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BACKGROUND: To analyze the outcomes of heparin-bonded expanded polytetrafluoroethylene (HePTFE) graft as an alternative conduit in infrapopliteal revascularization of chronic limb-threatening ischemia (CLTI) in the absence of an autologous vein conduit. METHODS: A single-center retrospective analysis of patients with CLTI submitted to infrapopliteal bypasses with autologous vein graft (VEIN group) or HePTFE graft (HePTFE group) was implemented. Primary end points were freedom from CLTI at 12 months and recurrence of CLTI at 3 years. Secondary end points included freedom from major amputation, amputation-free survival (AFS), survival, and primary (PP) and secondary patency (SP) rates at 3 years of follow-up. RESULTS: A total of 348 limbs submitted to infrapopliteal bypasses, 214 with venous graft and 134 with HePTFE graft, were followed-up for a median of 25 months. Most patients of the HePTFE group were male (69%), with a median age of 76 years (interquartile range [IQR] 15). Fifty-nine percent of the limbs of the HePTFE group had Wound grade ≥2, being 46% of them infected. Eighty-eight percent were GLASS stage III. Freedom from CLTI was not significantly different between HePTFE and VEIN groups (75% vs. 84%, adjusted hazard ratio [aHR] 0.88, confidence interval [CI] 0.66-1.18, P = 0.401). Recurrence of CLTI was higher in the HePTFE group (42% vs.18% at 3 years; aHR 2.82, CI 1.59-5.00, P < 0.001). The VEIN group achieved higher rates of freedom from major amputation (87% vs.69% at 3 years; aHR 2.21, CI 1.31-3.75, P = 0.003) and AFS (59% vs. 37% at 3 years; aHR 1.39, CI 1.02-1.88, P = 0.036), but no significance in survival (aHR 1.10, CI 0.72-1.66, P = 0.667). Patency rates were inferior in the HePTFE group, with 2-year PP and SP rates of 52% vs. 74%, and 76% vs. 90%, respectively (PP: aHR 1.70, CI 1.11-2.59, P = 0.014; SP: aHR 2.51, CI 1.42-4.42, P = 0.001). CONCLUSIONS: Infrapopliteal bypass with autologous vein graft is the gold standard to treat CLTI limbs. HePTFE graft should be regarded as an alternative for complex infrapopliteal revascularization when lacking an autologous vein conduct.
Subject(s)
Blood Vessel Prosthesis Implantation , Heparin , Humans , Male , Aged , Female , Heparin/adverse effects , Anticoagulants , Polytetrafluoroethylene , Retrospective Studies , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/adverse effects , Vascular Patency , Treatment Outcome , Ischemia/diagnostic imaging , Ischemia/surgery , Limb Salvage , Risk FactorsABSTRACT
BACKGROUND: To overcome knowledge gaps and optimize long-term follow-up (LTFU) care for childhood cancer survivors, the concept of the Survivorship Passport (SurPass) has been invented. Within the European PanCareSurPass project, the semiautomated and interoperable SurPass (version 2.0) will be optimized, implemented, and evaluated at 6 LTFU care centers representing 6 European countries and 3 distinct health system scenarios: (1) national electronic health information systems (EHISs) in Austria and Lithuania, (2) regional or local EHISs in Italy and Spain, and (3) cancer registries or hospital-based EHISs in Belgium and Germany. OBJECTIVE: We aimed to identify and describe barriers and facilitators for SurPass (version 2.0) implementation concerning semiautomation of data input, interoperability, data protection, privacy, and cybersecurity. METHODS: IT specialists from the 6 LTFU care centers participated in a semistructured digital survey focusing on IT-related barriers and facilitators to SurPass (version 2.0) implementation. We used the fit-viability model to assess the compatibility and feasibility of integrating SurPass into existing EHISs. RESULTS: In total, 13/20 (65%) invited IT specialists participated. The main barriers and facilitators in all 3 health system scenarios related to semiautomated data input and interoperability included unaligned EHIS infrastructure and the use of interoperability frameworks and international coding systems. The main barriers and facilitators related to data protection or privacy and cybersecurity included pseudonymization of personal health data and data retention. According to the fit-viability model, the first health system scenario provides the best fit for SurPass implementation, followed by the second and third scenarios. CONCLUSIONS: This study provides essential insights into the information and IT-related influencing factors that need to be considered when implementing the SurPass (version 2.0) in clinical practice. We recommend the adoption of Health Level Seven Fast Healthcare Interoperability Resources and data security measures such as encryption, pseudonymization, and multifactor authentication to protect personal health data where applicable. In sum, this study offers practical insights into integrating digital health solutions into existing EHISs.
