RESUMO
Illicit drug use is a serious and complex public health problem, not only due to the severity of the health damage but also to the social implications, such as marginalization and drug trafficking. Currently, cocaine (COC) is among the most abused drugs worldwide with about 22 million users. Drug abuse has also been found in women during the pregnancy period, which has shed light on a new group for epidemiology. The diagnosis of COC use in these cases usually depends largely on the mother's reports, which in several cases omit or deny consumption. Therefore, considering physical-chemical methods of sample preparation and exposure biomarkers, the development of analytic toxicological methods can help to confirm drug use during pregnancy. Thus, the objective of the present work was to develop an analytical method based on dispersive liquid-liquid microextraction for the determination of COC analytes, using umbilical cord tissue as an alternative biological matrix, and detection by gas chromatography coupled to mass spectrometry. Therefore, after optimization, the dispersive liquid-liquid microextraction method was fully validated for quantification of COC, benzoylecgonine, cocaethylene, ecgonine, ecgonine methyl ester and norcocaine. The limits of detection were between 15 and 25 ng/g, the limits of quantification were 30 ng/g for ecgonine and 25 ng/g for the other analytes. Linearity ranged from the limits of quantification to 1,000 ng/g. Coefficients of variation for intra-assay precision were <18.5%, inter-assay was <8.75% and bias was <16.4% for all controls. The developed method was applied in 10 suspected positive samples, based on the mother's report and maternal urine screening and confirmation. COC, benzoylecgonine, ecgonine and ecgonine methyl ester were quantified in four umbilical cords with concentrations that ranged from 39.6 to 420.5 ng/g.
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Cocaína , Cromatografia Gasosa-Espectrometria de Massas , Microextração em Fase Líquida , Troca Materno-Fetal , Detecção do Abuso de Substâncias , Cordão Umbilical , Humanos , Cocaína/análogos & derivados , Cocaína/análise , Feminino , Gravidez , Cordão Umbilical/química , Detecção do Abuso de Substâncias/métodos , Limite de Detecção , Reprodutibilidade dos Testes , Exposição MaternaRESUMO
BACKGROUND: In 2019, we reported the first efficacy and safety analysis of EUCROSS, a phase II trial investigating crizotinib in ROS1 fusion-positive lung cancer. At that time, overall survival (OS) was immature and the effect of crizotinib on intracranial disease control remained unclear. Here, we present the final analysis of OS, systemic and intracranial activity, and the impact of co-occurring aberrations. MATERIALS AND METHODS: EUCROSS was a prospective, single-arm, phase II trial. The primary endpoint was best overall response rate (ORR) using RECIST 1.1. Secondary and exploratory endpoints were progression-free survival (PFS), OS, and efficacy in pre-defined subgroups. RESULTS: Median OS of the intention-to-treat population (N = 34) was 54.8 months [95% confidence interval (CI) 20.3 months-not reached (NR); median follow-up 81.4 months] and median all-cause PFS of the response-evaluable population (N = 30) was 19.4 months (95% CI 10.1-32.2 months). Time on treatment was significantly correlated with OS (R = 0.82; P < 0.0001). Patients with co-occurring TP53 aberrations (28%) had a significantly shorter OS [hazard ratio (HR) 11; 95% CI 2.0-56.0; P = 0.006] and all-cause PFS (HR 4.2; 95% CI 1.2-15; P = 0.025). Patients with central nervous system (CNS) involvement at baseline (N = 6; 20%) had a numerically shorter median OS and all-cause PFS. Median intracranial PFS was 32.2 months (95% CI 23.7 months-NR) and the rate of isolated CNS progression was 24%. CONCLUSIONS: Our final analysis proves the efficacy of crizotinib in ROS1-positive lung cancer, but also highlights the devastating impact of TP53 mutations on survival and treatment efficacy. Additionally, our data show that CNS disease control is durable and the risk of CNS progression while on crizotinib treatment is low.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Crizotinibe/farmacologia , Crizotinibe/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Proteínas Tirosina Quinases/genética , Estudos Prospectivos , Proteínas Proto-Oncogênicas/genética , Sistema Nervoso CentralRESUMO
INTRODUCTION: Musical intervention (MI) is a valuable strategy for addressing the psychological and emotional challenges faced by patients undergoing imaging procedures. This study explores MI's impact on psychophysiological outcomes during imaging procedures, detailing the sound repertoire and technical characteristics employed in MI. METHODS: A systematic review (SR) and meta-analysis (MA) were conducted. Electronic database searches of PubMed, Web-of-Science, and Scopus were performed encompassing original randomised research and quasi-experimental articles published until June 2023. RESULTS: Thirteen articles were included in this SR, scoring between 23 and 68 on the Joanna Briggs Institute (JBI) Checklist. Four articles were included to perform a MA concerning anxiety and heart rate (HR) outcomes. Most studies utilised digital playlists as the medium for MI. Headphones were commonly used, with an average volume of 50-60 dB and a musical frequency of 60-80 beats/min. While authors generally preferred selecting musical genres for the repertoire, two articles specifically chose Johann Pachelbel's "Canon in D major" as their musical theme. In terms of psychological parameters, the experimental groups exhibited lower anxiety values than the control groups, with further reductions after MI. However, MA shows that this trend is only marginally significant. Patient comfort and overall examination experience showed improvement with MI. Regarding physiological parameters, HR, especially in the final phase of the examination, was significantly lower in the experimental group compared to the control group. CONCLUSION: Across multiple studies, MI demonstrated the ability to reduce anxiety and HR. However, no specific music repertoire emerged as the most effective. IMPLICATIONS FOR PRACTICE: MI arises as a painless, reliable, low-cost, and side-effect-free strategy, presenting imaging departments with a practical means to enhance patient comfort and mitigate anxiety and stress during medical procedures.
