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1.
J Sex Med ; 20(3): 269-276, 2023 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-36751985

RESUMO

BACKGROUND: Virtually all patients with human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) have some degree of erectile dysfunction (ED), but ED is also found in a large percentage of HTLV-1 carriers. AIM: To evaluate the evolution of ED in individuals infected with HTLV-1 who were followed for up to 15 years. METHODS: This prospective cohort study included men infected with HTLV-1 who had ED, were aged 18 to 70 years, and were followed from January 2004 to December 2019. We used the International Index of Erectile Function-5 (IIEF-5), the Expanded Disability Status Scale and Osame Motor Disability Scale, and the Overactive Bladder Symptom Score (OABSS) to define and stratify ED, neurologic disability, and bladder dysfunction, respectively. OUTCOMES: Time to development of severe ED was the main outcome. RESULTS: We studied 90 men with ED (mean ± SD age, 52.8 ± 9.78 years). At baseline, 42 were carriers, 16 had probable HAM/TSP, and 32 had definite HAM/TSP. IIEF-5 was highest among carriers and lowest in patients with definite HAM/TSP, whereas OABSS was lowest in carriers and highest in patients with definite HAM/TSP. Median (IQR) follow-up was 8.50 years (3.00-12.00). IIEF-5 fell significantly from baseline to last follow-up among carriers and patients with probable and definite HAM/TSP. There was an inverse correlation between the IIEF-5 and the OABSS at last follow-up (r = -0.62, P < .001). In survival analysis, the time to development of severe ED was significantly shorter in patients with definite HAM/TSP when compared with carriers (P = .001) and those with probable HAM/TSP (P = .014). The presence of definite HAM/TSP at baseline was independently associated with the development of severe ED, after adjustment for baseline age and proviral load (hazard ratio, 6.74; P = .008). CLINICAL IMPLICATIONS: Formal assessment of erectile function should be part of the routine clinical assessment of individuals infected with HTLV-1; worsening erectile function should alert clinicians to the possibility of neurologic deterioration. STRENGTHS AND LIMITATIONS: This is the first prospective cohort study to describe the course of ED in men infected with HTLV-1. The small sample size and absence of seronegative controls are limitations. CONCLUSION: ED is a slowly progressive clinical manifestation of HTLV-1 infection, and the degree of neurologic compromise at baseline is the main predictor of time to progression to severe ED.


Assuntos
Pessoas com Deficiência , Disfunção Erétil , Vírus Linfotrópico T Tipo 1 Humano , Transtornos Motores , Paraparesia Espástica Tropical , Masculino , Humanos , Adulto , Pessoa de Meia-Idade , Disfunção Erétil/complicações , Estudos Prospectivos
2.
BMC Pediatr ; 23(1): 125, 2023 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-36932378

RESUMO

AIM: To analyze the association between neonatal near miss and infant development at two years. METHODS: Data from two birth cohorts, one conducted in Ribeirão Preto (RP)/São Paulo and the other in São Luís (SL)/Maranhão, were used. The cognitive, motor and communication development of children was evaluated using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). The following criteria were used for the definition of NNM: birth weight < 1,500 g, 5-min Apgar score < 7, gestational age < 32 weeks, and report of congenital malformations. The relationship between neonatal near miss and development was assessed using the weighted propensity score from the Inverse Probability of Treatment Weighting (IPTW). A directed acyclic graph was built to select the adjustment variables. RESULTS: A total of 1,050 mother-newborn dyads were evaluated in SL and 1,840 in RP. Regarding outcomes in SL and RP, respectively, 2.4% and 17.3% of the children were not competent in the cognitive domain, 12.1% and 13.3% in the receptive communication domain, 39.2% and 47.1% in the expressive communication domain, 20.7% and 12.6% in the fine motor domain, and 14.3% and 13.8% in the gross motor domain. The prevalence of neonatal near miss was 5.4% in SL and 4.3% in RP. Unadjusted analysis showed an association of neonatal near miss with fine motor development in SL and RP and with the cognitive, receptive communication, expressive communication, and gross motor domains only in RP. These associations remained after adjusted analysis. CONCLUSION: Neonatal near miss is a risk factor for developmental delays.


