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1.
PLoS One ; 19(6): e0300706, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38935649

RESUMEN

The Level of Personality Functioning Scale-Self-Report (LPFS-SR) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. The current study aimed 1) to examine the internal consistency of the Portuguese version of the LPFS-SR in a community sample and a clinical sample, 2) to compare non-clinical participants (N = 282, Mage = 48.01, SD = 10.87) with two samples of clinical participants, one composed of patients with a personality disorder diagnosis (PD sample, n = 40, Mage = 46.18, SD = 13.59) and the other of patients with other psychiatric diagnoses (OD sample, n = 148, Mage = 49.49, SD = 11.88), with respect to LPFS-SR dimensions and total score, 3) to examine the capacity of the LPFS-SR to discriminate between samples through the ROC curve analyses, and 4) to examine the factor structure of the Portuguese version of the LPFS-SR. The Portuguese version of the LPFS-SR revealed adequate internal consistency results, akin to the original data, in the community and clinical samples. The community sample differed significantly from both clinical samples in all the LPFS-SR dimensions and total score. The ROC curve analysis indicated an optimal cut-off for the total score of 272.00, corresponding to a sensitivity of 75% and a specificity of 89%, in the PD vs. community samples. The LPFS-SR total score discriminative capacity between the PD and OD samples was lower, albeit also significant (area-under-the-curve of .63; p = .027; 95% CI: .52-.74). The current study provided evidence of the LPFS-SR's unidimensionality in both community and clinical samples. Although this study has limitations, its findings contribute to a deeper understanding of the LPFS-SR construct, as well as to its cross-cultural validation.


Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos de la Personalidad , Autoinforme , Humanos , Femenino , Masculino , Persona de Mediana Edad , Adulto , Trastornos de la Personalidad/diagnóstico , Portugal , Personalidad , Psicometría/métodos , Curva ROC , Reproducibilidad de los Resultados
2.
Clin Nutr ESPEN ; 63: 84-91, 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38935496

RESUMEN

BACKGROUND & AIMS: Aging frequently causes changes in body composition, such as a loss of strength and muscular mass and an increase in fat mass. Exercise training programs have been suggested as effective strategies to mitigate or prevent age-related declines in body composition. Therefore, this study examined the effects of a sixteen-week High-Speed Resistance Training (HSRT) program on body composition parameters in community-dwelling independent older adults. METHODS: The present clinical trial included 79 older adults, who were divided into two groups: intervention group (IG, N = 40, age, 68.50 ± 3.54 years; weight, 68.65 ± 11.36 kg) and control group (CG, N = 39, age, 72.08 ± 5.89 years; weight, 67.04 ± 10.69 kg). IG performed the supervised HSRT for 16 weeks, with 3 sessions per week of 60-70min, each session of 5-6 exercises, 2-3 sets, and 6-10 reps/exercise, while CG did not perform any exercise training program. Body composition parameters were assessed using a multifrequency tetrapolar bioelectrical impedance analyzer (InBody® S10). The level of physical activity and the dietary intake were evaluated by the International Physical Activity Questionnaire (IPAQ-SF) and the Food Frequency Questionnaire, respectively. Statistical analyses were performed using the analysis of covariance (ANCOVA), and effect size (Cohen's dunbiased). RESULTS: The analysis showed significant effects of the group factor for IG on phase angle (F(1) = 14.39, p < 0.001, η2p = 0.159). Additionally, results from Δ changes (post-minus pre-values) revealed small and medium effects in favor to IG for body cell mass (t(77) = 1.21, p = 0.230, dunb = 0.27 [-0.17, 0.71]) and phase angle (t(77) = 2.82, p = 0.006, dunb = 0.63 [0.18, 1.08]), respectively. CONCLUSIONS: The HSRT could effectively prevent the decline in cellular health and cell integrity in older adults, as evidenced by the significant improvements in the phase angle. REGISTRATION: Clinicaltrial.gov (ID: NCT05586087).

