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1.
J Oral Maxillofac Surg ; 81(9): 1146-1154, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37308089

RESUMO

BACKGROUND: An edema assessment following dental surgeries is essential to improving the dental surgeon's technique and, consequentially, patient comfort. PURPOSE: Two-dimensional (2D) methods are limited in analyzing 3-dimensional (3D) surfaces. Currently, 3D methods are used to investigate postoperative swelling. However, there are no studies that directly compare 2D and 3D methods. The goal of this study is to directly compare 2D and 3D methods used in the assessment of postoperative edema. STUDY DESIGN AND SAMPLE: The investigators implemented a prospective, cross-sectional study with each subject serving as its own control. The sample was composed of dental student volunteers without facial deformities. PREDICTOR VARIABLE: The predictor variable is the method used to measure edema. After simulating edema, manual (2D) and digital (3D) techniques were used to measure edema. The manual method used direct facial perimeter measurements. The two digital methods were photogrammetry using a smartphone (iPhone 11, Apple Inc, Cupertino, California), and facial scanning with a smartphone application (Bellus3D FaceApp, Bellus3D Inc, Campbell, California) [3D measurements] MAIN OUTCOME VARIABLE: The coefficient of variation (CV) (CV = standard deviation /mean) was used to assess homogeneity of edema measurements. ANALYSIS: The Shapiro-Wilk and equal variance tests were applied to assess data homogeneity. Next, one-way analysis of variance was performed, followed by a correlation analysis. Finally, the data were submitted to Tukey's test. The statistical significance threshold was set at 5% (P < .05). RESULTS: The sample was composed of 20 subjects aged 18-38 years. The CV showed higher values using the manual (2D) method (47%; 4.88% ± 2.99), compared with the photogrammetry method (18%; 8.55 mm ± 1.52) and the smartphone application (21%; 8.97 mm ± 1.93). A statistically significant difference was observed between the manual method values and those of the other two groups (P < .001). There was no difference between the facial scanning and photogrammetry groups (3D methods) (P = .778) CONCLUSION AND RELEVANCE: Both digital measuring methods (3D) demonstrated greater homogeneity than the manual method in analyzing facial distortions caused by the same swelling simulation. Therefore, it can be affirmed that digital methods may be more reliable that manual methods for assessing facial edema.


Assuntos
Imageamento Tridimensional , Fotogrametria , Humanos , Imageamento Tridimensional/métodos , Estudos Transversais , Estudos Prospectivos , Simulação por Computador , Edema/diagnóstico
2.
Rural Remote Health ; 23(3): 7126, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37516453

RESUMO

INTRODUCTION: Xingu Indigenous Park (XIP) currently protects 16 ethnic Indigenous groups and is located in the central area of Brazil. XIP is the first and the largest Indigenous land to be recognized in the country. Community access is limited and restricted for the non-Indigenous population, and the Indigenous women are constantly dealing with shortages of medical care. High-risk human papillomavirus (HR-HPV) is the most common cause of cervical cancer and is detected in 99% of cervical precancers. HPV infections may be associated with bacterial agents such as Chlamydia trachomatis and Neisseria gonorrhoeae, which are also important causative agents of sexually transmitted infections and are responsible for the most frequent bacterial infections in the world. The present study evaluated the frequency and potential impact of Chlamydia trachomatis, Neisseria gonorrhoeae, and HR-HPV in the Indigenous women of XIP. METHODS: In this cross-sectional study, 992 cervical-vaginal samples were collected from Indigenous women, using a Cervex-Brush, and were immediately placed in a SurePath medium. All samples were submitted to the cobas® 4800 detection system for the identification of 14 different types of HR-HPV, and the multiplex Abbott RealTime CT/NG assay for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae. RESULTS: HR-HPV was detected in 18.2% of women; 6% were positive for HPV16, 5% for HPV18, and 81% for other types of HR-HPV. Co-infections of HPV16 and other types was observed in 5% of women, and 3% had co-infections of HPV18 and other types. Moreover, 1.8% of women were positive for Chlamydia trachomatis, while Neisseria gonorrhoeae was not detected. In women with HR-HPV, 33% had Chlamydia trachomatis infections, 28% were positive for HR-HPV other than HPV16 or HPV18, and 5% had co-infections of HPV16 and the other types of HPV. Younger women were found to be more susceptible to HPV infections. CONCLUSION: The findings indicate a high frequency of HR-HPV and a considerable frequency of Chlamydia trachomatis in the Indigenous women of XIP. The detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and/or HR-HPV does not present evidence of a potential interrelationship for a combined pathogenic action in these women.


