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1.
Food Chem ; 393: 133453, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-35751208

RESUMO

The biological activities of Porphyra sp., Gracilaria gracilis, Alaria esculenta and Saccharina latissima extracts prepared by enzymatic and ball milling-assisted methods and hot water were evaluated. Enzyme-assisted methods allowed the highest extraction yields. Alcalase-assisted extraction (EAA) was the most effective in the recovery of polyphenolic compounds and Porphyra sp. had the highest content. The efficiency of flavonoids extraction was highly dependent on the used method. Globally, Porphyra sp. and EAA extracts exhibited the highest antioxidant and chelating activities. The highest α-amylase inhibitory activity was determined in HW Porphyra sp. extract while EAA A. esculenta extract had the highest α-glucosidase inhibitory activity. The highest ACE inhibitory activity was obtained in EAA from S. latissima. None of the extracts showed antimicrobial activity against the tested bacteria. The results showed that Porphyra sp. and S. latissima are potentially useful as ingredient in functional foods and nutraceuticals.


Assuntos
Gracilaria , Porphyra , Alga Marinha , Antioxidantes/farmacologia , Extratos Vegetais/farmacologia
4.
Dermatol Online J ; 27(6)2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34387058

RESUMO

Eccrine squamous syringometaplasia (ESS) is a histological term describing a mature squamous metaplasia of the eccrine ducts. Eccrine squamous syringometaplasia is not an infrequent histological finding and may be associated with chemotherapy or with a variety of non-specific conditions including infections, neoplastic conditions, and inflammatory skin diseases. We report a 75-year-old man who developed ESS within lesions of leukemia cutis (LC). The patient had an inaugural diagnosis of acute myeloid leukemia (AML) and he was not on chemotherapy when the biopsy was performed.


Assuntos
Glândulas Écrinas/patologia , Leucemia/patologia , Neoplasias Cutâneas/patologia , Idoso , Humanos , Leucemia/complicações , Masculino , Metaplasia/complicações , Neoplasias Cutâneas/complicações
5.
Braz J Med Biol Res ; 54(11): e10974, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34431871

RESUMO

Continuous positive airway pressure (CPAP) has been used to improve gas exchange and diaphragmatic function, among others benefits. Moreover, it can be used to increase exercise tolerance and positively influence ventilatory function and breathing pattern (BP) during exercise. However, there is no information about the long-term effects of CPAP, as an adjunct to an inpatient cardiac rehabilitation (CR) program, on BP and heart rate variability (HRV) of patients after coronary artery bypass grafting surgery (CABG). Twenty patients were allocated to receive, after randomization, standard inpatient CR without CPAP (control group - CG) or CR with CPAP between 10 to 12 cmH2O (CPAP group - CPG) associated with the exercises. Participants were assessed preoperatively and on the discharge day, in the sitting rest position. Outcome measurements included BP variables, collected by respiratory inductive plethysmography, and HRV, collected by polar precision performance. The CPG presented lower values of percent rib cage inspiratory and expiratory contributions to tidal volume (%RCi and %RCe) at discharge time, compared to CG. No statistical differences between groups were observed for HRV variables and both groups presented lower values of these indices, compared to preoperative ones. In this context, the patients who received CPAP throughout the whole rehabilitation program were discharged with a better BP, which could indicate more synchronized breathing. CPAP did not influence cardiac autonomic modulation in the long term.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Exercício Físico , Ponte de Artéria Coronária , Frequência Cardíaca , Humanos , Respiração
6.
Clin Oncol (R Coll Radiol) ; 33(3): e118-e131, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32798157

