Application of nanomaterials for the electrical and optical detection of the hepatitis B virus.

This work describes different approaches for the detection of hepatitis B virus (HBV) genomic DNA, using electrochemical and optical techniques. The platforms consisted of a single-stranded DNA probe (HEPB1S), specific to HBV, grafted on a gold electrode modified with reduced graphene oxide or gold nanoparticles. Differential pulse voltammetry analysis indicates that the addition of HBV genomic DNA caused an increase of about 1.4 times in the current peak value, when compared to the negative control. It was observed a linear dependence with the log HBV-genomic DNA concentration and the electrochemical biosensor detected until 7.65 pg µL-1 of the target. Electrochemical impedance spectroscopy measurements showed an increase of about 2 times in the charge transfer resistance, after the addition of HBV genomic DNA. Assays using colloidal suspension of gold nanoparticles showed a shift of the peak wavelength, linearly proportional to the HBV-genomic DNA concentration, with a detection limit of 0.15 ng µL-1. The applicability of the gold nanoparticles for clinical samples was tested with success in the blood plasma. All the approaches used in this work were effective in detecting genomic DNA or blood plasma in positive samples for HBV.

Associação entre Disfunção Erétil e Piora na Qualidade de Vida de Pacientes com Doença Arterial Coronariana / Association between Erectile Dysfunction and Quality of Life in Patients with Coronary Artery Disease

Fundamentos: A disfunção erétil (DE) e a doença arterial coronariana (DAC) compartilham os mesmos fatores de risco e as associações entre DE, qualidade de vida (QV) e DAC têm sido motivo de estudos recentes. Objetivo: Avaliar se a DE está associada a piora da QV em pacientes com DAC. Métodos: Estudo transversal, multicêntrico, prospectivo e analítico, realizado de dezembro de 2014 a abril de 2016, que recrutou 304 homens (idade média: 57 ± 9,9 anos) com diagnóstico clínico de DAC. A QV foi avaliada através do Short Form-36 e a DE pelo Índice Internacional de Função Erétil. Foram realizadas análises estatísticas descritiva e analítica, sendo que o teste não paramétrico Kruskal-Wallis foi usado para analisar se existem diferenças significativas em cada domínio de qualidade de vida quando se comparam os diferentes tipos de DE. Para todos os testes, valor de p ≤ 0,05 foi considerado significante. Resultados: A prevalência de DE foi de 76,3%. As medianas e percentis 25 e 75 de cada domínio de qualidade de vida de acordo com a ausência de DE, DE leve, leve a moderada, moderada e grave, respectivamente, foram: Capacidade funcional: 85 (63-100), 75 (50-95), 60 (32-85), 55 (35-75), 50 (30-70), p < 0,001; Aspectos físicos: 87 (0-100), 40 (0-100), 0 (0-100), 0 (0-31), 0 (0-12), p < 0,001; Dor: 72 (51-100), 66 (51-100), 74 (51-100), 62 (51-100), 51 (31-62), p = 0,001; Estado geral de saúde: 77 (62-87), 72 (57-77), 67 (55-82), 67 (59-75), 52 (37-68), p < 0,001; Vitalidade: 75 (60-85), 65 (50-75), 65 (55-75), 60 (43-75), 50 (32-65), p < 0,001; Aspectos sociais: 87 (62-100), 87 (62-100), 87 (68-100), 75 (62-100), 75 (50-93), p = 0,139; Aspectos emocionais: 100 (58-100), 100 (33-100), 100 (33-100), 100 (0-100), 0 (0-100), p = 0,001; Saúde mental: 80 (67-89), 72 (60-84), 72 (66-80), 68 (58-80), 56 (50-74), p < 0,001. Conclusões: A prevalência de disfunção erétil foi elevada. A DE esteve associada a piora da QV em pacientes com DAC