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Música , Humanos , Música/psicologia , Ansiedade/prevenção & controle , Estresse Psicológico , Diagnóstico por Imagem , RadiografiaAssuntos
Vulvovaginite , Feminino , Humanos , Vulvovaginite/diagnóstico , Vulvovaginite/microbiologiaRESUMO
Differences and/or similarities in the influence of sex class for hair sheep requirements remain inconclusive. Knowledge of energy requirements allows well-formulated diets to be provided which is crucial for improving animal production. We aimed to determine the effect of sex class on the net energy requirements of growing hair sheep in a multi-study approach. We used a data set composed of individual measurements of 382 hair sheep (299 non-castrated and 83 castrated males) from 11 studies that used the methodology of comparative slaughter. Net energy requirements for maintenance (NEm) were obtained by the regression between heat production and metabolizable energy intake. The metabolizable energy requirements for maintenance (MEm) were calculated by the iterative method, and the efficiency of use of metabolizable energy for maintenance (km) was obtained by NEm divided by MEm. The net energy requirements for gain (NEg) were estimated from retained energy (RE) against empty BW gain (EBWG). The efficiency of energy use for weight gain (kg) was obtained from the relationship between RE and the energy metabolizable intake for gain, removing the intercept. There was an effect of sex on NEg and two equations were generated: NEg (MJ/day) = 1.040 (±0.04055) × EBW0.75 × EBWG0.8767(±0.03293) and NEg (MJ/day) = 1.040 (±0.04055) × EBW0.75 × EBWG0.8300(±0.03468) (R2 = 0.86; MSE = 0.0037; AIC = -468.0) for non-castrated and castrated males, respectively. Sex class did not affect kg (P > 0.05) and one kg was generated (0.29). Sex did not affect kprotein (P = 0.14) and kfat (P = 0.32), assuming an average deposition efficiency of 0.27 for protein and 0.78 for fat. The NEm and MEm did not differ (P > 0.05) between sex classes, with a value of 0.272 and 0.427 MJ/kg0.75 EBW per day, respectively. The km observed was 0.64. In conclusion, non-castrated and castrated male hair sheep have similar maintenance energy requirements although energy requirements for gain differed among them. The Committees overestimate the gain and maintenance requirements for hair sheep. Therefore, the equations generated in this study are recommended.
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Ração Animal , Metabolismo Energético , Animais , Masculino , Ovinos , Ração Animal/análise , Composição Corporal , Dieta/veterinária , Ingestão de Energia , Necessidades Nutricionais , Carneiro Doméstico , Peso CorporalRESUMO
Com o propósito de compreender a realidade do atendimento odontológico e contribuir para o planejamento do acesso a estes serviços, o presente estudo realizou uma investigação sobre a cobertura de procedimentos diagnósticos por imagem em odontologia ofertados pelo Sistema Único de Saúde no estado de Minas Gerais (SUS-MG). Foi realizada revisão de dados secundários, coletados através do Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIA-SUS), correlacionando-os a dados do Censo Demográfico de 2022, de modo a permitir uma análise aprofundada do panorama atual da radiologia odontológica na rede de atenção à saúde bucal do SUS-MG. Foi constatado que a macrorregião Centro foi responsável pela maioria absoluta dos procedimentos realizados no período abrangido pelo estudo, enquanto a macrorregião do Triângulo do Sul apresentou mais procedimentos por número de habitantes. A radiografia periapical/interproximal foi o exame mais solicitado até o ano de 2020, quando houve uma súbita interrupção. Desde então, a radiografia panorâmica passou a ser a mais solicitada. A desigualdade no acesso às tecnologias diagnósticas odontológicas parece ser ainda uma realidade em Minas Gerais. A disseminação de conhecimento sobre o padrão de utilização dos serviços de saúde pode impactar positivamente na diminuição da iniquidade no acesso à saúde.