Assuntos
Infecções por Chlamydia , Coinfecção , Gonorreia , Infecções por Papillomavirus , Feminino , Humanos , Neisseria gonorrhoeae , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/epidemiologia , Chlamydia trachomatis , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Papillomavirus Humano , Estudos Transversais , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/epidemiologia , Genitália
3.
Brain Behav Immun ; 95: 287-298, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33838250

RESUMO

Sepsis survivors show long-term impairments, including alterations in memory and executive function. Evidence suggests that systemic inflammation contributes to the progression of Alzheimers disease (AD), but the mechanisms involved in this process are still unclear. Boosted (trained) and diminished (tolerant) innate immune memory has been described in peripheral immune cells after sepsis. However, the occurrence of long-term innate immune memory in the post-septic brain is fully unexplored. Here, we demonstrate that sepsis causes long-lasting trained innate immune memory in the mouse brain, leading to an increased susceptibility to Aß oligomers (AßO), central neurotoxins found in AD. Hippocampal microglia from sepsis-surviving mice shift to an amoeboid/phagocytic morphological profile when exposed to low amounts of AßO, and this event was accompanied by the upregulation of several pro-inflammatory proteins (IL-1ß, IL-6, INF-γ and P2X7 receptor) in the mouse hippocampus, suggesting that a trained innate immune memory occurs in the brain after sepsis. Brain exposure to low amounts of AßO increased microglial phagocytic ability against hippocampal synapses. Pharmacological blockage of brain phagocytic cells or microglial depletion, using minocycline and colony stimulating factor 1 receptor inhibitor (PLX3397), respectively, prevents cognitive dysfunction induced by AßO in sepsis-surviving mice. Altogether, our findings suggest that sepsis induces a long-lasting trained innate immune memory in the mouse brain, leading to an increased susceptibility to AßO-induced neurotoxicity and cognitive impairment.


Assuntos
Doença de Alzheimer , Sepse , Peptídeos beta-Amiloides/metabolismo , Animais , Hipocampo/metabolismo , Memória Imunológica , Camundongos , Microglia/metabolismo
4.
Am J Physiol Endocrinol Metab ; 318(6): E866-E877, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32315212

RESUMO

The receptor activator of nuclear factor-κB (NF-κB) (RANK), its ligand (RANKL), and the decoy receptor osteoprotegerin (OPG) are a triad of proteins that regulate bone metabolism, and serum OPG is considered a biomarker for cardiovascular diseases and Type 2 diabetes; however, the implications of OPG in adipose tissue metabolism remains elusive. In this study, we investigate RANK-RANKL-OPG signaling in white adipose tissue browning. Histological analysis of osteoprotegerin knockout (OPG-/-) mice showed subcutaneous white adipose tissue (sWAT) browning, resistance for high-fat diet-induced weight gain, and preserved glucose metabolism compared with wild-type (WT) mice. Stromal vascular fraction (SVF) cells from sWAT of OPG-/- mice showed multilocular morphology and higher expression of brown adipocyte marker genes compared with those from the WT group. Infusion of RANKL induced browning and elevated respiratory rates in sWAT, along with increased whole body oxygen consumption in mice measured by indirect calorimetry. Subcutaneous WAT-derived SVF and 3T3-L1 cells, but not mature white adipocytes, differentiated into beige adipose tissue in the presence of RANKL. Moreover, SVF cells, even under white adipocyte differentiation, showed multilocular lipid droplet, lower lipid content, and increased expression of beige adipocyte markers with RANKL stimulation. In this study, we show for the first time the contribution of RANKL to increase energy expenditure by inducing beige adipocyte differentiation in preadipocytes.


Assuntos
Adipócitos Bege/metabolismo , Adipogenia/genética , Tecido Adiposo Branco/metabolismo , Obesidade/metabolismo , Osteoprotegerina/genética , Ligante RANK/metabolismo , Receptor Ativador de Fator Nuclear kappa-B/metabolismo , Células 3T3-L1 , Adipócitos Bege/citologia , Adipócitos Bege/ultraestrutura , Adipócitos Brancos/citologia , Adipócitos Brancos/metabolismo , Adipócitos Brancos/ultraestrutura , Tecido Adiposo Bege/citologia , Tecido Adiposo Bege/metabolismo , Tecido Adiposo Branco/citologia , Animais , Calorimetria Indireta , Dieta Hiperlipídica , Metabolismo Energético/efeitos dos fármacos , Metabolismo Energético/genética , Gotículas Lipídicas/ultraestrutura , Camundongos , Camundongos Knockout , Osteoprotegerina/metabolismo , Consumo de Oxigênio/efeitos dos fármacos , Consumo de Oxigênio/genética , Ligante RANK/farmacologia , Transdução de Sinais , Gordura Subcutânea/efeitos dos fármacos , Gordura Subcutânea/metabolismo , Aumento de Peso/efeitos dos fármacos , Aumento de Peso/genética
5.
BMC Vet Res ; 16(1): 2, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31900155

