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1.
Med Oral Patol Oral Cir Bucal ; 25(4): e461-e467, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32388527

RESUMO

BACKGROUND: As third molar surgery is the most commonly procedure performed in Dentistry and has been accompanied by serious postoperative disorders such as pain, edema and trismus, the study aimed to evaluate if ultrasound device would be able to reduce such postoperative features. The aim of this study was to assess the effects of soft tissue flap elevation, osteotomy and odontosection using piezosurgery versus conventional technique in mandibular third molar extractions. MATERIAL AND METHODS: Twenty patients with impacted mandibular third molars underwent tooth extractions using two different methods. Ten patients were included in the Piezo Flap Group (PFG - the flap was elevated using piezosurgery) and ten patients were part of the Piezo Ostectomy Group (POG - osteotomy and odontosection were carried out with ultrasound tips). The contralateral tooth was included in the Control Group (CG - conventional technique). The patients were evaluated at postoperative periods of 1, 3, 7 and 14-days. The measured parameters were duration of surgery, pain, trismus and swelling. RESULTS: The mean duration of surgery for the PFG was 17.21 minutes (CG 10.07 minutes) and POG was 40.09 minutes (CG 15.97 minutes). There was no statistically significant difference in pain and trismus for any of the postoperative periods evaluated in PFG and POG (p>0.05). There was a statistically significant difference in swelling between the PFG and POG, presenting less swelling at the 3-day postoperative period (p=0.038; p<0,05). However, for the remaining analyzed periods there was no difference (p>0.05). CONCLUSIONS: Piezosurgery for tissue elevation of the surgical flap, osteotomy and dental sectioning in mandibular third molar extraction surgery promoted less edema in the early postoperative stages in mandibular third molar extractions despite the longer surgical duration.


Assuntos
Osteotomia , Dor Pós-Operatória , Retalhos Cirúrgicos , Dente Impactado , Edema , Humanos , Dente Serotino , Boca , Estudos Prospectivos , Extração Dentária , Trismo
2.
Int Endod J ; 52(5): 588-603, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30387864

RESUMO

The aim of this systematic review and meta-analysis was to evaluate whether the use of calcium hydroxide (CH) liner improves the clinical success in the treatment of deep caries lesions of primary and permanent teeth. The review was reported in accordance with the PRISMA Statement. Only studies that evaluated deep carious lesions treated with and without a CH liner were included. The required outcomes had to be obtained by clinical, radiographic or laboratory evaluations. Statistical analyses were performed with the RevMan 5.2 program (The Cochrane Collaboration, Copenhagen, Denmark) for randomized clinical trials with at least 12 months of follow-up, using fixed-effect models at a significance level of P < 0.05. The literature search was performed in eight databases: PubMed (MEDLINE), Lilacs, IBECS, BBO, Web of Science, Scopus, SciELO and The Cochrane Library. A total of 17 studies were included (15 in primary teeth, two in permanent teeth). The overall risk difference for CH versus adhesive system in primary teeth was 0.06 [95% CI -0.01 to 0.13], and the overall risk difference for CH versus GIC was 0.10 [95% CI -0.01 to 0.22], with no significant differences between materials. CH liner did not influence the clinical success of treatment for deep caries lesions of primary or permanent teeth. Although the present analysis demonstrated that use of CH liner in deep caries lesions was unnecessary, the evidence was of moderate to very low quality; thus, further well-designed, randomized and controlled clinical trials are necessary to provide stronger recommendations.


Assuntos
Hidróxido de Cálcio , Cárie Dentária , Dinamarca , Dentição Permanente , Humanos , Dente Decíduo
3.
Chaos ; 29(10): 103135, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31675799

RESUMO

The conventional impedance profile of a neuron can identify the presence of resonance and other properties of the neuronal response to oscillatory inputs, such as nonlinear response amplifications, but it cannot distinguish other nonlinear properties such as asymmetries in the shape of the voltage response envelope. Experimental observations have shown that the response of neurons to oscillatory inputs preferentially enhances either the upper or lower part of the voltage envelope in different frequency bands. These asymmetric voltage responses arise in a neuron model when it is submitted to high enough amplitude oscillatory currents of variable frequencies. We show how the nonlinearities associated to different ionic currents or present in the model as captured by its voltage equation lead to asymmetrical response and how high amplitude oscillatory currents emphasize this response. We propose a geometrical explanation for the phenomenon where asymmetries result not only from nonlinearities in their activation curves but also from nonlinearites captured by the nullclines in the phase-plane diagram and from the system's time-scale separation. In addition, we identify an unexpected frequency-dependent pattern which develops in the gating variables of these currents and is a product of strong nonlinearities in the system as we show by controlling such behavior by manipulating the activation curve parameters. The results reported in this paper shed light on the ionic mechanisms by which brain embedded neurons process oscillatory information.