3.
Phytomedicine ; 129: 155634, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38718637

RESUMEN

BACKGROUND: The African continent is home to five biodiversity hotspots, boasting an immense wealth of medicinal flora, fungi and marine life. Diterpenes extracted from such natural products have compelling cytotoxic activities that warrant further exploration for the drug market, particularly in cancer therapy, where mortality rates remain elevated worldwide. PURPOSE: To demonstrate the potential of African natural products on the global stage for cancer therapy development and provide an in-depth analysis of the current literature on the activity of cancer cytotoxic diterpenes from African natural sources (to our knowledge, the first of its kind); not only to reveal the most promising candidates for clinical development, but to demonstrate the importance of preserving the threatened ecosystems of Africa. METHODS: A comprehensive search by means of the PRISMA strategy was conducted using electronic databases, namely Web of Science, PubMed, Google Scholar and ScienceDirect. The search terms employed were 'diterpene & mechanism & cancer' and 'diterpene & clinical & cancer'. The selection process involved assessing titles in English, Portuguese and Spanish, adhering to predefined eligibility criteria. The timeframe for inclusion spanned from 2010 to 2023, resulting in 218 relevant papers. Chemical structures were visualized using ChemDraw 21.0, PubChem was utilized to search for CID numbers. RESULTS: Despite being one of the richest biodiverse zones in the world, African natural products are proportionally underreported compared to Asian countries or otherwise. The diterpenes andrographolide (Andrographis paniculata), forskolin (Coleus forskohlii), ent-kauranes from Isodon spp., euphosorophane A (Euphorbia sororia), cafestol & kahweol (Coffea spp.), macrocylic jolkinol D derivatives (Euphorbia piscatoria) and cyathane erinacine A (Hericium erinaceus) illustrated the most encouraging data for further cancer therapy exploration and development. CONCLUSIONS: Diterpenes from African natural products have the potential to be economically significant active pharmaceutical and medicinal ingredients, specifically focussed on anticancer therapeutics.


Asunto(s)
Productos Biológicos , Diterpenos , Diterpenos/farmacología , Diterpenos/química , Productos Biológicos/farmacología , Productos Biológicos/química , Humanos , África , Neoplasias/tratamiento farmacológico , Antineoplásicos Fitogénicos/farmacología , Antineoplásicos Fitogénicos/química , Animales , Antineoplásicos/farmacología , Antineoplásicos/química
4.
Sensors (Basel) ; 24(10)2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38794111

RESUMEN

Plasma science and engineering is a multidisciplinary area encompassing some of the most exciting fundamental and applied research themes in today's scientific landscape, with an extraordinarily broad impact in science, technology, and industry [...].

5.
Acta Trop ; 255: 107224, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38643822

RESUMEN

Green silver nanoparticles (G-Ag NPs) have contributed to the development of ecological technologies with low environmental impact and safer for human health, as well as demonstrating potential for the control of vectors and intermediate hosts. However, knowledge about its toxicity in the early stages of gastropod development remains scarce. Therefore, the current study aimed to investigate the toxicity of G-Ag NPs synthesized from Croton urucurana leaf extracts in snail species Biomphalaria glabrata, which is an intermediate host for Schistosoma mansoni parasite. G-Ag NPs were synthesized using two types of plant extracts (aqueous and hydroethanolic) and characterized using multiple techniques. Bioassays focused on investigating G-Ag NPs and plant extracts were carried out with embryos and newly hatched snails, for 144 h and 96 h, respectively; toxicity was analyzed based on mortality, hatching, development inhibition, and morphological changes. Results have shown that both G-Ag NPs were more toxic to embryos and newly hatched snails than the investigated plant extracts. G-Ag NPs deriving from aqueous extract have higher molluscicidal activity than those deriving from hydroethanolic extract. Both G-Ag NPs induced mortality, hatching delay, development inhibition, and morphological changes (i.e., hydropic embryos), indicating their molluscicidal activities. Moreover, embryos were more sensitive to G-Ag NPs than newly hatched snails. Thus, the toxicity of G-Ag NPs to freshwater snails depends on the type of extracts and the snail's developmental stages. These findings can contribute to the development of green nanobiotechnologies applicable to control snails of medical importance.