RESUMO

BACKGROUND: Hyperlipidaemia is considered a cause of other diseases that are clinically important and potentially life threatening. Combination of pea and barley as exclusive starch sources is known to interfere with glycemic control in diabetic dogs, but their effect on lipid profile of hiperlipidaemic dogs is yet to be evaluated. Twelve adult diabetic dogs were fed three dry extruded diets with different starch sources and different fat levels: peas and barley (PB), maize (Mi), and peas, barley and rice (Ba) with 15.7, 15.6 and 9.0% of their dry matter as fat, respectively. Plasmatic cholesterol and triglycerides concentration curves over 10 h were obtained after 60 days on each diet and with the same NPH insulin dose. ANOVA test or Friedman test were used to compare the dietary effects on triglycerides and cholesterol variables among the diets. RESULTS: Dogs presented lower mean (p = 0.05), fasting (p = 0.03), and time 8-h postprandial (p = 0.05) triglyceridemia after PB diet period than Ba diet period and time 4-h postprandial (p = 0.02) lower after PB than Mi diet. Cholesterolemia mean, minimum, maximum, area under the cholesterol curve and times points: 2, 4, 6, 8 and 10-h postprandial, had lower values after PB ingestion in comparison to Mi, without difference to Ba diet. CONCLUSION: Inclusion of pea and barley, as exclusive starch sources, in therapeutic diets for diabetic dogs can minimize plasmatic triglycerides and cholesterol concentration at fasting and at different postprandial time, compared to the maize diet or diet with lesser fat content.


Assuntos
Ração Animal/análise , Diabetes Mellitus/veterinária , Dieta/veterinária , Hiperlipidemias/veterinária , Animais , Colesterol/sangue , Carboidratos da Dieta , Gorduras na Dieta , Cães , Hordeum/química , Hiperlipidemias/prevenção & controle , Masculino , Oryza/química , Pisum sativum/química , Triglicerídeos/sangue , Zea mays/química
6.
BMC Vet Res ; 16(1): 463, 2020 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-33246455

RESUMO

BACKGROUND: The knowledge of how owners view the body condition of their animals is an important factor for the success of the prevention/treatment of obesity and the engagement/adherence to nutritional interventions, which are fundamental to improve the animal prognosis. For this reason, the objective of this study was to evaluate the perception of the owners regarding the body condition score of their animals, compare the perception between cat vs. dog owners, and owners from the countryside vs. metropolitan region of São Paulo State in Brazil. RESULTS: 601 dogs and 110 cats were included in this study. There was no significant difference in body condition score assigned by owners by species. Owners of dogs and cats classified by the veterinarian as ideal, overweight, and obese who disagree with body condition score assigned by veterinarian mainly underestimate the body condition score of their animals, while lean dogs' owners overestimate it. Countryside dog owners had a higher rate of disagreement with the veterinarian and more often underestimate the body condition score than owners from the metropolitan region. The owners of lean cats have the same judgments with veterinarians. CONCLUSIONS: Owners of dogs and cats have difficulty assessing the body condition score, especially owners from countryside.


Assuntos
Composição Corporal , Doenças do Gato/prevenção & controle , Doenças do Cão/prevenção & controle , Obesidade/veterinária , Fenômenos Fisiológicos da Nutrição Animal , Animais , Brasil , Gatos , Cães , Feminino , Humanos , Masculino , Obesidade/prevenção & controle , Propriedade
7.
Br J Nutr ; 120(7): 777-786, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30132436