4.
J Viral Hepat ; 25(1): 28-36, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28719060

RESUMO

This study estimated latent classes (ie, unobserved subgroups in a population) of people who use drugs in Vancouver, Canada, and examined how these classes relate to phylogenetic clustering of hepatitis C virus (HCV) infection. HCV antibody-positive people who use drugs from two cohorts in Vancouver, Canada (1996-2012), with a Core-E2 sequence were included. Time-stamped phylogenetic trees were inferred, and phylogenetic clustering was determined by time to most common recent ancestor. Latent classes were estimated, and the association with the phylogenetic clustering outcome was assessed using an inclusive classify/analyse approach. Among 699 HCV RNA-positive participants (26% female, 24% HIV+), recent drug use included injecting cocaine (80%), injecting heroin (70%), injecting cocaine/heroin (ie, speedball, 38%) and crack cocaine smoking (28%). Latent class analysis identified four distinct subgroups of drug use typologies: (i) cocaine injecting, (ii) opioid and cocaine injecting, (iii) crack cocaine smoking and (iv) heroin injecting and currently receiving opioid substitution therapy. After adjusting for age and HIV infection, compared to the group defined by heroin injecting and currently receiving opioid substitution therapy, the odds of phylogenetic cluster membership was greater in the cocaine injecting group (adjusted OR [aOR]: 3.06; 95% CI: 1.73, 5.42) and lower in the crack cocaine smoking group (aOR: 0.06; 95% CI: 0.01, 0.48). Combining latent class and phylogenetic clustering analyses provides novel insights into the complex dynamics of HCV transmission. Incorporating differing risk profiles associated with drug use may provide opportunities to further optimize and target HCV treatment and prevention strategies.


Assuntos
Análise por Conglomerados , Variação Genética , Hepacivirus/classificação , Hepacivirus/isolamento & purificação , Hepatite C/virologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Canadá/epidemiologia , Estudos de Coortes , Feminino , Genótipo , Hepacivirus/genética , Hepatite C/epidemiologia , Humanos , Masculino , Epidemiologia Molecular , Filogenia , Adulto Jovem
5.
Helminthologia ; 55(2): 140-145, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31662640

RESUMO

We tested the role of sex, size, and mass of the lizards Phyllopezus pollicaris, Gymnodactylus geckoides, Hemidactylus agrius, Lygodactylus klugei, and Hemidactylus brasilianus on the rates of pentastomid infection in the Brazilian Caatinga. We collected 355 individuals of these five species, of which four (prevalence of infection: P. pollicaris 15.9 %, G. geckoides 1.4 %, H. agrius 28.57 %, and H. brasilianus 4.16 %) were infected by Raillietiella mottae. Parasite abundance was influenced by host body size and mass only in P. pollicaris. Host sex did not infl uence the abundance of parasites in any species. Hemidactylus agrius, G. geckoides, and H. brasilianus are three new host records for pentastomids.

6.
HIV Med ; 18(5): 342-353, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27704659

RESUMO

OBJECTIVES: The World Health Organization (WHO)'s HIV drug resistance (HIVDR) early warning indicators (EWIs) measure antiretroviral therapy (ART)-site factors associated with HIVDR prevention, without HIVDR laboratory testing. We assessed the relationship between EWIs and HIVDR acquisition using data from British Columbia, Canada. METHODS: Eligible patients were ART-naïve, were ≥ 19 years old, had initiated ART between 1 January 2000 and 31 December 2012, had ≥ 15 months of follow-up, and were without transmitted HIVDR. Patients were followed for acquired HIVDR until 31 March 2014, the last contact date, or death. We built logistic regression models to assess the associations and predictive ability of individual indicators and of the EWI Score (the number of indicators for which a patient did not meet the criteria) on HIVDR acquisition (to any class of HIVDR, lamivudine (3TC)/emtricitabine (FTC), nonnucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs) or protease inhibitors (PIs)]). RESULTS: All explored EWIs were associated with at least one class of HIVDR, with the exception of 'ART prescribing practices'. We observed a dose-response relationship between acquiring HIVDR to any antiretroviral class and an increasing EWI score in our predictive logistic regression model. The area under the curve was 0.848 (excellent discrimination). The adjusted odds ratios for acquiring any class of HIVDR for an EWI score of 1, 2 and ≥ 3 versus 0 were 2.30 [95% confidence Interval (CI) 1.21-4.38], 3.35 (95% CI: 1.86-6.03) and 7.26 (95% CI: 4.18-12.61), respectively. CONCLUSIONS: Several EWIs were associated with and predictive of HIVDR, supporting the WHO EWIs as a component of the HIVDR prevention method in settings where HIVDR testing is not routinely or widely available.