In order to understand the reality of dental care and contribute to planning access to these services, this study investigated the coverage of diagnostic imaging procedures in dentistry offered by the Unified Health System in the state of Minas Gerais (SUS-MG). A review of secondary data collected through the Outpatient Information System of the Unified Health System (SIA-SUS) was carried out, correlating it with data from the 2022 Demographic Census, in order to allow an in-depth analysis of the current panorama of dental radiology in the SUS-MG oral health care network. It was found that the Central macro-region was responsible for the absolute majority of procedures carried out in the period covered by the study, while the Southern Triangle macro-region had more procedures per number of inhabitants. Periapical/interproximal radiography was the most requested exam until 2020, when there was a sudden interruption. Since then, panoramic radiography has become the most requested. Inequality in access to dental diagnostic technologies still seems to be a reality in Minas Gerais. Disseminating knowledge about the pattern of use of health services can have a positive impact on reducing inequality in access to health.
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Sistema Único de Saúde , Diagnóstico por Imagem , Radiografia Dentária , Inquéritos de Saúde BucalRESUMO
BACKGROUND: Tick control is a worldwide challenge due to its resistance to acaricides. Essential oils (EOs) and isolated compounds (EOCs) are potential alternatives for tick control technologies. METHODS: A review with EOs and EOCs, under field and semi-field conditions, was performed based on Scopus, Web of Science and PubMed databases. Thirty-one studies published between 1991 and 2022 were selected. The search was performed using the following keywords: "essential oil" combined with "tick," "Ixodes," "Argas," "Rhipicephalus," "Amblyomma," "Hyalomma," "Dermacentor," "Haemaphysalis" and "Ornithodoros." The words "essential oil" and "tick" were searched in the singular and plural. RESULTS: The number of studies increased over the years. Brazil stands out with the largest number (51.6%) of publications. The most studied tick species were Rhipicephalus microplus (48.4%), Ixodes scapularis (19.4%), Amblyomma americanum and R. sanguineus sensu lato (9.7% each). Cattle (70%) and dogs (13%) were the main target animal species. Regarding the application of EOs/EOCs formulations, 74% of the studies were conducted with topical application (spray, pour-on, foam, drop) and 26% with environmental treatment (spray). Efficacy results are difficult to evaluate because of the lack of information on the methodology and standardization. The nanotechnology and combination with synthetic acaricides were reported as an alternative to enhance the efficacy of EOs/EOCs. No adverse reactions were observed in 86.6% of the studies evaluating EOs/EOCs clinical safety. Studies regarding toxicity in non-target species and residues are scarce. CONCLUSIONS: This article provides a comprehensive review on the use of EOs and EOCs to reduce tick infestations, in both the hosts and the environment. As future directions, we recommend the chemical characterization of EOs, methodology standardization, combination of EOs/EOCs with potential synergists, nanotechnology for new formulations and safety studies for target and non-target organisms, also considering the environmental friendliness.
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Acaricidas , Doenças dos Bovinos , Doenças do Cão , Ixodes , Ixodidae , Óleos Voláteis , Rhipicephalus , Infestações por Carrapato , Animais , Cães , Bovinos , Óleos Voláteis/química , Acaricidas/farmacologia , Acaricidas/uso terapêutico , Infestações por Carrapato/tratamento farmacológico , Infestações por Carrapato/prevenção & controle , Infestações por Carrapato/veterinária , Amblyomma , Controle de Ácaros e Carrapatos/métodos , Doenças dos Bovinos/tratamento farmacológico , Doenças do Cão/tratamento farmacológicoRESUMO
Mercury's extreme toxicity and persistence in the environment justifies a thorough evaluation of its dynamics in ecosystems. Aveiro Lagoon (Portugal) was for decades subject to mercury effluent discharges. A Nature-based Solution (NbS) involving Zostera noltei re-colonization is being tested as an active ecosystem restoration measure. To study the effect of Zostera noltei on the sediment contaminant biogeochemistry, seasonal (summer/winter) sediment, interstitial water and labile mercury vertical profiles were made in vegetated (Transplanted and Natural seagrass meadows) and non-vegetated sites (Bare-bottom area). While no significant differences (p > 0.05) were observed in the sedimentary phase, Zostera noltei presence reduced the reactive/labile mercury concentrations in the top sediment layers by up to 40% when compared to non-vegetated sediment, regardless of season. No differences were found between vegetated meadows, highlighting the fast recovery of the contaminant regulation ecosystem function provided by the plants after re-colonization and its potential for the rehabilitation of historically contaminated ecosystems.