Assuntos
Coorte de Nascimento , Near Miss , Recém-Nascido , Feminino , Humanos , Lactente , Fatores Socioeconômicos , Estudos de Coortes , Brasil/epidemiologia , Recém-Nascido de muito Baixo Peso
3.
J Med Internet Res ; 25: e43132, 2023 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-37256680

RESUMO

BACKGROUND: Social media has emerged as an effective tool to mitigate preventable and costly health issues with social network interventions (SNIs), but a precision public health approach is still lacking to improve health equity and account for population disparities. OBJECTIVE: This study aimed to (1) develop an SNI framework for precision public health using control systems engineering to improve the delivery of digital educational interventions for health behavior change and (2) validate the SNI framework to increase organ donation awareness in California, taking into account underlying population disparities. METHODS: This study developed and tested an SNI framework that uses publicly available data at the ZIP Code Tabulation Area (ZCTA) level to uncover demographic environments using clustering analysis, which is then used to guide digital health interventions using the Meta business platform. The SNI delivered 5 tailored organ donation-related educational contents through Facebook to 4 distinct demographic environments uncovered in California with and without an Adaptive Content Tuning (ACT) mechanism, a novel application of the Proportional Integral Derivative (PID) method, in a cluster randomized trial (CRT) over a 3-month period. The daily number of impressions (ie, exposure to educational content) and clicks (ie, engagement) were measured as a surrogate marker of awareness. A stratified analysis per demographic environment was conducted. RESULTS: Four main clusters with distinctive sociodemographic characteristics were identified for the state of California. The ACT mechanism significantly increased the overall click rate per 1000 impressions (ß=.2187; P<.001), with the highest effect on cluster 1 (ß=.3683; P<.001) and the lowest effect on cluster 4 (ß=.0936; P=.053). Cluster 1 is mainly composed of a population that is more likely to be rural, White, and have a higher rate of Medicare beneficiaries, while cluster 4 is more likely to be urban, Hispanic, and African American, with a high employment rate without high income and a higher proportion of Medicaid beneficiaries. CONCLUSIONS: The proposed SNI framework, with its ACT mechanism, learns and delivers, in real time, for each distinct subpopulation, the most tailored educational content and establishes a new standard for precision public health to design novel health interventions with the use of social media, automation, and machine learning in a form that is efficient and equitable. TRIAL REGISTRATION: ClinicalTrials.gov NTC04850287; https://clinicaltrials.gov/ct2/show/NCT04850287.


Assuntos
Saúde Pública , Obtenção de Tecidos e Órgãos , Idoso , Humanos , Estados Unidos , Medicare , Escolaridade , Rede Social
4.
Eur J Public Health ; 32(Suppl 1): i38-i43, 2022 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-36031817

RESUMO

BACKGROUND: To date, few data on the quality and quantity of online physical education (P.E.) during the COVID-19 pandemic have been published. We assessed activity in online classes and reported allocated curriculum time for P.E. in a multi-national sample of European children (6-18 years). METHODS: Data from two online surveys were analysed. A total of 8395 children were included in the first round (May-June 2020) and 24 302 in the second round (January-February 2021). RESULTS: Activity levels during P.E. classes were low in spring 2020, particularly among the youngest children and in certain countries. 27.9% of students did not do any online P.E. and 15.7% were hardly ever very active. Only 18.4% were always very active and 14.9% reported being very active quite often. In winter 2020, we observed a large variability in the allocated curriculum time for P.E. In many countries, this was lower than the compulsory requirements. Only 65.7% of respondents had the same number of P.E. lessons than before pandemic, while 23.8% had less P.E., and 6.8% claimed to have no P.E. lessons. Rates for no P.E. were especially high among secondary school students, and in large cities and megapolises. CONCLUSIONS: During the COVID-19 pandemic, European children were provided much less P.E. in quantity and quality than before the pandemic. Countermeasures are needed to ensure that these changes do not become permanent. Particular attention is needed in large cities and megapolises. The critical role of P.E. for students' health and development must be strengthened in the school system.


Assuntos
COVID-19 , Educação a Distância , Criança , Humanos , Pandemias , Educação Física e Treinamento , Instituições Acadêmicas
5.
Int J Sport Nutr Exerc Metab ; 32(6): 479-490, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-35894910

RESUMO

During the athletic season, changes in body composition occur due to fluctuations in energy expenditure and energy intake. Literature regarding changes of energy availability (EA) is still scarce. The aim was to estimate EA of athletes from nonweight and weight-sensitive sports during the athletic season (i.e., preparatory and competitive phase). Eighty-eight athletes (19.1 ± 4.2 years, 21.8 ± 2.0 kg/m2, 27% females, self-reported eumenorrheic) from five sports (basketball [n = 29]; handball [n = 7]; volleyball [n = 9]; swimming [n = 18]; and triathlon [n = 25]) were included in this observational study. Energy intake and exercise energy expenditure were measured through doubly labeled water (over 7 days and considering neutral energy balance) and metabolic equivalents of tasks, respectively. Fat-free mass (FFM) was assessed through a four-compartment model. EA was calculated as EA = (energy intake - exercise energy expenditure)/FFM. Linear mixed models, adjusted for sex, were performed to assess EA for the impact of time by sport interaction. Among all sports, EA increased over the season: basketball, estimated mean (SE): 7.2 (1.5) kcal/kg FFM, p < .001; handball, 14.8 (2.9) kcal/kg FFM, p < .001; volleyball, 7.9 (2.8) kcal/kg FFM, p = .006; swimming, 8.7 (2.0) kcal/kg FFM, p < .001; and triathlon, 9.6 (2.0) kcal/kg FFM, p < .001. Eleven athletes (12.5%) had clinical low EA at the preparatory phase and none during the competitive phase. During both assessments, triathletes' EA was below optimal, being lower than basketballers (p < .001), volleyballers (p < .05), and swimmers (p < .001). Although EA increased in all sports, triathlon's EA was below optimal during both assessments. Risk of low EA might be seasonal and resolved throughout the season, with higher risk during the preparatory phase. However, in weight-sensitive sports, namely triathlon, low EA is still present.