Assuntos
Técnicas de Apoio para a Decisão , Farmacorresistência Viral , Infecções por HIV/virologia , HIV/efeitos dos fármacos , Adulto , Idoso , Colúmbia Britânica , Seguimentos , Humanos , Pessoa de Meia-Idade , Organização Mundial da Saúde , Adulto Jovem
7.
HIV Med ; 18(3): 151-160, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27385643

RESUMO

OBJECTIVES: To document the quality of initial HIV care in Canada using the Programmatic Compliance Score (PCS), to explore the association of the PCS with mortality, and to identify factors associated with higher quality of care. METHODS: We analysed data from the Canadian Observational Cohort Collaboration (CANOC), a multisite Canadian cohort of HIV-positive adults initiating combination antiretroviral therapy (ART) from 2000 to 2011. PCS indicators of noncompliance with HIV treatment guidelines include: fewer than three CD4 count tests in the first year of ART; fewer than three viral load tests in the first year of ART; no drug resistance testing before initiation; baseline CD4 count < 200 cells/mm3 ; starting a nonrecommended ART regimen; and not achieving viral suppression within 6 months of initiation. Indicators are summed for a score from 0 to 6; higher scores indicate poorer care. Cox regression was used to assess the association between PCS and mortality and ordinal logistic regression was used to explore factors associated with higher quality of care. RESULTS: Of the 7460 participants (18% female), the median score was 1.0 (Q1-Q3 1.0-2.0); 21% scored 0 and 8% scored ≥ 4. In multivariable analysis, compared with a score of 0, poorer PCS was associated with mortality for scores > 1 [score = 2: adjusted hazard ratio (AHR) 1.64; 95% confidence interval (CI) 1.13-2.36; score = 3: AHR 2.02; 95% CI 1.38-2.97; score ≥ 4: AHR 2.14; 95% CI 1.43-3.21], after adjustments for age, sex, province, ART start year, hepatitis C virus (HCV) coinfection, and baseline viral load. Women, individuals with HCV coinfection, younger people, and individuals starting ART earlier (2000-2003) had poorer scores. CONCLUSIONS: Our findings further validate the PCS as a predictor of all-cause mortality. Disparities identified suggest that further efforts are needed to ensure that care is equitably accessible.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Pesquisa sobre Serviços de Saúde , Qualidade da Assistência à Saúde , Canadá , Infecções por HIV/mortalidade
8.
Parasite Immunol ; 39(12)2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28929503

RESUMO

We aimed to induce and inhibit HO-1, ascertaining its effect on infection rate, parasite load and the levels of superoxide, reactive oxygen species (ROS), nitric oxide (NO), TNF-alpha and IL-10 in cultured macrophages from healthy dogs infected by Leishmania infantum. Macrophages obtained from 15 healthy dogs were cultured alone or infected with L. infantum, with or without association of HO-1 inducer and inhibitor. The infection rate and the parasite load were determined by the number of infected macrophages and number of promastigotes per macrophage, respectively. HO-1 levels and gene expression, as well as IL-10 and TNF-alpha levels were also measured in these cultures. Superoxide, ROS and NO levels in macrophages were measured through flow cytometry. Induction of HO-1 increased the infection rate and parasite load, while its inhibition decreased the infection rate and IL-10 production. There was a positive correlation between HO-1 and infection rate or parasite load. Increased infection rate was associated with decreased superoxide, ROS and NO levels. Induction of HO-1 metabolism in dogs infected by L. infantum is possibly one of the mechanisms responsible for increasing the infection of macrophages, mainly through reduction in the oxidative and nitrosative metabolisms of these cells.


