmas associated with critically low body mass indices. A case review is included to illustrate the complexities of managing both conditions in the context of declining respiratory function.


Assuntos
Anorexia Nervosa/fisiopatologia , Fibrose Cística/psicologia , Comportamento Alimentar , Adolescente , Adulto , Humanos , Administração dos Cuidados ao Paciente , Medição de Risco , Fatores de Risco
16.
Respir Med ; 127: 40-44, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28502417

RESUMO

BACKGROUND: Chronic cough is commonly associated with asthma, gastro-oesophageal reflux disease and postnasal drip, but in a significant proportion, no associated cause can be found. We determined whether examination of bronchial biopsies would be useful in determining the cause associated with chronic cough. METHODS: 100 consecutive patients referred to a specialist cough clinic underwent a systematic assessment including a fiberoptic bronchoscopy for bronchial biopsies. RESULTS: In 38 patients, treatment of associated causes led to amelioration of cough ('explained') and in 62, there was no association or improvement ('idiopathic'). The latter group had a longer duration of cough, a lower FeNO levels and a more sensitive capsaicin cough response, with an increase in basement membrane thickness with no differences in goblet cell hyperplasia and seromucinous hyperplasia, and in lymphocyte, neutrophil and eosinophil counts. The duration of cough was inversely correlated with the degree of neutrophil infiltration. CONCLUSION: We conclude that pathological examination of bronchial biopsies is unlikely to be useful in the diagnosis of chronic cough in non-smokers.


Assuntos
Biópsia/métodos , Brônquios/patologia , Broncoscopia/métodos , Doença Crônica , Tosse/patologia , Refluxo Gastroesofágico/complicações , Adulto , Asma/complicações , Membrana Basal/patologia , Capsaicina/administração & dosagem , Capsaicina/efeitos adversos , Tosse/etiologia , Tosse/metabolismo , Tosse/fisiopatologia , Eosinófilos/citologia , Eosinófilos/patologia , Feminino , Células Caliciformes/patologia , Humanos , Linfócitos/citologia , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Neutrófilos/citologia , Neutrófilos/patologia , Espirometria/métodos
17.
Ann Am Thorac Soc ; 14(6): 903-911, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28267932

RESUMO

RATIONALE: PaO2 and SaO2 are commonly measured in respiratory practice, but arterial oxygen content (CaO2) refers to the volume of oxygen delivered to the tissues per unit blood volume. CaO2 is calculated from SaO2 and the hemoglobin concentration in blood, recognizing that each gram of hemoglobin can transport approximately 1.34 ml of oxygen when fully saturated. OBJECTIVES: To prospectively evaluate serial changes in CaO2 in humans, incorporating and excluding dynamic changes to oxygenation and hemoglobin parameters that may occur during life. METHODS: A cohort of 497 consecutive patients at risk of both hypoxemia and anemia were recruited. The patients had radiologically proven pulmonary arteriovenous malformations (PAVMs), which result in hypoxemia due to right-to-left shunting, and concurrent hereditary hemorrhagic telangiectasia, which placed them at risk of iron deficiency anemia due to recurrent hemorrhagic iron losses. Presentation SaO2 (breathing room air, by pulse oximetry), hemoglobin, red cell and iron indices were measured, and CaO2 calculated as SaO2 × hemoglobin × 1.34 ml/g. Serial measurements were evaluated in 100 cases spanning up to 32.1 (median, 10.5) years. RESULTS: Presentation CaO2 ranged from 7.6 to 27.5 (median, 17.6) ml/dl. CaO2 did not change appreciably across the SaO2 quartiles. In contrast, hemoglobin ranged from 5.9 to 21.8 g/dl (median, 14.1 g/dl), with a linear increase in CaO2 across hemoglobin quartiles. After PAVM embolization and an immediate increase in SaO2, hemoglobin fell and CaO2 was unchanged 1.6-12 (median, 4) months later. When hemoglobin fell because of iron deficiency, there was no change in SaO2. Similarly, when hemoglobin rose after iron treatment, there was no change in SaO2, and the expected CaO2 increment was observed. These relationships were not evident during pregnancy when hemoglobin fell, and PAVMs usually deteriorated: in pregnancy SaO2 commonly increased, and serial CaO2 values (incorporating hemodilution/anemia) more accurately reflected deteriorating PAVM status. An apparent fall in CaO2 with age in females was attributable to the development of iron deficiency. There was an unexplained increase in CaO2 with age in follow-up of males after embolization. CONCLUSIONS: Hemoglobin/CaO2 should be further incorporated into oxygenation considerations. More attention should be given to modest changes in hemoglobin that substantially modify CaO2.


