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1.
Orbit ; : 1-4, 2024 Oct 01.
Article in English | MEDLINE | ID: mdl-39352797

ABSTRACT

Congenital fibrous soft tissue tumors in the eyelids are exceptionally rare, with only seven cases of neonatal myofibromas reported. Myopericytoma, a variant with pericytic differentiation, has not previously been described in neonatal eyelid tumors. This report details a case of a massive congenital myopericytoma in a newborn's lower eyelid. The lesion had a broad area of adhesion to the anterior lamella of the lid. After resection, when the child was 11 days old, the resulting defect was successfully reconstructed with a V-Y type perforator-based flap.

2.
Cien Saude Colet ; 29(10): e010982023, 2024 Oct.
Article in Portuguese, English | MEDLINE | ID: mdl-39292026

ABSTRACT

The objective was to identify through integrative review the approach on maternity and motherhood in street situation. This is an integrative review performed in the databases PubMed, BIREME, Medline, and SciELO search portal, in Portuguese, English and Spanish. The survey was conducted between October and December 2021, following the recommendations of the Prisma flowchart and support of the Mendeley software, submitted to content analysis by Minayo. Eighteen articles were selected. The reading allowed the identification of two thematic categories: "Maternity and mothering in the streets" and "Main challenges experienced in maternity and mothering in street situation". Address about motherhood and mothering as a field of knowledge production creates a tension of the social constructions that do not have effecting rights for lack of programs and forceful intersectoral policies. In addition to the stigmatization for use of psychoactive substances, as well as the patriarchal structure attributed to motherhood. The responsibility for care entails several issues that cross the motherhood and mothering in the streets, namely: concern with the health of children, the fear of losing custody of their loved ones.


Objetivou-se identificar através da revisão integrativa a abordagem sobre a maternidade e maternagem em situação de rua. Trata-se de uma revisão integrativa realizada nas bases de dados PubMed, BIREME, Medline, e portal de buscas SciELO, em português, inglês e espanhol. A pesquisa foi realizada entre os meses de outubro a dezembro de 2021, seguindo às recomendações do fluxograma Prisma e suporte do software Mendeley, submetidos à análise de conteúdo de Minayo. Foram selecionados 18 artigos. A partir da leitura foi possível identificar duas categorias temáticas: "Maternidade e maternagem nas ruas" e "Principais desafios vivenciados na maternidade e maternagem em situação de rua". Abordar sobre a maternidade e maternagem enquanto um campo de produção de saberes cria-se um tensionamento das construções sociais que não possuem efetivação de direitos por falta de programas e políticas intersetoriais contundentes. Além da estigmatização por uso de substâncias psicoativas como também a estrutura patriarcal atribuída à maternidade. A responsabilidade pelo cuidado acarreta diversas questões que atravessam a maternidade e maternagem nas ruas, são elas: preocupação com a saúde dos filhos, a criação da prole, bem como, o temor pela perda da custódia de seus entes.


Subject(s)
Ill-Housed Persons , Mothers , Female , Humans , Pregnancy , Ill-Housed Persons/psychology , Mothers/psychology
3.
BMC Public Health ; 24(1): 2131, 2024 Aug 06.
Article in English | MEDLINE | ID: mdl-39107721

ABSTRACT

BACKGROUND: The temporal relationships across cardiometabolic diseases (CMDs) were recently conceptualized as the cardiometabolic continuum (CMC), sequence of cardiovascular events that stem from gene-environmental interactions, unhealthy lifestyle influences, and metabolic diseases such as diabetes, and hypertension. While the physiological pathways linking metabolic and cardiovascular diseases have been investigated, the study of the sex and population differences in the CMC have still not been described. METHODS: We present a machine learning approach to model the CMC and investigate sex and population differences in two distinct cohorts: the UK Biobank (17,700 participants) and the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) (7162 participants). We consider the following CMDs: hypertension (Hyp), diabetes (DM), heart diseases (HD: angina, myocardial infarction, or heart failure), and stroke (STK). For the identification of the CMC patterns, individual trajectories with the time of disease occurrence were clustered using k-means. Based on clinical, sociodemographic, and lifestyle characteristics, we built multiclass random forest classifiers and used the SHAP methodology to evaluate feature importance. RESULTS: Five CMC patterns were identified across both sexes and cohorts: EarlyHyp, FirstDM, FirstHD, Healthy, and LateHyp, named according to prevalence and disease occurrence time that depicted around 95%, 78%, 75%, 88% and 99% of individuals, respectively. Within the UK Biobank, more women were classified in the Healthy cluster and more men in all others. In the EarlyHyp and LateHyp clusters, isolated hypertension occurred earlier among women. Smoking habits and education had high importance and clear directionality for both sexes. For ELSA-Brasil, more men were classified in the Healthy cluster and more women in the FirstDM. The diabetes occurrence time when followed by hypertension was lower among women. Education and ethnicity had high importance and clear directionality for women, while for men these features were smoking, alcohol, and coffee consumption. CONCLUSIONS: There are clear sex differences in the CMC that varied across the UK and Brazilian cohorts. In particular, disadvantages regarding incidence and the time to onset of diseases were more pronounced in Brazil, against woman. The results show the need to strengthen public health policies to prevent and control the time course of CMD, with an emphasis on women.