Assuntos
Heme Oxigenase-1/metabolismo , Leishmania infantum/fisiologia , Leishmaniose Visceral/veterinária , Macrófagos/parasitologia , Carga Parasitária , Animais , Células Cultivadas , Doenças do Cão/parasitologia , Cães , Expressão Gênica , Heme Oxigenase-1/antagonistas & inibidores , Interleucina-10/genética , Interleucina-10/metabolismo , Óxido Nítrico/metabolismo , Superóxidos/metabolismo , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo
9.
Parasite Immunol ; 39(11)2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28929498

RESUMO

Visceral leishmaniosis is a zoonotic disease that is transmitted by Lutzomyia longipalpis sandflies. Dogs are the main peri-urban reservoir of the disease, and progression of canine leishmaniosis is dependent on the type of immune response elaborated against the parasite. Type 1 immunity is characterized by effective cellular response, with production of pro-inflammatory cytokines such as tumour necrosis factor alpha (TNF-α). In contrast, Type 2 immunity is predominantly humoral, associated with progression of the disease and mediated by anti-inflammatory cytokines such as interleukin 10 (IL-10). Although seemly important in the dynamics of leishmaniosis, other gene products such as toll-like receptor 2 (TRL-2) and inducible nitric oxide synthase (iNOS) exert unclear roles in the determination of the type of immune response. Given that the dog skin serves as a micro-environment for the multiplication of Leishmania spp., we investigated the parasite load and the expression of TLR-2, iNOS, IL-10 and TNF-α in the skin of 29 infected and 8 control dogs. We found that increased parasite load leads to upregulation of TLR-2, IL-10 and TNF-α, indicating that abundance of these transcripts is associated with infection. We also performed a xenodiagnosis to demonstrate that increased parasitism is a risk factor for infectiousness to sandflies.


Assuntos
Doenças do Cão/parasitologia , Interleucina-10/biossíntese , Leishmania infantum/imunologia , Leishmaniose Visceral/veterinária , Óxido Nítrico Sintase Tipo II/biossíntese , Receptor 2 Toll-Like/biossíntese , Fator de Necrose Tumoral alfa/biossíntese , Animais , Reservatórios de Doenças/parasitologia , Doenças do Cão/diagnóstico , Cães , Insetos Vetores/parasitologia , Interleucina-10/imunologia , Leishmania infantum/patogenicidade , Leishmaniose Visceral/parasitologia , Óxido Nítrico Sintase Tipo II/imunologia , Carga Parasitária , Psychodidae/parasitologia , Pele/parasitologia , Pele/patologia , Receptor 2 Toll-Like/imunologia , Fator de Necrose Tumoral alfa/imunologia , Zoonoses
10.
Epidemiol Infect ; 145(15): 3219-3225, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28903791

RESUMO

An outbreak of mumps within a student population in Scotland was investigated to assess the effect of previous vaccination on infection and clinical presentation, and any genotypic variation. Of the 341 cases, 79% were aged 18-24. Vaccination status was available for 278 cases of whom 84% had received at least one dose of mumps containing vaccine and 62% had received two. The complication rate was 5·3% (mainly orchitis), and 1·2% were admitted to hospital. Genetic sequencing of mumps virus isolated from cases across Scotland classified 97% of the samples as genotype G. Two distinct clusters of genotype G were identified, one circulating before the outbreak and the other thereafter, suggesting the virus that caused this outbreak was genetically different from the previously circulating virus. Whilst the poor vaccine effectiveness we found may be due to waning immunity over time, a contributing factor may be that the current mumps vaccine is less effective against some genotypes. Although the general benefits of the measles-mumps-rubella (MMR) vaccine should continue to be promoted, there may be value in reassessing the UK vaccination schedule and the current mumps component of the MMR vaccine.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Vacina contra Caxumba/uso terapêutico , Vírus da Caxumba/genética , Caxumba/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Surtos de Doenças/prevenção & controle , Feminino , Variação Genética/genética , Humanos , Masculino , Caxumba/imunologia , Caxumba/prevenção & controle , Caxumba/virologia , Vacina contra Caxumba/imunologia , Vírus da Caxumba/imunologia , Reação em Cadeia da Polimerase em Tempo Real , Escócia/epidemiologia , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-28748556