Subject(s)
Telemedicine , Humans , Telemedicine/methods , Europe , Surveys and Questionnaires , Electronic Health Records , Cancer Survivors , Computer Security , SurvivorshipABSTRACT
A Schwannoma is an infrequent lesion. This tumor derives from the myelin sheath of the peripheral nerves; in most cases, it is benign and rarely presents in the foot and ankle region. Patients affected by this type of pathology are usually asymptomatic. Still, they sometimes have sensory or motor neurologic symptoms if the tumor is large enough to cause direct or indirect compression of the affected nerve. A 55-year-old male patient presented to our department with non-traumatic swelling and pain in the lateral aspect of the right foot and leg. A magnetic resonance imaging (MRI) scan of the right leg revealed a well-circumscribed lesion, measuring 2,5 by 1 cm, showing hypointensity on T1 sequences and hyperintensity on T2, compatible with a superficial peroneal nerve sheath cells tumor. Surgical excision of the lesion was performed, and the histopathological examination confirmed the initial suspicion-Schwannoma of the superficial peroneal nerve. The postoperative period was uneventful, with progressive improvement of pain and complete functional recovery without neurological deficits. Rigorous clinical examination associated to MRI scans allow adequate diagnosis as well as the exclusion of other pathologies with similar clinical presentation. Thus, the surgeon has to be aware of all the data for an effective diagnosis and treatment in this type of rare pathology that cannot be neglected.
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UV-stabilizers are a class of additives that provide extended polymer resistance to UV-degradation, but have also been suggested to have antimicrobial activity, potentially preventing the spread of pathogens, and inhibiting microbial-induced biodegradation. In this work, we incorporated different UV-stabilizers, a hindered amine light stabilizer (HALS), Tinuvin 770 DF and Tinuvin PA 123, or a hybrid HALS/UV-absorber, Tinuvin 5151, in polyurethane formulations to produce lacquer-films, and tested their antimicrobial activity against Staphylococcus aureus (methicillin-resistant and -sensitive strains), Escherichia coli and Candida albicans. Lacquer-films incorporated with Tinuvin 770 DF showed strong antimicrobial performance against bacteria and fungi, while maintaining cytocompatibility. The mechanism of action revealed a positive relationship between Tinuvin 770 DF concentration, microbial death, and reactive nitrogen species (RNS), suggesting that RNS produced during autoxidation of Tinuvin 770 DF is responsible for the antimicrobial properties of this UV-stabilizer. Conversely, lacquer-films incorporated with Tinuvin 5151 or Tinuvin PA 123 exhibited no antimicrobial properties. Collectively, these results highlight the commercial potential of Tinuvin 770 DF to prevent photo- and biodegradation of polymers, while also inhibiting the spread of potentially harmful pathogens. Furthermore, we provide a better understanding of the mechanism underlying the biocidal activity of HALS associated to autooxidation of the amine group.
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In the emerging research field of bioelectronic medicine, it has been indicated that neuromodulation of the vagus nerve (VN) has the potential to treat various conditions such as epilepsy, depression, and autoimmune diseases. In order to reduce side effects, as well as to increase the effectiveness of the delivered therapy, sub-fascicle stimulation specificity is required. In the electrical domain, increasing spatial selectivity can only be achieved using invasive and potentially damaging approaches like compressive forces or nerve penetration. To avoid these invasive methods while obtaining a high spatial selectivity, a 2-mm diameter extraneural cuff-shaped proof-of-concept design with integrated lead zirconate titanate (PZT) based ultrasound (US) transducers is proposed in this article. For the development of the proposed concept, wafer-level microfabrication techniques are employed. Moreover, acoustic measurements are performed on the device, in order to characterize the ultrasonic beam profiles of the integrated PZT-based US transducers. A focal spot size of around [Formula: see text] is measured for the proposed cuff. Moreover, the curvature of the device leads to constructive interference of the US waves originating from multiple PZT-based US transducers, which in turn leads to an increase of 45% in focal pressure compared to the focal pressure of a single PZT-based US transducer. Integrating PZT-based US transducers in an extraneural cuff-shaped design has the potential to achieve high-precision US neuromodulation of the VN without requiring intraneural implantation.
Subject(s)
Equipment Design , Feasibility Studies , Transducers , Vagus Nerve Stimulation , Vagus Nerve , Vagus Nerve Stimulation/instrumentation , Vagus Nerve Stimulation/methods , Vagus Nerve/physiology , Vagus Nerve/diagnostic imaging , Vagus Nerve/radiation effects , Ultrasonography/methods , Ultrasonography/instrumentation , Humans , Lead , Titanium , ZirconiumABSTRACT
Patella baja is an infrequent knee pathology, but it is limiting due to joint stiffness and localized pain in the anterior region of the knee. It may occur after trauma, prolonged immobilization or local surgical intervention. The striking pathological finding is the shortening and increase in thickness of the patellar ligament. Several surgical techniques have been described for its treatment, and there is no standardized treatment. We describe the case of a 73-year-old female patient who presented with knee stiffness, significant functional deficit, and patella baja after total knee arthroplasty. She underwent a recently described soft tissue surgical procedure, with excellent functional evolution, improving from a Lysholm Knee Score of 16 to 81 points, allowing early mobilization and return to daily life activities.