Background: Erectile dysfunction (ED) and coronary artery disease (CAD) share the same risk factors and the associations between ED, quality of life (QoL) and CAD have been the subject of recent studies. Objective: To evaluate whether ED is associated with worsening QoL in patients with CAD. Methods:A cross-sectional, multicenter, prospective and analytic study was carried out from EDcember 2014 to April 2016, which recruited 304 men (mean age: 57 ± 9.9 years) with clinical diagnosis of CAD. QoL was assessed using Short Form-36 and ED by the International Erectile Function InEDx. EDscriptive and analytical statistical analyzes were performed, and the Kruskal-Wallis non-parametric test was used to test whether there are significant differences in each quality of life domain when comparing different types of ED. For all tests, p ≤ 0.05 was consiEDred significant. Results: The prevalence of ED was 76.3%. The median and percentiles 25 and 75 of each life quality domain according to the absence of ED; mild ED, mild to moderate, moderate and severe ED and severe ED, respectively, were: Functional capacity: 85 (63-100), 75 (50 -95), 60 (32-85), 55 (35-75), 50 (30-70), p < 0.001; Physical aspects: 87 (0-100), 40 (0-100), 0 (0-100), 0 (0-31), 0 (0-12), p < 0.001; Pain: 72 (51-100), 66 (51-100), 74 (51-100), 62 (51-100), 51 (31-62), p = 0.001; General state of health: 77 (62-87), 72 (57-77), 67 (55-82), 67(59-75), 52 (37-68), p < 0.001; Vitality: 75 (60-85), 65 (50-75), 65 (55-75), 60 (43-75), 50 (32-65), p < 0.001; Social Aspects: 87 (62-100), 87 (62-100), 87 (68-100), 75 (62-100), 75 (50-93), p = 0.139; Emotional Aspects: 100 (58-100), 100 (33-100), 100 (33-100), 100 (0-100), 0 (0-100), p = 0.001; Mental health: 80 (67-89), 72 (60-84), 72 (66-80), 68 (58-80), 56 (50-74), p < 0.001. Conclusions: The prevalence of erectile dysfunction was high. ED was associated with worsening of QoL in patients with CAD

Relação entre índice tornozelo-braquial e doença aterosclerótica carotídea / Association between ankle-brachial index and carotid atherosclerotic disease

FUNDAMENTO: A associação do índice tornozelo-braquial (ITB) com a medida do complexo médio intimal das artérias carótidas (MCMI) não está amplamente estudada. OBJETIVO: Objetivamos avaliar se pacientes com ITB < 0,9 apresentam maior prevalência de placa aterosclerótica carotídea do que aqueles com ITB > 0,9. MÉTODOS: No período de janeiro a dezembro de 2011, recrutamos 118 pacientes (48 homens e 70 mulheres) que tiveram seus ITB e MCMI mensurados. Os pacientes foram divididos em grupo 1 (ITB < 0,9) e grupo 2 (ITB > 0,9). Utilizamos os testes de Mann-Whitney, qui-quadrado e Fischer para comparações entre os grupos. Para avaliar correlação entre ITB e MCMI empregamos a correlação de Pearson. RESULTADOS: A prevalência de ITB < 0,9 foi 29,7%, enquanto a da MCMI > 1,5 mm de 34,7%. Não houve diferença de características clínicas entre os grupos 1 e 2: idade média (64 ± 9 vs. 62 ± 7,2 anos, p = 0,1), homens (40% vs. 41%, p = 0,9), hipertensão (74% vs. 59%, p = 0,1), diabetes melito (54% vs. 35%, p = 0,051), dislipidemia 26% vs. 24%, p = 0,8), tabagismo (57% vs. 65%, p = 0,4). A prevalência de placa carotídea foi maior no grupo 1 (48,6% vs. 28,9%, p = 0,04). A correlação de Pearson entre o ITB e a MCMI foi de - 0,235, com valor de p = 0,01. CONCLUSÕES: Pacientes com ITB < 0,9 apresentaram maior prevalência de aterosclerose carotídea. Houve correlação negativa entre o ITB e a MCMI.