Assuntos
Esportes , Feminino , Humanos , Masculino , Estações do Ano , Atletas , Ingestão de Energia , Composição Corporal , Metabolismo Energético , Água
6.
Sensors (Basel) ; 22(16)2022 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-36015797

RESUMO

In urban mobility, Vehicular Ad Hoc Networks (VANETs) provide a variety of intelligent applications. By enhancing automobile traffic management, these technologies enable advancements in safety and help decrease the frequency of accidents. The transportation system can now follow the development and growth of cities without sacrificing the quality and organisation of its services thanks to safety apps that include collision alerts, real-time traffic information, and safe driving applications, among others. Applications can occasionally demand a lot of computing power, making their processing impractical for cars with limited onboard processing capacity. Offloading of computation is encouraged by such a restriction. However, because vehicle mobility operations are dynamic, communication times (also known as link lifetimes) between nodes are frequently short. VANET applications and processes are impacted by such communication delays (e.g., the offloading decision when using the Computational Offloading technique). Making an accurate prediction of the link lifespan between vehicles is therefore challenging. The effectiveness of the communication time estimation is currently constrained by the link lifespan prediction methods used in the computational offloading process. This work investigates five machine learning (ML) algorithms to predict the link lifetime between nodes in VANETs in different scenarios. We propose the procedures required to carry out the link lifetime prediction method using existing ML techniques. The tactic creates datasets with the features the models need to learn and be trained. The SVR and XGBoost algorithms that were selected as part of the assessment process were trained. To make the prediction using the trained models, we modified the lifespan prediction function from an offloading approach. To determine the viability of applying link lifespan predictions from the models trained in the road and urban scenarios, we conducted a performance study. The findings indicate that compared to the conventional prediction strategy described in the literature, the suggested link lifetime prediction via regression approaches decreases prediction error rates. An offloading method from the literature is extended by the selected SVR. The task loss and recovery rates might be significantly reduced using the SVR. XGBoost outperformed its ML competitors in task recovery or drop rate by 70% to 80% in an assessed hypothesis compared to an offloading choice technique in the literature. With greater offloading rates from an application on the VANET, this effort is intended to give better efficiency in estimating this data using machine learning in various vehicular settings.


Assuntos
Condução de Veículo , Redes de Comunicação de Computadores , Algoritmos , Aprendizado de Máquina , Meios de Transporte
7.
Homeopathy ; 111(4): 278-287, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35477183

RESUMO

OBJECTIVE: The present study aimed to identify possible phenotypic changes in 4T1 (murine mammary adenocarcinoma) cells in vitro, including viability, HER-2 (human epidermal growth factor receptor-type 2) expression, and metastatic potential, after treatment with Carcinosinum in different homeopathic dilutions (12cH, 30cH, 200cH) shaken mechanically in pure, sterile, water from a commercial stock dilution. METHODS: Treated cells were cultured in R10 medium, using 24-well plates, 105 cells per well, and treated with vehicle, Carcinosinum 12cH, 30cH or 200cH; untreated cells were used as the baseline control. After 24 hours of treatment, the percentage of apoptotic cells was analyzed by annexin V. Cell morphology was evaluated by microscopy after hematoxylin-eosin and Giemsa staining, whilst HER-2 expression was assessed using immunocytochemistry. The metastatic potential was determined by the expression and activity of the enzyme matrix metalloproteinase 9 (MMP-9) using zymography. The cytokine profile was established using the cytometric bead array method. RESULT: Treatment of 4T1 cells in vitro with Carcinosinum 30cH produced an increase in the number of annexin V-positive cells (apoptosis) and decreased expression of proactivated MMP-9. Cells treated with Carcinosinum 200cH presented hyper-expression of HER-2 on the plasma membrane, identified by immunocytochemistry. There were no differences in cytokine production among treatments. CONCLUSION: The data show promising results for Carcinosinum 30cH in vitro, but in vivo studies are also required to evaluate the role of tumor microenvironment in its effects.


