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1.
AIDS Care ; 34(2): 163-172, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-33745404

RESUMO

The purpose of this study was to assess the effect of training modality and exercise intensity on the modulation of lymphocytes CD4 count in people living with HIV (PLWH). A search for randomised controlled trials was performed using five databases (PubMed/Medline, Cochrane, LILACS, Scielo and CAPES). Meta-analyses of mean differences (MD) were conducted using a random-effects model to compare the effects of training modality and intensity on CD4 count. The CD4 count comparing physical training vs. control group (MD of CD4 was 54.58 cell/ml³ [CI 95% 15.58-93.59], p =< 0.01). In according to the subgroup analysis, only aerobic exercise has proved to have a significant effect on CD4 (MD 79.91 cell/ml³ [CI 95% 19.30-140.52], p =< 0.01). When exercise intensities were stratified, only intense training proved to have a significant effect on CD4 (MD 64.87 cell/ml³ [CI 95% 15.79-113.95], p =< 0.01). In meta-regression analysis showed that the aerobic training, as well, high the intensity training were predictors significant to the improvement of CD4 (p =< 0.01). Exercise training is an important strategy to assist in the treatment of PLWH. The aerobic training modality and the high intensity training were able to promote improve the modulation of CD4 count chronically in PLWH.


Assuntos
Infecções por HIV , Contagem de Linfócito CD4 , Exercício Físico , Terapia por Exercício , Infecções por HIV/terapia , Humanos
2.
Qual Life Res ; 28(7): 1803-1812, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30790154

RESUMO

PURPOSE: The aim of the present study was to verify the effects of a 16-week multidisciplinary obesity treatment program (MOTP) on health-related quality of life (HRQoL) in adolescents with weight excess. In addition, we verified a possible association between changes on HRQoL and anthropometric, body composition, and cardiorespiratory fitness (CRF) parameters. METHODS: Two hundred four adolescents aged from 15 to 18 years were distributed in control group (CG) and intervention group (IG). They underwent a 16-week MOTP composed by nutritional, psychological, and health-related physical activity group sessions. Moreover, they performed physical exercise sessions three times per week during the whole 16-week program. Data on HRQoL, body composition, CRF and anthropometry were collected using standard protocols and validated questionnaires. RESULTS: The MOTP promoted significant enhancements in all HRQoL domains, except for the school domain in IG. Furthermore, positive correlations between HRQoL and body weight (BW), body fat (BF), waist circumference (WC), and body mass index (BMI) z-score were verified. Higher scores of HRQoL might be achieved by improving these variables. CONCLUSIONS: The 16-week MOTP was effective to improve HRQoL in adolescents with weight excess. This improvement has a positive correlation with enhancements in BW, BMI z-score, WC, and BF. Nevertheless, these findings have not reached a consensus on literature and still need to be further enlightened.


Assuntos
Aptidão Cardiorrespiratória/psicologia , Nível de Saúde , Obesidade/psicologia , Obesidade/terapia , Qualidade de Vida/psicologia , Programas de Redução de Peso/estatística & dados numéricos , Adolescente , Antropometria , Composição Corporal/fisiologia , Índice de Massa Corporal , Peso Corporal/fisiologia , Exercício Físico/psicologia , Feminino , Humanos , Masculino , Instituições Acadêmicas , Inquéritos e Questionários , Circunferência da Cintura/fisiologia
3.
J Clin Lab Anal ; 32(6): e22428, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29512191

RESUMO

BACKGROUND: Although more than 14 loci may be involved in the development of nonsyndromic cleft lip and palate (NSCLP), the etiology has not been fully elucidated due to genetic and environmental risk factor interactions. Despite advances in identifying genes associated with the NSCLP development using traditional genetic mapping strategies of candidate genes, genome-wide studies, and epidemiologic and linkage analysis, microarray techniques have become important complementary tools in the search for potential causative oral clefts genes in genetic studies. Microarray hybridization enables scanning of the whole genome and detecting copy number variants (CNVs). Although common benign CNVs are often smaller, with sizes smaller than 20 kb, here we reveal small exonic CNVs based on the importance of the encompassed genes in cleft lip and palate phenotype. METHODS: Microarray hybridization analysis was performed in 15 individuals with NSCLP. RESULTS: We identified 11 exonic CNVs affecting at least one exon of the candidate genes. Thirteen candidate genes (COL11A1-1p21; IRF6-1q32.3; MSX1-4p16.2; TERT-5p15.33; MIR4457-5p15.33; CLPTM1L-5p15.33; ESR1-6q25.1; GLI3-7p13; FGFR-8p11.23; TBX1-22q11.21; OFD-Xp22; PHF8-Xp11.22; and FLNA-Xq28) overlapped with the CNVs identified. CONCLUSIONS: Considering the importance to NSCLP, the microdeletions that encompass MSX1, microduplications over TERT, MIR4457, CLPTM1L, and microduplication of PHF8 have been identified as small CNVs related to sequence variants associated with oral clefts susceptibility. Our findings represent a preliminary study on the clinical significance of small CNVs and their relationship with genes implicated in NSCLP.