RESUMO

The aim of this multinational retrospective cohort study, conducted at academic and community oncology centres, was to describe real-world treatment patterns for patients with a confirmed diagnosis of advanced/metastatic (stage IIIB/IV) non-small cell lung cancer (NSCLC) who initiated first-line systemic therapy from January 2011 through June 2014. The study included 1265 patients in Italy, Spain, Germany, Australia, Korea, Taiwan and Brazil. The proportion of patients with squamous versus non-squamous NSCLC was approximately 20% versus 75%, and associated patient demographic characteristics were similar in all countries, excepting race. Patients with squamous NSCLC were predominantly male and current/ex-smokers. Biomarker tests were performed for the majority of patients with non-squamous NSCLC, ranging from 54% (Brazil) to 91% in Taiwan, where, of those tested, 68% with non-squamous NSCLC had positive epidermal growth factor receptor (EGFR)-mutation status; in other countries the EGFR-positive percentages ranged from 17% (Spain/Brazil) to 40% (Korea). Platinum-based regimens were the most common first-line therapy in all countries except Taiwan, where gefitinib was the most common first-line agent. Median overall survival ranged from 9.3 months (Brazil) to 25.5 months (Taiwan). The diagnostic and treatment patterns recorded in this study were heterogeneous but largely in line with NSCLC guidelines during the study period.


Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Padrões de Prática Médica , Inibidores de Proteínas Quinases/uso terapêutico , Adenocarcinoma/genética , Adenocarcinoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quinase do Linfoma Anaplásico , Austrália , Brasil , Carboplatina/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Cisplatino/administração & dosagem , Estudos de Coortes , Receptores ErbB/genética , Feminino , Alemanha , Humanos , Itália , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Mutação , Receptores Proteína Tirosina Quinases/genética , República da Coreia , Estudos Retrospectivos , Espanha , Taxa de Sobrevida , Taiwan
12.
Genet Mol Res ; 16(3)2017 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-28973743

RESUMO

The expansion of agriculture, coupled with the need for sustainable cropping, is one of the greatest challenges of the scientific community working on the generation of new cultivars adapted to abiotic stress conditions. The aim of this study was to evaluate the variability of popcorn lines as to responsiveness and efficiency in phosphorus use, as a first step towards the implementation of a breeding program interested in the practice of sustainable agriculture. Twenty-five popcorn lines were evaluated in two locations with different phosphorus levels in the soil, using a randomized block design. The following traits were measured: plant height, ear height, female flowering date, male flowering date, male-female flowering interval, ear diameter, ear length, 100-grain weight, grain yield, popping expansion, and expanded popcorn volume per hectare. A combined analysis of variance and test of means were performed, and the lines were classified as to their phosphorus use efficiency, according to their production performance in the different environments. The genetic diversity between the lines was estimated by Tocher's and UPGMA clustering methods, using generalized Mahalanobis distance. Lines L59, P7, P2, P3, P4, P8, P10, P9, L66, L70, L69, and P5 were efficient and responsive, whereas lines L75, L80, L61, L77, L63, L65, P1, L54, L53, L88, and L71 were inefficient and nonresponsive. Genetic variability was greater in the environments with low phosphorus in the soil, suggesting that the selection pressure exerted in the stressing environment is a decisive factor to obtain a higher expression of variability.


Assuntos
Grão Comestível/genética , Variação Genética , Fósforo/análise , Solo/química , Zea mays/genética , Meio Ambiente , Melhoramento Vegetal/métodos , Seleção Artificial , Estresse Fisiológico , Zea mays/classificação
13.
J Helminthol ; 91(3): 312-319, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27121487

RESUMO

Ecological characteristics and environmental variation influence both host species composition and parasite abundance. Abiotic factors such as rainfall and temperature can improve parasite development and increase its reproduction rate. The comparison of these assemblages between different environments may give us a more refined analysis of how environment affects the variation of helminth parasite abundance. The aim of the present study was to evaluate how temporal variation, host size, sex and reproduction affect helminth abundance in the Tropidurus hispidus lizard in Caatinga, Restinga and Atlantic Forest environments. Overall, larger-sized lizards showed higher helminth abundance. We found a monthly variation in the helminth species abundance in all studied areas. In the Caatinga area, monoxenic and heteroxenic parasites were related to the rainy season and to the reproductive period of lizards. In Restinga, monoxenic and heteroxenic helminth species were more abundant during the driest months. In the Atlantic Forest, the rainy and host reproductive season occurred continuously throughout the year, so parasite abundance was relatively constant. Nevertheless, heteroxenic species were more abundant in this area. The present results showed that the temporal variation, body size, sex, reproductive period and habitat type influence the abundance and composition of helminth species in T. hispidus.