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Mercúrio , Zosteraceae , Ecossistema , Mercúrio/análise , Plantas , Portugal , Sedimentos GeológicosRESUMO
Monkeypox virus is a member of the family Poxviridae, as are variola virus and vaccinia virus. It has a linear double-strand DNA genome approximately 197 kb long, containing ~190 non-overlapping ORFs. Comparison of members of the Central and West African clades shows the presence of unique genes that are associated with different disease presentations, depending on the strain. The last smallpox vaccination efforts ended in the mid-1980s, and there is concern about the recent spread of human monkeypox disease around the world. Almost 87,000 human monkeypox cases have been diagnosed in the world, of which more than 10,900 were in Brazil. The aim of this study was to evaluate the epidemiology and molecular evolution of hMpxV. From computational biology analysis of 640 hMpxV genomes from 1962 to 2022, synteny breaks and gene conservation were observed between Central and West clade genomes, and strains belonged with the 2022 outbreak assigned to the West African clade. Evidence was found for diversifying selective pressure at specific sites within protein coding sequences, acting on immunomodulatory processes. The existence of different sites under diversifying and purifying selection in paralog genes indicates adaptive mechanisms underlying the host-pathogen interaction of monkeypox virus in humans.
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Mpox , Poxviridae , Humanos , Monkeypox virus/genética , Mpox/epidemiologia , Poxviridae/genética , Genômica , Evolução MolecularRESUMO
This study aimed to assess the effect of combining amitraz with essential oils (EOs) from Thymus vulgaris and Lippia sidoides, as well as the monoterpenes thymol and thymol acetate, on Rhipicephalus microplus in laboratory conditions, and to select the most effective combination for testing in field conditions. The chemical analysis showed that EOs were mainly composed of monoterpenes, with thymol and p-cymene as the major compounds. In larval (LIT) and adult (AIT) immersion tests using different concentrations of the oils and terpenes mixed with amitraz, the results showed that both EOs and thymol improved the efficacy of amitraz against larvae and engorged females of R. microplus, whereas thymol acetate only enhanced activity against larvae. The most favorable outcome was obtained with the EO of L. sidoides combined with amitraz, resulting in 99 % and 100 % efficacy against larvae and engorged females, respectively. Furthermore, the combination of amitraz with thymol showed presented an efficacy of 94 % and 91 % against larvae and engorged females, respectively. Thus, for the other tests, the combination of thymol + amitraz was chosen due to the ease of working with pure thymol in bioassays, and easier standardization. The immersion test (thymol + amitraz) with semi-engorged females showed 100 % efficacy for the combination of thymol + amitraz, while in tests with different solvents (thymol + amitraz), ethanol being the most effective solvent among those tested (ethanol, Triton, and Tween), resulting in 95 % efficacy on engorged females. In the field test, in treatments with amitraz and thymol + amitraz, efficacy of 54 % and 74 % was observed on day + 3 and 33 % and 43 % on day + 7, respectively. Assessing the reproductive biology of females recovered from animals treated with amitraz or amitraz + thymol, in day + 7, efficacies of 33 % and 52 %, respectively, were observed. EOs from T. vulgaris and L. sidoides and thymol improved the acaricidal activity of amitraz on larvae and engorged females of R. microplus under laboratory conditions, while thymol acetate only enhanced activity against larvae. Thymol increased the efficacy of amitraz under field conditions, however for the development of a commercially available acaricide to R. microplus control, additional studies are needed to increase the efficacy. Further research is needed (by changing concentrations, adding other compounds and/or developing formulations) to increase acaricidal efficacy and develop new effective products to combat R. microplus infestations in cattle.