4.
Clin Infect Dis ; 63(12): 1622-1625, 2016 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-27601223

RESUMO

Zika virus (ZIKV) infection acquired during pregnancy is associated with congenital microcephaly. We describe 2 cases of ZIKV infection in women in their 36th week of pregnancy whose fetuses had preserved head circumference at birth and findings of subependymal cysts and lenticulostriate vasculopathy in postnatal imaging. These represent the first signs of congenital brain injury acquired due to ZIKV in the third trimester.


Assuntos
Encefalopatias/congênito , Doenças Fetais/virologia , Complicações Infecciosas na Gravidez , Infecção por Zika virus , Adolescente , Adulto , Encefalopatias/diagnóstico por imagem , Encefalopatias/virologia , Cistos do Sistema Nervoso Central/congênito , Cistos do Sistema Nervoso Central/diagnóstico por imagem , Feminino , Doenças Fetais/diagnóstico por imagem , Doenças Fetais/tratamento farmacológico , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico por imagem , Terceiro Trimestre da Gravidez , Ultrassonografia Doppler Transcraniana , Infecção por Zika virus/complicações
6.
Neuromolecular Med ; 26(1): 31, 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39073519

RESUMO

The aim of this study was to evaluate the effects of swimming in the brain and behavior of young and aged mice. Forty-eight male C57BL/6 J mice were randomly distributed into 4 groups (n = 12 per group, 3 and 18 months old). The subdivision of the groups was: 3 months-SED, 18 months-SED, 3 months-EXE, and 18 months-EXE. SED mice did not swim, while EXE mice performed the physical exercise protocol. Training was initiated 48 h after the adaptation week. Swimming sessions consisted of 30 min, with no overload, 5 days per week, for 4 weeks. After the exercise protocol, it was revealed working and spatial memory were impaired in the 18 months-SED group. Pre- and post-synaptic proteins were enhanced in the groups that swam when compared to the 3- and 8 months-SED groups. Lipid peroxidation was greater in the aged mice that did not perform the physical exercise protocol and might have contributed to the cognitive impairment in this group. In conclusion, an aerobic physical exercise protocol, performed through regular swimming sessions, inhibited cognitive impairment, memory loss and lipid peroxidation in the aged mice, while pre- and post-synaptic proteins were enhanced in the hippocampus of young and aged mice.


Assuntos
Envelhecimento , Hipocampo , Peroxidação de Lipídeos , Transtornos da Memória , Camundongos Endogâmicos C57BL , Condicionamento Físico Animal , Natação , Animais , Masculino , Camundongos , Hipocampo/metabolismo , Envelhecimento/fisiologia , Transtornos da Memória/etiologia , Transtornos da Memória/prevenção & controle , Disfunção Cognitiva/prevenção & controle , Disfunção Cognitiva/etiologia , Proteínas do Tecido Nervoso/biossíntese , Memória Espacial/fisiologia , Aprendizagem em Labirinto , Memória de Curto Prazo/fisiologia , Proteína 4 Homóloga a Disks-Large/metabolismo , Sinaptofisina/metabolismo
7.
Arq Bras Cardiol ; 120(4): e20220398, 2023 03.
Artigo em Inglês, Português | MEDLINE | ID: mdl-37098987