Assuntos
Helmintíase Animal/parasitologia , Helmintos/classificação , Helmintos/isolamento & purificação , Lagartos/parasitologia , Carga Parasitária , Animais , Brasil , Exposição Ambiental , Análise Espaço-Temporal
14.
HIV Med ; 17(4): 269-79, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26216126

RESUMO

OBJECTIVES: The aim of the study was to explore non-HIV-related health care service (NHRHS) utilization, demographic, clinical and laboratory factors associated with timely initial "retention" in HIV care among individuals "linked" to HIV care in British Columbia (BC), Canada. METHODS: We conducted a Weibull time-to-initial-retention analysis among BC Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) cohort participants linked in 2000-2010, who had ≥ 1 year of follow-up. We defined "linked" as the first HIV-related service accessed following HIV diagnosis and "retained" as having, within a calendar year, either: (i) at least two HIV-related physician visits/diagnostic tests or (ii) at least two antiretroviral therapy (ART) dispensations, ≥ 3 months apart. Individuals were followed until they were retained, died, their last contact date, or until 31 December 2011, whichever occurred first. RESULTS: Of 5231 linked individuals (78% male; median age 39: (Q1-Q3: 32-46) years], 4691 (90%) were retained [median time to initial retention of 9 (Q1-Q3: 5-13) months] by the end of follow-up and 540 (10%) were not. Eighty-four per cent of not retained and 96% of retained individuals used at least one type of NHRHS during follow-up. Individuals who saw a specialist for NHRHS during follow-up had a shorter time to initial retention than those who did not [adjusted hazard ratio (aHR) 2.79; 95% confidence interval (CI): 2.47-3.16]. However, those who saw a general practitioner (GP) for NHRHS (aHR 0.79; 95% CI: 0.74-0.84) and those admitted to the hospital for NHRHS (aHR 0.60; 95% CI: 0.54-0.67), versus those who did/were not, respectively, had longer times to initial retention, as did female patients, people who inject drugs (PWID) and individuals < 40 years old. CONCLUSIONS: Overall, 84% of not retained individuals used some type of NHRHS during follow-up. Given that 71% of not retained individuals used GP NHRHS, our results suggest that GP-targeted interventions may be effective in improving time to initial retention.


Assuntos
Infecções por HIV/prevenção & controle , Adulto , Colúmbia Britânica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Fatores de Tempo
15.
HIV Med ; 17(9): 694-701, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27279453

RESUMO

OBJECTIVES: Since 2006, the British Columbia HIV/AIDS Drug Treatment Program (DTP) has expanded enrolment and dramatically increased its number of participants. We examined the effect this expansion has had on the underlying cause of death in HIV-infected individuals. METHODS: We analysed data from participants aged 18 years and older in the DTP to measure 2-year mortality rates and causes of death from 2001 to 2012. We conducted tests of trend for all-cause and cause-specific mortality, and compared demographics and characteristics of individuals. Cox proportional hazard models were used to determine the risk of death. RESULTS: A total of 8185 participants received antiretroviral therapy (ART) during the study period. Mortality declined from 3.88 per 100 person-years (PY) in 2001-2002 to 2.15 per 100 PY in 2011-2012 (P = 0.02). There were significant decreases in HIV-related deaths (2.34 to 0.56 per 100 PY; P = 0.02) and deaths attributable to chronic liver disease (0.20 to 0.09 per 100 PY; P = 0.01), cardiovascular disease (0.24 to 0.05 per 100 PY; P = 0.03) and suicides (0.47 to 0 per 100 PY; P = 0.003). Multivariate models, adjusted for age, gender, history of injecting drug use, AIDS diagnoses and baseline CD4 cell counts, demonstrated that initiation of ART in all time periods after 2001-2002 was independently associated with reduced mortality (P < 0.001). CONCLUSIONS: We observed declines in HIV-related mortality and certain non-HIV-related causes of death among participants in the BC DTP from 2001 to 2012. These findings suggest that there may be broader benefits to the increasingly liberal HIV treatment guidelines, including reductions in death caused by cardiovascular disease and chronic liver disease.