Subject(s)
Cardiovascular Diseases , Machine Learning , Adult , Aged , Female , Humans , Male , Middle Aged , Brazil/epidemiology , Cardiometabolic Risk Factors , Cardiovascular Diseases/epidemiology , Cohort Studies , Longitudinal Studies , Sex Factors , UK Biobank , United Kingdom/epidemiology
4.
Materials (Basel) ; 17(13)2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38998310

ABSTRACT

To meet the current demand for lead-free piezoelectric ceramics, a novel sol-gel synthesis route is presented for the preparation of Ba0.85Ca0.15Ti0.9Zr0.1O3 doped with cerium (Ce = 0, 0.01, and 0.02 mol%) and vanadium (V = 0, 0.3, and 0.4 mol%). X-ray diffraction patterns reveal the formation of a perovskite phase (space group P4mm) for all samples after calcination at 800 °C and sintering at 1250, 1350, and 1450 °C, where it is proposed that both dopants occupy the B site. Sintering studies show that V doping allows the sintering temperature to be reduced to at least 1250 °C. Undoped BCZT samples sintered at the same temperature show reduced functional properties compared to V-doped samples, i.e., d33 values increase by an order of magnitude with doping. The dissipation factor tan δ decreases with increasing sintering temperature for all doping concentrations, while the Curie temperature TC increases for all V-doped samples, reaching 120 °C for high-concentration co-doped samples. All results indicate that vanadium doping can facilitate the processing of BCZT at lower sintering temperatures without compromising performance while promoting thermal property stability.

5.
Mol Genet Genomic Med ; 12(2): e2387, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38337160

ABSTRACT

BACKGROUND: Disease-related variants in PHEX cause XLH by an increase of fibroblast growth factor 23 (FGF23) circulating levels, resulting in hypophosphatemia and 1,25(OH)2 vitamin D deficiency. XLH manifests in early life with rickets and persists in adulthood with osseous and extraosseous manifestations. Conventional therapy (oral phosphate and calcitriol) improves some symptoms, but evidence show that it is not completely effective, and it can lead to nephrocalcinosis (NC) and hyperparathyroidism (HPT). Burosumab (anti-FGF23 antibody) has shown to be effective and safety in the clinical trials. METHODS: The current real-world collaborative study evaluated genetic, clinical and laboratory data of XLH Brazilian adult patients treated with burosumab. RESULTS: Nineteen unrelated patients were studied. Patients reported pain, limb deformities and claudication, before burosumab initiation. 78% of them were previously treated with conventional therapy. The severity of the disease was moderate to severe (15 patients with score >5). At the baseline, 3 patients presented NC (16.7%) and 12 HPT (63%). After 16 ± 8.4 months under burosumab, we observed a significant: increase in stature (p = 0.02), in serum phosphate from 1.90 ± 0.43 to 2.67 ± 0.52 mg/dL (p = 0.02); in TmP/GFR from 1.30 ± 0.46 to 2.27 ± 0.64 mg/dL (p = 0.0001), in 1,25 (OH)2 D from 50.5 ± 23.3 to 71.1 ± 19.1 pg/mL (p = 0.03), and a decrease in iPTH from 86.8 ± 37.4 pg/mL to 66.5 ± 31.1 (p = 0.002). Nineteen variants were found (10 novel). HPT tended to develop in patients with truncated PHEX variants (p = 0.06). CONCLUSIONS: This study confirms the efficacy and safety of burosumab on XLH adult patients observed in clinical trials. Additionally, we observed a decrease in iPTH levels in patients with moderate to severe HPT at the baseline.