RESUMO

Central blood pressure (cBP) is considered an independent predictor of organ damage, cardiovascular events and all-cause mortality. Evidence has shown that high intensity interval training (HIIT) is superior to moderate-intensity continuous training (MICT) for improving cardiorespiratory fitness and vascular function. However, the effects of these aerobic training modalities on cBP have not yet been properly reviewed.This meta-analysis aims to investigate to effects of HIIT versus MICT on cBP.We conducted a meta-analysis of randomized controlled trials that compared HIIT versus MICT on cBP. Primary outcomes were measures of central systolic blood pressure (cSBP) and central diastolic blood pressure (cDBP). Peripheral systolic blood pressure (pSBP) and diastolic blood pressure (pDBP), pulse wave velocity (PWV) and maximal oxygen uptake (VO2max) were analyzed as second outcomes. Meta-analysis of mean differences (MD) was conducted using the random effects model.Our study included 163 patients enrolled in six trials. We found that HIIT was superior to MICT in reducing the cSBP (MD = -3.12 mmHg, 95% CI: -4.75 to -1.50, p = 0.0002) and SBP (MD = -2.67 mmHg, 95% CI: -5.18 to -0.16, p = 0.04), and increasing VO2max(MD = 2.49 mL/kg/min, 95% CI: 1.25 to 3.73, p = 0.001). However, no significant differences were reported for cDBP, DBP and PWV.HIIT was superior to MICT in reducing the cSBP, which suggests its potential role as a non-pharmacological therapy for high blood pressure.


A pressão arterial central (PAc) é considerada um preditor independente de lesão de órgão, eventos cardiovasculares e mortalidade por todas as causas. Evidências mostram que o treino intervalado de alta intensidade (HIIT) é superior ao treino contínuo de intensidade moderada (MICT) na melhoria da aptidão cardiorrespiratória e da função vascular. No entanto, os efeitos dessas modalidades de treino aeróbico sobre a PAc não foram propriamente revisados. Esta metanálise tem como objetivo investigar os efeitos do HIIT versus MICT sobre a PAc.Conduzimos uma metanálise de ensaios controlados randomizados que compararam HIIT versus MICT sobre a PAc. Os desfechos primários foram Pressão Arterial Sistólica (PAS) central (PASc) e Pressão Arterial Diastólica central (PADc). A PAS periférica (PASp), a PAD periférica (PADp), a Velocidade de Onda de Pulso (VOP) e a captação máxima de oxigênio (VO2max) foram analisadas como desfechos secundários. A metanálise das diferenças médias (DM) foi conduzida usando modelos de efeitos aleatórios.Nosso estudo incluiu 163 pacientes recrutados em seis ensaios. Encontramos que HIIT foi superior ao MICT em reduzir PASc (DM = -3,12 mmHg, IC95% -4,75 ­ 1,50, p = 0,0002) e PAS (DM = -2,67 mmHg, IC95% -5,18 ­ -0,16, p = 0,04) e aumentar VO2max (DM = 2,49 mL/Kg/min, IC95% 1,25 ­ 3,73, p = 0,001). No entanto, não foram relatadas diferenças quanto à PADc, PAD ou VOP. O HIIT foi superior ao MICT em reduzir PASc, sugerindo seu potencial papel como uma terapia não farmacológica para a pressão arterial elevada.


Assuntos
Aptidão Cardiorrespiratória , Treinamento Intervalado de Alta Intensidade , Hipertensão , Humanos , Pressão Sanguínea/fisiologia , Análise de Onda de Pulso , Hipertensão/terapia
8.
Einstein (Sao Paulo) ; 21: eRC0543, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37255063

RESUMO

We report the long-term outcomes of a case of prenatal gastroschisis repair using a fully percutaneous fetoscopic approach with partial carbon dioxide insufflation. Surgery was performed as an experimental procedure before the scheduled elective birth. The fetal intestines were successfully returned to the abdominal cavity without any fetal or maternal complications. Ultrasonography performed 24 hours later revealed bowel peristalsis and no signs of fetal distress. After 48 hours, partial extrusion of the small bowel was observed, and the fetus was delivered. Gastroschisis repair was immediately performed upon delivery using the EXIT-like procedure as per our institutional protocol. The newborn did not require assisted mechanical ventilation, was discharged at 14 days of age and was then exclusively breastfed. At 3-year follow-up, the patient had no associated gastroschisis-related complications. This is the first case of prenatal repair of gastroschisis, which provides baseline knowledge for future researchers on the potential hurdles and management of prenatal repair.