RESUMO

The source of starch may interfere with glycaemic control in dogs, but few studies have evaluated these aspects in diabetic dogs. This study compared the effects of two isonutrient diets with different starch sources, peas and barley (PB) v. maize (Mi), on diabetic dogs. The Mi diet was processed in order to generate a lower starch gelatinisation index. In all, fifteen adult diabetic dogs without other conditions were included. The animals were fed two dry extruded rations with moderate levels of fat and starch and high levels of protein and fibre using a random, double-blind cross-over design. Glycaemic curves over 48 h were developed via continuous glucose monitoring after 60 d on each diet and with the same neutral protamine Hagedorn (NPH) insulin dosage. The following were compared: fasting, mean, maximum and minimum blood glucose, maximum and minimum glycaemia difference, glycaemic increment, area under the glycaemic curve, area under the glycaemic increment curve and serum fructosamine concentration. Paired t tests or Wilcoxon signed-rank tests were used to compare the amount of food and nutrients ingested and the dietary effects on glycaemic variables between the diets. Dogs fed the PB diet presented a lower average mean interstitial glucose (P=0·01), longer mean hypoglycaemic time (P<0·01), shorter mean hyperglycaemic time (P<0·01) and smaller difference between maximum and minimum blood glucose levels (P=0·03). Thus, the processing applied to the Mi diet was not sufficient to achieve the same effects of PB on glycaemic control in diabetic dogs.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus/sangue , Dieta , Hordeum/química , Pisum sativum/química , Amido/farmacologia , Zea mays/química , Animais , Área Sob a Curva , Carboidratos da Dieta/sangue , Carboidratos da Dieta/farmacologia , Fibras na Dieta/administração & dosagem , Proteínas Alimentares/administração & dosagem , Cães , Método Duplo-Cego , Jejum , Feminino , Frutosamina/sangue , Hiperglicemia/sangue , Hiperglicemia/etiologia , Hiperglicemia/prevenção & controle , Hipoglicemia/sangue , Hipoglicemia/etiologia , Hipoglicemia/prevenção & controle , Hipoglicemiantes/farmacologia , Masculino , Distribuição Aleatória , Amido/sangue
8.
J Mech Behav Biomed Mater ; 143: 105934, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37257313

RESUMO

The aim of this study was to evaluate the influence of various opacities and thicknesses of lithium disilicate on the degree of conversion (DC) of two resin cements and on their bond strength (BS) to the ceramic. Two hundred and forty ceramic samples of lithium disilicate with high translucency (HT), low translucency (LT), and medium opacity (MO) were obtained from IPS e. max CAD in five different thicknesses. Light-cured and dual-cured resin cements were used for DC (n = 9) and BS (n = 8). Cement samples were light-cured under ceramic samples and analyzed using a Raman confocal spectrometer to determine the DC. For BS, resin cement cylinders were fabricated using ceramic samples which were thsen subjected to a microshear bond strength test. The mean values were provided for statistical analysis. The increase in thickness resulted in a decrease in DC for both cements under all experimental conditions, but only affected the BS of the light-cured cement for the MO ceramic. Comparing the opacities, the most translucent ceramics with particular thicknesses exhibited higher DC values than the less translucent ceramics. The LT and MO ceramics with certain thicknesses exhibited the highest BS values than the HT. The dual-cured cement generally showed highest values in both analyses than the light-cured cement. A thicker and more opaque ceramic material can reduce the DC of the cement. The BS decreases with the increasing thickness of the more-opaque ceramics.


Assuntos
Porcelana Dentária , Cimentos de Resina , Cimentos de Resina/química , Teste de Materiais , Cerâmica/química , Propriedades de Superfície
9.
Braz Dent J ; 34(6): 67-74, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38133093

RESUMO

This study aimed to evaluate the influence of dental adhesive color on the chromatic stability and fluorescence intensity of composite resin restorations of different thicknesses. Ninety bovine enamel samples were obtained and restored with resin composite varying thicknesses of restorative material and enamel (1.0 mm enamel and 1.0 mm composite; 1.5 mm enamel and 0.5 mm composite; 0.5 mm enamel and 1.5 mm composite). The restorations were made of composite resin (Opallis E-bleach H) using different types of dental adhesives: Ambar, Ambar APS, and Single Bond Universal (n=10). The samples were subjected to color measurement tests in a spectrophotometer using CIEDE2000 and fluorescence intensity measurements before and after aging in a red wine coloring solution. Data were subjected to analysis of variance (ANOVA) and Tukey's test (α = 0.05). There were no statistically significant changes in color stability or fluorescence intensity for restorations made of different materials or thicknesses (p>0.05). Single Bond Universal showed greater color stability at 0.5 mm thickness (ΔE00 = 4.4 ± 1.6) compared to other thicknesses of the same material (p=0.003), as well as a greater difference in fluorescence intensity after aging at 1.5 mm thickness (-414.9 ± 103.8) compared to other materials (p=0.0002). Overall, it was concluded that the different adhesive systems did not influence the color stability and fluorescence of restorations of different thicknesses.


