RESUMO
BACKGROUND: Psoriasis is a chronic inflammatory skin disease associated with several important medical comorbidities. There are scant data available on the comorbidities of patients with psoriasis in South America. AIM: To examine the comorbidity profile of adult patients with psoriasis in Chile and its association with severity of psoriasis. METHODS: This was a multicentre, cross-sectional study involving 16 hospitals and clinics in Chile, which used a 48-item questionnaire to study clinician- and patient-reported outcomes and comorbidities. Inferential analyses were performed by psoriasis severity, using Fisher exact test, Student t-test and multivariable logistic regression. RESULTS: In total, 598 adult patients with psoriasis were included (51.1% male; mean age 49.2 ± 15.1 years); 48.5% mild and 51.4% moderate to severe; Psoriasis Area and Severity Index 11.6 ± 11.5; body surface area 14.7 ± 18.2%. Plaque psoriasis was the most common phenotype (90.2%), followed by guttate (13.4%). Psoriatic arthritis occurred in 27.3% of patients. Comorbidities were reported in 60.2% of all patients with psoriasis. Frequent concomitant diseases were obesity (25.3%), hypertension (24.3%), Type 2 diabetes mellitus (T2DM) (18.7%), dyslipidaemia (17.4%), metabolic syndrome (16.7%) and depression (14.4%). After adjustment, significant associations were found between moderate to severe psoriasis and obesity, T2DM and nonalcoholic fatty liver disease (NAFLD) compared with mild psoriasis. CONCLUSIONS: We report a large study of comorbidities, including depression, dyslipidaemia, T2DM and NAFLD, in people with psoriasis in Chile. The prevalence of comorbidities with psoriasis in Chile appears similar to that found in Western countries, and emphasizes the importance of assessing patients with psoriasis for risk factors for and presence of, comorbid disease in a multidisciplinary setting.
Assuntos
Diabetes Mellitus Tipo 2 , Dislipidemias , Hepatopatia Gordurosa não Alcoólica , Psoríase , Masculino , Feminino , Humanos , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Chile/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Estudos Transversais , Psoríase/epidemiologia , Comorbidade , Obesidade/epidemiologia , Atenção à SaúdeRESUMO
This study assessed the intra-individual reliability of oxygen saturation in intercostal muscles (SmO2-m.intercostales) during an incremental maximal treadmill exercise by using portable NIRS devices in a test-retest study. Fifteen marathon runners (age, 24.9 ± 2.0 years; body mass index, 21.6 ± 2.3 kg·m-2; VÌO2-peak, 63.7 ± 5.9 mL·kg-1·min-1) were tested on two separate days, with a 7-day interval between the two measurements. Oxygen consumption (VÌO2) was assessed using the breath-by-breath method during the VÌO2-test, while SmO2 was determined using a portable commercial device, based in the near-infrared spectroscopy (NIRS) principle. The minute ventilation (VE), respiratory rate (RR), and tidal volume (Vt) were also monitored during the cardiopulmonary exercise test. For the SmO2-m.intercostales, the intraclass correlation coefficient (ICC) at rest, first (VT1) and second ventilatory (VT2) thresholds, and maximal stages were 0.90, 0.84, 0.92, and 0.93, respectively; the confidence intervals ranged from -10.8% - +9.5% to -15.3% - +12.5%. The reliability was good at low intensity (rest and VT1) and excellent at high intensity (VT2 and max). The Spearman correlation test revealed (p ≤ 0.001) an inverse association of SmO2-m.intercostales with VÌO2 (ρ = -0.64), VE (ρ = -0.73), RR (ρ = -0.70), and Vt (ρ = -0.63). The relationship with the ventilatory variables showed that increased breathing effort during exercise could be registered adequately using a NIRS portable device.
Assuntos
Exercício Físico/fisiologia , Músculos Intercostais/fisiologia , Consumo de Oxigênio/fisiologia , Espectroscopia de Luz Próxima ao Infravermelho/instrumentação , Trabalho Respiratório/fisiologia , Adulto , Desempenho Atlético/fisiologia , Teste de Esforço/métodos , Humanos , Masculino , Reprodutibilidade dos Testes , Taxa Respiratória/fisiologia , Corrida/fisiologia , Volume de Ventilação Pulmonar/fisiologia , Adulto JovemRESUMO
Gastroliths are highly calcified structures formed in the cardiac stomach wall of crustaceans for the temporary storage of amorphous CaCO3 (ACC). The gastrolithic ACC is stabilized by the presence of biomolecules, and represents a novel model for research into biomineralization. For the first time, an in vitro biomimetic retrosynthesis of scaffolds of gastrolithic matrices with CaCO3 is presented. With the help of synthetic polyacrylic (PAA) and phytic (PA) acids, amorphous precursor particles were stabilized in double (DD) and gas (GD) diffusion crystallization assays. The presence of these synthetic molecules as efficient inhibitors of nucleation and growth of CaCO3, and the use of biological gastrolith scaffolds as confined reaction environments determined the kinetics of crystallization, and controlled the morphogenesis of CaCO3. The formation of ACC particles was demonstrated and their crystallization was followed by light microscopy, scanning and transmission electron microscopy, and electron diffraction.