Assuntos
Gastrosquise , Insuflação , Gravidez , Recém-Nascido , Feminino , Humanos , Fetoscopia/métodos , Gastrosquise/diagnóstico por imagem , Gastrosquise/cirurgia , Dióxido de Carbono , Feto
9.
Nutrition ; 74: 110744, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32217458

RESUMO

OBJECTIVE: The aims of this study were to assess the capacity of tri-ponderal mass index (TMI) to screen and predict insulin resistance (IR) in overweight Brazilian adolescents, comparing it with body mass index (BMI) predictive capacity; and to verify the IR predictive capacity of other assessment tools such as waist circumference (WC), and waist-to-height ratio (WHR). METHODS: A cross-sectional study was carried out with 217 overweight adolescents, from both sexes, between 12 and 18 y of age. The participants were classified as having IR according to a previous established cutoff point of ≤3.16. IR was determined by the homeostasis model assessment of insulin resistance. The other assessment tools were measured with standard protocols. RESULTS: There was no difference between TMI and BMI to explain the presence of IR. In girls, BMI presented a slightly better predictive capacity to explain IR than TMI. Moreover, WC was reported to be the most effective IR screening methods for girls. Receiver operating characteristic curves showed that TMI and BMI presented similar values of sensibility and specificity for boys. Nevertheless, BMI had a better sensibility and TMI had a better specificity for girls. Interestingly, WC demonstrated a strong sensibility for both sexes. CONCLUSIONS: TMI did not present a superior predictive accuracy for IR screening in overweight Brazilian adolescents when compared with BMI. TMI and BMI presented similar values of sensitivity and specificity for boys and WC a slightly superior IR predictive capacity for girls.


Assuntos
Resistência à Insulina , Obesidade Infantil , Adolescente , Índice de Massa Corporal , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Sobrepeso/diagnóstico , Curva ROC , Circunferência da Cintura
10.
Int J Lab Hematol ; 42(5): 594-603, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32452631

RESUMO

BACKGROUND: Despite the advances in the cure rate for acute myeloid leukemia (AML), a considerable number of patients die from the disease due to the occurrence of multidrug resistance (MDR). Overexpression of the transporter proteins, such as P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP), confers resistance to the treatment of these leukemias. METHODS: To analyze the expression of the Pgp and MRP1 in patients with AML and determine their correlation between expression and demographic, clinical, and laboratorial variables, bone marrow and peripheral blood samples from 346 patients with a diagnosis of AML were assessed for the expression of Pgp and MRP1 by flow cytometry. RESULTS: The expression of Pgp and MRP1 was found in 111 (32.1%) and 133 (38.4%) patients, respectively, with greater prevalence in older patients and lower in children, while also observing a high incidence in patients with refractory, recurrence, and secondary disease in comparison with the cases of de novo AML. Regarding the laboratory findings, we observed an association between the expression of Pgp and MRP1 and CD34, CD7, and also M7, M5a, and M2-AML of French-American-British classification. CONCLUSIONS: The results showed that the detection of MDR phenotype by flow cytometry can be a molecular marker for prognosis of patients with AML.


Assuntos
Membro 1 da Subfamília B de Cassetes de Ligação de ATP/genética , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/genética , Proteínas Associadas à Resistência a Múltiplos Medicamentos/genética , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Biomarcadores Tumorais , Criança , Pré-Escolar , Resistência a Múltiplos Medicamentos , Resistencia a Medicamentos Antineoplásicos , Feminino , Citometria de Fluxo , Humanos , Imunofenotipagem , Lactente , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Proteínas Associadas à Resistência a Múltiplos Medicamentos/metabolismo , Fenótipo , Prognóstico , Avaliação de Sintomas , Adulto Jovem
11.
J Pediatr Endocrinol Metab ; 32(10): 1163-1170, 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31472061

RESUMO

Background The aim of the present study was to investigate the correlation between the triglyceride/glucose index (TyG index) and homeostasis model assessment of insulin resistance (HOMA-IR). Additionally, we compared the ability of the TyG index and triglycerides/high-density lipoprotein cholesterol (TG/HDL-c) index and the combination of these two indices (TyG index plus TG/HDL-c) to predict insulin resistance (IR) in South American overweight and obese children and adolescents. Methods A cross-sectional study was carried out in 345 overweight adolescents aged 10-18 years, from both the sexes. The TyG index was calculated as Ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL])/2, while the TG/HDL-c index was calculated by the division of TG (mg/dL) by HDL-c (mg/dL). HOMA-IR was calculated with the formula: fasting insulin (FI) (U/mL) × fasting glucose (mmol/L)/22.5. The cut-off point used to determine the presence of IR was HOMA-IR ≥ 3.16. Results The TyG index showed a positive correlation with HOMA-IR. The area under the receiver operating characteristic (ROC) curve of the TyG index was 0.74, indicating good sensitivity (75.7%) and specificity (67.4%). Furthermore, the TyG index cut-off point of >4.44 was established for IR prediction in this population. Conclusions The TyG index is a simple and cost-effective surrogate marker of IR in South American overweight children and adolescents. Moreover, due to its good accessibility, it can be used in large epidemiological studies.