Subject(s)
Antibodies, Monoclonal, Humanized , Familial Hypophosphatemic Rickets , Adult , Humans , Familial Hypophosphatemic Rickets/drug therapy , Familial Hypophosphatemic Rickets/genetics , Antibodies, Monoclonal/therapeutic use , Brazil , Fibroblast Growth Factors/genetics , Fibroblast Growth Factors/metabolism , Phosphates/therapeutic use
6.
Saúde debate ; 47(139): 806-817, out.-dez. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1522971

ABSTRACT

ABSTRACT The immunization campaign against COVID-19 started in Brazil in January 2021 after strong pressure from society on the federal government, which had created a series of ideological obstacles against vaccines, especially those produced with Chinese inputs. This article analyzes the impact of far-right ideology on the spatial distribution of vaccine coverage against COVID-19 in Brazilian municipalities. By means of hierarchical models, it was identified that, maintaining constant socio-demographic characteristics and the structures of the Unified Health System, the degree of bolsonarismo in the municipalities had a negative impact on the coverage rates of the first, second and, especially, of the third dose.


RESUMO A campanha de imunização contra a Covid-19 foi iniciada no Brasil em janeiro de 2021 após forte pressão da sociedade sobre o governo federal, que havia criado uma série de empecilhos ideológicos às vacinas, sobretudo as produzidas com insumos chineses. Este artigo analisa o impacto da ideologia de extrema direita na distribuição espacial da cobertura vacinal contra Covid-19 nos municípios brasileiros. Por meio de modelos hierárquicos multiníveis de dois estágios identificou-se que, mantidas constantes as características sociodemográficas e as estruturas do Sistema Único de Saúde, o grau de bolsonarismo nos municípios impactou negativamente as taxas de cobertura da primeira, da segunda e, especialmente, da terceira dose da vacina.

7.
Biomed Pharmacother ; 165: 115126, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37494787

ABSTRACT

Several medicinal plants have drawn the attention of researchers by its phytochemical composition regarding their potential for treating chronic complications of diabetes mellitus. In this context, plants of the Myrtaceae family popularly used in Brazil for the treatment of diabetes mellitus, including Eugenia sonderiana, have shown beneficial effects due to the presence of phenolic compounds and saponins in their chemical constitution. Thus, the present work aimed to perform the phytochemical characterization of the hydroethanolic extract of E. sonderiana leaves using high-performance liquid chromatography coupled with mass spectrometry (HPLC-MS), along with in vitro and in vivo studies of antidiabetic activity. The chemical characterization revealed the presence of phenolic compounds, flavonoids, neolignans, tannins, and saponins. In addition, the extract exhibited minimum inhibitory concentrations of alpha-amylase and alpha-glycosidase higher than the acarbose in the in vitro tests. Also, the in vivo tests revealed a slight increase in body mass in diabetic rats, as well as a significant decrease in water and feed consumption provided by the extract. Regarding serum biochemical parameters, the extract showed significant activity in decreasing the levels of glucose, hepatic enzymes, and triglycerides, in addition to maintaining HDL cholesterol levels within normal ranges, protecting the cell membranes against oxidative damage. Thus, the extract of E. sonderiana leaves was considered promising pharmaceutical ingredient in the production of a phytotherapy medication.


Subject(s)
Diabetes Mellitus, Experimental , Eugenia , Saponins , Rats , Animals , Hypoglycemic Agents/therapeutic use , Plant Extracts/therapeutic use , Diabetes Mellitus, Experimental/drug therapy , Diabetes Mellitus, Experimental/metabolism , Phytochemicals/therapeutic use , Phenols/pharmacology , Plant Leaves/chemistry , Saponins/therapeutic use
8.
Front Aging ; 4: 1188552, 2023.
Article in English | MEDLINE | ID: mdl-37288071

ABSTRACT

Introduction: Functional disabilities are more prevalent in older adults with multimorbidity and depression. However, few studies have investigated the combination of multimorbidity and depression with functional disability. This study aims to verify whether symptoms of depression and multimorbidity combined increase the prevalence of functional disability in Brazilian older adults. Material and methods: This is a cross-sectional study conducted with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline examination in 2015-2016 in adults aged 50 years and older. The variables included were basic (BADL) and instrumental activities of daily living (IADL), depressive symptoms, multimorbidity (≥2 chronic diseases), sociodemographic variables, and lifestyle. Logistic regression was performed to estimate crude and adjusted odds ratios. Results: A total of 7,842 participants over 50 years of age were included. Of these, 53.5% were women and 50.5% were between 50 and 59 years old, 33.5% reported ≥4 depressive symptoms, 51.4% had multimorbidity, 13.5% reported difficulty in performing at least one BADL, and 45.1% reported difficulty in performing the IADL. In the adjusted analysis, the prevalence of difficulty on BADL was 6.52 (95% CI: 5.14; 8.27) and on IADL was 2.34 (95% CI: 2.15; 2.55), higher for those with depression and multimorbidity combined when compared with those without these conditions. Conclusion: The combination of symptoms of depression and multimorbidity may increase functional impairments in the BADL and IADL of Brazilian older adults, impairing self-efficacy, independence, and autonomy. Early detection of these factors benefits the person, their family, and the healthcare system for health promotion and disease prevention.