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INTRODUCTION: Portugal has one of the highest prevalence of patients on a regular dialysis program. This population has a higher incidence of peripheral arterial disease with higher rates of postoperative morbidity and mortality. Our goal was to compare outcomes between dialysis and non-dialysis patients with chronic limb threatening ischemia (CLTI) submitted to infrapopliteal bypass. MATERIALS AND METHODS: A retrospective single-center study of infrapopliteal bypass for CLTI was performed between 2012 and 2019. Patients were divided in two groups based on dialysis status (group 1 incorporated patients on dialysis). Primary end point was 1-year freedom from CLTI. Secondary end points were limb-salvage, survival and primary (PP) and tertiary patency (TP) rates at 3 years of follow-up. RESULTS: A total of 352 infrapopliteal bypasses were performed in 310 patients with CLTI. Fourteen percent of the revascularizations were performed on dialysis patients (48/352). Median age was 73 years (interquartile range - IQR 15) and 74% (259/352) were male. Median follow-up was 26 months (IQR 42). Overall, 92% (325/352) had tissue loss and 44% (154/352) had some degree of infection. The majority of revascularization procedures were performed with vein grafts (61%, 214/352). The 30-day mortality was 4% (11/310), with no difference between groups (p = 0.627). Kaplan-Meier analysis showed no difference between groups regarding freedom from CLTI (76% vs. 79%; HR 0.96, CI 0.65-1.44, p=0.857), limb-salvage (70% vs. 82%; HR 1.40, CI 0.71-2.78, p=0.327) and survival (62% vs. 64%; HR 1.08, CI 0.60-1.94, p=0.799). PP rates were 39% in group 1 and 64% in group 2 (HR 1.71, CI 1.05-2.79, p=0.030). TP rates were not different between groups (57% and 78%; HR 1.79, CI 0.92-3.47, p=0.082). CONCLUSION: Infrapopliteal bypass for CLTI, on dialysis patients, resulted in lower PP rates. No differences were observed in freedom from CLTI, TP, limb salvage and survival.
Subject(s)
Limb Salvage , Peripheral Arterial Disease , Popliteal Artery , Renal Dialysis , Vascular Patency , Humans , Male , Female , Aged , Retrospective Studies , Peripheral Arterial Disease/surgery , Peripheral Arterial Disease/mortality , Popliteal Artery/surgery , Portugal/epidemiology , Middle Aged , Aged, 80 and over , Ischemia/mortality , Ischemia/surgery , Treatment Outcome , Vascular Grafting/adverse effects , Risk FactorsABSTRACT
Hydrothermal liquefaction aqueous phase (HTL-AP) is a waste product from a thermochemical process where wet biomass is converted into biocrude oil. This nutrient-rich wastewater may be repurposed to benefit society by assisting crop growth after adequate treatment to increase inorganic nitrogen, especially NO3 -. This study aims to increase HTL-AP inorganic nitrogen, specifically NH3/NH4 + and NO3 -, through fungal remediation for further use in hydroponic systems. Trametes versicolor, a white-rot fungus known for degrading a range of organic pollutants, was used to treat a diluted (5 %) HTL-AP for 9 days. No fungal growth was observed, but T. versicolor activity was suspected by laccase activity throughout cultivation time. NO3 --N and NH3/NH4 +-N increased by 17 and 8 times after three days of fungal treatment, which was chosen as the appropriate time for HTL-AP fungal treatment as it resulted in the highest concentration of NO3 --N. The addition of nitrifying bacteria to the fungal treatment resulted in a twofold increase in NO3 --N concentration compared to the fungal treatment alone, indicating an enhancement in treatment efficacy. COD decreased by 51.33 % after 24 h, which may be related to the fungus' capacity to reduce the concentration of organics in the wastewater; nonetheless, COD increased in the following days, which may be related to the release of fungal byproducts. T. versicolor shows promise as a potential candidate for increasing inorganic nitrogen in HTL-AP. However, future studies should primarily address HTL-AP toxicity, reducing NH3/NH4 +-N while increasing NO3 --N, and hydroponics crop production after fungal treatment.