BACKGROUND: The association between the ankle brachial index (ABI) and the measurement of intimal medial thickness (IMT) has not been fully studied. OBJECTIVE: We aimed to evaluate whether the prevalence of carotid atherosclerosis was higher in patients with ABI < 0.9 than in those with ABI > 0.9. METHODS: From January 2011 to December 2011, 118 patients (48 men and 70 women) were enrolled. ABI and IMT Measurements were performed in all patients. Patients were divided in Group 1 (ABI < 0.9) and Group 2 (ABI > 0.9) according to ABI values. Mann-Whitney, Chi-square and Fischer tests were used for comparison among the groups. Pearson's correlation was used to assess correlation between ABI and IMT. RESULTS: The prevalence of ABI < 0.9 was 29.7%, whereas carotid atherosclerosis > 1.5 mm was 34.7 %. Clinical characteristics were similar between groups 1 and 2: mean age (64 ± 9 vs. 62 ± 7.2 years, p = 0.1), male gender (40% vs. 41%, p = 0.9), hypertension (74% vs. 59%, p = 0.1), diabetes mellitus (54% vs. 35%, p = 0.051), dyslipidemia (26% vs. 24%, p = 0.8), smoking (57% vs. 65%, p = 0.4). The prevalence of carotid atherosclerosis was higher in group 1 (48.6% vs. 28.9%, p = 0.04). Pearson's correlation between ABI and IMT was -0.235, with a p value = 0.01. CONCLUSION: Patients with ABI < 0.9 showed a higher prevalence of carotid atherosclerosis. There was a negative correlation between ABI and IMT.

Association between ankle-brachial index and carotid atherosclerotic disease.

BACKGROUND: The association between the ankle brachial index (ABI) and the measurement of intimal medial thickness (IMT) has not been fully studied. OBJECTIVE: We aimed to evaluate whether the prevalence of carotid atherosclerosis was higher in patients with ABI < 0.9 than in those with ABI > 0.9. METHODS: From January 2011 to December 2011, 118 patients (48 men and 70 women) were enrolled. ABI and IMT Measurements were performed in all patients. Patients were divided in Group 1 (ABI < 0.9) and Group 2 (ABI > 0.9) according to ABI values. Mann-Whitney, Chi-square and Fischer tests were used for comparison among the groups. Pearson's correlation was used to assess correlation between ABI and IMT. RESULTS: The prevalence of ABI < 0.9 was 29.7%, whereas carotid atherosclerosis > 1.5 mm was 34.7 %. Clinical characteristics were similar between groups 1 and 2: mean age (64 ± 9 vs. 62 ± 7.2 years, p = 0.1), male gender (40% vs. 41%, p = 0.9), hypertension (74% vs. 59%, p = 0.1), diabetes mellitus (54% vs. 35%, p = 0.051), dyslipidemia (26% vs. 24%, p = 0.8), smoking (57% vs. 65%, p = 0.4). The prevalence of carotid atherosclerosis was higher in group 1 (48.6% vs. 28.9%, p = 0.04). Pearson's correlation between ABI and IMT was -0.235, with a p value = 0.01. CONCLUSION: Patients with ABI < 0.9 showed a higher prevalence of carotid atherosclerosis. There was a negative correlation between ABI and IMT.

Adesão ao tratamento anti-hipertensivo: conceitos, aferição e estratégias inovadoras de abordagem / Compliance to treatment for hypertension: concepts, measurement, and innovative approach strategies