9.
J Multimorb Comorb ; 13: 26335565231173845, 2023.
Article in English | MEDLINE | ID: mdl-37223823

ABSTRACT

Background: To identify multimorbidity patterns, by sex, according to sociodemographic and lifestyle in ELSA-Brasil. Methods: Cross-sectional study with 14,516 participants from ELSA-Brasil (2008-2010). Fuzzy c-means was used to identify multimorbidity patterns of 2+ chronic morbidities, where the consequent morbidity had to occur in at least 5% of all cases. Association rule (O/E≥1.5) was used to identify co-occurrence of morbidities, in each cluster, by sociodemographic and lifestyle factors. Results: The prevalence of multimorbidity was higher in women (73.7%) compared to men (65.3%). Among women, cluster 1 was characterized by hypertension/diabetes (13.2%); cluster 2 had no overrepresented morbidity; and cluster 3 all participants had kidney disease. Among men, cluster 1 was characterized by cirrhosis/hepatitis/obesity; cluster 2, most combinations included kidney disease/migraine (6.6%); cluster 3, no pattern reached association ratio; cluster 4 predominated co-occurrence of hypertension/rheumatic fever, and hypertension/dyslipidemia; cluster 5 predominated diabetes and obesity, and combinations with hypertension (8.8%); and cluster 6 presented combinations of diabetes/hypertension/heart attack/angina/heart failure. Clusters were characterized by higher prevalence of adults, married and participants with university degrees. Conclusion: Hypertension/diabetes/obesity were highly co-occurred, in both sexes. Yet, for men, morbidities like cirrhosis/hepatitis were commonly clustered with obesity and diabetes; and kidney disease was commonly clustered with migraine and common mental disorders. The study advances in understanding multimorbidity patterns, benefiting simultaneously or gradually prevention of diseases and multidisciplinary care responses.

10.
mBio ; 13(6): e0231922, 2022 12 20.
Article in English | MEDLINE | ID: mdl-36264102

ABSTRACT

Repetitive elements cause assembly fragmentation in complex eukaryotic genomes, limiting the study of their variability. The genome of Trypanosoma cruzi, the parasite that causes Chagas disease, has a high repetitive content, including multigene families. Although many T. cruzi multigene families encode surface proteins that play pivotal roles in host-parasite interactions, their variability is currently underestimated, as their high repetitive content results in collapsed gene variants. To estimate sequence variability and copy number variation of multigene families, we developed a read-based approach that is independent of gene-specific read mapping and de novo assembly. This methodology was used to estimate the copy number and variability of MASP, TcMUC, and Trans-Sialidase (TS), the three largest T. cruzi multigene families, in 36 strains, including members of all six parasite discrete typing units (DTUs). We found that these three families present a specific pattern of variability and copy number among the distinct parasite DTUs. Inter-DTU hybrid strains presented a higher variability of these families, suggesting that maintaining a larger content of their members could be advantageous. In addition, in a chronic murine model and chronic Chagasic human patients, the immune response was focused on TS antigens, suggesting that targeting TS conserved sequences could be a potential avenue to improve diagnosis and vaccine design against Chagas disease. Finally, the proposed approach can be applied to study multicopy genes in any organism, opening new avenues to access sequence variability in complex genomes. IMPORTANCE Sequences that have several copies in a genome, such as multicopy-gene families, mobile elements, and microsatellites, are among the most challenging genomic segments to study. They are frequently underestimated in genome assemblies, hampering the correct assessment of these important players in genome evolution and adaptation. Here, we developed a new methodology to estimate variability and copy numbers of repetitive genomic regions and employed it to characterize the T. cruzi multigene families MASP, TcMUC, and transsialidase (TS), which are important virulence factors in this parasite. We showed that multigene families vary in sequence and content among the parasite's lineages, whereas hybrid strains have a higher sequence variability that could be advantageous to the parasite's survivability. By identifying conserved sequences within multigene families, we showed that the mammalian host immune response toward these multigene families is usually focused on the TS multigene family. These TS conserved and immunogenic peptides can be explored in future works as diagnostic targets or vaccine candidates for Chagas disease. Finally, this methodology can be easily applied to any organism of interest, which will aid in our understanding of complex genomic regions.