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The genome of Pseudomonas aeruginosa encodes three type VI secretion systems, each comprising a dozen distinct proteins, which deliver toxins upon T6SS sheath contraction. The least conserved T6SS component, TssA, has variations in size which influence domain organisation and structure. Here we show that the TssA Nt1 domain interacts directly with the sheath in a specific manner, while the C-terminus is essential for oligomerisation. We built chimeric TssA proteins by swapping C-termini and showed that these can be functional even when made of domains from different TssA sub-groups. Functional specificity requires the Nt1 domain, while the origin of the C-terminal domain is more permissive for T6SS function. We identify two regions in short TssA proteins, loop and hairpin, that contribute to sheath binding. We propose a docking mechanism of TssA proteins with the sheath, and a model for how sheath assembly is coordinated by TssA proteins from this position.
Subject(s)
Bacterial Proteins , Protein Domains , Pseudomonas aeruginosa , Type VI Secretion Systems , Type VI Secretion Systems/metabolism , Type VI Secretion Systems/genetics , Type VI Secretion Systems/chemistry , Pseudomonas aeruginosa/metabolism , Pseudomonas aeruginosa/genetics , Bacterial Proteins/metabolism , Bacterial Proteins/genetics , Bacterial Proteins/chemistry , Protein Binding , Recombinant Fusion Proteins/metabolism , Recombinant Fusion Proteins/chemistry , Recombinant Fusion Proteins/geneticsABSTRACT
Increasing evidence shows that cardiovascular diseases (CVDs) are associated with an increased risk of cognitive impairment and Alzheimer's diseases (AD). It is unknown whether systemic vascular dysfunction occurs prior to the development of AD, if this occurs in a sex-dependent manner, and whether endothelial cells play a role in the deposition of amyloid beta (Aß) peptides. We hypothesized that vascular dysfunction occurs prior to the onset of amyloid pathology, thus escalating its progression. Furthermore, endothelial cells from female mice will present with an exacerbated formation of Aß peptides due to an exacerbated pressure pulsatility. To test this hypothesis, we used a double transgenic mouse model of early-onset AD (APPswe/PSEN1dE9). We evaluated hippocampus-dependent recognition memory and the cardiovascular function by echocardiography and direct measurements of blood pressure through carotid artery catheterization. Vascular function was evaluated in resistance arteries, morphometric parameters in the aortas, and immunofluorescence in the hippocampus and aortas. We observed that endothelial dysfunction occurred prior to the onset of amyloid pathology irrespective of sex. However, during the onset of amyloid pathology, only female APP/PS1 mice had vascular stiffness in the aorta. There was elevated Aß deposition which colocalized with endothelial cells in the hippocampus from female APP/PS1 mice. Overall, these data showed that vascular abnormalities may be an early marker, and potential mediator of AD, but exacerbated aortic stiffness and pressure pulsatility after the onset of amyloid pathology may be associated with a greater burden of Aß formation in hippocampal endothelial cells from female but not male APP/PS1 mice.
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Background: Small artery remodeling and endothelial dysfunction are hallmarks of hypertension. Growing evidence supports a likely causal association between cardiovascular diseases and the presence of endothelial-to-mesenchymal transition (EndMT), a cellular transdifferentiation process in which endothelial cells (ECs) partially lose their identity and acquire additional mesenchymal phenotypes. EC reprogramming represents an innovative strategy in regenerative medicine to prevent deleterious effects induced by cardiovascular diseases. Methods: Using a partial reprogramming of ECs, via overexpression of Oct-3/4, Sox-2, and Klf-4 (OSK) transcription factors, we aimed to bring ECs back to a youthful phenotype in hypertensive mice. Primary ECs were infected with lentiviral vectors (LV) containing the specific EC marker cadherin 5 (Cdh5) and the fluorescent reporter enhanced green fluorescence protein (EGFP) with empty vector (LVCO) or with OSK (LV-OSK). Confocal microscopy and western blotting analysis were used to confirm the OSK overexpression. Cellular migration, senescence, and apoptosis were evaluated. Human aortic ECs (HAoECs) from male and female normotensive and hypertensive patients were analyzed after OSK or control treatments for their endothelial nitric oxide synthase (eNOS) levels, nitric oxide (NO), and genetic profile. Male and female normotensive (BPN/3J) and hypertensive (BPH/2J) mice were treated with an intravenous (i.v.) injection of LVCO or LV-OSK and evaluated 10 days post-infection. The blood pressure, cardiac function, vascular reactivity of small arteries, in vivo EGFP signal and EndMT inhibition were analyzed. Results: OSK overexpression induced partial EC reprogramming in vitro , and these cells showed endothelial progenitor cell (EPC)-like features with lower migratory capability. OSK treatment of hypertensive BPH/2J mice normalized blood pressure and resistance arteries hypercontractility, via the attenuation of EndMT and elastin breaks. EGFP signal was detected in vivo in the prefrontal cortex of both BPN/3J and BPH/2J-treated mice, but OSK induced angiogenesis only in male BPN/3J mice. OSK-treated human ECs from hypertensive patients showed high eNOS activation and NO production, with low ROS formation. Single-cell RNA analysis showed that OSK alleviated EC senescence and EndMT, restoring their phenotypes in human ECs from hypertensive patients. Conclusion: Overall, these data indicate that OSK treatment and EC reprogramming can decrease blood pressure and reverse hypertension-induced vascular damage.