Assuntos
Cimentos Dentários , Cimentos de Resina , Animais , Bovinos , Cimentos Dentários/química , Cimentos de Resina/química , Resinas Compostas/química , Cor , Teste de Materiais
10.
Acta Trop ; 241: 106865, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36787861

RESUMO

In the present study, an immunoproteomic approach using Leishmania infantum parasites isolated from naturally infected dogs from an endemic region of the disease, was carried out to identify new antigens to be used in the diagnosis of canine visceral leishmaniasis (CVL). Protein extracts, obtained from parasites isolated from asymptomatic (CanLA) and symptomatic (CanLS) dogs, were used to perform the two-dimensional gels. Western Blotting assays were carried out by employing a pool of sera from dogs with visceral leishmaniasis (CanLA or CanLS), healthy dogs from an endemic area, or dogs with similar diseases associated with cross-reactions (babesiosis and ehrlichiosis). With these results, it was possible to exclude the spots that showed a cross-reactivity of the sera from groups of healthy dogs, and those with babesiosis or ehrlichiosis. Taken together, 20 proteins were identified, 15 of which have already been described in the literature and 5 of which are hypothetical. An immunogenomic screen strategy was applied to identify conserved linear B-cell epitopes in the identified hypothetical proteins. Two peptides were synthesized and tested in ELISA experiments as a proof of concept for the validation of our immunoproteomics findings. The results demonstrated that the antigens presented sensitivity and specificity values ranging from 81.93% to 97.59% and 78.14 to 85.12%, respectively. As a comparative antigen, a preparation of a Leishmania extract showed sensitivity and specificity values of 75.90% and 74.88%, respectively. The present study was able to identify proteins capable of being used for the serodiagnosis of canine visceral leishmaniasis.


Assuntos
Babesiose , Doenças do Cão , Leishmania infantum , Leishmaniose Visceral , Animais , Cães , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/veterinária , Antígenos de Protozoários , Doenças do Cão/parasitologia , Ensaio de Imunoadsorção Enzimática/métodos , Sensibilidade e Especificidade , Testes Sorológicos/métodos
11.
Funct Neurol ; 27(3): 187-92, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23402680

RESUMO

Botulinum toxin (BTX) is the best therapeutic option inpatients with cervical dystonia (CD), but physical therapy (PT) can be added to the treatment to achieve better results. Forty of our 70 patients with CD were en-rolled in a controlled open study. Subjects were divided into two groups: G1 (intervention group comprising patients receiving BTX and PT) and G2 (control group comprising patients receiving BTX only). Both groups were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and the 36-Item Short-Form Health Survey (SF-36). On the TWSTRS, significant improvements in disease severity were seen in G1 and G2 but significant improvements on the pain and disability subscales were seen only in G1 patients.There was a significant difference only on the pain sub-scale between G2 and G1 following treatment. An analysis of the physical aspects of SF-36 showed significant improvement in G1 on three subscales. An intergroup difference was also seen on two subscales.Regarding emotional aspects, G1 showed a significant improvement on three subscales. A significant difference on two subscales was also seen between G2 and G1 following treatment. BTX plus PT treatment achieved symptom relief in patients with CD and improved their quality of life.


Assuntos
Toxinas Botulínicas/uso terapêutico , Modalidades de Fisioterapia , Torcicolo/terapia , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Manejo da Dor/métodos , Torcicolo/complicações , Torcicolo/tratamento farmacológico , Resultado do Tratamento
12.
Prev Vet Med ; 206: 105704, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35850073

RESUMO

The pharmacovigilance of a veterinary company may include the analysis of spontaneous reports of adverse events (AE) related to its products. The present study developed an AE classification flowchart to analyze AE notified to the customer service and pharmacovigilance department of a multinational veterinary pharmaceutical company in Brazil. The product-AE binomials using the flowchart were characterized in terms of their frequencies and subsequently, three signal detection models were used: Reporting Odds Ratio, Bayesian confidence propagation neural network, and Gamma Poisson Shrinker. The signals detected with the three methods were classified according to their intensity, always with the most intense signal in the first position. Among the signals detected by the three methods, the positions of each signal were summed to obtain an aggregated classification that considered the results of the three methods and allowed a serial interpretation. Among the 531 reports, 20 types of AE; 88 product-AE binomials were identified. From the total of reports, seven were signs identified by the three methods. The classification of AE following explicit criteria and the combined use of more than one signal detection method enhances spontaneous-reports-based pharmacovigilance.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Drogas Veterinárias , Sistemas de Notificação de Reações Adversas a Medicamentos , Animais , Teorema de Bayes , Bases de Dados Factuais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/veterinária , Farmacovigilância , Drogas Veterinárias/efeitos adversos
13.
Sci Rep ; 12(1): 18510, 2022 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-36396966

RESUMO

Food production is responsible for almost one-quarter of the environmental impact and, therefore, its importance regarding sustainability should not be overlooked. The companion animal population is increasing, and an important part of pet food is composed of ingredients that have a high environmental impact. This study aimed to evaluate the impact of dry, wet, and homemade pet diets on greenhouse gas emission, land use, acidifying emission, eutrophying emissions, freshwater withdrawals, and stress-weighted water use. The wet diets were responsible for the highest impact, and dry diets were the type of diet that least impacted the environment, with a positive correlation between the metabolizable energy provided by animal ingredients and the environmental impact. It is necessary to consider the environmental impact of pet food since it is significant, and the population of pets tends to increase.