Assuntos
Adenocarcinoma , Homeopatia , Humanos , Camundongos , Animais , Metaloproteinase 9 da Matriz/metabolismo , Linhagem Celular Tumoral , Anexina A5 , Camundongos Endogâmicos BALB C , Citocinas , Adenocarcinoma/tratamento farmacológico , Microambiente Tumoral
9.
Scand J Med Sci Sports ; 31(8): 1612-1620, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33817862

RESUMO

We aimed to validate bioelectrical impedance spectroscopy (BIS), compared with tracer dilution measurements, for assessing total body water (TBW), intracellular water (ICW), and extracellular water (ECW) in athletes differing in hydration status. A total of 201 athletes participated. Reference TBW and ECW were determined by deuterium and bromide dilution methods, respectively; ICW was calculated as TBW-ECW. Water compartments were estimated by BIS. Urine specific gravity (USG) classified athletes into well-hydrated (WH) (USG < 1.023), euhydrated (EH) (USG:1.024-1.026), and dehydrated (DH) (USG>1.027). No significant differences were found between BIS and the reference methods for WH, EH, and DH athletes for TBW, ICW nor ECW (p>0.05). Concordance of TBW and its compartments by method was significant (p < 0.001) with coefficients of determination ranging by hydration classification [EH:52-96%;DH:56-98%;WH:71-96%]. Bland-Altman analyses showed no trend for TBW and its compartments with the exception of ICW in the WH athletes. The 95% confidence BIS intervals for the WH group ranged from -3.08 to 2.68 kg for TBW, -4.28 to 4.14 kg for ICW, and -3.29 to 3.02 kg for ECW. For the EH athletes, the 95% confidence intervals ranged from -2.78 to 2.24 kg for TBW, -4.10 to 3.94 kg for ICW, and -3.44 to 3.06 kg for ECW. In DH group, TBW ranged between -1.99 and 2.01 kg, ICW between -3.78 and 6.34 kg, and ECW between -6.22 and 3.74 kg. These findings show that BIS is useful at a group level in assessing water compartments in athletes differing in hydration status. However, the usefulness of BIS is limited at an individual level, especially in dehydrated athletes.


Assuntos
Atletas , Água Corporal/metabolismo , Impedância Elétrica , Estado de Hidratação do Organismo/fisiologia , Análise Espectral/normas , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
10.
BMC Public Health ; 21(1): 1797, 2021 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-34615500

RESUMO

BACKGROUND: Physical inactivity has been recognised as a global public health problem that requires concerted action. This calls for systematic physical activity (PA) surveillance as a mechanism for assessing the problem and evaluating the effectiveness of related policies. Because countries tend to design their policy measures based on national surveillance data, here we present an inventory of existing national surveillance systems on PA, sedentary behaviour (SB) and sport participation (SP) among adult population in all European Union (EU) Member States. METHODS: As a part of the European Physical Activity and Sports Monitoring System (EUPASMOS) project, a questionnaire was constructed in the form of an on-line survey to collect detailed information on existing national surveillance systems on either PA, SB, or SP. National HEPA focal points from all 27 EU Member States were invited to answer the on-line questionnaire and data collection took part in the period May 2018-September 2019. RESULTS: National monitoring of PA or SB or SP for adults has been established in 16/27 EU Member States, that host 33 different PA/SB/SP monitoring systems. Apart from 3 countries that are using accelerometers (Finland, Ireland and Portugal), surveillance is typically based on questionnaires. In most Member States these questionnaires have not been validated in the particular language and cultural setting. Next, specific domains and dimensions of PA, SB and SP assessed vary a lot across countries. Only 3 countries (the Netherlands, Portugal and Slovenia) are monitoring all three behaviours while covering most of the domains and dimensions of PA/SB/SP. Lastly, as half of the existing surveillance systems set an upper age limit, in 9/16 countries that are monitoring PA/SB/SP, no data for people older than 80 years are available. CONCLUSIONS: Systematic surveillance of PA is lacking among 11/27 EU countries, with even few monitoring SB and SP. Besides, existing surveillance systems typically fail to assess all dimensions and domains of PA/SB/SP with only three countries maintaining monitoring systems that encompass all three behaviours while covering most of the domains and dimensions of PA/SB/SP. Hence, additional efforts in advocacy of systematic PA surveillance in the EU are called for.