Subject(s)
Chagas Disease , Trypanosoma cruzi , Humans , Animals , Mice , Trypanosoma cruzi/genetics , DNA Copy Number Variations , Genome, Protozoan , Mannose-Binding Protein-Associated Serine Proteases/genetics , Multigene Family , Chagas Disease/parasitology , High-Throughput Nucleotide Sequencing/methods , Mammals/genetics
11.
PLoS One ; 17(10): e0275619, 2022.
Article in English | MEDLINE | ID: mdl-36206287

ABSTRACT

BACKGROUND: Multimorbidity is a worldwide concern related to greater disability, worse quality of life, and mortality. The early prediction is crucial for preventive strategies design and integrative medical practice. However, knowledge about how to predict multimorbidity is limited, possibly due to the complexity involved in predicting multiple chronic diseases. METHODS: In this study, we present the use of a machine learning approach to build cost-effective multimorbidity prediction models. Based on predictors easily obtainable in clinical practice (sociodemographic, clinical, family disease history and lifestyle), we build and compared the performance of seven multilabel classifiers (multivariate random forest, and classifier chain, binary relevance and binary dependence, with random forest and support vector machine as base classifiers), using a sample of 15105 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We developed a web application for the building and use of prediction models. RESULTS: Classifier chain with random forest as base classifier performed better (accuracy = 0.34, subset accuracy = 0.15, and Hamming Loss = 0.16). For different feature sets, random forest based classifiers outperformed those based on support vector machine. BMI, blood pressure, sex, and age were the features most relevant to multimorbidity prediction. CONCLUSIONS: Our results support the choice of random forest based classifiers for multimorbidity prediction.


Subject(s)
Multimorbidity , Quality of Life , Adult , Algorithms , Brazil/epidemiology , Humans , Longitudinal Studies , Machine Learning , Support Vector Machine
12.
Cien Saude Colet ; 27(6): 2269-2278, 2022 Jun.
Article in Portuguese, English | MEDLINE | ID: mdl-35649015

ABSTRACT

This article aims to estimate the prevalence of cognitive impairment and analyze its association with blood pressure control in elderly hypertensive individuals. Cross-sectional study of 383 elderly hypertensive individuals in the state of Piauí, Brazil. The authors collected sociodemographic and clinical data, performed blood pressure measurement, and assessed cognitive function using the Montreal Cognitive Assessment (MoCA) test. Poisson regression with robust variance was used. Overall prevalence of cognitive impairment was 74.4%, higher in the age group 80 years and over and among older persons with less schooling. Prevalence of uncontrolled blood pressure was 61.6%, with a higher proportion in the elderly with cognitive impairment. An association was observed between cognitive impairment and uncontrolled blood pressure (aPR: 3.98; 95%CI = 2.51-6.33). The significant association between cognitive function and blood pressure control suggest that cognitive impairment is an important risk factor for uncontrolled blood pressure in older persons. The inclusion of screening measures for possible cognitive deficits may be useful for better monitoring blood pressure levels among elderly hypertensive individuals.


O objetivo deste artigo é estimar a prevalência de comprometimento cognitivo e analisar sua associação com o controle da pressão arterial em idosos hipertensos. Trata-se de um estudo transversal realizado com 383 idosos hipertensos no estado do Piauí, Brasil. Foram coletados dados sociodemográficos, clínicos, realizada aferição da pressão arterial e avaliação da função cognitiva utilizando o teste Montreal Cognitive Assessment (MoCA). Utilizou-se regressão de Poisson com variância robusta. A prevalência de comprometimento cognitivo foi de 74,4%, sendo maior na faixa etária entre 80 anos ou mais de idade e naqueles com menor escolaridade. A prevalência de pressão arterial não controlada foi de 61,6%, com maior proporção entre os idosos com comprometimento cognitivo. Observou-se associação entre o comprometimento cognitivo e pressão arterial não controlada (RPAjustada: 3,98; IC95% = 2,51-6,33). A associação significativa entre função cognitiva e controle pressórico sugere que comprometimento cognitivo é um importante fator de risco para pressão arterial não controlada em pessoas idosas. A inclusão de medidas de rastreamento para possíveis déficits cognitivos podem ser úteis para melhor monitoramento da elevação dos níveis pressóricos entre idosos hipertensos.