Assuntos
Dieta , Animais , Gatos , Cães , Doenças do Gato , Dieta/veterinária , Doenças do Cão , Meio Ambiente , Alimentos
14.
J Voice ; 2022 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-36550002

RESUMO

OBJECTIVE: To characterize the clinical practice of Brazilian speech-language-hearing therapists regarding voice therapy for older adults during the COVID-19 pandemic. METHODS: Cross-sectional survey conducted remotely. Data were collected through a form shared online with approximately 1.500 speech-language-hearing therapists. The form included voice therapy practice with older adults during the COVID-19 pandemic. It was responded by 155 voice experts. RESULTS: Most respondents were females with over 21 years' experience in vocal health care, working with both in-person therapy and teletherapy. Obtaining acoustic parameters and using therapy strategies for breathing and body training were the most reported changes in remote therapy during the pandemic. The main difficulties involved wearing masks in in-person therapy and assessing the voice in teletherapy. Patient adherence and goals reached were deemed positive by most participants. Associations were found between place and format of service; between patient adherence and goals reached; and between difficulties in teletherapy and use of complementary therapeutic resources. CONCLUSION: The COVID-19 pandemic led Brazilian speech-language-hearing therapists to change their clinical practice with older adults in both remote and in-person therapy. The main changes involved wearing masks in in-person therapy and assessing the voice in teletherapy. Remote therapy proved to be a safe and effective possibility.

15.
Front Pharmacol ; 13: 927179, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36034836

RESUMO

Background: The treatment of rheumatoid arthritis (RA), a chronic systemic inflammatory autoimmune disease, is based on disease-modifying anti-rheumatic drugs (DMARDs). Typically, it starts with conventional synthetic DMARDs (csDMARDs), and depending on the patient's response to the treatment and the adverse events experienced, biological DMARDs (bDMARDs) are initiated. bDMARDs are more specific to inflammatory factors than csDMARDs and more efficient in inducing remission and low disease activity. Thus, this study aimed to assess the effectiveness of biological therapy in patients with rheumatoid arthritis in administrative health databases. Methods: PubMed, Embase, Lilacs, Ovid, Scopus, and Web of Science databases were searched from inception to 21 October 2021, to identify observational studies that evaluated the effectiveness of biological therapy in patients with rheumatoid arthritis using administrative databases and real-world data. The methodological quality was assessed by the methodological index for non-randomized studies (MINORS). A fixed or random-effects model estimated risk ratios with 95% confidence intervals. The analysis was divided into four groups: tumor necrosis factor inhibitors (TNFi) versus non-TNFi; TNFi versus TNFi (adalimumab, etanercept, and golimumab versus infliximab); bDMARDs versus Janus kinase inhibitors (JAKi); and bDMARDs monotherapy versus combination therapy (bDMARDs and MTX). Results: Twenty-one records were eligible for inclusion in this systematic review and meta-analysis; seven population-based cohorts, eight prospective, and six retrospective cohort studies. Overall, 182,098 rheumatoid arthritis patients were evaluated. In the meta-analysis, lower effectiveness was observed among TNFi users than in non-TNFi (RR: 0.88; 95% CI: 0.81-0.95; p < 0.01; I2 = 94.0%) and bDMARDs than in JAKi (RR: 0.86; 95% CI: 0.79-0.94; p < 0.01; I2 = 93.0%). Higher effectiveness among adalimumab, etanercept, and golimumab than in infliximab (RR: 1.19; 95% CI: 1.05-1.36; p < 0.01; I2 = 96.0%) was found. No significant differences in the effectiveness of bDMARD monotherapy compared to combination therapy (RR: 0.83; 95% CI: 0.68-1.00; p < 0.01; I2 = 81.0%) was observed. E-value analysis indicated that the estimates were not robust against unmeasured confounding. Conclusion: According to the available real-world data, our results suggest that biological therapy effectively treats patients with rheumatoid arthritis, indicating higher effectiveness with non-TNFi and JAKi than with TNFi. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID#CRD42020190838, identifier CRD42020190838.