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Acaricidas , Lippia , Óleos Voláteis , Rhipicephalus , Thymus (Planta) , Feminino , Animais , Bovinos , Óleos Voláteis/farmacologia , Óleos Voláteis/química , Timol/farmacologia , Timol/química , Lippia/química , Monoterpenos/farmacologia , Larva , Acaricidas/farmacologia , Acaricidas/químicaRESUMO
Anthropogenic activities are regarded as point sources of pollution entering freshwater bodies worldwide. With over 350,000 chemicals used in manufacturing, wastewater treatment and industrial effluents are comprised of complex mixtures of organic and inorganic pollutants of known and unknown origins. Consequently, their combined toxicity and mode of action are not well understood in aquatic organisms such as Daphnia magna. In this study, effluent samples from wastewater treatment and industrial sectors were used to examine molecular-level perturbations to the polar metabolic profile of D. magna. To determine if the industrial sector and/or the effluent chemistries played a role in the observed biochemical responses, Daphnia were acutely (48 h) exposed to undiluted (100%) and diluted (10, 25, and 50%) effluent samples. Endogenous metabolites were extracted from single daphnids and analyzed using targeted mass spectrometry-based metabolomics. The metabolic profile of Daphnia exposed to effluent samples resulted in significant separation compared to the unexposed controls. Linear regression analysis determined that no single pollutant detected in the effluents was significantly correlated with the responses of metabolites. Significant perturbations were uncovered across many classes of metabolites (amino acids, nucleosides, nucleotides, polyamines, and their derivatives) which serve as intermediates in keystone biochemical processes. The combined metabolic responses are consistent with oxidative stress, disruptions to energy metabolism, and protein dysregulation which were identified through biochemical pathway analysis. These results provide insight into the molecular processes driving stress responses in D. magna. Overall, we determined that the metabolic profile of Daphnia could not be predicted by the chemical composition of environmentally relevant mixtures. The findings of this study demonstrate the advantage of metabolomics in conjunction with chemical analyses to assess the interactions of industrial effluents. This work further demonstrates the ability of environmental metabolomics to characterize molecular-level perturbations in aquatic organisms exposed to complex chemical mixtures directly.
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Aminoácidos , Poluentes Químicos da Água , Animais , Aminoácidos/metabolismo , Daphnia , Metabolômica/métodos , Metaboloma , Estresse Oxidativo , Organismos Aquáticos , Poluentes Químicos da Água/análiseRESUMO
The aim of this study was to evaluate the reproductive biology and histopathology of the ovaries of engorged females of Rhipicephalus sanguineus sensu lato exposed to combinations of thymol and eugenol, as well as to evaluate in silico the possible interactions of thymol and eugenol in tick cell membranes. To evaluate the tick reproductive biology, the adult immersion test (AIT) was performed, in which the engorged females were immersed in solutions of thymol and eugenol, combined or alone, at concentrations of 2.5 and 5.0 mg/mL. Two control groups (water and 3% DMSO) were also performed. The ticks were kept in a controlled chamber (B.O.D - 27 ± 1 °C and 80% ± 5% RH) to evaluate egg production and viability. To perform the ovaries histopathological evaluation, females were immersed in combination of thymol and eugenol (each at 2.5 and 5.0 mg/mL) and control (water and 3% DMSO) solutions. After immersion, the females were kept in B.O.D (27 ± 1 °C and RH of 80% ± 5%) for four days, they were dissected and the ovaries processed for histological analysis. In addition, an in silico analysis was performed using PASS online® software to predict probability activity (PA) of thymol and eugenol in cell membranes. The treatment with the combination of thymol and eugenol (each at 5.0 mg/mL) caused a reduction (p < 0.01) in oviposition, while the treatments with thymol (5.0 mg/mL) and combination of thymol and eugenol (5.0 mg/mL) reduced (p < 0.05) the egg viability. The treatment with combination of thymol and eugenol (5.0 mg/mL) resulted in a control percentage of 99.9%, while in the other treatments, control percentages below 56% were observed. Oocytes from the females exposed to the combinations of thymol and eugenol (each compound at 2.5 mg/mL) showed histopathological changes, except on oocyte V, while those treated with these compounds alone at 2.5 mg/mL, did not reveal any change. Changes in the shape of the oocyte, presence of vacuoles in the cytoplasm and germinal vesicle, reduction and fusion of yolk granules and rupture of some oocytes were observed. In silico analysis, showed that these compounds can act as membrane permeability inhibitors, membrane permeability agonists, membrane integrity antagonists and apoptosis agonists. We conclude that the combination of thymol and eugenol causes changes in the reproductive biology and morphophysiology of engorged females oocytes. The in silico analysis using thymol and eugenol revealed the possibility of disorganization in the cell membranes, a fact that may explain the histopathological alterations observed.