RESUMO

AIMS: Twenty per cent of patients with non-small cell lung cancer present with stage III locally advanced disease. Precision radiotherapy with pencil beam scanning (PBS) protons may improve outcomes. However, stage III is a heterogeneous group and accounting for complex tumour motion is challenging. As yet, it remains unclear as to whom will benefit. In our retrospective planning study, we explored if patients with superior sulcus tumours (SSTs) are a select cohort who might benefit from this treatment. MATERIALS AND METHODS: Patients with SSTs treated with radical radiotherapy using four-dimensional planning computed tomography between 2010 and 2015 were identified. Tumour motion was assessed and excluded if greater than 5 mm. Photon volumetric-modulated arc therapy (VMAT) and PBS proton single-field optimisation plans, with and without inhomogeneity corrections, were generated retrospectively. Robustness analysis was assessed for VMAT and PBS plans involving: (i) 5 mm geometric uncertainty, with an additional 3.5% range uncertainty for proton plans; (ii) verification plans at maximal inhalation and exhalation. Comparative dosimetric and robustness analyses were carried out. RESULTS: Ten patients were suitable. The mean clinical target volume D95 was 98.1% ± 0.4 (97.5-98.8) and 98.4% ± 0.2 (98.1-98.9) for PBS and VMAT plans, respectively. All normal tissue tolerances were achieved. The same four PBS and VMAT plans failed robustness assessment. Inhomogeneity corrections minimally impacted proton plan robustness and made it worse in one case. The most important factor affecting target coverage and robustness was the clinical target volume entering the spinal canal. Proton plans significantly reduced the mean lung dose (by 21.9%), lung V5, V10, V20 (by 47.9%, 36.4%, 12.1%, respectively), mean heart dose (by 21.4%) and thoracic vertebra dose (by 29.2%) (P < 0.05). CONCLUSIONS: In this planning study, robust PBS plans were achievable in carefully selected patients. Considerable dose reductions to the lung, heart and thoracic vertebra were possible without compromising target coverage. Sparing these lymphopenia-related organs may be particularly important in this era of immunotherapy.


Assuntos
Neoplasias Pulmonares , Terapia com Prótons , Radioterapia de Intensidade Modulada , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/radioterapia , Órgãos em Risco , Prótons , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Estudos Retrospectivos
7.
Braz. j. med. biol. res ; 54(10): e10514, 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1285648

RESUMO

Exercise intolerance is the hallmark consequence of advanced chronic heart failure (HF). The six-minute step test (6MST) has been considered an option for the six-minute walk test because it is safe, inexpensive, and can be applied in small places. However, its reliability and concurrent validity has still not been investigated in participants with HF with reduced ejection fraction (HFrEF). Clinically stable HFrEF participants were included. Reliability and error measurement were calculated by comparing the first with the second 6MST result. Forty-eight hours after participants underwent the 6MST, they were invited to perform a cardiopulmonary exercise test (CPET) on a cycle ergometer. Concurrent validity was assessed by correlation between number of steps and peak oxygen uptake (V̇O2 peak) at CPET. Twenty-seven participants with HFrEF (60±8 years old and left ventricle ejection fraction of 41±6%) undertook a mean of 94±30 steps in the 6MST. Intra-rater reliability was excellent for 6MST (ICC=0.9), with mean error of 4.85 steps and superior and inferior limits of agreement of 30.6 and -20.9 steps, respectively. In addition, strong correlations between number of steps and CPET workload (r=0.76, P<0.01) and peak V̇O2 (r=0.71, P<0.01) were observed. From simple linear regression the following predictive equations were obtained with 6MST results: V̇O2 peak (mL/min) = 350.22 + (7.333 × number of steps), with R2=0.51, and peak workload (W) = 4.044 + (0.772 × number of steps), with R2=0.58. The 6MST was a reliable and valid tool to assess functional capacity in HFrEF participants and may moderately predict peak workload and oxygen uptake of a CPET.


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Teste de Esforço , Insuficiência Cardíaca/diagnóstico , Consumo de Oxigênio , Volume Sistólico , Reprodutibilidade dos Testes , Tolerância ao Exercício , Teste de Caminhada
8.
Braz. j. med. biol. res ; 54(11): e10974, 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1285663