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BACKGROUND: Eco-anxiety is increasingly recognized as a shared experience by many people internationally, encompassing fear of environmental catastrophe and anxiety about ecological crises. Despite its importance in the context of the changing climate, measures for this construct are still being developed in languages other than English. METHODS: To contribute to global eco-anxiety research, we translated the Hogg Eco-Anxiety Scale (HEAS) into Spanish, creating the HEAS-SP. We validated this measure in samples from both Argentina (n = 990) and Spain (n = 548), performing measurement invariance and confirmatory factor analyses. Internal consistency of the scale and score stability over time were investigated through reliability analyses. Differences in eco-anxiety across sociodemographic variables were explored through Student's t-tests and Pearson's r tests. RESULTS: The four-factor model of the HEAS-SP comprising affective and behavioural symptoms, rumination, and anxiety about personal impact demonstrated excellent model fit. We found good internal consistency for each subscale, and established measurement invariance between Spanish and Argentine samples, as well as across genders and participants' age. Spanish participants reported higher scores on the affective symptoms and personal impact anxiety factors compared to the Argentinian sample. Also, men reported lower levels than women on the subscales of affective symptoms, rumination, and personal impact anxiety. It was found that the relationship between both age and personal impact anxiety and age and affective symptoms varies significantly depending on the gender of the individuals. Younger participants tended to report higher scores on most dimensions of eco-anxiety. CONCLUSIONS: These findings enhance the global initiative to investigate, explore and therefore comprehend eco-anxiety by introducing the first valid and reliable Spanish-language version of this psychometric instrument for its use within Spanish and Argentinian populations. This study augments the body of evidence supporting the robust psychometric properties of the HEAS, as demonstrated in prior validations for Australian, Turkish, Portuguese, German, French, and Italian populations.
Subject(s)
Anxiety , Psychometrics , Humans , Argentina , Male , Female , Spain , Adult , Anxiety/psychology , Anxiety/diagnosis , Middle Aged , Psychometrics/instrumentation , Reproducibility of Results , Young Adult , Adolescent , Aged , Psychiatric Status Rating Scales/standards , Mental Health , TranslatingABSTRACT
Necrotizing otitis externa (NOE) is a rare invasive infection affecting the EAC and the base of the skull. This condition is more prevalent in the elderly, diabetics, and immunocompromised individuals, often attributed to the bacterium Pseudomonas aeruginosa. In this case report, we present the clinical scenario of a 90-year-old woman with a history of diabetes and epilepsy. Initially admitted with acute pyelonephritis, fever, and prostration, she subsequently developed left facial paralysis during treatment. Cranial computed tomography (CT) revealed inflammation in the middle ear and bone erosion of the facial nerve canal. The examination by the Department of Ear, Nose, and Throat (ENT) describes that NOE would be the most likely diagnosis. Given the patient's comorbidities and the severity of the disease, the treatment was initiated empirically and later adjusted based on the culture and sensitivity results with ceftazidime. NOE is a critical condition requiring early diagnosis and interdisciplinary collaboration due to the associated risk of complications. Adequate glycemic control is imperative, and the judicious use of antibiotics is crucial in light of escalating resistance.
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Este artigo busca dar subsídios teóricos e metodológicos ao processo de reontologização dos corpos africanos homens diaspóricos que se relacionam afetiva e sexualmente entre si. Parte-se do deslocamento do conceito de masculinidade e de sua relação estritacom as questões de gênero e sexualidades, situando esse processo em uma perspectiva afrocêntrica. Assim, a partir do conhecimento oriundo da matriz civilizatória africana, busca-se trazer novas contribuições no sentido de ampliar a compreensão sobre os modos de existir dos corpos africanos homens na diáspora, tomando a orixalidade como uma forma de repensar essas homenidades
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ABSTRACT Notifications concerning American tegumentary leishmaniasis (ATL) are increasing in the northern areas of Brazil, particularly due to the ongoing increase in human settlements inside the Amazon Forest. Notwithstanding the economical and sanitary importance of the ATL, the ecological aspects of its potential vectors, the Phlebotomine sand flies (Diptera: Psychodidae), remains largely neglected. This study aimed to investigate the diversity of the phlebotomine fauna as well as the detection of Leishmania DNA in these insects in the rural settlement Perimetral Norte, in the state of Amapá, eastern region of the Amazon, endemic region for tegumentary leishmaniasis. Sand flies were collected bimonthly from February 2018 to February 2019, using CDC light traps exposed for three consecutive nights in 10 houses of settlement residents. DNA extraction and multiplex PCR were performed to detect trypanosomatids. A total of 3,946 sandflies belonging to 37 species were collected. The most abundant species were Ty. trichopyga (Floch & Abonnenc, 1945) (21.9%) and Mi. rorotaensis (Floch & Abonnenc, 1944) (16.9%). A total of 36 positive pools were found with Leishmania DNA (Kinetoplastida: Trypanosomatidae), representing 17.9% of the total pools tested (201), those with the highest Minimum infection rates were Mg. migonei (França, 1920) and Lu. gomezi (Nitzulescu, 1931), Leishmania DNA was also detected in Bi. flaviscutellata (Mangabeira, 1942), Ny. umbratilis (Ward & Fraiha, 1977), Ny. anduzei (Roseboom, 1942) and Ny. antunesi (Coutinho, 1939). These data confirm the probable participation of these four species in the tegumentary leishmaniasis cycle in the eastern Amazon.