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Acaricidas , Rhipicephalus sanguineus , Rhipicephalus , Feminino , Animais , Timol/farmacologia , Eugenol/farmacologia , Dimetil Sulfóxido , Acaricidas/farmacologiaRESUMO
The present study compared the efficacy of different methods to apply an acaricide formulation to control Rhipicephalus (Boophilus) microplus. To compare the methods, an acaricide blend containing three active ingredients (a pyrethroid and two organophosphates) was used. In experiment 1 (farm 1: Goiânia, GO, Brazil), three methods were tested: a backpack sprayer (BS), power sprayer (PS) and spray race (SR). In experiment 2 (farm 2: São José do Rio Pardo, SP, Brazil), two methods were tested: BS and PS. In both experiments, 10 cattle with similar tick burdens were used. On day 0 in both experiments, the animals were treated with the acaricide. On day +1 (only in experiment 1), +3, +7, +14, +21, +28 and +35 (only in experiment 2), tick counts were performed to determine the control efficacy. The time application, pressure (KPa), volume applied (L) and ergonomic aspects of each spraying system were also evaluated. The adult immersion test (AIT) using three different acaricide blends (combinations of pyrethroid + organophosphate) was performed to compare the susceptibility of strains of each farm. In experiment 1, all treatments significantly reduced (p < 0.05) the number of ticks on the animals, and PS resulted in the greatest acaricide efficacy since day +1. In experiment 2, both treatments (PS and BS) reduced (p < 0.05) the tick burden, and as observed in experiment 1, PS resulted in the best reduction. The application times were 4.5, 150 and 330 s, while pressures were 306.8, 4,826.3 and 220.6 KPa for SR, PS and BS, respectively. In the AIT, the efficacy values were between 99.8 and 100% for the tick strain form farm 1 (Goiânia), while for tick strain from farm 2 (São José do Rio Pardo), the efficacy was between 67.2 and 80.9%. We conclude that the sprayer methods chosen influences the efficacy of the acaricide. All sprayer methods were efficient for acaricide application; the best efficacy was obtained using the PS, while the SR resulted in good efficacy and lower application time. The strain from farm 2 was less susceptible to all acaricides tested.
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Acaricidas , Doenças dos Bovinos , Piretrinas , Rhipicephalus , Infestações por Carrapato , Animais , Bovinos , Acaricidas/farmacologia , Piretrinas/farmacologia , Organofosfatos , Brasil , Doenças dos Bovinos/prevenção & controle , Infestações por Carrapato/prevenção & controle , Infestações por Carrapato/veterináriaRESUMO
INTRODUCTION: Age-related white matter hyperintensities (ARWMHs) on brain magnetic resonance imaging have been associated with lower urinary tract symptoms/dysfunction (LUTS/LUTD), namely overactive bladder (OAB) and detrusor overactivity. We aimed to systematically review existing data on the association between ARWMH and LUTS and which clinical tools have been used for this assessment. MATERIALS AND METHODS: We searched PubMed/MEDLINE, Cochrane Library, and clinicaltrials.gov (from 1980 to November 2021) and considered original studies reporting data on ARWMH and LUTS/LUTD in patients of both sexes aged 50 or above. The primary outcome was OAB. We calculated the unadjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for the outcomes of interest using random-effects models. RESULTS: Fourteen studies were included. LUTS assessment was heterogeneous and mainly based on the use of nonvalidated questionnaires. Urodynamics assessment was reported in five studies. ARWMHs were graded using visual scales in eight studies. Patients with moderate-to-severe ARWMHs were more likely to present with OAB and urgency urinary incontinence (UUI; OR = 1.61; 95% CI: 1.05-2.49, p = 0.03), I2 = 21.3%) when compared to patients with similar age and absent or mild ARWMH. DISCUSSION AND CONCLUSIONS: High-quality data on the association between ARWMH and OAB is scarce. Patients with moderate to severe ARWMH showed higher levels of OAB symptoms, including UUI, when compared to patients with absent or mild ARWMH. The use of standardized tools to assess both ARWMH and OAB in these patients should be encouraged in future research.
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Sintomas do Trato Urinário Inferior , Bexiga Urinária Hiperativa , Incontinência Urinária , Substância Branca , Masculino , Feminino , Humanos , Substância Branca/diagnóstico por imagem , Incontinência Urinária/complicações , Sintomas do Trato Urinário Inferior/diagnóstico , Inquéritos e QuestionáriosRESUMO
Objetivo: Identificar o perfil ginecológico e obstétrico de mulheres que realizam o exame Papanicolau em uma população do Nordeste, Brasil. Métodos: Estudo descritivo com abordagem quantitativa, realizado em unidades básicas de saúde entre os anos de 2014 e 2018. Resultados: Do total de 724 mulheres atendidas, 33,7% (n=244) tinham idade ≥48 anos e 64,2% (n=465) se autodeclararam pardas. A faixa etária mais prevalente da menarca foi de 13 a 15 anos, com 46,1% (n=334), e a da coitarca foi de 16 a 18 anos, com 39,1% (n=283). Os dados ainda evidenciaram que 58,6% (n=424) tiveram de 1 a 5 gestações e 32% (n=232) relataram a primeira gestação entre 18 e 21 anos. Conclusão: Conhecer o perfil desta população é de suma importância para identificação das principais vulnerabilidades do grupo, de modo que as estratégias de promoção, proteção e recuperação da saúde sejam condizentes com a realidade vivenciada por essas mulheres (AU).