Subject(s)
Cognition , Hypertension , Aged , Aged, 80 and over , Blood Pressure , Cross-Sectional Studies , Humans , Hypertension/complications , Hypertension/epidemiology , Mental Status and Dementia Tests
13.
Ciênc. Saúde Colet. (Impr.) ; Ciênc. Saúde Colet. (Impr.);27(6): 2269-2278, jun. 2022. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1374992

ABSTRACT

Resumo O objetivo deste artigo é estimar a prevalência de comprometimento cognitivo e analisar sua associação com o controle da pressão arterial em idosos hipertensos. Trata-se de um estudo transversal realizado com 383 idosos hipertensos no estado do Piauí, Brasil. Foram coletados dados sociodemográficos, clínicos, realizada aferição da pressão arterial e avaliação da função cognitiva utilizando o teste Montreal Cognitive Assessment (MoCA). Utilizou-se regressão de Poisson com variância robusta. A prevalência de comprometimento cognitivo foi de 74,4%, sendo maior na faixa etária entre 80 anos ou mais de idade e naqueles com menor escolaridade. A prevalência de pressão arterial não controlada foi de 61,6%, com maior proporção entre os idosos com comprometimento cognitivo. Observou-se associação entre o comprometimento cognitivo e pressão arterial não controlada (RPAjustada: 3,98; IC95% = 2,51-6,33). A associação significativa entre função cognitiva e controle pressórico sugere que comprometimento cognitivo é um importante fator de risco para pressão arterial não controlada em pessoas idosas. A inclusão de medidas de rastreamento para possíveis déficits cognitivos podem ser úteis para melhor monitoramento da elevação dos níveis pressóricos entre idosos hipertensos.


Abstract This article aims to estimate the prevalence of cognitive impairment and analyze its association with blood pressure control in elderly hypertensive individuals. Cross-sectional study of 383 elderly hypertensive individuals in the state of Piauí, Brazil. The authors collected sociodemographic and clinical data, performed blood pressure measurement, and assessed cognitive function using the Montreal Cognitive Assessment (MoCA) test. Poisson regression with robust variance was used. Overall prevalence of cognitive impairment was 74.4%, higher in the age group 80 years and over and among older persons with less schooling. Prevalence of uncontrolled blood pressure was 61.6%, with a higher proportion in the elderly with cognitive impairment. An association was observed between cognitive impairment and uncontrolled blood pressure (aPR: 3.98; 95%CI = 2.51-6.33). The significant association between cognitive function and blood pressure control suggest that cognitive impairment is an important risk factor for uncontrolled blood pressure in older persons. The inclusion of screening measures for possible cognitive deficits may be useful for better monitoring blood pressure levels among elderly hypertensive individuals.

14.
Aging Clin Exp Res ; 34(8): 1885-1891, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35364784

ABSTRACT

BACKGROUND: Osteoporotic fractures are common, and their incidence are increasing worldwide. The first fracture doubles the risk of new fractures. Despite that, up to 80% of patients with a fragility fracture are evaluated or treated to reduce the risk of new fractures. AIMS: To evaluate the results of the operation of the hospital Fracture Liaison Service (FLS) and to analyze the clinical characteristics of the patients attending the service in its first 2 years of operation and to estimate the fracture risk reduction ratio. METHODS: The FLS managed patients older than 50 years who were admitted with a low-energy trauma fracture between January 2017 and April 2018. This management consists in a full medical evaluation, nutritional and physical activity guidance, and specific osteoporosis treatment, if needed. RESULTS: We monitored and treated 135 patients. Forty percent of them had a previous fracture and only 20.3% of them received treatment to prevent new fractures. On Kaplan-Meier analysis, the estimated incidence of new fractures over 24 months was 12.1% (95% CI 7.2-20.8%), indicating that the percentage of patients without new fractures due to bone fragility during treatment was estimated at 87.9% (95% CI 79.2-92.8%). CONCLUSIONS: The evaluation and treatment of patients who sustained a fragility fracture to prevent a secondary fracture is effective in reducing the risk of new fractures in high-risk patients.


Subject(s)
Bone Density Conservation Agents , Osteoporosis , Osteoporotic Fractures , Bone Density Conservation Agents/therapeutic use , Hospitalization , Humans , Incidence , Osteoporosis/complications , Osteoporosis/drug therapy , Osteoporosis/epidemiology , Osteoporotic Fractures/prevention & control , Secondary Prevention/methods
16.
Arch Phys Med Rehabil ; 103(10): 1944-1950, 2022 10.
Article in English | MEDLINE | ID: mdl-35430240