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Abstract: The Odonata Order comprises one of the largest groups of aquatic insects, 7,000 species are described worldwide, with approximately 860 species registered in Brazil, around 14% of the global fauna known to date. However, there are still great gaps in the knowledge of Odonata fauna in many areas of Brazil. This study aims to present the results of the survey of Odonata species sampled in three counties in the state of Amapá. The state is located in the north of the country, inserted in the Amazon Biome. Odonata were caught between January and December 2018, with 472 specimens being sampled, belonging to seven families, 36 genera and 53 species. In total, 27 of the species found during the study correspond to new records for the state of Amapá. Due to the lack of information on the diversity of the Odonata order in Amapá, the list of species presented should serve as input for new studies contributing to the knowledge of the order in the state.
Resumo: A ordem Odonata compreende um dos maiores grupos de insetos aquáticos, mundialmente são descritas 7.000 espécies, sendo que, para o Brasil estão registradas aproximadamente 860 espécies, algo em torno de 14% da fauna global conhecida até o momento. No entanto, ainda existem grandes lacunas no conhecimento da odonatofauna em muitas áreas do Brasil. Este estudo tem como objetivo apresentar o resultado do levantamento de espécies de Odonata amostradas em três municípios do estado Amapá. O estado se encontra na região norte do país, inserido no Bioma amazônico. As capturas de Odonata foram realizadas entre os meses de janeiro e dezembro de 2018, sendo amostrados 472 espécimes pertencentes a sete famílias, 36 gêneros e 53 espécies. No total, 27 das espécies encontradas durante o estudo correspondem a novos registros para o estado do Amapá. Devido à falta de informação sobre a diversidade da ordem Odonata no Amapá, a lista de espécies apresentada deve servir de aporte para novos estudos contribuindo com o conhecimento da ordem no estado.
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Resumen Introducción: En marzo de 2020, la Organización Mundial de la Salud (OMS) decretó la pandemia de la enfermedad por coronavirus de 2019 (COVID-19), que consiste en la infección por coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2). Este virus utiliza la enzima convertidora de angiotensina II (ECA-II) como receptor celular humano, que está presente en el tejido pulmonar, cardíaco, gastrointestinal, hepático, renal y vascular, lo que configura un potencial de afectación multisistémica por parte del patógeno. El hígado puede resultar dañado tanto por la liberación excesiva de citocinas inflamatorias en COVID-19 como por la adopción de fármacos con potencial hepatotóxico en el tratamiento de sus síntomas. Objetivo: analizar la relación entre los cambios en la función hepática causados por el SARS-CoV-2 y su impacto en el pronóstico del paciente. Métodos: el presente estudio consiste en una revisión sistemática, realizada a partir de estudios seleccionados de las bases de datos PMC, LILACS y SciELO. Después de aplicar los criterios de inclusión y exclusión, se definieron 30 artículos para componer la base de datos de este estudio. Resultados: La enzima aspartato-aminotransferasa (AST) estaba aumentando en mayor prevalencia, con un total de 4695 casos, mientras que la alanina-aminotransferasa (ALT) estaba elevada en 3226 casos. Se observa que los pacientes que presentaban síntomas digestivos tenían más probabilidades de presentar daño hepatocelular y, en consecuencia, alteraciones enzimáticas. Además, la mortalidad ocurrió en el 28,9 % de los casos de pacientes con función hepática alterada, mientras que, en aquellos con función normal, esta tasa fue del 9 %. Conclusión: es evidente que existe una relación entre la afectación hepática por COVID-19 y su mortalidad. Sin embargo, todavía existe una limitación en la cantidad y, principalmente, en la homogeneidad de los estudios que realizaron dicha valoración.