Assuntos
Anemia/sangue , Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/terapia , Hemoglobinas/análise , Hipóxia/sangue , Adulto , Gasometria , Embolização Terapêutica , Feminino , Humanos , Ferro/sangue , Londres , Pulmão/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Oximetria , Oxigênio/sangue , Gravidez , Estudos Prospectivos , Artéria Pulmonar/anormalidades , Veias Pulmonares/anormalidades , Análise de Regressão
18.
Appl Physiol Nutr Metab ; 42(5): 503-510, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28177723

RESUMO

There is a growing interest to better understand how lifestyle choices can improve memory functions. Treadmill exercise and long-chain n-3 polyunsaturated fatty acids found in fish oil are able to stimulate hippocampal antioxidant defenses and improve memory. The aim was to test whether fish oil and exercise can improve rat's performance on memory tasks and optimize hippocampal antioxidant state in an age-dependent manner. Therefore, young and adult rats were exercised and received fish oil during 4 weeks. The exercise was performed for 30 min/day, with the speed gradually increasing from the first to the last week. Afterwards, episodic memory was measured by the recognition of object identity and spatial location. Hippocampal oxidative state was investigated with the levels of malondialdehyde (MDA), carbonyls content, antioxidant enzymatic activity (superoxide dismutase (SOD), catalase (CAT)), and antioxidant nonenzymatic activity (reduced glutathione, sulfhydryl content). The adult rats treated with fish oil and exercise (FO&EX) were able to recognize object's shape and placement; however, FO&EX young rats had impaired spatial recognition (p < 0.05). The FO&EX young rats did not have reduced MDA or carbonyl content, though either fish oil or exercise reduced MDA (p < 0.05) and carbonyl levels (p < 0.01). Exercise increased SOD (p < 0.001) and CAT activities (p < 0.05), and fish oil enhanced SOD activity (p < 0.05) in young rats. At adulthood, exercise increased MDA levels (p < 0.05), and FO&EX reduced MDA (p < 0.001). Finally, exercise and fish oil improved nonenzymatic antioxidant defense (p < 0.05) only in adult rats. Results support age-dependent effects of fish oil and exercise on memory and oxidative state of the hippocampus during either neurodevelopment or adulthood.


Assuntos
Envelhecimento/efeitos dos fármacos , Óleos de Peixe/farmacologia , Hipocampo/efeitos dos fármacos , Memória/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Condicionamento Físico Animal/fisiologia , Animais , Biomarcadores , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Glutationa Transferase/genética , Glutationa Transferase/metabolismo , Memória/fisiologia , Estresse Oxidativo/fisiologia , Ratos , Ratos Wistar
19.
Av. enferm ; 34(3): 259-267, sep.-dic. 2016. tab
Artigo em Português | LILACS, BDENF - enfermagem (Brasil), COLNAL | ID: biblio-950667

RESUMO

Objetivo: Identificar os fatores que influenciam a solidão das pessoas idosas. Metodologia: Tratou-se de uma pesquisa descritiva e quantitativa, realizada com 94 idosos conforme a Res. do cns 466/12. Foi utilizado um formulário dividido em duas partes: a primeira continha os dados de caracterização socio-demográfica; a segunda estava composta por questões pertinentes à temática do estudo. Resultados: A maioria dos participantes do estudo possuía entre 70 e 79 anos de idade (52,13%) e estava composta por mulheres (87,23%), destacando-se o analfabetismo (42,55%). Verificou-se que 78,73% moravam com seus familiares; 55,32% referiram não sentir-se só; e 79,79% não moravam sozinhos. Um número significante dos idosos da pesquisa (75,53%) não se sentiu excluído da sociedade e apenas 15,96% têm sentimento solitário. Conclusão: Os dados apresentados mostram que é fundamental a elaboração de grupos de convivência para idosos, pois estas atividades favorecem o bem estar físico, psíquico e social, fazendo-os esquecerem dos possíveis momentos de solidão.