Assuntos
Biomarcadores/sangue , Glicemia/análise , Intolerância à Glucose/diagnóstico , Resistência à Insulina , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Triglicerídeos/sangue , Adolescente , Criança , Estudos Transversais , Feminino , Seguimentos , Intolerância à Glucose/sangue , Intolerância à Glucose/epidemiologia , Humanos , Incidência , Masculino , Prognóstico , América do Sul/epidemiologia
12.
Pesqui. bras. odontopediatria clín. integr ; 23: e220028, 2023. tab, graf
Artigo em Inglês | LILACS, BBO | ID: biblio-1529119

RESUMO

ABSTRACT Objective: To evaluate the influence of non-invasive treatment associated with the use of infiltrating resin for managing caries lesions in primary teeth. Material and Methods: A systematic review was performed by selecting articles from 6 online databases, using a search algorithm and eligibility criteria for data extraction and data synthesis for the papers included. Clinical trials involving primary teeth with incipient caries lesions (1/2 of the enamel or 1/3 of the outer dentin) were included, presenting full text and answering the study's guiding question. This study used the RoB 2 tool for the risk of bias assessment and GRADE for certainty of evidence. Random effects meta-analyses were implemented, and lesion progression treatment effects were estimated through relative risk (RR) and associated 95% confidence intervals. Results: A total of 440 studies were found. After analyzing the inclusion criteria and removal of duplicates, eight studies were analyzed for quality evidence. Five of the eight studies included in this review contributed to the meta-analysis, all with some reflections regarding the risk of bias. Overall, the results of the meta-analysis showed that non-invasive treatment, when associated with the use of infiltrating resins, significantly reduced the risk of caries progression in relation to the treatment without this addition for follow-up periods ranging from 12 months to 2 years (RR 0.51 [0.40-0.65]). Conclusion: There is moderate certainty of evidence that the use of infiltrating resins associated with non-invasive treatments decreases the risk of caries progression in primary teeth with incipient caries lesions (1/2 of the enamel or 1/3 of the dentin outer) when combined with non-invasive control methods alone.


Assuntos
Fluoretos Tópicos/uso terapêutico , Cárie Dentária/prevenção & controle , Materiais Dentários
13.
Arq. bras. cardiol ; 120(4): e20220398, 2023. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1429806

RESUMO

Resumo A pressão arterial central (PAc) é considerada um preditor independente de lesão de órgão, eventos cardiovasculares e mortalidade por todas as causas. Evidências mostram que o treino intervalado de alta intensidade (HIIT) é superior ao treino contínuo de intensidade moderada (MICT) na melhoria da aptidão cardiorrespiratória e da função vascular. No entanto, os efeitos dessas modalidades de treino aeróbico sobre a PAc não foram propriamente revisados. Esta metanálise tem como objetivo investigar os efeitos do HIIT versus MICT sobre a PAc.Conduzimos uma metanálise de ensaios controlados randomizados que compararam HIIT versus MICT sobre a PAc. Os desfechos primários foram Pressão Arterial Sistólica (PAS) central (PASc) e Pressão Arterial Diastólica central (PADc). A PAS periférica (PASp), a PAD periférica (PADp), a Velocidade de Onda de Pulso (VOP) e a captação máxima de oxigênio (VO2max) foram analisadas como desfechos secundários. A metanálise das diferenças médias (DM) foi conduzida usando modelos de efeitos aleatórios.Nosso estudo incluiu 163 pacientes recrutados em seis ensaios. Encontramos que HIIT foi superior ao MICT em reduzir PASc (DM = -3,12 mmHg, IC95% -4,75 - 1,50, p = 0,0002) e PAS (DM = -2,67 mmHg, IC95% -5,18 - -0,16, p = 0,04) e aumentar VO2max (DM = 2,49 mL/Kg/min, IC95% 1,25 - 3,73, p = 0,001). No entanto, não foram relatadas diferenças quanto à PADc, PAD ou VOP. O HIIT foi superior ao MICT em reduzir PASc, sugerindo seu potencial papel como uma terapia não farmacológica para a pressão arterial elevada.