Abstract Introduction: In March 2020, the World Health Organization declared COVID-19, a disease caused by SARS-CoV-2 infection, a global pandemic. This virus uses human angiotensin-converting enzyme 2 (ACE2) as its receptor for entry. ACE2 is found in pulmonary, cardiac, gastrointestinal, hepatic, renal and vascular tissues, thus posing a potential risk for multisystemic involvement. The excessive release of inflammatory cytokines in COVID-19, as well as the use of medicines with hepatotoxic potential for the treatment of its symptoms, can damage the liver. Objective: To analyze the relationship between changes in liver function tests caused by SARS-CoV-2 infection and their impact on patient prognosis. Methodology: This is a systematic review of studies selected from the PMC, LILACS and SciELO databases. After applying the inclusion and exclusion criteria, 30 articles were included in the final sample for analysis. Results: Elevated AST (aspartate aminotransferase) enzyme levels were reported most frequently and were found in 4 695 cases, while ALT (alanine aminotransferase) elevation was described in 3 226 cases. It was observed that patients with digestive symptoms were more likely to present hepatocellular damage and, consequently, enzymatic alterations. Furthermore, 28.9 % of individuals with impaired liver function died, compared to 9 % of patients with normal function. Conclusion: It is evident that there is a relationship between liver involvement in COVID-19 and mortality. However, there is still a limitation in the number and, more importantly, the homogeneity of the research that performed this assessment.
Subject(s)
Humans , Patients , Cytokines , Coronavirus , Infections , Liver Function Tests , Research , Alanine Transaminase , Enzymes , COVID-19 , TransaminasesABSTRACT
Este estudo investigou como as medidas de distanciamento social para o combate ao COVID-19 tem influenciado o nível de atividade física. Um questionário estruturado sobre as práticas de atividade física antes e durante o período de distanciamento social foi disponibilizado on-line para coleta das informações dos 2004 adultos (18 anos ou mais de idade) residentes em municípios das cinco regiões brasileiras. Utilizou-se teste Qui-quadrado para avaliar associações entre o nível de atividade física anterior e durante o período da pandemia. Associações entre variáveis intervenientes foram verificadas através do odds ratio. Os participantes reduziram o nível de atividade física após a adoção das medidas de distanciamento social. O maior nível de atividade física durante a pandemia está associado ao sexo masculino, residir em região metropolitana e não pertencer a grupos de risco. Embora estes fatores já influenciassem o nível de atividade física antes da pandemia, os resultados do odds ratio indicaram que no período da pandemia os fatores sexo, região e risco apresentaram reduções no seu poder de predição. Questões levantadas neste estudo podem auxiliar o planejamento de ações voltadas ao incentivo da prática de atividade física em períodos de crise
This study investigated how measures of social distancing to mitigate COVID-19 influences physical activity level. A structured questionnaire with questions related to the practice of physical activities before and during the period of social distancing was provided online to collect informations of the 2004 adults (aged >18 years) who lived in municipalities from all five regions in Brazil. A Chi-square test was used to assess associations between physical activity level previous and during the pandemic period. Associations between intervening variables were verified using odds ratio. The participants reduced the level of physical activity after the adoption of social distancing measures. The highest level of physical activity during the pandemic is associated with male sex, living in the metropolitan region and not being a higher-risk group. Although these factors already influenced physical activity level before the pandemic, odds ratio results indicated that in the pandemic period the sex, region and risk factors showed reductions in their predictive power. Questions raised in this study can help to plan actions aimed at encouraging the practice of physical activities in times of crisis
Subject(s)
Humans , Male , Female , Coronavirus Infections , Evaluation Studies as Topic , Pandemics , Motor ActivityABSTRACT
Resumo Introdução O processo de envelhecimento ocasiona redução da função física podendo o indivíduo ter uma diminuição na percepção da qualidade de vida. Sendo assim, realizar atividade física regular pode ser um fator favorável a uma melhor percepção de qualidade de vida. Objetivo comparar a percepção da qualidade de vida em idosas praticantes e não praticantes do método Pilates. Método as idosas foram separadas em grupo Pilates (n = 60), ginástica (n = 63) e não praticantes de atividades físicas regulares (n = 62) e pelas faixas etárias de 60 a 64,9 anos e 70 a 74,9 anos. A percepção da qualidade de vida foi estimada pelo questionário WHOQOL-OLD e WHOQOL-BREF. A distribuição dos dados foi verificada com o teste de Shapiro-Wilk, além disso, foi utilizado o teste de Kruskal-Wallis com post hoc de Mann-Whitney e correção de Bonferroni. Resultados para a faixa etária de 60 a 64,9 anos avaliada pelo questionário WHOQOL-OLD, as idosas que não praticavam atividade física regular apresentaram uma melhor percepção no domínio de participação social do que o grupo da ginástica. Para a faixa etária de 70 a 74,9 anos, avaliada pelo mesmo questionário, o grupo de Pilates apresentou melhores percepções na maioria dos domínios de qualidade de vida. Conclusão o grupo das idosas praticantes do Método Pilates apresentou os maiores escores na maioria dos domínios de qualidade de vida para a faixa etária de 70 a 74,9 anos.