Asunto(s)
Biomphalaria , Croton , Nanopartículas del Metal , Extractos Vegetales , Plata , Animales , Plata/toxicidad , Biomphalaria/efectos de los fármacos , Extractos Vegetales/toxicidad , Extractos Vegetales/química , Croton/química , Nanopartículas del Metal/toxicidad , Nanopartículas del Metal/química , Agua Dulce , Hojas de la Planta/química , Moluscocidas/toxicidad , Schistosoma mansoni/efectos de los fármacos , Tecnología Química Verde
6.
Rev Esp Enferm Dig ; 2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38591599

RESUMEN

Intraductal radiofrequency ablation (RFA) has been used in the management of malignant biliary obstruction and ampullary neoplasms. Some small studies refer to its role in managing benign biliary strictures with some promising results. The complications are not neglectable, namely cholangitis, pancreatitis, bleeding, and perforation, although most of them can be managed conservatively. There are two catheters available. Only the ERLA (EndoLumunal Radiofrequency Ablation, Taewoong Medical) catheter can control temperature and impedance, allowing it to reduce the risk of complications.

7.
RSC Med Chem ; 15(4): 1348-1361, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38665830

RESUMEN

Multidrug resistance (MDR) remains a challenging issue in cancer treatment. Aiming at finding anticancer agents to overcome MDR, the triacetyl derivative (2) of the labdane diterpenoid lactone andrographolide (1) underwent the Michael-type addition reaction followed by elimination, yielding twenty-three new derivatives, bearing nitrogen-containing substituents (3-25). Their structures were assigned, mainly, by 1D and 2D NMR experiments. The MDR reversal potential of compounds 1-25 was assessed, by functional and chemosensitivity assays, using resistant human ABCB1-gene transfected L5178Y mouse lymphoma cells as a model. Several derivatives exhibited remarkable P-glycoprotein (P-gp) inhibitory ability. Compounds 13 and 20, bearing thiosemicarbazide moieties, were the most active exhibiting a strong MDR reversal effect at 2 µM. Some compounds showed selectivity towards the resistant cells, with compound 5 exhibiting a collateral sensitivity effect associated with significant antiproliferative activity (IC50 = 5.47 ± 0.22 µM). Moreover, all selected compounds displayed synergistic interaction with doxorubicin, with compound 3 being the most active. In the ATPase assay, selected compounds exhibited characteristics of P-gp inhibitors.

8.
Small ; 20(27): e2303421, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38533978

RESUMEN

Materials with tunable negative electromagnetic performance, i.e., where dielectric permittivity becomes negative, have long been pursued in materials research due to their peculiar electromagnetic (EM) characteristics. Here, this promising feature is reported in materials on the case of plasma-synthesized nitrogen-doped graphene sheets with tunable permittivity over a wide (1-40 GHz) frequency range. Selectively incorporated nitrogen atoms in a graphene scaffold tailor the electronic structure in a way that provides an ultra-low energy (0.5-2 eV) 2D surface plasmon excitation, leading to subunitary and negative dielectric constant values in the Ka-band, from 30 up to 40 GHz. By allowing the tailoring of structures at atomic scale, this novel plasma-based approach creates a new paradigm for designing 2D nanomaterials like nanocarbons with controllable and tunable permittivity, opening a path to the next generation of 2D metamaterials.