JUSTIFICATIVA E OBJETIVOS: A prevalência da hipertensão arterial sistêmica (HAS) é crescente no mundo e é o principal fator de risco para as doenças cardiovasculares e renais. Apesar de existirem tratamentos eficazes, as taxas de descontrole da doença oscilam de 35% a 80%. A baixa adesão ao tratamento está presente em 50% dos casos de pacientes hipertensos descompensados. O objetivo deste estudo foi descrever os principais aspectos relacionados à adesão ao tratamento da HAS. CONTEÚDO: Foram pesquisados artigos nas bases de dados Pubmed/Medline, LILACS, Scielo, Cochrane Embase e CINAHL,no período 2005 a 2010, em que foi proposto o uso de índices de adesão na prática clínica como elementos diferenciais em relação à hipertensão resistente e à inércia terapêutica. Foram descritos os principais métodos de mensuração da adesão com suas vantagens e desvantagens, as quais determinam a dificuldade em obter padrões uniformes de comparação entre os estudos. Discutiram-se os conceitos de adesão inicial e persistente, assim como os principais fatores intervenientes relacionados ao paciente,aos profissionais de saúde, à terapia e à estrutura dos sistemas de saúde. Finalmente, descreveram-se os resultados do emprego de estratégias promissoras mais recentemente utilizadas como acombinação de doses fixas de medicamentos, o auxílio de farmacêuticos, a automensuração domiciliar da pressão, a monitorização eletrônica de doses e os sistemas de suporte, monitoramento e apoio à decisão.CONCLUSÃO: A adesão ao tratamento é a chave para a redução das altas taxas de complicações cardiovasculares relacionadas à hipertensão.

BACKGROUND AND OBJECTIVES: The prevalence of systemic hypertension (SH) is increasing worldwide and is the main risk factor for cardiovascular and renal diseases. Though effective treatments exist, the rates of uncontrolled disease vary between 35% and 80%. The low compliance to treatment is present in 50% of decompensated hypertensive patients. The objective of this study was to describe main aspects of SH treatment compliance. CONTENTS: We have searched for the articles published between 2005 and 2010 in the following databases: PUBMED/Medline, LILACS, Scielo, EMBASE, Cochrane Library and CINAHL. We have proposed the use of rates of compliance in clinical practice as differential elements for resistant hypertension and therapeutic inertia. The main compliance measurement methods were described, with advantages and disadvantages, determining the difficulty in obtaining uniform standards of comparison among studies. The concepts of early and persistent compliance were discussed, as well as the main intervening factors related to patients, health professionals, therapy and the structure of health systems. Finally, the results of the use of most recent promising strategies were described, such as a fixed dose drug combination, help of pharmacists, home self-measurement of blood pressure, electronic dosages monitoring, and support systems, monitoring and support of decision making.CONCLUSION: Compliance to treatment is the key action to reduce the high rates of cardiovascular complications related to hypertension.

Sarcoma primário da artéria pulmonar: relato de caso / Primary sarcoma of the pulmonary artery: case report

JUSTIFICATIVA E OBJETIVOS: O sarcoma primário da artéria pulmonar é uma doença rara. O conhecimento dos aspectos clínicos e do seu diagnóstico tem impacto no prognóstico do paciente.O objetivo deste estudo foi descrever e discutir aspectos clínicos e de exames complementares deste tumor. RELATO DO CASO: O paciente foi internado para ser submetido à embolectomia cirúrgica de artéria pulmonar. Entretanto,na sala de cirurgia notou-se presença de tumor que invadia a artéria pulmonar direita, estruturas do mediastino, veia cava superior e artéria aorta. Nesse momento não foi realizada a ressecção tumoral.Exames complementares revelaram sarcoma primário da artéria pulmonar. O paciente foi tratado com quimioterápicos,com planejamento de cirurgia após o seu término. CONCLUSÃO: Houve boa resposta a terapêutica e melhora clinica.Infelizmente, após a quimioterapia, o paciente não aceitou cirurgia para ressecção do tumor.