Abstract Central blood pressure (cBP) is considered an independent predictor of organ damage, cardiovascular events and all-cause mortality. Evidence has shown that high intensity interval training (HIIT) is superior to moderate-intensity continuous training (MICT) for improving cardiorespiratory fitness and vascular function. However, the effects of these aerobic training modalities on cBP have not yet been properly reviewed.This meta-analysis aims to investigate to effects of HIIT versus MICT on cBP.We conducted a meta-analysis of randomized controlled trials that compared HIIT versus MICT on cBP. Primary outcomes were measures of central systolic blood pressure (cSBP) and central diastolic blood pressure (cDBP). Peripheral systolic blood pressure (pSBP) and diastolic blood pressure (pDBP), pulse wave velocity (PWV) and maximal oxygen uptake (VO2max) were analyzed as second outcomes. Meta-analysis of mean differences (MD) was conducted using the random effects model.Our study included 163 patients enrolled in six trials. We found that HIIT was superior to MICT in reducing the cSBP (MD = -3.12 mmHg, 95% CI: -4.75 to -1.50, p = 0.0002) and SBP (MD = -2.67 mmHg, 95% CI: -5.18 to -0.16, p = 0.04), and increasing VO2max(MD = 2.49 mL/kg/min, 95% CI: 1.25 to 3.73, p = 0.001). However, no significant differences were reported for cDBP, DBP and PWV.HIIT was superior to MICT in reducing the cSBP, which suggests its potential role as a non-pharmacological therapy for high blood pressure.

14.
Pesqui. bras. odontopediatria clín. integr ; 23: e210213, 2023. tab, graf
Artigo em Inglês | LILACS, BBO | ID: biblio-1448798

RESUMO

ABSTRACT Objective: To assess the efficacy and safety of the use of midazolam as monotherapy, compared to the associated use of midazolam and hydroxyzine for minimum and moderate sedation of children in dental offices, using data obtained from clinical trials. Material and Methods: A systematic review protocol was developed and registered on PROSPERO (CR42020208633). An electronic search was carried out in Pubmed, Lilacs, Science Direct, Open Gray, Web of Science, and central Cochrane Library. No language restrictions were included. Clinical trials were carried out with children aged 0-12 years, using midazolam as monotherapy compared to the use of midazolam associated with hydroxyzine to verify the effectiveness and safety of oral sedation. The quality of the studies was individually assessed and grouped using the RoB 2 (Revised Cochrane risk-of-bias tool for randomized trials) and GRADE (Grading of Recommendations Assessment, Development and Evaluation) systems, respectively. Results: A total of 749 studies were found. After analyzing the inclusion and removal of duplicates, two studies were analyzed for the quality of evidence. Through this analysis, it was possible to verify the very low level of scientific evidence on the superiority of the efficacy and safety of the combined use of midazolam and hydroxyzine for oral sedation in children in dental offices. Conclusion: The conflicting results and limitations of the studies enabled to establish that there is insufficient evidence to support the use of these drugs combined. There is only evidence for the use of midazolam as monotherapy.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança
15.
Einstein (Säo Paulo) ; 21: eRC0543, 2023. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1440062

RESUMO

ABSTRACT We report the long-term outcomes of a case of prenatal gastroschisis repair using a fully percutaneous fetoscopic approach with partial carbon dioxide insufflation. Surgery was performed as an experimental procedure before the scheduled elective birth. The fetal intestines were successfully returned to the abdominal cavity without any fetal or maternal complications. Ultrasonography performed 24 hours later revealed bowel peristalsis and no signs of fetal distress. After 48 hours, partial extrusion of the small bowel was observed, and the fetus was delivered. Gastroschisis repair was immediately performed upon delivery using the EXIT-like procedure as per our institutional protocol. The newborn did not require assisted mechanical ventilation, was discharged at 14 days of age and was then exclusively breastfed. At 3-year follow-up, the patient had no associated gastroschisis-related complications. This is the first case of prenatal repair of gastroschisis, which provides baseline knowledge for future researchers on the potential hurdles and management of prenatal repair.