Assuntos
Antirretrovirais/uso terapêutico , Causas de Morte , Infecções por HIV/tratamento farmacológico , Infecções por HIV/mortalidade , Adolescente , Adulto , Colúmbia Britânica/epidemiologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise de Sobrevida , Adulto Jovem
16.
Parasite Immunol ; 38(11): 698-704, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27506591

RESUMO

Canine visceral leishmaniasis (CVL) is caused by the intracellular parasite Leishmania infantum. Increased levels of arginase, nitric oxide (NO2 ) and prostaglandin E2 (PGE2 ) can play a regulatory role regarding the immune response in CVL cases. This study aimed to evaluate the arginase activity in adherent macrophages cultured from the lymph nodes of healthy and naturally infected dogs and to examine the NO2 and PGE2 levels in the supernatant of these cultures. In addition, the regulatory effect of PGE2 on the production of tumour necrosis factor (TNF-α) and interleukin-10 (IL-10) in supernatants from the total lymph node was observed in leucocyte cultures. The arginase activity was lower in the adherent macrophages cultured from the lymph nodes of naturally infected dogs and there were higher concentrations of NO2 and PGE2 in the supernatants of these cultures. Higher TNF-α and IL-10 concentrations were observed in supernatants from total lymph node leucocytes cultures, from infected dogs, and the presence of indomethacin only decreased TNF-α in the supernatant of these cultures. We conclude that the low arginase activity in macrophages suggested that M1 polarization and PGE2 were participating in the immune response and were increasing TNF-α in CVL.


Assuntos
Dinoprostona/metabolismo , Doenças do Cão/imunologia , Cães/imunologia , Leishmania infantum/fisiologia , Leishmaniose Visceral/veterinária , Linfonodos/imunologia , Macrófagos/imunologia , Fator de Necrose Tumoral alfa/imunologia , Animais , Arginase/análise , Arginase/metabolismo , Dinoprostona/análise , Doenças do Cão/patologia , Leishmaniose Visceral/patologia , Linfonodos/citologia , Linfonodos/parasitologia , Linfonodos/patologia , Macrófagos/química , Óxido Nítrico/análise
17.
Genet Mol Res ; 15(2)2016 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-27173336

RESUMO

Molecular markers are a useful tool for identification of complementary heterotic groups in breeding programs aimed at the production of superior hybrids, particularly for crops such as popcorn in which heterotic groups are not well-defined. The objective of the present study was to analyze the genetic diversity of 47 genotypes of tropical popcorn to identify possible heterotic groups for the development of superior hybrids. Four genotypes of high genetic value were studied: hybrid IAC 125, strain P2, and varieties UENF 14 and BRS Angela. In addition, 43 endogamous S3 progenies obtained from variety UENF 14 were used. Twenty-five polymorphic SSR-EST markers were analyzed. A genetic distance matrix was obtained and the following molecular diversity parameters were estimated: number of alleles, number of effective alleles, polymorphism information content (PIC), observed and expected heterozygosities, Shannon diversity index, and coefficient of inbreeding. We found a moderate PIC and high diversity index, indicating that the studied population presents both good discriminatory ability and high informativeness for the utilized markers. The dendrogram built based on the dissimilarity matrix indicated six distinct groups. Our findings demonstrate the genetic diversity among the evaluated genotypes and provide evidence for heterotic groups in popcorn. Furthermore, the functional genetic diversity indicates that there are informative genetic markers for popcorn.


Assuntos
Vigor Híbrido/genética , Zea mays/genética , Alelos , Brasil , Produtos Agrícolas/genética , Etiquetas de Sequências Expressas , Marcadores Genéticos , Variação Genética , Genótipo , Heterozigoto , Repetições de Microssatélites , Melhoramento Vegetal/métodos , Polimorfismo Genético
18.
Genet Mol Res ; 15(4)2016 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-27966763

RESUMO

The successful development of hybrid cultivars depends on the reliability of estimated combining ability of the parent lines. The objectives of this study were to assess the combining ability of partially inbred S3 families of popcorn derived from the open-pollinated variety UENF 14, via top-crosses with four testers, and to compare the testers for their ability to discriminate the S3 progenies. The experiment was conducted in the 2015/2016 crop season, in an incomplete-block (Lattice) design with three replications. The following agronomic traits were evaluated: average plant height, grain yield (GY), popping expansion (PE), and expanded popcorn volume per hectare. The top-cross hybrid, originating from the BRS-Angela vs S3 progeny 10 combination, was indicated as promising, showing high values for specific combining ability for GY and PE. For the S3 progenies that showed high and positive GCA values for GY and PE, the continuity of the breeding program is recommended, with the advance of self-pollination generations. Fasoulas' differentiation index discriminated the BRS-Angela tester as the most suitable for identifying the superior progenies.