Assuntos
Comportamento Sedentário , Esportes , Adulto , Idoso de 80 Anos ou mais , União Europeia , Exercício Físico , Humanos , Saúde Pública
11.
BMC Public Health ; 21(Suppl 1): 381, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33892658

RESUMO

BACKGROUND: Physical inactivity is a global phenomenon in European welfare countries. Proper monitoring is essential to measure the physical activity level of the population. METHODS: In the Hungarian cohort of the European Physical Activity and Sport Monitoring System (EUPASMOS) project, our participants (N = 598) completed sociodemographic questions and the International Physical Activity Questionnaire - short form (IPAQ-SF) survey. The validity and reliability of the subjective measurement tool were examined, IPAQ-SF outcomes were contrasted against triaxial RM42 accelerometer wore for 7 consecutive days. RESULTS: The IPAQ-SF showed moderate internal consistency (Cronbach Alpha = 0.647). The concurrent validity of the IPAQ-SF to triaxial accelerometer indicated a significant weak-to-moderate correlation (R = 0.111-0.338, p = 0.042; p < 0.001). The test-retest reliability showed a significant correlation between two measurements (R = 0.788-0.981, p < 0.001). CONCLUSION: The Hungarian version of the IPAQ-SF had excellent test-retest reliability, but low-to-fair concurrent validity for moderate and vigorous physical activity, walking and sitting time, as compared to the objective criterion measure among Hungarian adults.


Assuntos
Acelerometria , Exercício Físico , Adulto , Europa (Continente) , Humanos , Hungria , Reprodutibilidade dos Testes , Inquéritos e Questionários
12.
BMC Nephrol ; 21(1): 34, 2020 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000715

RESUMO

BACKGROUND: Given the aging of the population, nephrologists are ever more frequently assisting nonagenarians with acute kidney injury (AKI). The management of these patients presents unique characteristics, including bioethical dilemmas, such as the utilization of renal replacement therapy (RRT) at this extreme age. METHODS: We conducted a retrospective cohort study at a tertiary hospital. Over a 10-year period, 832 nonagenarians were hospitalized for two or more days. A random sample of 461 patients was obtained; 25 subjects were excluded due to lack of essential data. AKI was defined and staged according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. RESULTS: We analyzed data from 436 patients, mean age 93.5 ± 3.3 years, 74.3% female; 76.4% required intensive care unit (ICU). The incidence of AKI was 45%. Length of hospital stay, ICU admission, vasopressors, and mechanical ventilation (MV) were independent predictors of AKI. Overall in-hospital mortality was 43.1%. Mortality was higher in the AKI compared to the no AKI group (66.8% vs. 23.8%, p < 0.001). Only 13 patients underwent RRT; all were critically ill, requiring vasopressors and 76.9% in MV. Mortality for this RRT group was 100% but not significantly higher than that observed in 26 non-RRT controls (96.1%, p = 1.0) obtained by proportional random sampling, matched by variables related to illness severity. In multivariable analysis, age, Charlson's score, vasopressors, MV, and AKI - but not RRT - were independent predictors of mortality. CONCLUSIONS: AKI is common in hospitalized nonagenarians and carries a grave prognosis, especially in those who are critically iil. The use of RRT was not able to change the fatal prognosis of this subgroup of patients. Our data may help guide informed decisions about the utility of RRT in this scenario.


Assuntos
Injúria Renal Aguda/epidemiologia , Mortalidade Hospitalar , Pacientes Internados/estatística & dados numéricos , Injúria Renal Aguda/mortalidade , Injúria Renal Aguda/terapia , Idoso de 80 Anos ou mais , Cuidados Críticos , Feminino , Humanos , Incidência , Tempo de Internação , Masculino , Prognóstico , Curva ROC , Diálise Renal/estatística & dados numéricos , Respiração Artificial , Estudos Retrospectivos , Fatores de Risco , Vasoconstritores/uso terapêutico
13.
Curr Opin Nephrol Hypertens ; 28(5): 417-423, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31268919

RESUMO

PURPOSE OF REVIEW: Hyperkalemia is a potentially fatal electrolyte disorder, more commonly present when the potassium excretion capacity is imparied. Hyperkalemia can lead to adverse outcomes, especially due to severe cardiac arrhythmias. It can also impair the cardiovascular effects of renin-angiotensin-aldosterone system inhibitors (RAASis) and potassium rich diets, as hyperkalemia frequently leads to their discontinuation. RECENT FINDINGS: Potassium is a predictor of mortality and should be monitored closely for patients who are at risk for hyperkalemia. Acute hyperkalemia protocols have been revised and updated. Randomized trials have shown that the new anti-hyperkalemic agents (patiromer and zirconium cyclosilicate) are effective hyperkalemia treatment options. The use of anti-hyperkalemic agents may allow for a less restrictive potassium diet and lower RAASi discontinuation rates. SUMMARY: Hyperkalemia should be monitored closely for high-risk patients, as it is associated with adverse outcomes. New therapies have demonstrated effective control, offering hope for potential use in patients that would benefit from diet or medications associated with an increase in serum potassium, indicating that the use of hyperkalemic agents can be associated with better outcomes.