Objetivo: Identificar los factores que influyen en la soledad de los adultos mayores. Metodología: Estudio descriptivo y cuantitativo, llevado a cabo con 94 adultos mayores según Res. cns 466/12. Se utilizó un formulario dividido en dos partes: la primera contenía los datos sociodemográ-ficos; la segunda estaba compuesta de temas relevantes al objeto de estudio. Resultados: La mayoría de los sujetos de la muestra tenía entre 70 y 79 años (52,13%) y estaba compuesta por mujeres (87,23%); se destacó el nivel de alfabetización (42,55%). Se encontró que el 78,73% vivían con sus familias; el 55,32 % señalaron no sentirse solos; y el 79,79% no vivían solos. Un número significativo de los adultos mayores objeto del estudio (75,53%) no se sentían excluidos de la sociedad y sólo el 15,96% mostró sentimientos de soledad. Conclusión: Los datos presentados evidencian que es necesario crear grupos de convivencia para adultos mayores, ya que estas actividades promueven el bienestar físico, mental y social, haciéndoles olvidar los posibles momentos de soledad.


Objective: To identify the factors that sway the loneliness of the elderly. Methodology: Descriptive and quantitative research carried out with 94 elderly people under Res. cns 466/12. A form was used, divided into two parts: the first one contained sociodemographic data; the second one consisted of significant issues of the subject matter. Results: Most subjects in the sample were between 70 and 79 years old (52.13%); it consisted of women (87.23%), standing the illiteracy out (42.55%). It is found that 78.73% of them lived with their families; 55.32% reported not feeling alone and 79.79% did not live alone. A significant number of elderly from this study (75.53%) did not feel excluded from society; only 15.96% has lonely feeling. Conclusion: The data resulting shows that it is fundamental to create living groups for elderly, inasmuch as these activities promote the physical, mental and socialwell-being, making them forget possible moments of solitude.


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Idoso , Enfermagem , Emoções , Solidão
20.
Appl Physiol Nutr Metab ; 41(12): 1271-1277, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27863203

RESUMO

Carthamus tinctorius L. (common name: safflower) is an herb whose extracted oil (safflower oil) has been employed in both alternative and conventional medicine in the treatment of disease. Overnutrition during early postnatal life can increase the lifetime risk of obesity and metabolic syndrome. Here we investigate the effect of safflower oil supplementation given during a critical early developmental stage on the eventual occurrence of metabolic disease in overnourished rats. Groups of overnourished or adequately nourished rats were randomly assigned into 2 additional groups for supplementation with either safflower oil (SF) or vehicle for 7 to 30 days. Murinometric data and weights were examined. Serum was collected for measurement of glucose, cholesterol, high-density lipoprotein cholesterol, and triglycerides. Heart and liver oxidative status were also measured. Overnutrition for 7-30 days induced a significant increase in body weight and in values for abdominal circumference, thoracic circumference, body length, and body mass index. SF supplementation did not attenuate the effect of overnutrition on any of these parameters. In addition, overnutrition increased levels of glucose, triglycerides, and very low-density lipid compared with normal controls, but SF supplementation had no effect on these parameters. Measures of oxidative status in heart or liver were not influenced by overnutrition. However, oxidative measures were altered by SF supplementation in both of these organs. The present study reveals that nutritional manipulation during early development induces detrimental effects on metabolism in the adult that are not ameliorated by supplemental SF.


Assuntos
Carthamus tinctorius/química , Ácidos Graxos Ômega-6/uso terapêutico , Fígado/metabolismo , Miocárdio/metabolismo , Hipernutrição/dietoterapia , Estresse Oxidativo , Óleo de Cártamo/uso terapêutico , Animais , Suplementos Nutricionais/efeitos adversos , Ácidos Graxos Ômega-6/efeitos adversos , Feminino , Hiperglicemia/etiologia , Hiperlipidemias/etiologia , Lactação , Masculino , Fenômenos Fisiológicos da Nutrição Materna , Obesidade/etiologia , Obesidade/prevenção & controle , Hipernutrição/sangue , Hipernutrição/metabolismo , Hipernutrição/fisiopatologia , Preparações de Plantas/efeitos adversos , Preparações de Plantas/uso terapêutico , Gravidez , Distribuição Aleatória , Ratos Wistar , Óleo de Cártamo/efeitos adversos , Desmame , Aumento de Peso
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