Objective: To identify the gynecological and obstetrical profile of women who undergo the Pap smear in a population in Northeast Brazil. Methods: Descriptive study with a quantitative approach, carried out in basic health units between 2014 and 2018. Results: Of the total of 724 women assisted, 33.7% (n=244) were aged ≥48 years and 64.2% (n=465) self-declared brown. The most prevalent age group at menarche was 13 to 15 years old, with 46.1% (n=334), and that of coitarche was 16 to 18 years old, with 39.1% (n=283). The data also showed that 58.6% (n=424) had 1 to 5 pregnancies and 32% (n=232) reported their first pregnancy between 18 and 21 years old. Conclusion: Knowing the profile of this population is of paramount importance for identifying the main vulnerabilities of the group, so that health promotion, protection and recovery strategies are consistent with the reality experienced by these women (AU).
Objetivo: Identificar el perfil ginecoobstétrico de mujeres que se realizan el Papanicolaou en una población del Nordeste de Brasil. Métodos: Estudio descriptivo con abordaje cuantitativo, realizado en unidades básicas de salud entre 2014 y 2018. Resultados: Del total de 724 mujeres atendidas, 33,7% (n=244) tenían edad ≥48 años y 64,2% (n=465) marrón autodeclarado. El grupo etario más prevalente de menarquia fue de 13 a 15 años, con 46,1% (n=334), y el de coitarquia fue de 16 a 18 años, con 39,1% (n=283). Los datos también mostraron que el 58,6% (n=424) tuvo de 1 a 5 embarazos y el 32% (n=232) reportó su primer embarazo entre los 18 y los 21 años. Conclusión: Conocer el perfil de esta población es de suma importancia para identificar las principales vulnerabilidades del grupo, para que las estrategias de promoción, protección y recuperación de la salud sean acordes a la realidad que viven estas mujeres (AU).
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Neoplasias do Colo do Útero , Saúde da Mulher , Enfermagem , Centros de Saúde , Teste de PapanicolaouRESUMO
Amblyomma sculptum is a species of public health interest because it is associated with the transmission of the bacteria that causes Brazilian Spotted Fever (BSF). The use of repellents on humans is a prophylactic measure widely used to provide protection against a series of arthropod vectors, including mosquitoes and ticks. However, in Brazil, the effectiveness of commercial repellents against A. sculptum is little known. Therefore, it is necessary to carry out specific studies to evaluate the repellency of these commercial products, registered for use against mosquitoes, against the star tick. The main goal of the present work was to evaluate the effectiveness of six commercial repellents against A. sculptum. Unfed nymphs, aged between two and eight weeks, were tested against products based on DEET (OFF!® and Repelex®), Icaridin (Exposis® and SBP®), and IR3535 (Johnsons and Henlau). Three bioassays were conducted to evaluate tick behavior: (i) filter paper, (ii) fingertip, and (iii) field. All bases tested showed high repellent activity, differing significantly (p < 0.05) from the control. It was observed the formulation with DEET resulted in the best results in the filter paper bioassay. In the fingertip bioassay, the DEET base repelled a greater number of ticks compared to Icaridin. In the field bioassay, there was no significant difference between the Icaridin base and DEET, and both formulations differed from the control (p < 0.05). The six formulations tested showed significant percentages of repellency against ticks; however, for the fingertip and field bioassays, the products OFF!®, Repelex®, and Exposis® were tested as they showed better performance in the filter paper test. OFF!® showed the best percentage of repellency (100%), followed by Repelex® (96.8%), and Exposis® (93.1%), considering the two-hour period of the bioassay-field-test. Proving the effectiveness of repellents on the market against A. sculptum presented in this study is crucial, since this is the main ectoparasite of humans that can transmit Rickettsia rickettsii when infected. The effectiveness of commercial insect repellents against other tick species that parasitize humans can also be explored.
RESUMO
INTRODUCTION: the complex regional pain syndrome type II, also called causalgia, is a rare clinical condition that appears after a traumatic or surgical event with evidence of nervous system involvement. Its clinical presentation is the consequence of a multifactorial pathogenic process that involves peripheral and central mechanisms and has variable clinical manifestations. We present the photographic record of a patient with complex regional syndrome type II. CLINICAL CASE: 43-year-old patient who consulted for neuropathic pain during the last four years, of severe intensity, associated with sensory, vasomotor and trophic changes in the right upper limb, as a consequence of neurectomy of the palmar digital nerves of the third finger. CONCLUSION: achieving the photographic record of the clinical phases of complex regional pain syndrome type II in its entirety is difficult, because not all patients present all clinical phases, a fact that gives relevance to this case.