16.
J. Phys. Educ. (Maringá) ; 33: e3360, 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1421886

RESUMO

ABSTRACT The Table Tennis game does not involve large displacements by the practitioner in the environment, a characteristic that can promote greater safety for the elderly in locomotor terms. In addition, it needs coordination, agility, speed of reaction, dynamic balance, which have been the focus of current recommendations of physical activity for the health of adults and the elderly. The aim of this study is to investigate the effects of table tennis practice on physical and functional fitness in the elderly. This quasi-experimental research with a parallel and controlled design. The sample consisted of 16 elderly people, allocated 8 in the experimental group (EG) and 8 in the control group (CG). The research lasted 18 weeks, with 2 weeks of evaluation (initial and final) and 16 weeks of intervention. Physical fitness assessments were carried out using the agility and balance and functional fitness tests. In the intra-group comparison (pre-post intervention), EG showed a significant difference for the variable agility (pre: 15.6 ± 1.2 s; post: 14.7 ± 0.7 s). Also, the EG showed a reduction in Area (pre: 11.00±3.32 cm2; post: 6.52±3.06 cm2), AP Amplitude (pre: 4.92±2.77 cm; post: 3.28±0.58 cm) and ML speed (pre: 2.77±1.07 cm/s; post: 2.31±1.03 cm/s) in the Tandem posture with eyes open. Our findings highlight the importance of a Table Tennis program, administered twice a week and consisted of low to moderate intensity activities, to promote a beneficial effect on the agility and balance of physically active elderly people.


RESUMO O jogo de Tênis de Mesa não envolve grandes deslocamentos do praticante no ambiente, característica que pode promover maior segurança ao idoso em termos locomotores. Além disso, precisa de coordenação, agilidade, velocidade de reação, equilíbrio dinâmico, que têm sido foco das atuais recomendações de atividade física para a saúde de adultos e idosos. O objetivo deste estudo é investigar os efeitos da prática de tênis de mesa na aptidão física e funcional de idosos. Esta pesquisa apresenta delineamento quase experimental com um desenho paralelo e controlado. A amostra foi composta por 16 idosos, alocados 8 no grupo experimental (GE) e 8 no grupo controle (GC). A pesquisa teve duração de 18 semanas, sendo 2 semanas de avaliação (inicial e final) e 16 semanas de intervenção. As avaliações da aptidão física foram realizadas por meio dos testes de agilidade e equilíbrio e aptidão funcional. Na comparação intragrupo (pré-pós intervenção), o GE apresentou diferença significativa para a variável agilidade (pré: 15,6 ± 1,2 s; pós: 14,7 ± 0,7s). Além disso, o GE apresentou redução na Área (pré: 11,00±3,32 cm2; pós: 6,52±3,06 cm2), Amplitude AP (pré: 4,92±2,77 cm; pós: 3,28±0,58 cm) e velocidade ML (pré: 2,77±1,07 cm/s; pós: 2,31±1,03 cm/s) na postura Tandem com os olhos abertos. Nossos achados destacam a importância de um programa de Tênis de Mesa, administrado duas vezes por semana e composto por atividades de baixa a moderada intensidade, para promover um efeito benéfico na agilidade e equilíbrio de idosos fisicamente ativos.


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Jogos e Brinquedos , Idoso/fisiologia , Tênis , Aptidão Física/fisiologia , Fenômenos Biomecânicos , Envelhecimento/fisiologia , Esportes com Raquete , Equilíbrio Postural/fisiologia
17.
Einstein (Sao Paulo) ; 15(4): 395-402, 2017.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29364360

RESUMO

OBJECTIVE: To describe our initial experience with a novel approach to follow-up and treat gastroschisis in "zero minute" using the EXITlike procedure. METHODS: Eleven fetuses with prenatal diagnosis of gastroschisis were evaluated. The Svetliza Reductibility Index was used to prospectively evaluate five cases, and six cases were used as historical controls. The Svetliza Reductibility Index consisted in dividing the real abdominal wall defect diameter by the larger intestinal loop to be fitted in such space. The EXIT-like procedure consists in planned cesarean section, fetal analgesia and return of the herniated viscera to the abdominal cavity before the baby can fill the intestines with air. No general anesthesia or uterine relaxation is needed. Exteriorized viscera reduction is performed while umbilical cord circulation is maintained. RESULTS: Four of the five cases were performed with the EXIT-like procedure. Successful complete closure was achieved in three infants. The other cases were planned deliveries at term and treated by construction of a Silo. The average time to return the viscera in EXIT-like Group was 5.0 minutes, and, in all cases, oximetry was maintained within normal ranges. In the perinatal period, there were significant statistical differences in ventilation days required (p = 0.0169), duration of parenteral nutrition (p=0.0104) and duration of enteral feed (p=0.0294). CONCLUSION: The Svetliza Reductibility Index and EXIT-like procedure could be new options to follow and treat gastroschisis, with significantly improved neonatal outcome in our unit. Further randomized studies are needed to evaluate this novel approach.