ABSTRACT

OBJECTIVE: To investigate the association of isotemporal substitution modeling (ISM) of time spent in sedentary activities with physical activity in different intensities on pain and disability of patients with chronic low back pain (LBP). DESIGN: Observational and cross-sectional study. Device-measured physical activity levels were assessed using an actigraph. Pain intensity was measured using the 11-point numeric rating scale, and disability was measured using the Roland Morris Disability Questionnaire. The ISM was used to estimate the theoretical substitution association of reallocating time from 1 exposure variable to an equal amount of time in another exposure variable while holding total activity time constant. SETTINGS: Outpatient physical therapy clinic. PARTICIPANTS: This study included data from 358 patients (N=358) with chronic LBP aged between 18 and 60 years. MAIN OUTCOME MEASURES: Pain and disability. RESULTS: Our results suggest that replacing 60 minutes of sedentary behavior with 60 minutes of vigorous activity in a week is significantly associated with a decrease in pain (ß=-1.67; 95% confidence interval [CI], -3.18 to -0.15). Additionally, replacing 60 minutes of light physical activity (ß=-1.67; 95% CI, -3.18 to -0.16) or moderate activity (ß=-1.67; 95% CI, -3.21 to -0.13) with the same amount of time of vigorous activity per week may also favorable reductions in pain. For the analysis of disability, no significant associations (P>.05) for disability in any of the isotemporal models were found. CONCLUSIONS: Our results showed that replacing 60 minutes of sedentary behavior with equal amounts of vigorous activity per week was associated with reductions in pain intensity. Similarly, replacing a light or moderate activities with vigorous activity was also associated with reductions in pain intensity. Finally, no significant associations were observed between time spent in sedentary activities with physical activity in different intensities for disability.


Subject(s)
Low Back Pain , Sedentary Behavior , Adolescent , Adult , Cross-Sectional Studies , Exercise , Humans , Middle Aged , Pain Measurement , Young Adult
17.
Prev Med ; 154: 106904, 2022 01.
Article in English | MEDLINE | ID: mdl-34863810

ABSTRACT

This study aims to estimate the effect of internet use on the incidence of cognitive impairment in older adults. Data are from the EpiFloripa Aging Cohort Study which has been following a population-based sample of older adults (60+) residing in Florianópolis, southern Brazil, for ten years. The outcome was the incidence of cognitive decline in follow-up waves measured by the Mini-Mental State Examination using cutoff points according to education. The exposure was internet use according to wave (yes/no). We excluded individuals with cognitive impairment from Wave 1 (n = 453). We used a longitudinal analysis model (Generalized Estimating Equations) to estimate incidence rate ratios (IRR) with 95% confidence intervals. We estimated the risk of cognitive impairment in Wave 2 or Wave 3 according to internet use in the previous wave. The incidence of cognitive impairment was 13.4% in Wave 2 and 13.3% in Wave 3. Despite the aging of this cohort, the prevalence of internet users increased from 26.4% in Wave 1 to 32.8% in Wave 2 and 46.8% in Wave 3. The risk of cognitive impairment in Wave 2 or Wave 3 was 70% lower for older adults who used the internet in the previous wave, adjusted for sex, age, years of education, household income, and self-reported comorbidities (IRR = 0.30; 95% CI: 0.15-0.61; p = 0.001). Internet use was associated with a decline in the incidence of cognitive impairment among older adults living in the urban areas of southern Brazil after a period of ten years.


Subject(s)
Cognitive Dysfunction , Internet Use , Aged , Aging/psychology , Cognitive Dysfunction/epidemiology , Cohort Studies , Humans , Incidence , Longitudinal Studies
18.
Mar Pollut Bull ; 172: 112821, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34380100

ABSTRACT

Abandoned, lost, or otherwise discarded fishing gear (ALDFG) is responsible for the entanglement of several marine species. Based on a search of digital media (i.e., Google and YouTubeBR), we assessed the negative impacts of ghost nets-a type of ALDFG-on Brazilian marine biodiversity. We found that ghost nets negatively affected crustaceans, fishes, reptiles, birds, and mammals in different parts of the Brazilian coast. Our reports include marine megafauna, such as the Bryde's whale and Guiana dolphin. In addition, we found that ghost nets impacted seven threatened species and had negative effects on animals within marine protected areas. Here, we provide an update on the negative impacts of ghost nets on Brazilian marine biota, but the real situation remains underestimated and somewhat obscure.