16.
Front Pharmacol ; 13: 928471, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36034855

RESUMO

Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease that affects the synovial fluid of joints, tendons, and some extra-articular sites. Biologic agents have been highly effective and are comparable in reducing RA symptoms, slowing disease progression, and improving physical function; however, concerns have been raised about the risks of several potential adverse effects. Thus, this study aimed to assess the safety of biological therapy in patients with rheumatoid arthritis in observational studies using administrative health databases. Methods: PubMed, Embase, Lilacs, Ovid, Scopus, and Web of Science were searched from inception to 21 October 2021. The analysis was divided into five groups: tumor necrosis factor inhibitors (TNFi) versus non-TNFi; TNFi versus csDMARDs; bDMARDs versus csDMARDs; abatacept versus bDMARDs; and TNFi versus Janus kinase inhibitors (JAKi). The adverse events were cancer, cardiovascular events, infection, herpes zoster, tuberculosis, and death. The methodological quality of the studies was assessed by the Newcastle-Ottawa Scale. A random-effects model estimated risk ratios with 95% confidence intervals. Results: Thirty-one studies were eligible for inclusion in the present systematic review, published from 2014 to 2021. A total of 1,039,398 RA patients were assessed. The 31 studies evaluated eleven different biological drugs. No significant differences were found regarding safety between TNFi versus non-TNFi (RR 1.08; 95% CI 0.92-1.28; p < 0.01; I2 = 93.0%), TNFi versus csDMARDs (RR 0.91; 95% CI 0.75-1.10; p < 0.01; I2 = 87.0%), bDMARDs versus csDMARDs (RR 0.99; 95% CI 0.82-1.20; p < 0.01; I2 = 93.0%), abatacept versus bDMARDs (RR 0.80; 95% CI 0.54-1.18; p < 0.01; I2 = 90.0%), and TNFi versus JAKi (RR 3.54; 95% CI 0.30-42.09; p = 0.01; I2 = 81.0%). In the subgroup analysis, among studies comparing abatacept to TNFi, a lower risk of cardiovascular events was associated with abatacept (RR 0.37; 95% CI 0.24-0.55). Conclusion: Our results do not suggest an increased risk of adverse events associated with biological therapy in treating RA patients, indicating a lower risk of cardiovascular events with abatacept than TNFi. However, these findings must be interpreted with caution given the limitations of this study and the low/very low certainty of the evidence. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?, identifier [CRD42020190838].

17.
Vet Comp Oncol ; 19(3): 529-540, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33724647

RESUMO

Histological grading systems remain cornerstones in the prognosis of canine cutaneous mast cell tumours (MCTs), but the distinct biological behaviour of each tumour often necessitates the use of complementary markers. Although a plethora of immunohistochemical markers have been proposed as prognostic factors, few are presently applied in routine diagnosis. This systematic review and meta-analysis was designed to establish which immunohistochemical markers have verifiable prognostic value for cutaneous MCTs in dogs. A Boolean search of five databases identified 200 articles for screening, of which 73 were selected for full-text assessment and 24 ultimately included in the systematic review. Odds Ratio (OR) was adopted as the summary measure for subsequent meta-analysis but only 15 articles, relating to the immunomarkers Ki-67 (9), KIT (5), and BAX (2), provided either a value for OR or sufficient data to calculate this statistic. Meta-analysis verified that canine cutaneous MCTs with elevated expression of Ki-67 or BAX, as well aberrant immuno-expression of KIT, showed an increased odds of death, with respective OR values of 11.2 (95% CI 6.3-20.0; p < .01), 9.9 (95% CI 1.3-73.6; p = .03), and 4.1 (95% CI 1.1-15.3; p = .03). Despite KIT, Ki67, and BAX arise as suitable prognostic factor for canine MCTs, this study highlighted the lack of important clinical and statistical data in many published articles, rendering it impossible to complete the meta-analysis of several potentially valuable immunohistochemical markers.


Assuntos
Doenças do Cão , Mastocitoma Cutâneo , Mastocitose Cutânea , Neoplasias Cutâneas , Animais , Doenças do Cão/diagnóstico , Cães , Imuno-Histoquímica , Antígeno Ki-67 , Mastócitos , Mastocitoma Cutâneo/diagnóstico , Mastocitoma Cutâneo/veterinária , Mastocitose Cutânea/diagnóstico , Mastocitose Cutânea/veterinária , Prognóstico , Proteínas Proto-Oncogênicas c-kit , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/veterinária , Proteína X Associada a bcl-2
18.
Front Vet Sci ; 7: 79, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32226792

RESUMO

Some effects of expressing stereotypic behavior have not yet been elucidated. During gestation, the environment has the potential to interfere with offspring development and to have prenatal or longer-term consequences. We tested the hypothesis that the occurrence of stereotypic behavior during gestation could affect the phenotype of the offspring. Twenty-eight pregnant sows were studied by comparing two groups differing in the amount of stereotypy shown. We analyzed emotionality in the offspring from sows showing high or low stereotypy frequency using the open field and novel object tests. In the open field test, piglets from sows with a high rate of stereotypies walked more in central sectors (p < 0.0001) and lateral sectors (p = 0.04) than piglets from sows with a low rate of stereotypies. In the novel object test, the offspring from low stereotypy sows vocalized more (p = 0.008). We demonstrate for the first time that the stereotypic behavior by the mother during gestation changes the phenotype of the offspring, in particular, their emotionality.