BACKGROUND AND OBJECTIVES: The primary pulmonary artery sarcoma is a rare tumor. The knowledge of the characteristics of this kind of tumor has impact on patients' survival. We aimed tod escribe and discuss a couple of characteristics of this cancer. CASE REPORT: The patient came in hospital to be submitted to embolectomy from pulmonary artery surgery. At operating room the tumor was discovered invading the right pulmonary artery,mediastinal structures, the superior vena cava and the aorta.It was therefore decided not to perform a tumor resection. We have decided to treat the patient with chemotherapy. It was our idea to perform surgery after the chemotherapy. CONCLUSION: The patient experienced good tolerance to the therapy and indicated clinical improvement. Unfortunately, at this time he does not accept surgery.

Hemostasia após procedimentos percutâneos em pacientes idosos: compressão manual versus mecânica / Hemostasis after percutaneous procedures in elderly patients: manual versus mechanical compression

JUSTIFICATIVA E OBJETIVOS: A expectativa de vida está aumentando no mundo. Mais idosos estão se submetendo a procedimentos endovasculares percutâneos, no entanto a ocorrênciade complicações vasculares na área de acesso pode afetar o prognóstico destes pacientes. O objetivo deste estudo foi comparar as taxas de complicações vasculares na área de acesso femoral em idosos submetidos à hemostasia, mecânica ou clássica da artériafemoral após procedimentos percutâneos. MÉTODO: Estudo prospectivo, aleatório, 1:1, que envolveu 110 pacientes recrutados entre novembro de 2009 e dezembrode 2010. Foram avaliadas as seguintes complicações vasculares: hematoma, equimose, fístula arteriovenosa, pseudoaneurisma, hematoma retroperitoneal e oclusão vascular periférica. P < 0,05 foi considerado estatisticamente significante. RESULTADOS: Considerando os grupos de compressão manual e mecânica respectivamente: a média de idade foi 69,6 ± 7,3 versus 67,8 ± 6,7 anos p = 0,2. As taxas de complicações vasculares maiores na fase hospitalar (0% versus 1,8%, p = 1,0) e no seguimento de sete dias (0% versus 1,8%, p = 0.5). No seguimento clínico de sete dias foi observado que a taxa total de complicações vasculares foi maior no grupo da compressão manual (64% versus 41,8%, p = 0.02) bem como a taxa de pacientes com complicações vasculares nessa técnica (48% versus 27,3%, p = 0,03). A taxa de complicações vasculares menores não foi diferente para os grupos nos dois períodos de observação. CONCLUSÃO: Não houve diferença nas taxas de complicações vasculares (maior ou menor) entre as técnicas hemostáticas. No seguimento de sete dias, a taxa total de complicações vasculares e de pacientes com estas complicações foi menor no uso da técnica mecânica.

BACKGROUND AND OBJECTIVES: Life expectancy is increasing worldwide. More elderly people are undergoing percutaneous endovascular procedures and the occurrence of vascular complications in the site access can adversely affect the patient's prognosis. This study to compare the rates of vascular complicationsin elderly patients submitted to mechanical or classical hemostasis of the femoral artery after percutaneous procedures. METHOD: A prospective, randomized, 1:1 study, which involved 110 patients, recruited between November/09 and December/10. The following vascular complications were assessed: hematoma, ecchymosis, arteriovenous fistula, pseudoaneurysm, retroperitoneal hematoma, peripheral vascular occlusion. Was considered to be statically significant p < 0.05. RESULTS: Considering manual and mechanical compression groups respectively: the mean age was 69.6 ± 7.3 v 67.8 ± 6.7 years, p = 0.2. The rates of major vascular complications were in the hospital phase (0% versus 1.8%, p = 1.0) and the seven days follow-up (0% versus 1.8%, p = 0.5). It was observed in the clinical follow-up after seven days that the total rate of vascular complications was higher in the manual compression group (64%versus 41.8%, p = 0.02), as was the rate of patients who suffered complications with this technique (48% versus 27.3%, p = 0.03).The rate of minor vascular complications was not different for the groups in the two periods of observation. CONCLUSION: There was no difference in the rates of vascular complications (major or minor) between the hemostatics techniques. At seven day follow-up the total rates of vascular complications and the number of patients with vascular complications were smaller in the mechanical technique.