Subject(s)
Fisheries , Internet , Animals , Biodiversity , Mammals , Reptiles
19.
J. coloproctol. (Rio J., Impr.) ; 41(2): 182-187, June 2021. tab, graf
Article in English | LILACS | ID: biblio-1286987

ABSTRACT

Introduction: Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory conditions of the gastrointestinal tract. Studies have shown that polymorphisms of the vitamin D receptor (VDR) gene may help elucidate the pathogenesis of CD. Objectives: To analyze the role of VDR gene polymorphisms (ApaI, BsmI, FokI, and TaqI) in the development of CD. Methods: The present study is a systematic review with meta-analysis. a total of 50 articles in English and Portuguese published from 2000 to 2020 were selected from 3 databases. The relationship between CD and the VDR gene was addressed in 16 articles. Results: The TaqI polymorphism was analyzed in 3,689 patients and 4,645 control subjects (odds ratio [OR]=0.948; 95% confidence interval [95%CI]=0.851-1.056; p=0.3467). The ApaI polymorphism was studied in 3,406 patients and 4,415 control subjects (OR=1,033; 95%CI=0.854-1.250; p=0.7356). For FokI polymorphism, there were 2,998 patients and 4,146 control subjects (OR=0.965; 95%CI=0.734-1.267; p=0.7958). Lastly, the BsmI polymorphism was analyzed in 2,981 patients and 4,477 control subjects (OR=1,272; 95%CI=0.748-2.161; p=0.3743). Conclusion: These four VDR gene polymorphisms were not associated with CD. Therefore, further studies with larger samples are required to corroborate or rectify the conclusions from the present meta-analysis. (AU)


Introdução: A doença de Crohn (DC) e a retocolite ulcerativa (RU) são condições inflamatórias crônicas do trato gastrointestinal. Estudos indicam que os polimorfismos do gene do receptor de vitamina D (RVD) são promissores para a patogênese da DC. Objetivos: Avaliar papel dos os polimorfismos do gene do RVD (ApaI, BsmI, FokI e TaqI) no desenvolvimento da DC. Métodos: Trata-se de uma revisão sistemática com metanálise. Foram identificados 50 artigos em inglês e português publicados entre 2000 a 2020 em 3 bases de dados. Destes, foram selecionados 16 artigos que contemplavama relação entre a DC e o genedo RVD. Resultados: Para o polimorfismo TaqI, a amostra foi composta por 3.689 pacientes e 4.645 controles (razão de probabilidade [RP]=0,948; intervalo de confiança de 95% [IC95%]=0,851-1,056; p=0,3467). Para o polimorfismo ApaI, 3.406 pacientes e 4.415 controles (RP=1,033; IC95%=0,854-1,250; p=0,7356). Para o polimorfismo FokI, 2.998 pacientes e 4.146 controles (RP=0,965; IC95%=0,734-1,267; p=0,7958). E, para o polimorfismo BsmI, 2.981 pacientes e 4.477 controles (RP =1,272; IC95%=0,748-2,161; p=0,3743). Conclusão: Esses quatro polimorfismos do gene do RVD não apresentaram associação coma DC. Logo, sugere-se a realização de mais estudos com amostras maiores a fimde corroborar ou retificar a conclusão desta metanálise. (AU)


Subject(s)
Humans , Polymorphism, Genetic , Crohn Disease/genetics , Receptors, Calcitriol/genetics
20.
Sci Rep ; 11(1): 2541, 2021 01 28.
Article in English | MEDLINE | ID: mdl-33510223

ABSTRACT

In the present study, novel, 1,3-diaryltriazene-derived triazene compounds were synthesized and tested. Triazenes are versatile and belong to a group of alkylating agents with interesting physicochemical properties and proven biological activities. This study describes the synthesis, molecular and crystalline structure, biological activity evaluation, and antifungal and antimicrobial potentials of 1,3-bis(X-methoxy-Y-nitrophenyl)triazenes [X = 2 and 5; Y = 4 and 5]. The antimicrobial and antifungal activities of the compounds were tested by evaluating the sensitivity of bacteria (American Type Culture Collection, ATCC) and clinical isolates to their solutions using standardized microbiological assays, cytotoxicity evaluation, and ecotoxicity tests. The antimicrobial potentials of triazenes were determined according to their minimum inhibitory concentrations (MICs); these compounds were active against gram-positive and gram-negative bacteria, with low MIC values. The most surprising result was obtained for T3 having the effective MIC of 9.937 µg/mL and antifungal activity against Candida albicans ATCC 90028, C. parapsilosis ATCC 22019, and C. tropicallis IC. To the best of our knowledge, this study is the first to report promising activities of triazene compounds against yeast and filamentous fungi. The results showed the potential utility of triazenes as agents affecting selected resistant bacterial and fungal strains.


Subject(s)
Triazenes/chemistry , Triazenes/pharmacology , Anti-Infective Agents/chemistry , Anti-Infective Agents/pharmacology , Antineoplastic Agents/chemistry , Antineoplastic Agents/pharmacology , Dose-Response Relationship, Drug , Microbial Sensitivity Tests , Models, Molecular , Molecular Structure , Structure-Activity Relationship
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