RESUMO

Continuous positive airway pressure (CPAP) has been used to improve gas exchange and diaphragmatic function, among others benefits. Moreover, it can be used to increase exercise tolerance and positively influence ventilatory function and breathing pattern (BP) during exercise. However, there is no information about the long-term effects of CPAP, as an adjunct to an inpatient cardiac rehabilitation (CR) program, on BP and heart rate variability (HRV) of patients after coronary artery bypass grafting surgery (CABG). Twenty patients were allocated to receive, after randomization, standard inpatient CR without CPAP (control group - CG) or CR with CPAP between 10 to 12 cmH2O (CPAP group - CPG) associated with the exercises. Participants were assessed preoperatively and on the discharge day, in the sitting rest position. Outcome measurements included BP variables, collected by respiratory inductive plethysmography, and HRV, collected by polar precision performance. The CPG presented lower values of percent rib cage inspiratory and expiratory contributions to tidal volume (%RCi and %RCe) at discharge time, compared to CG. No statistical differences between groups were observed for HRV variables and both groups presented lower values of these indices, compared to preoperative ones. In this context, the patients who received CPAP throughout the whole rehabilitation program were discharged with a better BP, which could indicate more synchronized breathing. CPAP did not influence cardiac autonomic modulation in the long term.


Assuntos
Exercício Físico , Pressão Positiva Contínua nas Vias Aéreas , Respiração , Ponte de Artéria Coronária , Frequência Cardíaca
9.
Braz. j. med. biol. res ; 54(2): e10084, 2021. tab, graf
Artigo em Inglês | LILACS, ColecionaSUS | ID: biblio-1142577

RESUMO

The objective of this study was to investigate the impact of chronic obstructive pulmonary disease (COPD)-heart failure (HF) coexistence on linear and nonlinear dynamics of heart rate variability (HRV). Forty-one patients (14 with COPD-HF and 27 HF) were enrolled and underwent pulmonary function and echocardiography evaluation to confirm the clinical diagnosis. Heart rate (HR) and R-R intervals (iRR) were collected during active postural maneuver (APM) [supine (10 min) to orthostasis (10 min)], respiratory sinus arrhythmia maneuver (RSA-M) (4 min), and analysis of frequency domain, time domain, and nonlinear HRV. We found expected autonomic response during orthostatic changes with reduction of mean iRR, root mean square of successive differences between heart beats (RMSSD), RR tri index, and high-frequency [HF (nu)] and an increased mean HR, low-frequency [LF (nu)], and LF/HF (nu) compared with supine only in HF patients (P<0.05). Patients with COPD-HF coexistence did not respond to postural change. In addition, in the orthostatic position, higher HF nu and lower LF nu and LF/HF (nu) were observed in COPD-HF compared with HF patients. HF patients showed an opposite response during RSA-M, with increased sympathetic modulation (LF nu) and reduced parasympathetic modulation (HF nu) (P<0.05) compared with COPD-HF patients. COPD-HF directly influenced cardiac autonomic modulation during active postural change and controlled breathing, demonstrating an autonomic imbalance during sympathetic and parasympathetic maneuvers compared with isolated HF.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença Pulmonar Obstrutiva Crônica/complicações , Insuficiência Cardíaca/complicações , Frequência Cardíaca , Volume Sistólico , Função Ventricular Esquerda , Dinâmica não Linear
10.
Braz. j. med. biol. res ; 53(11): e9529, 2020. tab, graf
Artigo em Inglês | LILACS, ColecionaSUS | ID: biblio-1132492

RESUMO

Norovirus (NoV) is the main cause of gastroenteritis outbreaks worldwide. Although NoV spreads mainly from person to person, it is estimated that a large proportion of NoV outbreaks are caused by foodborne transmission. Bivalve mollusks are one of the most important foods involved in NoV transmission to humans. Little is known about NoV prevalence in shellfish harvested and commercialized in Brazil. The aim of this study was to map, for the first time, the distribution of NoV contamination in oysters and mussels harvested and commercialized in the coast of Pernambuco state, northeast Brazil. A total of 380 mollusks (260 oysters and 120 mussels) were collected between February and August 2017 either directly from harvesting areas or obtained from beach vendors at 17 sites in Pernambuco. Samples were processed and tested for NoV contamination using a SYBR Green real-time PCR assay. All samples were negative for NoV GI or GII contamination, suggesting a low risk of NoV contamination from this food source during the study period. Additional surveys in different areas of the Brazilian coast are warranted to monitor the risk of NoV infection upon seafood consumption.