9.
Cuad. psicol. deporte ; 24(1): 297-306, Ene 2, 2024. graf
Artículo en Inglés | IBECS | ID: ibc-229633

RESUMEN

La función cognitiva es crucial en entornos de rendimiento competitivo debido al tipo de tareas y carga de trabajo involucradas. Sin embargo, aún se necesita determinar cómo toda la información ambiental en un entorno competitivo afecta la carga cognitiva.Por lo tanto, el objetivo fue investigar la percepción cognitiva de los entrenadores sobre las tareas de entrenamiento de fútbol, mediante el uso de un cuestionario y comparar los resultados con una herramienta de marco para evaluar las demandascognitivas en juegos reducidos. Un total de 57 entrenadores de fútbol (a nivel nacional y regional) completaron un cuestionario para calificar las demandas cognitivas percibidas de doce situaciones diferentes de juegos en espacios reducidos. Las respuestas fueron hechas por cada entrenador a partir de un conjunto de alternativas proporcionadas por los autores utilizando una escala de uso de Likert de 10 puntos. La carga cognitiva durante los juegos reducidos se calculó mediante una ecuación que incluía el número de jugadores implicados en la tarea, la superficie ocupada por cada jugador y la duración del ejercicio. Los resultados del cuestionario mostraron que los entrenadores de nivel nacional presentaron resultados de correlación más altos, mostrando una alta concordancia entre la percepción de los entrenadores y los resultados de la carga cognitiva en comparación con los entrenadores de nivel regional. La relación establecida entre todas las variables mostró que la complejidad de las tareas aumenta utilizando formatos con mayor número de jugadores, áreas pequeñas y ejercicios de mayor duración. Por lo tanto, el marco de carga cognitiva puede ser una herramienta útil y sencilla para quelos entrenadores evalúen las demandas cognitivas durante las sesiones de entrenamiento.(AU)


Cognitive function is crucial in competitive performance environments due to the type of tasks and workload involved. Thus, the present study aimed to investigate coaches’ cognitive perception of football training tasks, through the use of a questionnaire and compare the results with a framework tool to assess cognitive demands in small-sided games. A total of 57 football coaches (national and regional levels) filled out a questionnaire to rate the perceived cognitive demands of twelve different small-sidedgame situations. The answers were made by each coach from a set of alternatives supplied by the authors using a 10-point Likert use scale. The cognitive load during small-sided games was calculated using an equation that included the number of players involved in the task, the surface area occupied by eachplayer, and the duration of the exercise. The questionnaire results have shown that national-level coaches presented higher correlation results showing a high agreement between coaches' perception and the cognitive load results when compared to regional-level coaches. The relationship established between all variables showed that the complexity of tasks increases using formats with a larger number of players, small areas, and bigger duration drills. Thus, the cognitive load framework may be a useful and simple tool to coaches assess the cognitive demands during training sessions.(AU)


A função cognitiva é crucial em ambientes de desempenho competitivo devido ao tipo de tarefas e carga de trabalho envolvidas. No entanto, ainda precisa ser determinado como todas as informações ambientais em em contexto competitivo afetam a carga cognitiva. Assim, o objetivo deste estudofoi investigar a perceção cognitiva de treinadores sobre tarefas de treino de futebol, através de um questionário e comparando os resultados com um instrumento para avaliar as exigências cognitivas durante jogos reduzidos.Um total de 57 treinadores de futebol (nível nacional e regional) preencheram um questionário para avaliar as exigências cognitivas de doze situações diferentes jogos-reduzido. As respostas foram dadas por cada treinador a partir de um conjunto de alternativas fornecidas pelos autores utilizando uma escala de Likert de 10 pontos. A carga cognitiva durante pequenos jogos foi calculada através de uma equação queincluía o número de jogadores envolvidos na tarefa, a área de superfície ocupada por cada jogadore a duração do exercício. Os resultados do questionário mostraram que os treinadores de nível nacional apresentaram resultados de correlação mais elevados, mostrando uma alta concordância entre a perceção dos treinadores e os resultados de carga cognitiva em comparação com os treinadores de nível regional. A relação estabelecida entre todas as variáveis mostrou que a complexidade das tarefas aumenta utilizandoformatos com maior número de jogadores, áreas pequenas e exercícios de maior duração. Portanto, esta ferramenta para avaliar a carga cognitiva pode ser uma forma útil e simples para os treinadores avaliarem as exigências cognitivas durante as sessões de treino.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Fútbol/psicología , Atletas/psicología , Rendimiento Atlético/psicología , Ejercicio Físico , Mentores , Cognición , Psicología del Deporte , Medicina Deportiva , Deportes/psicología , Encuestas y Cuestionarios
10.
Bragança; s.n; 20240000. il., tab..
Tesis en Portugués | BDENF - Enfermería | ID: biblio-1527118