Assuntos
Hiperpotassemia/tratamento farmacológico , Eletrocardiografia , Insuficiência Cardíaca/complicações , Humanos , Hiperpotassemia/etiologia , Polímeros/uso terapêutico , Potássio/sangue , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Sistema Renina-Angiotensina/efeitos dos fármacos
14.
J Sex Med ; 16(11): 1763-1768, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31521570

RESUMO

INTRODUCTION: Erectile dysfunction (ED) is associated with neurological damage due to human T-lymphotropic virus 1 (HTLV-1) infection, but hormonal and psychogenic factors also cause ED. AIM: To evaluate the association of psychogenic and hormonal factors with ED in men infected with HTLV-1. METHODS: In this cross-sectional study, we compared total testosterone, follicle stimulating hormone, luteinizing hormone, prolactin, anxiety symptoms, depressive symptoms, and neurologic manifestations in HTLV-1-infected men with or without ED. The International Index of Erectile Function was used to determine the degree of ED. Participants were grouped according to Osame's Motor Disability Scale and the Expanded Disability Status Scale: HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP), probable HAM/TSP, or HTLV-1 carrier. Chi-square and Fisher's exact tests were used to compare the groups, and regression analyses were used to show predictors of ED. MAIN OUTCOME MEASURE: Sexual hormonal levels, psychogenic factors, and neurologic disabilities were found to be associated with ED. RESULTS: ED was associated with age older than 60 years (P < .001), degree of neurologic involvement (P < .001), depression (P = .009), and anxiety (P = .008). In the multivariate analyses, only age and degree of neurological injury remained as risk factors for ED. CLINICAL IMPLICATIONS: Neurological manifestations are a stronger predictor of ED than hormonal and psychogenic factors in HTLV-1-infected men. STRENGTHS & LIMITATIONS: The statistical power of the study was limited due to the low number of participants, but neurologic manifestations were clearly associated with ED. There was no strong association between hormonal and psychogenic factors and ED. CONCLUSION: Hormonal and psychogenic factors did not show a strong association with ED in individuals with HTLV-1, but neurological manifestations were strongly associated with ED in these individuals. de Oliveira CJV, Neto, JAC, Andrade RCP, et al. Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV-1. J Sex Med 2019; 16:1763-1768.


Assuntos
Disfunção Erétil/epidemiologia , Infecções por HTLV-I/complicações , Comportamento Sexual , Adulto , Estudos Transversais , Depressão/epidemiologia , Pessoas com Deficiência , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Motores/epidemiologia , Paraparesia Espástica Tropical/epidemiologia , Fatores de Risco
15.
Neuroimmunomodulation ; 26(6): 285-291, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31935743

RESUMO

OBJECTIVE: Previously we observed an attenuation of body temperature in lactating rats treated with lipopolysaccharide (LPS) compared with virgin saline-treated females. We proposed that high levels of prolactin (PRL) during lactation may induce this attenuation because PRL has a suppressive effect on inflammation. In the present study, we induced hyperprolactinemia in female virgin rats to investigate the effects of PRL on body temperature and sickness behavior induced by LPS. METHODS: To induce hyperprolactinemia, female rats in the estrous phase received domperidone 3 times/day for 5 days and an LPS injection (D + LPS group). Two other groups were treated with saline solution for 5 days, and one of them received a saline injection (S + S group) and the other LPS (S + LPS group). Tympanic temperature was assessed 0, 2, 4, 6, 8, 10, 24, 48, 72, and 96 h after treatment. Body weight gain and food and water consumption were observed 24, 48, 72, and 96 h after treatment. RESULTS: Hyperprolactinemia impaired LPS-induced hypothermia and hyperthermia phases of body temperature. Body weight gains in the S + LPS group and the D + LPS group were similar. A decrease in food consumption was observed in the D + LPS rats at 72 and 96 h compared to the S + LPS group. CONCLUSION: Hyperprolactinemia impaired the body temperature increase induced by LPS and several signs of sickness behavior, suggesting that febrile responses to LPS can be modulated by the physiological state. These phenomena may have adaptive value for reproduction.