INTRODUCCIÓN: el síndrome doloroso regional complejo (SDRC) tipo II, también llamado causalgia, es una condición clínica poco frecuente que aparece después de un evento traumático o quirúrgico con evidencia de afectación del sistema nervioso. Su presentación clínica es consecuencia de un proceso patogénico multifactorial que involucra mecanismos periféricos y centrales y tiene manifestaciones clínicas variables. Presentamos el registro fotográfico de un paciente con síndrome regional complejo tipo II. CASO CLÍNICO: paciente de 43 años que consultó por dolor neuropático durante los últimos cuatro años, de intensidad severa, asociado a cambios sensoriales, vasomotores y tróficos en miembro superior derecho, como consecuencia de neurectomía de los nervios digitales palmares propios del tercer dedo. CONCLUSIÓN: lograr el registro fotográfico de las fases clínicas del SDRC tipo II en su totalidad resulta difícil, debido a que no todos los pacientes presentan todas las fases clínicas; hecho que otorga la relevancia a este caso.
Assuntos
Causalgia , Humanos , Adulto , Extremidade Superior/cirurgia , Síndrome , Progressão da DoençaRESUMO
From 2016-2019, dry bulb onions were the suspected cause of three multistate outbreaks in the United States. We investigated a large multistate outbreak of Salmonella Newport infections that caused illnesses in both the United States and Canada in 2020. Epidemiologic, laboratory and traceback investigations were conducted to determine the source of the infections, and data were shared among U.S. and Canadian public health officials. We identified 1127 U.S. illnesses from 48 states with illness onset dates ranging from 19 June to 11 September 2020. Sixty-six per cent of ill people reported consuming red onions in the week before illness onset. Thirty-five illness sub-clusters were identified during the investigation and seventy-four per cent of sub-clusters served red onions to customers during the exposure period. Traceback for the source of onions in illness sub-clusters identified a common onion grower in Bakersfield, CA as the source of red onions, and onions were recalled at this time. Although other strains of Salmonella Newport were identified in environmental samples collected at the Bakersfield, CA grower, extensive environmental and product testing did not yield the outbreak strain. This was the third largest U.S. foodborne Salmonella outbreak in the last 30 years. It is the first U.S. multistate outbreak with a confirmed link to dry bulb onions, and it was nearly 10-fold larger than prior outbreaks with a suspected link to onions. This outbreak is notable for its size and scope, as well as the international data sharing that led to implication of red onions as the primary cause of the outbreak. Although an environmental assessment at the grower identified several factors that likely contributed to the outbreak, no main reason was identified. The expedient identification of the outbreak vehicle and response of multiple public health agencies allowed for recall and removal of product from the marketplace, and rapid messaging to both the public and industry on actions to protect consumers; these features contributed to a decrease in cases and expeditious conclusion of the outbreak.
Assuntos
Contaminação de Alimentos , Cebolas , Infecções por Salmonella , Salmonella enterica , Humanos , Canadá/epidemiologia , Surtos de Doenças , Cebolas/microbiologia , Salmonella , Infecções por Salmonella/epidemiologia , Estados Unidos/epidemiologiaRESUMO
Objective: This pilot study aimed to evaluate the characteristic signs and symptoms of chronic vulvovaginitis after blue light-emitting diode (LED) treatment. Methods: Women with characteristic signs and symptoms of vulvovaginitis were interviewed to obtain clinical and sociodemographic data. They answered the Female Sexual Function Index (FSFI) and the World Health Organization Quality of Life (WHOQOL)-bref questionnaires. Women with a suspected diagnosis of vulvovaginitis underwent clinical examination by a gynecologist, followed by microbiological evaluation, potassium hydroxide testing, vaginal pH assessment, and collection of vaginal fluid for oncotic cytology and fungal culture. The study participants were instructed to return after 15 days to undergo the 405 nm blue LED treatment, which consisted of three biweekly sessions. After 28 days of treatment completion, the patients returned for clinical re-evaluation and reassessment of the FSFI and WHOQOL-bref scores. Results: All eight women reported improvement or cure of at least one characteristic sign or symptom of vulvovaginitis, and five showed improvement in total FSFI and WHOQOL-bref scores. Conclusions: Treatment with blue LED may improve or cure symptoms associated with vulvovaginitis, sexual function, and the global quality of life score. Clinical Trial registration: NCT03075046 dated March 9, 2017.