RESUMEN

[{"text": "A dor torácica (DTC) aguda é o sintoma comum de Síndrome Coronário Agudo (SCA), que mais frequentemente leva as pessoas a procurarem cuidados de emergência no mundo. Dois terços das mortes por eventos coronários agudos ocorrem por arritmias fatais, em ambiente pré-hospitalar. O reconhecimento rápido de sintomas é mandatório para redução da mortalidade. O Enfermeiro SIV tem um papel fundamental na a determinação do diagnóstico célere e, no tratamento adequado da pessoa com SCA. Objetivos: Visando conhecer a atuação do enfermeiro Suporte Imediato de Vida (SIV) nas ocorrências de DTC, na pessoa com suspeita de SCA, relativamente às ambulâncias SIV de dois distritos do interior norte de Portugal, delinearam-se como objetivos específicos: (i) Analisar as ativações das ambulâncias SIV para ocorrências de DTC, na pessoa com suspeita de SCA, relativamente às características sociodemográficas e geográficas; (ii) Identificar o perfil de risco cardiovascular (verificável) nas ocorrências de DTC, da pessoa com suspeita de SCA, por ambulâncias SIV; (iii) Identificar os fatores de risco cardiovasculares (FRCV) modificáveis (verificáveis) nas ocorrências de DTC, da pessoa com suspeita de SCA, por ambulância SIV; (iv) Conhecer os tempos de resposta do pré-hospitalar nos diferentes momentos do socorro, nas ocorrências de DTC, na pessoa com suspeita de SCA; (v) Analisar a atuação do Enfermeiro tendo por base, a utilização do protocolo da DTC e, complementares, por ambulância SIV; (vi) Verificar a melhoria de sintomatologia decorrente da atuação do enfermeiro SIV em ocorrência de DTC, da pessoa com suspeita de SCA; (vii) Identificar episódios de complicações ocorridas durante a atuação do enfermeiro SIV, em situações de DTC, na pessoa com suspeita de SCA. Metodologia: Foi realizado um estudo retrospetivo, analítico transversal, de cariz quantitativo, envolvendo uma amostra por conveniência de 75 ativações para DTC, com suspeita de SCA, nas ambulâncias SIV do interior norte de Portugal, no período compreendido entre 01 junho de 2017 e o 31 de dezembro de 2018. A recolha de dados foi efetuada através de um IRD concebido para o efeito. Resultados: É predominante o sexo masculino, nas ativações de DTC, com suspeita de SCA, sendo a idade média de 65,90 anos na SIV 1 e, na SIV 2 de 72,33 anos. Na SIV 2 verificou-se que, entre o sexo masculino e a idade, existe relação estatística significativa (p=0,013), apresentando este uma idade inferior (


Asunto(s)
Humanos , Masculino , Anciano , Anciano de 80 o más Años , Dolor en el Pecho , Enfermedades Cardiovasculares , Síndrome Coronario Agudo , Enfermeros
11.
J Plant Res ; 137(2): 215-240, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38070055

RESUMEN

The genus Mimosa L. (Leguminosae; Caesalpinioideae; mimosoid clade), comprising more than 500 species, is an intriguing genus because, like other members of the mimosoid clade, it presents an enormous variation in floral characteristics and high merism lability. Thus, this study aimed to elucidate the floral development and identify which ontogenetic pathways give rise to merism variation and andromonoecy in Mimosa caesalpiniifolia, M. pudica, M. bimucronata, and M. candollei. Floral buds at various stages of development and flowers were collected, fixed, and processed for surface analysis (SEM). The development of the buds is synchronous in the inflorescences. Sepals appear simultaneously as individualized primordia in M. caesalpiniifolia and in reversed unidirectional order in M. bimucronata, with union and formation of an early ring-like calyx. Petal primordia appear in unidirectional order, with a noticeably elliptical shape in M. caesalpiniifolia. The wide merism variation in Mimosa results from the absence of organs from inception in the perianth and androecium whorls: in dimerous, trimerous, or tetramerous flowers, the additional organs primordia to compose the expected pentamerous flowers are not initiated. The haplostemonous androecium of M. pudica results from the absence of antepetalous stamens from inception. In the case of intraspecific variations (instabilities), there is no initiation and subsequent abortion of organs in the events of reduction in merosity. In addition, extra primordia are initiated in supernumerary cases. On the other hand, staminate flowers originate from the abortion of the carpel. Mimosa proved to be an excellent model for studying merism variation. The lability is associated with actinomorphic and rather congested flowers in the inflorescences. Our data, in association with others of previous studies, suggest that the high lability in merism appeared in clades that diverged later in the mimosoid clade. Thus, phylogenetic reconstruction studies are needed for more robust evolutionary inferences. The present investigation of ontogenetic processes was relevant to expand our understanding of floral evolution in the genus Mimosa and shed light on the unstable merism in the mimosoid clade.