Assuntos
Temperatura Corporal/efeitos dos fármacos , Hiperprolactinemia , Comportamento de Doença/efeitos dos fármacos , Lipopolissacarídeos/toxicidade , Animais , Temperatura Corporal/fisiologia , Feminino , Comportamento de Doença/fisiologia , Ratos , Ratos Wistar
16.
J Clin Densitom ; 22(3): 429-436, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29681438

RESUMO

Whole-body composition analysis by dual-energy X-ray absorptiometry (DXA) requires subjects to fit within the width limits of the DXA bed. To overcome this limitation, the aim of this study was to validate a partial scanning technique at which the upper left limb is deliberately left unscanned and measurements are "reflected" from the right-side upper limb. A Hologic Explorer-W densitometer was used in a sample of 189 participants, including athletes and nonathletes, ranging from underweight to obese (body mass index: 17.0-40.1 kg/m2). A whole-body scan was analyzed as the reference procedure to determine bone mineral content (BMC), lean soft tissue (LST), and fat mass (FM), and reanalyzed using a partial reflection scanning (RS) technique. RS estimates of BMC were associated with athletic status and differed significantly from reference estimates (p < 0.05). Also, the RS estimates of LST and FM were different (p < 0.05) from those of the reference whole-body scan, although differences were small (0.17 kg, -0.02 kg, and -0.10% for BMC, LST, and FM, respectively). The alternative procedure explained more than 99% of the reference scan variance with low limits of agreement (BMC: -13.8 to 23.9 g [athletes] and -6.3 to 18.0 g [nonathletes]; LST: -0.11 to 0.45 kg; FM: -0.22 to 0.17 kg). Regardless of body mass index, athletic status, and gender, RS is a useful and simple solution to be used in individuals wider than the DXA scan area. However, individual errors for BMC may be higher in athletes engaged in lateral dominant sports practice.


Assuntos
Absorciometria de Fóton/métodos , Atletas , Composição Corporal , Tamanho Corporal , Obesidade , Imagem Corporal Total/métodos , Absorciometria de Fóton/instrumentação , Tecido Adiposo/diagnóstico por imagem , Adolescente , Adulto , Índice de Massa Corporal , Densidade Óssea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
Sensors (Basel) ; 19(1)2019 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-30609788

RESUMO

Although prostate cancer is one of the most common cancers in the male population, its basic biological function at a cellular level remains to be fully understood. This lack of in depth understanding of its physiology significantly hinders the development of new, targeted and more effective treatment strategies. Whilst electrophysiological studies can provide in depth analysis, the possibility of recording electrical activity in large populations of non-neuronal cells remains a significant challenge, even harder to address in the picoAmpere-range, which is typical of cellular level electrical activities. In this paper, we present the measurement and characterization of electrical activity of populations of prostate cancer cells PC-3, demonstrating for the first time a meaningful electrical pattern. The low noise system used comprises a multi-electrode array (MEA) with circular gold electrodes on silicon oxide substrates. The extracellular capacitive currents present two standard patterns: an asynchronous sporadic pattern and a synchronous quasi-periodic biphasic spike pattern. An amplitude of ±150 pA, a width between 50⁻300 ms and an inter-spike interval around 0.5 Hz characterize the quasi-periodic spikes. Our experiments using treatment of cells with Gd³âº, known as an inhibitor for the Ca²âº exchanges, suggest that the quasi-periodic signals originate from Ca²âº channels. After adding the Gd³âº to a population of living PC-3 cells, their electrical activity considerably decreased; once the culture was washed, thus eliminating the Gd³âº containing medium and addition of fresh cellular growth medium, the PC-3 cells recovered their normal electrical activity. Cellular viability plots have been carried out, demonstrating that the PC-3 cells remain viable after the use of Gd³âº, on the timescale of this experiment. Hence, this experimental work suggests that Ca²âº is significantly affecting the electrophysiological communication pattern among PC-3 cell populations. Our measuring platform opens up new avenues for real time and highly sensitive investigations of prostate cancer signalling pathways.


Assuntos
Fenômenos Eletrofisiológicos , Espaço Extracelular/fisiologia , Neoplasias da Próstata/ultraestrutura , Bloqueadores dos Canais de Cálcio/farmacologia , Eletricidade , Eletrodos , Fenômenos Eletrofisiológicos/efeitos dos fármacos , Gadolínio/farmacologia , Humanos , Ativação do Canal Iônico/efeitos dos fármacos , Masculino , Modelos Biológicos , Células PC-3 , Neoplasias da Próstata/metabolismo
18.
Surg Radiol Anat ; 41(5): 539-542, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30600337

RESUMO

The cricoid cartilage serves as an anatomical reference for several surgical procedures for access to the airway. Additionally, it serves as an attachment point for muscles that move the vocal folds. We present a case where the cricoid cartilage arch is divided into distinct superior and inferior arches, with a fibrous membrane between them. We did not find any similar description to this case in the literature, which makes it unique to date. This type of variation is important knowledge for clinicians and surgeons during airway management in the anterior neck region. The presence of this variation could induce an error during a palpation of the thyroid and cricoid cartilages, realized in clinical examination and surgical or emergency procedures.