Assuntos
Humanos , Animais , Norovirus/genética , Frutos do Mar , Brasil/epidemiologia , Contaminação de Alimentos/análise , Alimentos Marinhos
11.
Radiother Oncol ; 135: 130-140, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31015159

RESUMO

Advances in technical radiotherapy have resulted in significant sparing of organs at risk (OARs), reducing radiation-related toxicities for patients with cancer of the head and neck (HNC). Accurate delineation of target volumes (TVs) and OARs is critical for maximising tumour control and minimising radiation toxicities. When performed manually, variability in TV and OAR delineation has been shown to have significant dosimetric impacts for patients on treatment. Auto-segmentation (AS) techniques have shown promise in reducing both inter-practitioner variability and the time taken in TV and OAR delineation in HNC. Ultimately, this may reduce treatment planning and clinical waiting times for patients. Adaptation of radiation treatment for biological or anatomical changes during therapy will also require rapid re-planning; indeed, the time taken for manual delineation currently prevents adaptive radiotherapy from being implemented optimally. We are therefore standing on the threshold of a transformation of routine radiotherapy planning via the use of artificial intelligence. In this article, we outline the current state-of-the-art for AS for HNC radiotherapy in order to predict how this will rapidly change with the introduction of artificial intelligence. We specifically focus on delineation accuracy and time saving. We argue that, if such technologies are implemented correctly, AS should result in better standardisation of treatment for patients and significantly reduce the time taken to plan radiotherapy.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Órgãos em Risco , Planejamento da Radioterapia Assistida por Computador/métodos , Humanos , Radiometria , Radioterapia/efeitos adversos
12.
Dermatol Online J ; 25(2)2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30865411

RESUMO

Mycobacterium marinum is a nontuberculous mycobacteria with worldwide distribution that lives in fresh or salt water and is responsible for infections in fish, and sometimes in humans. Human disease consists mainly of cutaneous nodules, but deep structure involvement may also occur. Diagnosis of M. marinum infection remains a challenge, with a considerable time delay between onset of symptoms and diagnosis. We present a 33-year-old man with no immunosuppressive history who was seen in our department with skin nodules over his hand and forearm, distributed in a sporotrichoid pattern. His hobbies included maintaining an aquarium of tropical fish. Histological examination of the patient's skin biopsy was compatible with the diagnosis of mycobacterial infection, and the Ziehl-Neelsen staining revealed acid-fast bacilli. Molecular techniques confirmed the suspicion of M. marinum infection. A necropsy was performed on one of the patient's fish, more specifically, a Poecilia reticulata, and resulted in identification of M. marinum from its gut. The patient was treated with clarithromycin, ethambutol, and rifampicin for 9 months, with clearance of infection.


Assuntos
Dermatoses da Mão/diagnóstico , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium marinum , Úlcera Cutânea/microbiologia , Adulto , Antebraço , Dermatoses da Mão/microbiologia , Passatempos , Humanos , Linfadenopatia/microbiologia , Masculino , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/patologia
13.
Biomed Pharmacother ; 101: 137-144, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29482059

RESUMO

Silver nanoparticles (AgNPs) were prepared by GREEN chemistry relying on the reduction of AgNO3 by phytochemicals present in black tea extract. AgNPs were fully characterized by transmission electron microscopy (TEM), ultraviolet-visible spectroscopy ((UV-vis)), X-ray diffraction (XRD) and energy dispersive absorption spectroscopy (EDS). The synthesized AgNPs induced a decrease of the cell viability in a dose-dependent manner with a low IC50 (0.5 ±â€¯0.1 µM) for an ovarian carcinoma cell line (A2780) compared to primary human fibroblasts (IC50 5.0 ±â€¯0.1 µM). The DNA binding capability of CT (calf thymus) DNA was investigated using electronic absorption and fluorescence spectroscopies, circular dichroism and viscosity titration methods. Additionally, the AgNPs strongly quench the intrinsic fluorescence of BSA, as determined by synchronous fluorescence spectra.