Asunto(s)
Fabaceae , Mimosa , Fabaceae/genética , Filogenia , Flores , Inflorescencia
12.
Rev. esp. enferm. dig ; 116(4): 216-217, 2024.
Artículo en Inglés | IBECS | ID: ibc-232465

RESUMEN

A 21-year-old man, with personal history of asthma and no usual medication, was referred to gastroenterology appointment due to dysphagia for solids and previous episodes of food impaction in the last 5 months. He also reported nocturnal heartburn without any other warning signs. Upper gastroscopy revealed a peptic stenosis in the distal esophagus. Histopathologic examination showed hyperplasia and numerous intraepithelial eosinophils, without dysplasia or malignancy. Therapy with a double-dose proton pump inhibitor (PPI) was started. (AU)


Asunto(s)
Humanos , Masculino , Adulto Joven , Reflujo Gastroesofágico/diagnóstico por imagen , Endoscopía del Sistema Digestivo , Endoscopía Gastrointestinal
13.
Cureus ; 15(12): e49785, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38058521

RESUMEN

Background The COVID-19 pandemic has brought about unprecedented global health challenges, with its impact extending beyond respiratory manifestations to encompass cardiovascular complications, including arrhythmias. Dysrhythmias in COVID-19 are multifactorial, ranging from direct myocardial insult due to the cytokine storm to metabolic derangements. Objective In this study, we aim to examine the incidence of new-onset atrial fibrillation and to study its association with all-cause mortality of COVID-19. Methods A cross-sectional study was conducted at Cabell Huntington Hospital, West Virginia, utilizing electronic medical records of COVID-19 patients from 2020 to 2021. Inclusion criteria comprised patients aged >18 years with COVID-19 diagnosis and cardiac arrhythmias during hospitalization. Logistic regression analysis was employed to examine the relationship between demographic and clinical variables and in-hospital mortality. Results Of the 264 eligible patients, those aged >66 years had lower odds of in-hospital mortality (p < 0.001), while gender, ejection fraction, and diabetes mellitus did not significantly predict mortality. Atrial fibrillation (p = 0.011) and heart failure (p = 0.030) were associated with increased odds of mortality, while hypertension showed no significant predictive power (p = 0.791). Conclusion This study highlights the significance of atrial fibrillation and heart failure as predictors of in-hospital mortality in COVID-19 patients. Our findings underscore the importance of recognizing and managing arrhythmias in COVID-19 and call for further research on the mechanisms and long-term effects of these cardiac complications in the context of the pandemic. These insights can guide clinical practice and interventions to optimize patient outcomes.

14.
GE Port J Gastroenterol ; 30(Suppl 2): 52-56, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38020819

RESUMEN

Introduction: Eosinophilic gastroenteritis (EoG) is a rare condition with a yet poorly understood pathophysiology. Case Presentation: We report on a case of a 36-year-old woman with a history of atopy presenting with nausea, abdominal discomfort, weight loss, and ascites. Laboratorial analysis revealed peripheral eosinophilia and a slight elevation of inflammatory markers. The patient pursued medical assistance several times with a delay in the diagnosis. The pathway to the diagnosis of EoG with serosal infiltration and further management is presented. Discussion: Despite being diagnosed by exclusion, it is important to suspect EoG with subserosa involvement in patients presenting with the uncommon association of peripheral eosinophilia and ascites, particularly if there is a history of atopy.