Abstract Background The aging process causes a reduction of the physical function, allowing the individual to have a decrease in the perception of the quality of life. Therefore, regular physical activity can be a favorable factor for a better perception of quality of life. Objective The aim of this study was to compare the quality-of-life perception of elderly women practitioners and non-practitioners of the Pilates' method. Method divided into three exercise type groups and two age groups: 60-64.9 and 70-74.9 years. The exercise type groups were as follows: Pilates' method practitioners (n=60), gymnastics practitioners (n=63), and non-practitioners of regular physical activity (n=62). The WHOQOL-OLD and WHOQOL-BREF questionnaires were applied to evaluate the quality-of-life perception. Statistics: The Shapiro-Wilk test verified the data distribution and comparative analysis was conducted using the Kruskal-Wallis test with Mann-Whitney Post-Hoc and Bonferroni correction. All analyses were processed using the SPSS software at 5% significance level (p<0.05). Results For 60-64.9-year-old group assessed by the WHOQOL-OLD questionnaire, the non-practitioners of regular physical activity showed better perception in the social participation domain than that of the gymnastic practitioners. For 70-74.9-year-old group assessed by the same instrument, the Pilates' method practitioners showed the best perception in most of the quality-of-life domains. Conclusion Elderly women practitioners of the Pilates' method obtained the highest scores in most of the quality-of-life domains for the 70-74.9-year-old group.
ABSTRACT
Abstract Objective: to investigate the association between body mass index (BMI) and functional fitness levels linked to the Elderly in Movement Program of the city of Curitiba, in the state of Paraná, Brazil. Methods: The study is characterized as correlational and cross-sectional. The sample consisted of 1,806 elderly female participants of the Elderly in Movement Program. The short version of the IPAQ was used to evaluate participation in physical activities; body weight (kg) and height (m) were measured to calculate BMI (kg/m²), while the motor tests proposed in the Senior Fitness Test were used to evaluate the functional fitness of the elderly women. Descriptive statistics, the chi-squared test and binary logistic regression were used for data analysis. Results: The results showed that 24.0% of the sample exhibited eutrophic nutritional status, 42.9% were overweight and 33.1% were obese. The elderly women classified as overweight and obese had lower functional fitness scores, based on the rating of Rikli and Jones, while the elderly women classified as eutrophic exhibited levels within the normal range. Obese elderly women were more likely to have low scores in the following functional fitness tests: Walk for 6 minutes, Chair Stand, Chair Sit and Reach, Back Scratch and 8-Foot Up and Go. Conclusion: The study indicated an association between, BMI and functional fitness in the elderly women participating in the program, where the majority of elderly women classified as obese exhibited low fitness in all tests.AU
Resumo Objetivo: Investigar a associação entre o índice de massa corporal (IMC) e níveis de aptidão funcional de idosas vinculadas ao programa Idoso em Movimento da Cidade de Curitiba, PR, Brasil. Métodos: O estudo caracteriza-se como correlacional, do tipo transversal. A amostra foi constituída por 1.806 idosas participantes do programa Idoso em Mo vimento. Foram utilizados como instrumentos o IPAQ versão curta para avaliar a participação em atividades físicas, o peso corporal (kg) e a estatura (m) foram mensurados para o cálculo do IMC (kg/m²) e os testes motores propostos no Senior Fitness Test foram utilizados para avaliar a aptidão funcional das idosas. Para análise dos dados foi utilizado a estatística descritiva, o teste de qui-quadrado e a regressão logística binária. Resultados: Foram identificados 24,0% da amostra como eutrófico, 42,9% com sobrepeso e 33,1% com obesidade. As idosas classificadas com sobrepeso e obesidade apresentaram menores escores de aptidão funcional, com base na classificação de aptidão funcional de Rikli e Jones, já as idosas classificadas como eutróficas apresentaram níveis dentro da normalidade. As idosas com obesidade tiveram maior chance de estar com a aptidão funcional baixa nos testes: Andar 6 minutos, Sentar e levantar, Sentar e Alcançar, Alcançar atrás das costas e Sentado e caminhar. Conclusão: O estudo indicou uma associação entre IMC e a aptidão funcional em mulheres idosas participantes do Programa, onde a maior proporção de idosas classificadas com obesidade apresentou aptidão baixa em todos os testes. AU