Assuntos
Sobrevivência Celular/efeitos dos fármacos , Proteínas de Ligação a DNA/metabolismo , Química Verde/métodos , Nanopartículas Metálicas/toxicidade , Extratos Vegetais/toxicidade , Prata/toxicidade , Animais , Bovinos , Sobrevivência Celular/fisiologia , Relação Dose-Resposta a Droga , Avaliação Pré-Clínica de Medicamentos/métodos , Células HCT116 , Humanos , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/metabolismo , Ligação Proteica/efeitos dos fármacos , Ligação Proteica/fisiologia , Soroalbumina Bovina/metabolismo , Prata/metabolismo , Chá/metabolismo , Chá/toxicidade
14.
Arq. bras. med. vet. zootec. (Online) ; 70(2): 347-352, mar.-abr. 2018. tab, ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-910360

RESUMO

Descreve-se o caso de uma égua, da raça Campeiro, utilizada como doadora de embriões, que apresentava quadros de cistite recorrente e incontinência urinária. Os sinais clínicos evoluíram para emagrecimento progressivo, anorexia, apatia e isolamento do plantel. Ao exame físico, foi identificada hipotonia da cauda, hipoalgesia da região perineal, flacidez retal e vesical, compatíveis com sinais relacionados à síndrome da cauda equina. Exames complementares laboratoriais, exame ultrassonográfico e necropsia confirmaram o diagnóstico de insuficiência renal crônica (IRC), a qual foi atribuida à pielonefrite ascendente. O exame de urocultura demonstrou crescimento de bactérias do gêneroStreptococcus sp. Este é um caso raro em equinos em que a disfunção de neurônio motor inferior propiciou o desenvolvimento de processo infeccioso no trato urinário, progredindo para um quadro crônico renal incompatível com a vida.(AU)


Descreve-se o caso de uma égua, da raça Campeiro, utilizada como doadora de embriões, que apresentava quadros de cistite recorrente e incontinência urinária. Os sinais clínicos evoluíram para emagrecimento progressivo, anorexia, apatia e isolamento do plantel. Ao exame físico, foi identificada hipotonia da cauda, hipoalgesia da região perineal, flacidez retal e vesical, compatíveis com sinais relacionados à síndrome da cauda equina. Exames complementares laboratoriais, exame ultrassonográfico e necropsia confirmaram o diagnóstico de insuficiência renal crônica (IRC), a qual foi atribuida à pielonefrite ascendente. O exame de urocultura demonstrou crescimento de bactérias do gênero Streptococcus sp. Este é um caso raro em equinos em que a disfunção de neurônio motor inferior propiciou o desenvolvimento de processo infeccioso no trato urinário, progredindo para um quadro crônico renal incompatível com a vida.(AU)


Assuntos
Animais , Cavalos/anormalidades , Pielonefrite/veterinária , Insuficiência Renal/classificação
15.
Braz. j. med. biol. res ; 51(11): e7837, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-974248

RESUMO

The objective of this study was to assess cardiovascular, respiratory, and metabolic responses during a commonly used dynamic leg press resistance exercise until exhaustion (TEx) at different intensities and compare with critical load (CL). This was a prospective, cross-sectional, controlled, and crossover study. Twelve healthy young men (23±2.5 years old) participated. The subjects carried out three bouts of resistance exercise in different percentages of 1 repetition maximum (60, 75, and 90% 1RM) until TEx. CL was obtained by means of hyperbolic model and linearization of the load-duration function. During all bout intensities, oxygen uptake (VO2), carbon dioxide production (VCO2), ventilation (VE), and respiratory exchange ratio (RER) were obtained. Variations (peak-rest=Δ) were corrected by TEx. In addition, systolic and diastolic blood pressure (SBP and DBP), blood lactate concentration [La-] and Borg scores were obtained at the peak and corrected to TEx. CL induced greater TEx as well as number of repetitions when compared to all intensities (P<0.001). During CL, Borg/TEx, ΔSBP/TEx, ΔDBP/TEx, and [La-] were significantly lower compared with 90% load (P<0.0001). In addition, VO2, VCO2, VE, and RER were higher during CL when compared to 90 or 75%. TEx was significantly correlated with VO2 on CL (r=0.73, P<0.05). These findings support the theory that CL constitutes the intensity that can be maintained for a very long time, provoking greater metabolic and ventilatory demand and lower cardiovascular and fatigue symptoms during resistance exercise.