Introdução: A gastroenterite eosinofílica é uma condição rara, com uma etiologia ainda pouco compreendida. Caso Clínico: Uma mulher de 36 anos, com antecedentes de atopia, que se apresenta com náuseas, desconforto abdominal difuso, perda ponderal e ascite de novo. As análises laboratoriais revelaram eosinofilia periférica e ligeira elevação dos parâmetros inflamatórios. A doente recorreu a cuidados de saúde repetidamente sem um diagnóstico. É apresentado o percurso até ao diagnóstico de gastroenterite eosinofílica com infiltração serosa e tratamento subsequente. Discussão: Apesar de ser um diagnóstico de exclusão, é importante suspeitar de gastroenterite eosinofílica com envolvimento subseroso perante a associação de ascite a sintomas gastrointestinais inespecíficos particularmente em doentes com história de atopia.

15.
GE Port J Gastroenterol ; 30(5): 390-397, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37868637

RESUMEN

Acute severe ulcerative colitis (ASUC) is an emergent medical condition and particularly challenging to treat efficaciously. Infliximab is one of the medical salvage treatment options after corticosteroid refractoriness, but the best induction strategy is not yet defined. With this case series, the authors intend to describe three corticosteroid-refractory ASUC cases with different intensified/accelerated infliximab induction approaches and review the literature on this topic. The first case describes an 18-year-old girl with ASUC at disease onset with rapid progression to toxic megacolon, complicated also with anemia, hypoalbuminemia, and coagulopathy. After corticosteroid failure, both accelerated and intensified (10 mg/kg) infliximab regimen was completed within 11 days, with solid clinical response and colon imaging normalization. Second, we present a 26-year-old male with left-sided ulcerative colitis known for 2 years, under mesalazine, who developed a moderate flare and was started on infliximab after partial and inconsistent response to corticosteroids. During the induction period, he presented this time an ASUC episode, which motivated an early and intensified third dose with good clinical response. Finally, we describe the case of a 78-year-old man with ulcerative proctitis for 12 years presenting ASUC with proximal disease extension as well. After unsatisfactory response to corticosteroids, infliximab was initiated on an accelerated induction regimen, completed in 13 days, with the standard dose, achieving clinical remission. Accelerated or intensified infliximab induction plans are becoming current clinical practice in corticosteroid-refractory ASUC. Current guidelines refer to the possibility of this type of strategies, not determining the optimal regimen due to lack of solid evidence. Literature is mainly based on retrospective studies, not randomized, with heterogeneous groups according to disease severity, and the effect on colectomy rates, mainly on the long term, is not clear. Additional well-supported studies are needed on this subject in order to seek a more widely uniform approach.


A agudização grave de colite ulcerosa é uma emergência médica, particularmente difícil de tratar de forma eficaz. O infliximab é uma das opções de tratamento médico de resgate após refractariedade aos corticosteróides, porém a melhor estratégia de indução ainda não está definida. Com este relato de série de casos, os autores pretendem descrever três casos de agudização grave de colite ulcerosa refratária a corticosteróides com diferentes abordagens de indução intensificada/acelerada de infliximab e rever a literatura sobre este tópico. O primeiro caso descreve uma jovem de 18 anos com agudização grave de colite ulcerosa, à apresentação da doença, com rápida progressão para megacólon tóxico, complicada também com anemia, hipoalbuminemia e coagulopatia. Após ausência de resposta a corticosteróides, foi iniciado regime acelerado e intensificado (10 mg/kg) de infliximab, concluído em 11 dias, com resposta clínica e normalização das alterações imagiológicas do cólon. Em segundo lugar, apresentamos um homem de 26 anos com colite ulcerosa esquerda conhecida há 2 anos, sob messalazina, que apresentou uma agudização moderada da doença e iniciou infliximab após resposta parcial e inconsistente aos corticosteróides. Durante o período de indução, apresentou desta vez um episódio de agudização grave, o que motivou uma terceira dose precoce e intensificada com boa resposta clínica. Por fim, descrevemos o caso de um homem de 78 anos com proctite ulcerosa há 12 anos apresentando agudização grave de colite ulcerosa, também com extensão proximal da doença. Após resposta insatisfatória a corticosteróides, foi iniciado infliximab em regime de indução acelerada, completado em 13 dias, com a dose padrão, obtendo remissão clínica. Os esquemas de indução de infliximab acelerados ou intensificados têm vindo a tornar-se prática clínica habitual nos casos de agudização grave de colite ulcerosa refratária a corticosteróides. As diretrizes atuais referem a possibilidade deste tipo de estratégias, não indicando qual o regime ideal por falta de evidência sólida. A literatura baseia-se principalmente em estudos retrospetivos, não randomizados, com heterogeneidade de grupos de estudo de acordo com a gravidade da doença e o efeito nas taxas de colectomia, sobretudo a longo prazo, não é claro. Estudos mais fundamentados são necessários sobre esta matéria de modo a que seja possível uma abordagem amplamente mais uniforme.