Assuntos
Cesárea/métodos , Doenças Fetais/cirurgia , Terapias Fetais/métodos , Gastrosquise/cirurgia , Assistência ao Convalescente , Dilatação Patológica , Feminino , Feto/patologia , Gastrosquise/diagnóstico por imagem , Gastrosquise/embriologia , Idade Gestacional , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Masculino , Idade Materna , Equipe de Assistência ao Paciente , Gravidez , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia Pré-Natal
18.
Sao Paulo Med J ; 134(4): 355-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27276083

RESUMO

CONTEXT: Umbilical cord thrombosis is related to greater fetal and perinatal morbidity and mortality. It is usually associated with umbilical cord abnormalities that lead to mechanical compression with consequent vascular ectasia. Its correct diagnosis and clinical management remains a challenge that has not yet been resolved. CASE REPORT: This study reports a case of umbilical artery thrombosis that occurred in the second half of a pregnancy. The umbilical cord was long, thin and overly twisted and the fetus presented severe intrauterine growth restriction. The clinical and histopathological findings from this case are described. CONCLUSIONS: This case report emphasizes the difficulty in diagnosing and clinically managing abnormalities of intrauterine life with a high chance of perinatal complications.


Assuntos
Feto/anormalidades , Artérias Umbilicais/irrigação sanguínea , Artérias Umbilicais/patologia , Trombose Venosa/patologia , Adulto , Feminino , Retardo do Crescimento Fetal/etiologia , Feto/diagnóstico por imagem , Humanos , Recém-Nascido , Masculino , Gravidez , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Diagnóstico Pré-Natal , Fatores de Risco , Artérias Umbilicais/diagnóstico por imagem , Trombose Venosa/complicações , Trombose Venosa/diagnóstico por imagem
20.
Saude e pesqui. (Impr.) ; 14(1): 113-123, jan-mar 2021.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1254255

RESUMO

O objetivo deste estudo foi avaliar os efeitos do timol e carvacrol contra Aspergillus flavus e a produção de aflatoxinas. Foram determinadas a concentração inibitória mínima (CIM), o espectro fungitóxico e a atividade inibidora de micotoxinas pelo timol e carvacrol. Os resultados mostraram que timol e carvacrol exibiram ação fungicida de acordo com a CIM de 2500 e 30 µg mL-1, respectivamente. Tanto o timol quanto o carvacrol inibiram significativamente o crescimento de A. flavus (p<0,05) a partir de 600 e 15 µg mL-1, respectivamente. A biomassa fúngica, estimada pela determinação da concentração de ergosterol, foi significativamente reduzida (p <0,05) em 2500 µg mL-1 de timol e 250 µg mL-1 de carvacrol. O timol e o carvacrol exibiram efeitos antiaflatoxigênicos em 600 e 125 µg mL-1, respectivamente. O timol e o carvacrol exibiram atividade antifúngica, mas não exibiram alta atividade antiaflatoxigênica. Carvacrol e timol podem ser considerados como potentes compostos naturais antifúngicos contra A. flavus.


The aim of this study was to evaluate the effects of thymol and carvacrol upon production of aflatoxins by Aspergillus flavus and upon its growth. Minimal inhibitory concentration (MIC), fungitoxic spectrum and mycotoxin inhibition were assessed. Results showed thymol and carvacrol exhibited fungicidal action, as determined by MIC values of 2500 and 30 µg mL-1, respectively. Both thymol and carvacrol significantly inhibited growth of A. flavus (p<0.05) at concentrations of 600 and 15 µg mL-1, respectively. Fungal biomass, as estimated by determination of ergosterol concentration, was significantly reduced (p<0.05) at thymol concentrations of 2500 µg mL-1 and at carvacrol concentrations of 250 µg mL-1. Thymol and carvacrol exhibited antiaflatoxigenic effects at concentrations of 600 and 125 µg mL-1, respectively. While both thymol and carvacrol showed possessing antifungal activities, neither were highly antiaflatoxigenic. Carvacrol and thymol might be considered for use as potential antifungal natural compounds against A. flavus.

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