Assuntos
Humanos , Masculino , Adulto , Consumo de Oxigênio/fisiologia , Troca Gasosa Pulmonar/fisiologia , Teste de Esforço/métodos , Treinamento Resistido , Fadiga/fisiopatologia , Frequência Cardíaca/fisiologia , Fatores de Tempo , Estudos Transversais , Estudos Prospectivos , Estudos Cross-Over
16.
Braz. j. med. biol. res ; 51(6): e6962, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-889112

RESUMO

Despite the appeal of ultra-short-term heart rate variability (HRV) methods of analysis applied in the clinical and research settings, the number of studies that have investigated HRV by analyzing R-R interval (RRi) recordings shorter than 5 min is still limited. Moreover, ultra-short-term HRV analysis has not been extensively validated during exercise and, currently, no indications exist for its applicability during resistance exercise. The aim of the present study was to compare ultra-short-term HRV analysis with standard short-term HRV analysis during low-intensity, dynamic, lower limb resistance exercise in healthy elderly subjects. Heart rate (HR) and RRi signals were collected from 9 healthy elderly men during discontinuous incremental resistance exercise consisting of 4-min intervals at low intensities (10, 20, 30, and 35% of 1-repetition maximum). The original RRi signals were segmented into 1-, 2-, and 3-min sections. HRV was analyzed in the time domain (root mean square of the of differences between adjacent RRi, divided by the number of RRi, minus one [RMSSD]), RRi mean value and standard deviation [SDNN] (percentage of differences between adjacent NN intervals that are greater than 50 ms [pNN50]), and by non-linear analysis (short-term RRi standard deviation [SD1] and long-term RRi standard deviation [SD2]). No significant difference was found at any exercise intensity between the results of ultra-short-term HRV analysis and the results of standard short-term HRV analysis. Furthermore, we observed excellent (0.70 to 0.89) to near-perfect (0.90 to 1.00) concordance between linear and non-linear parameters calculated over 1- and 2-min signal sections and parameters calculated over 3-min signal sections. Ultra-short-term HRV analysis appears to be a reliable surrogate of standard short-term HRV analysis during resistance exercise in healthy elderly subjects.


Assuntos
Humanos , Masculino , Idoso , Frequência Cardíaca/fisiologia , Treinamento Resistido/métodos , Eletrocardiografia , Valores de Referência , Fatores de Tempo
17.
Clin Otolaryngol ; 42(1): 11-28, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26990866

RESUMO

OBJECTIVES: To perform a national analysis of the perioperative outcome of major head and neck cancer surgery to develop a stratification strategy and outcomes assessment framework using hospital administrative data. DESIGN: A Hospital Episode Statistics N = near-all analysis. SETTINGS: The English National Health Service. MAIN OUTCOME MEASURES: Local audit data were used to assess and triangulate the quality of the administrative dataset. Within the national dataset, cancer sites, morbidities, social deprivation, treatment, complications, and in-hospital mortality were recorded. RESULTS: Within local audit datasets, the accuracy of assigning newly-derived Cancer Site Strata and Resection Strata were 92.3% and 94.2%, respectively. Accuracy of morbidities assignment was 97%. Within the national dataset, we identified 17 623 major head and neck cancer resections between 2002 and 2012. There were 12 413 males and mean age at surgery was 63 ± 12 years. The commonest cancer site strata were oral cavity (42%) and larynx-hypopharynx (32%). The commonest resection site was the larynx (n = 4217), and 13 211 and 11 841 patients had neck dissection and flap-based reconstruction, respectively. There were prognostically significant baseline differences between patients with oromandibular and pharyngolaryngeal malignancy. Patients with pharyngolaryngeal malignancies had a greater burden of morbidities, lower socio-economic status, fewer primary resections, and a sixfold increased risk of undergoing their major resection during an emergency hospital admission. Mean length of stay was 25 days and each complication linearly increased it by 9.6 days. There were 609 (3.5%) in-hospital deaths and a basket of seven medical and three surgical complications significantly increased the risk of in-hospital death. At least one potentially lethal complication occurred in 26% of patients. The risk of in-hospital death in a patient with no potentially lethal complication was 1.1% and this increased to 6% with one potentially lethal complication, and to 15.1% if two potentially lethal complications occurred in one patient. Complex oral-pharyngeal resections and pharyngolaryngectomies had the highest risks of complications and mortality. CONCLUSION: Mortality following head and neck cancer surgery shows variation across different resection strata. We propose an Informatics-based Framework for Outcomes Surveillance (IFOS) in Head and Neck Surgery for perpetual quality assurance, using the local hospital coding data or its collated destination, the national administrative dataset.


Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Complicações Intraoperatórias/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Inglaterra/epidemiologia , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/mortalidade , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Informática Médica , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Procedimentos de Cirurgia Plástica , Fatores de Tempo , Adulto Jovem
18.
Neth Heart J ; 24(11): 628-639, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27632192

RESUMO

OBJECTIVE: Studies in children with heart disease have been hampered by a lack of easily identifiable patient groups. Currently, there are few prospective population-based registries covering the entire spectrum of heart disease in children. KinCor is a Dutch national registry for children with heart diseases. This paper presents the aims, design and interim results of the KinCor project. METHODS: All children presenting at a Dutch university medical centre with a diagnosis of heart disease from 2012 onwards were eligible for registration in the KinCor database. Data entry is through a web-based portal. Entry codes have been synchronised with the European Paediatric Cardiac Coding system, allowing coupling with similar databases for adults, such as CONCOR. RESULTS: Between June 2012 and July 2015, 8421 patients were registered (76 % of those eligible). Median age of the patients was 9.8 years, 44.7 % were female; 6782 patients had morphological congenital heart disease. The most prevalent morphological congenital heart defects were ventricular septal defects (18 %), Tetralogy of Fallot (10 %) and transposition of great arteries (9 %). For 42 % of the patients additional diagnoses were registered. Sixty percent of patients had undergone at least one intervention (catheter intervention or surgery). CONCLUSION: The KinCor database has developed into a large registry of data of children with all types of heart disease and continues to grow. This database will provide the opportunity for epidemiological research projects on congenital and other types of heart disease in children. Entry codes are shared with the CONCOR database, which may provide a unique dataset.

19.
BJOG ; 123(11): 1804-13, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26662673

RESUMO

OBJECTIVE: To evaluate the effect of leptin and other selected variables on gestational weight gain (GWG) according to pre-gestational body mass index (BMI). DESIGN: Prospective cohort. SETTING: Public Health Center, Rio de Janeiro, Brazil. SAMPLE: Two hundred and twenty-eight pregnant women. METHODS: Women were followed at the 5-13, 20-26 and 30-36th gestational weeks. The effects of independent variables on GWG in normal weight (BMI 18.5-24.9 kg/m(2) ), overweight (BMI 25.0-29.9 kg/m(2) ) and obese (BMI ≥ 30.0 kg/m(2) ) women were assessed using longitudinal linear mixed-effects models. MAIN OUTCOME MEASURE: Maternal body weight (kg) throughout pregnancy. RESULTS: Leptin concentrations were associated with GWG in normal weight (ß = 0.048, P < 0.001) and overweight (ß = 0.023, P = 0.048) women, but not in obese ones (ß = 0.011, P = 0.308). Additionally, the number of hours slept per night decreased the effect of leptin on GWG in OW women (ß = -0.013, P = 0.002). The effect of other maternal characteristics on GWG was different depending on the BMI category. CONCLUSIONS: Leptin concentrations were positively associated with GWG in normal weight and overweight women, but not in obese ones. Maternal height was associated with GWG in all BMI categories, but other variables such as sleep duration, QUICKI values, HDL-c, smoking habit and marital status presented differential effects according to BMI. We encourage further studies to investigate the association between leptin and gestational weight gain, taking into account the pre-pregnancy weight and sleep duration, in order to compare and confirm our results. TWEETABLE ABSTRACT: Leptin is associated with weight gain in normal weight and overweight pregnant women, but not in obese ones.