17.
Appl Radiat Isot ; 202: 111032, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37801996

RESUMEN

In recent years, there has been significant advancement in the development of physical simulators for dose evaluation. Many dosimetric studies employ solid materials, equivalent to human tissues, to evaluate dose distribution. This study aims to evaluate the effectiveness of inhomogeneity correction carried out by the Monaco/Elekta radiotherapy planning software. To achieve this goal, a physical simulator was created using cork boards to simulate lung tissue and solid water to represent other tissues. This simulator was combined with a dosimetric system that utilized lithium fluoride thermoluminescent detectors - RADOS MTS-N (LiF:Mg,Ti). The thermoluminescent detectors were positioned at various depths using a precisely drilled 2.0 mm thick acrylic plate, and they were placed at predefined positions. The irradiation of the simulator was conducted using an Elekta Synergy® Platform accelerator, employing a 6 MV photon beam with a field size of 15 × 15 cm2 and a source-surface distance (SSD) of 97.5 cm. A radiation dose of 200 cGy was applied for this study. In addition to the dosimetric assessment using thermoluminescent detectors, GAFCHROMIC™ EBT-3 Dosimetry Films were utilized to evaluate the dose at the same measurement points. The dose distribution data measured with the detectors were compared with the values provided by the planning system (TPS) and the inhomogeneity correction was verified. The results support the hypothesis that there is a lack of precision in the analytical simulations performed by the TPS, particularly in cases involving dose distribution at interfaces with varying densities.

19.
Chronobiol Int ; 40(9): 1244-1250, 2023 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-37691400

RESUMEN

The molecular circadian timing system involves genes known as "clock genes," such as the PER3 gene. Studies have demonstrated associations among a repeat polymorphism (VNTR) of the PER3 gene with chronotypes, with the occurrence of circadian rhythm disorders and with sleep homeostasis phenotypes. The aim of this study was to investigate, by actigraphy, sleep and circadian rhythm profiles of people with different genotypes for the VNTR polymorphism of the PER3 gene. We genotyped 467 individuals (46,39% male) for the PER3 VNTR polymorphism. The mean age of the participants was 21.84 ± 2.64, ranging from 18 to 30 y old. Actigraphy data were collected from a subsample of 81 subjects with PER3 4-repeats homozygous (PER34/4) or 5-repeats homozygous (PER35/5) genotypes from April to June of 2021. From this sample, 48 PER34/4 and 33 PER35/5 subjects wore a wrist actigraph between 12 and 19 d. The sleep onset (weekdays, p = 0.015; weekend, p = 0.022) and offset (weekdays, p = 0.004; weekend, p = 0.041) of the PER35/5 group occurred later than the PER34/4 group. Similar results were observed for the mid-sleep phase of weekdays (MSW) (p = 0.008) and free days (MSF) (p = 0.019), and for the mid-sleep phase corrected for sleep debt accumulated over the week (MSFsc) (p = 0.024). Despite the phase differences found between the PER34/4 and PER35/5 groups, no differences were found in sleep duration and social jet lag. However, the PER34/4 group presented, on average, a longer sleep rebound on the days off when compared to the PER35/5 (p = 0.002). The PER35/5 group showed lower interdaily stability (IS) (p = 0.032) and higher daily activity rhythm variability (IV) (p = 0.035). The findings of the present study revealed associations between the PER3 gene, sleep, and circadian rhythms. In general, we found that the gene is associated with the expression of sleep timing and duration and to the phase of the activity rhythm. The experiments carried out here occurred in the COVID-19 pandemic scenario, which should be considered as an environmental element with potential effects on the results obtained.

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