Assuntos
Cruzamentos Genéticos , Locos de Características Quantitativas , Zea mays/genética , Genótipo , Fenótipo
19.
HIV Med ; 16(6): 337-45, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25721157

RESUMO

OBJECTIVES: The aim of the study was to examine trends in initiating highly active antiretroviral therapy (HAART) with a CD4 count ≤ 200 cells/µL and the contribution of having a CD4 count ≤ 200 cells/µL at the time of diagnosis to these trends, in British Columbia (BC), Canada. METHODS: We included in the analysis treatment-naïve BC residents aged ≥ 19 years who initiated HAART from 2003 to 2012. Participants were classified as follows: Group 1: diagnosed and initiated HAART with a CD4 count > 200 cells/µL; Group 2: diagnosed with a CD4 count > 200 cells/µL and initiated HAART with a CD4 count ≤ 200 cells/µL; and Group 3: diagnosed and initiated HAART with a CD4 count ≤ 200 cells/µL. We measured trends in initiating HAART with a CD4 count ≤ 200 cells/µL and used logistic regression models to measure factors associated with initiating HAART with a CD4 count ≤ 200 cells/µL, stratified by having a CD4 count ≤ 200 cells/µL or > 200 cells/µL at the time of diagnosis. RESULTS: Between 2003 and 2012, 3506 BC residents initiated HAART. Of these, 44% (1558 of 3506) initiated HAART with a CD4 count ≤ 200 cells/µL. This proportion declined from 69% (198 of 287) in 2003 to 21% (81 of 330) in 2012 (P < 0.001). The proportion of those in Group 3 increased from 49% (97 of 198) in 2003 to 69% (56 of 81) in 2012 (P < 0.001). Overall, 56% (1948), 22% (776) and 22% (782) made up Groups 1, 2, and 3, respectively. In adjusted analyses, seeing a specialist was significantly associated with being in Group 3. Using injection drugs and seeing a specialist were associated with being in Group 2. CONCLUSIONS: In recent years, among individuals who ever initiated HAART in BC, being diagnosed with low CD4 cell counts has become a greater contributor to initiating HAART with low CD4 cell counts.


Assuntos
Terapia Antirretroviral de Alta Atividade/tendências , Contagem de Linfócito CD4 , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Adulto , Colúmbia Britânica , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
20.
Hepatology ; 60(5): 1571-1580, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25042607

RESUMO

UNLABELLED: Little is known about factors associated with hepatitis C virus (HCV) transmission among people who inject drugs (PWID). Phylogenetic clustering and associated factors were evaluated among PWID in Vancouver, Canada. Data were derived from the Vancouver Injection Drug Users Study. Participants who were HCV antibody-positive at enrolment and those with HCV antibody seroconversion during follow-up (1996 to 2012) were tested for HCV RNA and sequenced (Core-E2 region). Phylogenetic trees were inferred using maximum likelihood analysis and clusters were identified using ClusterPicker (90% bootstrap threshold, 0.05 genetic distance threshold). Factors associated with clustering were assessed using logistic regression. Among 655 eligible participants, HCV genotype prevalence was: G1a: 48% (n=313), G1b: 6% (n=41), G2a: 3% (n=20), G2b: 7% (n=46), G3a: 33% (n=213), G4a: <1% (n=4), G6a: 1% (n=8), G6e: <1% (n=1), and unclassifiable: 1% (n=9). The mean age was 36 years, 162 (25%) were female, and 164 (25%) were HIV+. Among 501 participants with HCV G1a and G3a, 31% (n=156) were in a pair/cluster. Factors independently associated with phylogenetic clustering included: age <40 (versus age≥40, adjusted odds ratio [AOR]=1.64; 95% confidence interval [CI] 1.03, 2.63), human immunodeficiency virus (HIV) infection (AOR=1.82; 95% CI 1.18, 2.81), HCV seroconversion (AOR=3.05; 95% CI 1.40, 6.66), and recent syringe borrowing (AOR 1.59; 95% CI 1.07, 2.36). CONCLUSION: In this sample of PWID, one-third demonstrated phylogenetic clustering. Factors independently associated with phylogenetic clustering included younger age, recent HCV seroconversion, prevalent HIV infection, and recent syringe borrowing. Strategies to enhance the delivery of prevention and/or treatment strategies to those with HIV and recent HCV seroconversion should be explored, given an increased likelihood of HCV transmission in these subpopulations.


Assuntos
Usuários de Drogas , Hepacivirus/genética , Hepatite C/virologia , Filogenia , Adulto , Colúmbia Britânica/epidemiologia , Análise por Conglomerados , Feminino , Hepatite C/epidemiologia , Humanos , Masculino , Estudos Prospectivos
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