Assuntos
Índice de Massa Corporal , Leptina/sangue , Sobrepeso/sangue , Complicações na Gravidez/sangue , Trimestres da Gravidez/sangue , Aumento de Peso/fisiologia , Adulto , Brasil , Feminino , Humanos , Peso Corporal Ideal/fisiologia , Modelos Lineares , Estudos Longitudinais , Obesidade/sangue , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Gravidez , Complicações na Gravidez/fisiopatologia , Estudos Prospectivos
20.
Rev. bras. plantas med ; 18(2): 423-432, 2016. tab, graf
Artigo em Português | LILACS | ID: lil-787953

RESUMO

RESUMO O objetivo desse estudo foi observar a ação da romã (Punica granatum L.) em estomatites induzidas por queimaduras no dorso da língua de ratos Wistar. Foram utilizados 24 ratos Wistar machos adultos, provenientes do Biotério da UNIVASF. Foram formados quatro grupos (G1: Polpa da romã por gavagem; G2: Polpa da romã por gavagem + aplicação local do chá da casca do fruto; G3: aplicação local do chá da casca do fruto e G4: Controle negativo). As queimaduras foram confeccionadas com instrumental odontológico padrão. Os tratamentos foram realizados duas vezes ao dia, durante 14 dias. Metade dos animais de cada grupo (n=3) foi eutanasiada no sétimo dia de experimentação, enquanto o restante foi eutanasiado no 14º dia. As línguas foram removidas e fixadas com formaldeído a 10% tamponado, processadas com cortes de 5 µm e coradas em HE. Clinicamente, os animais do grupo G2 tiveram melhores resultados. Na análise histológica qualitativa foi avaliada a reepitelização e os graus de inflamação numa escala de 0 a 4. Na análise estatística, utilizou-se o teste Qui-quadrado de Pearson. Houve significância estatística (p=0,026 e p=0,023) quando se comparou o tratamento com os graus de reepitelização e inflamação nos quatro grupos estudados. O grupo G2 apresentou cicatrização completa com 14 dias. Os piores escores obtidos foram atribuídos ao Grupo G4 nos dois parâmetros de avaliação qualitativa. Diante dos resultados obtidos, observa-se que a romã (Punica granatum L.) possui ação cicatrizante na mucosa lingual de ratos Wistar.


ABSTRACT The objective of this study was to observe the action of pomegranate (Punica granatum L.) on stomatitis induced burns on the dorso-lingual musosa in Wistar rats. Twenty-four male, adult Wister albino rats were used, from the bioterium of UNIVASF. There were four groups (G1: Pomegranate juice by gavage; G2: Pomegranate juice by gavage + local application of fruit peel tea; G3: Local application of fruit peel tea only and G4: a negative control). The burns were made with standard dental instruments. The treatments were performed twice a day for 14 days. Half the animals in each group (n = 3) were euthanized on the seventh day of experimentation, while the remainder were euthanized on day 14. The tongues were removed and fixed with a 10% formaldehyde buffer, processed as 5µm sections and stained with HE. Clinically the animals treated with tea showed better healing. For statistical analysis the Pearson chi-squared test was used. There was a statistical significance (p = 0.026 and p = 0.023) when compared to treatment with the degree of re-epithelialization and inflammation of the four groups studied. The G2 group showed complete healing within 14 days. The worst scores were found in the G4 group in both qualitative assessment parameters. Based on these results, it was observed that pomegranate (Punica granatum L.) has a healing action on the lingual mucosa of Wistar rats.


Assuntos
Ratos , Úlcera/classificação , Cicatrização/fisiologia , /metabolismo , Estomatite/classificação
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