Assuntos
Variação Anatômica , Cartilagem Cricoide/anatomia & histologia , Cadáver , Dissecação , Humanos , Imageamento por Ressonância Magnética
19.
Graefes Arch Clin Exp Ophthalmol ; 256(1): 163-171, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29071374

RESUMO

PURPOSE: To report the clinical (anatomic and functional) and genetic findings of Wagner Syndrome (WS) in a Portuguese family. METHODS: Nine members of the family agreed to be examined. All had complete clinical eye examinations. The proband and selected patients underwent color fundus photography, spectral domain optical coherence tomography (SD-OCT), automatic static white-on-white computerized perimetry, and electrophysiology assessment (flash ERG, multifocal(mf) ERG and dark adaptometry). A pedigree was constructed based on interviews with known affected subjects. Genomic DNA samples derived from venous blood were collected from all affected family members examined. RESULTS: Twenty-eight family members are affected. This family has the typical features of Wagner Syndrome, namely an empty vitreous cavity with veils, mild myopia and cataract. Four examined patients underwent vitreoretinal surgery due to abnormal peripheral vitreoretinal adhesions with peripheral retinal traction (n = 3). Retinal detachment was observed in 5 of the examined subjects. Four of them occurred between the ages of 5 and 15 years. Chorioretinal atrophy is also a frequent finding which results in moderate to severe visual field and advanced rod-cone dystrophy from younger ages, also confirmed by absence of scotopic function on dark adaptation. The macular dysfunction on mfERG was profound and of early onset. A heterozygous mutation in intron 7 of the VCAN gene (c.4004-1G > A) was found. CONCLUSIONS: We described a rare autosomal dominant vitreoretinopathy with near complete penetrance in a Portuguese family. Abnormal peripheral vitreoretinal adhesions, retinal detachment and chorioretinal atrophy are present in most of the examined individuals at young ages. Early onset of advanced visual field and electrophysiologic abnormalities were observed in this family. We also added relevant information to the literature by reporting our experience in surgical management of Wagner Syndrome patients with, and at risk of, retinal detachment.


Assuntos
DNA/genética , Adaptação à Escuridão/fisiologia , Mutação , Degeneração Retiniana/diagnóstico , Tomografia de Coerência Óptica/métodos , Versicanas/deficiência , Campos Visuais/fisiologia , Adolescente , Adulto , Criança , Pré-Escolar , Análise Mutacional de DNA , Eletrorretinografia , Feminino , Humanos , Masculino , Linhagem , Portugal , Retina/patologia , Retina/fisiopatologia , Degeneração Retiniana/genética , Degeneração Retiniana/fisiopatologia , Versicanas/genética , Versicanas/metabolismo , Acuidade Visual , Testes de Campo Visual , Adulto Jovem
20.
Medicina (Kaunas) ; 54(3)2018 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-30344272

RESUMO

Background and objective: For a high level athlete, it is essential to ensure optimal energy as well as macro- and micro-nutrient and fluid intakes, in order to improve their performance during training and competition. Protein intake should be 1.2⁻2.1 g/kg/d, whereas the requirements for carbohydrate and fat intakes should be >5g/kg/d and 20⁻35% of energy, respectively. The micronutrient and fluid intakes in athletes were compared to the Dietary Reference Intake (DRI) and European Food Safety Authority (EFSA) recommendations, respectively. This study aimed to characterize and compare the nutritional habits of athletes at the preparatory and competitive phase, and to test if their nutritional intakes were in accordance with the recommendations. Materials and methods: A total of 276 professional athletes were assessed. To evaluate their nutritional intake, the athletes completed a 7 days food record. Under reporting was defined using a ratio of energy intake to basal metabolic rate (BMR) of 1.1. Body composition was assessed using dual energy X-ray absorptiometry (DXA). Results: Almost half (49%) of the athletes from the final sample reported lower measured intakes of carbohydrates and 27% reported a higher consumption of proteins than what was recommended. In both the preparatory and competitive phases, the micronutrients with a higher mismatch between the actual and recommended intakes were vitamins D and E, magnesium, folate, calcium, and zinc for both sexes, and iron intake for females. A large proportion of athletes reported a lower water intake. Compared to the recommendations, males reported a higher intake of carbohydrates, lipids, vitamins E, calcium, and magnesium (p <0.05) in the competitive phase, while females reported a lower ingestion of water, vitamins A and D, and calcium (p <0.05) in the preparatory phase. Conclusions: Overall, in the preparatory and competitive phases of the season, athletes reported a macro- and micro-nutrient intake below the recommendations, especially in the female athletic population. Dietary intakes in athletes need to be optimized and adjusted to their requirements, according to sex and sport, so as to avoid compromising health and performance.


Assuntos
Atletas/estatística & dados numéricos , Dieta/métodos , Ingestão de Energia , Estado Nutricional , Esportes/fisiologia , Adolescente , Composição Corporal , Inquéritos sobre Dietas , Feminino , Humanos , Masculino , Micronutrientes/análise , Fatores Sexuais , Adulto Jovem
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