19.
J Bodyw Mov Ther ; 24(3): 260-266, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32825998

RESUMO

INTRODUCTION: Patients with migraine may present a higher quantity of myofascial trigger points (MTrP) and alterations in the cervical muscles when compared to non-migraineurs. The magnetic resonance imaging (MRI) is a robust method for the study of human soft tissues and could be useful to investigate these points. OBJECTIVES: To identify the presence of MTrP in the descending fibers of the trapezius muscle in women with migraine and to quantify the muscle volume by MRI, correlating it with the headache characteristics. METHODS: A cross-sectional analytic study was conducted among 14 women, eight in migraine group, and six in without migraine group. The presence of MTrP was evaluated using Simons' criteria, and linolenic acid capsules subsequently marked the areas. MRI was performed with 1.5T, T1-weighted sequence, and T2 in the axial, sagittal, and coronal planes. The T1-weighted sequences were performed with and without gadolinium contrast. RESULTS: The T1-weighted image analysis with and without gadolinium did not show any signal alteration in the MTrP areas in both groups. The migraine group presented more MTrP in the trapezius muscle (MD [95%CI] = 1[1; 3]; MD [95%CI] = 1[0; 2] right and left side, respectively), and a smaller muscle volume (MD [95%CI] = -198.1[-338.7;-25.6], MD [95%CI] = -149.9[-325.05;-0.13] right and left side, respectively) than non-migraineurs. The migraine frequency presented a negative strong correlation with the trapezius volumes (r = -0.812; p = 0.014). CONCLUSION: Migraineurs present more MTrP and a smaller muscle volume than non-migraineurs. The trapezius volume is negatively correlated with migraine frequency. MRI is not a suitable outcome measure for assessing MTrP.


Assuntos
Síndromes da Dor Miofascial , Músculos Superficiais do Dorso , Estudos Transversais , Feminino , Humanos , Imageamento por Ressonância Magnética , Síndromes da Dor Miofascial/diagnóstico por imagem , Músculos Superficiais do Dorso/diagnóstico por imagem , Pontos-Gatilho
20.
Transbound Emerg Dis ; 66(4): 1693-1700, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30985065

RESUMO

Dog rabies and human rabies transmitted by dogs can be prevented through adequate dog vaccination coverage. For surveillance purposes, this coverage must be calculated using accurate population size estimates to avoid misleading conclusions. We used data from a Brazilian national survey comprising 64,348 households, to calculate point estimates and confidence intervals of the size, household density, and rabies vaccination coverage of the owned-dog population in Brazilian federative units. We also evaluated the precision of owned-dog population size estimates, based on the extrapolation among different areas, of the mean number of dogs per household and the human/dog ratio. The estimated owned-dog population size in Brazil was 52,198,324 (95% CI = 51,028,583-53,368,066) and the dog vaccination coverage was 80.09% (95% CI = 79.09%-81.09%). Both estimates had marked variation across Brazilian federative units and urban/rural strata. Only two of the 27 federative units had a confidence interval in rural vaccination coverage above 70% and six did not pass this threshold in their urban stratum. For the first time, we reported probabilistic estimates for an entire country and its main administrative areas. The estimated coverage for the country was high because the most populated federative unit also had high coverage. The mean number of dogs per household and the human/dog ratio were useful as survey estimates to characterize owned-dog density. However, the simple extrapolation of these parameters resulted in estimates of owned-dog population sizes with large errors (up to 254%) that must be interpreted with caution to avoid misleading conclusions. To evaluate the dog population size, we recommend the use of probabilistic sampling designs instead of simple human/dog ratio extrapolations, and the inclusion of animal-related questions in censuses and national surveys to obtain reliable estimates to support improvements in animal and human health.


Assuntos
Doenças do Cão/prevenção & controle , Vacina Antirrábica/administração & dosagem , Raiva/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Vacinação/veterinária , Animais , Brasil , Cães , Monitoramento Epidemiológico/veterinária , Características da Família , Propriedade , Densidade Demográfica , Vigilância da População , Vacinação/estatística & dados numéricos
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