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1.
Nitric Oxide ; 148: 1-12, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38636582

RESUMO

Epidemiological studies show a strong correlation between diabetes and the increased risk of developing different cancers, including melanoma. In the present study, we investigated the impact of a streptozotocin (STZ)-induced hyperglycemic environment on B16F10-Nex2 murine melanoma development. Hyperglycemic male C57Bl/6 mice showed increased subcutaneous tumor development, partially inhibited by metformin. Tumors showed increased infiltrating macrophages, and augmented IL-10 and nitric oxide (NO) concentrations. In vivo neutralization of IL-10, NO synthase inhibition, and depletion of macrophages reduced tumor development. STZ-treated TLR4 KO animals showed delayed tumor development; the transfer of hyperglycemic C57Bl/6 macrophages to TLR4 KO reversed this effect. Increased concentrations of IL-10 present in tumor homogenates of hyperglycemic mice induced a higher number of pre-angiogenic structures in vitro, and B16F10-Nex2 cells incubated with different glucose concentrations in vitro produced increased levels of IL-10. In summary, our findings show that a hyperglycemic environment stimulates murine melanoma B16F10-Nex2 primary tumor growth, and this effect is dependent on tumor cell stimulation, increased numbers of macrophages, and augmented IL-10 and NO concentrations. These findings show the involvement of tumor cells and other components of the tumor microenvironment in the development of subcutaneous melanoma under hyperglycemic conditions, defining novel targets for melanoma control in diabetic patients.

2.
Clinics (Sao Paulo) ; 79: 100320, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38301537

RESUMO

INTRODUCTION: Advanced Glycation End-Products (AGEs) are a diverse group of highly reactive molecules that play a vital role in the development of neurodegenerative disorders, such as Parkinson's Disease (PD), leading to a decline in functional and cognitive capacity. The objective of this study was to assess the intake and quantification of AGEs in individuals with PD and to correlate them with their functional and cognitive abilities. METHODS: This was a cross-sectional study involving 20 PD patients and 20 non-PD individuals as the Control group (C). The autofluorescence reader was used to evaluate skin AGEs, while food recall was used to quantify AGEs consumed for three different days. The Montreal Cognitive Assessment, Short Physical Performance Battery, and handgrip tests were used. PD patients demonstrated greater impairment in functional capacity compared to the control group. RESULTS: Dominant Handgrip (p = 0.02) and motor performance, in the sit and stand test (p = 0.01) and Short Physical Performance Battery (SPPB) (p = 0.01) were inferior in PD patients than the control group. Although PD patients tended to consume less AGEs than the control group, AGE intake was negatively correlated with handgrip strength in individuals with PD (r = -0.59; p < 0.05). CONCLUSION: PD patients had lower strength and functional capacity, suggesting that the effects of AGEs might be exacerbated during chronic diseases like Parkinson's.


Assuntos
Disfunção Cognitiva , Doença de Parkinson , Humanos , Estudos Transversais , Força da Mão , Cognição , Produtos Finais de Glicação Avançada
3.
Clinics ; 79: 100320, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1534238

RESUMO

Abstract Introduction Advanced Glycation End-Products (AGEs) are a diverse group of highly reactive molecules that play a vital role in the development of neurodegenerative disorders, such as Parkinson's Disease (PD), leading to a decline in functional and cognitive capacity. The objective of this study was to assess the intake and quantification of AGEs in individuals with PD and to correlate them with their functional and cognitive abilities. Methods This was a cross-sectional study involving 20 PD patients and 20 non-PD individuals as the Control group (C). The autofluorescence reader was used to evaluate skin AGEs, while food recall was used to quantify AGEs consumed for three different days. The Montreal Cognitive Assessment, Short Physical Performance Battery, and handgrip tests were used. PD patients demonstrated greater impairment in functional capacity compared to the control group. Results Dominant Handgrip (p = 0.02) and motor performance, in the sit and stand test (p = 0.01) and Short Physical Performance Battery (SPPB) (p = 0.01) were inferior in PD patients than the control group. Although PD patients tended to consume less AGEs than the control group, AGE intake was negatively correlated with handgrip strength in individuals with PD (r = -0.59; p < 0.05). Conclusion PD patients had lower strength and functional capacity, suggesting that the effects of AGEs might be exacerbated during chronic diseases like Parkinson's.

4.
Chem Biodivers ; 20(10): e202300083, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37681514

RESUMO

This work describes a new hair dyeing methodology using a chemical reaction between geniposide, an iridoid glycoside extracted from the fruit of Genipa americana (geniposide extract, GE) and the amine group of hair keratin. The influence of reaction conditions (pH, temperature, and extract concentration) on the staining of hair fibers, color development, fiber morphology, and mechanical hair properties of black and white human hair samples, was evaluated before and after GE dyeing treatment. Eye contact safety of GE was also studied using HET-CAM. The treatment of white hair fibers using GE at 20 mg mL-1 , temperature of 80 °C and pH 5.5 presented the greatest color change (ΔE=54.0). The higher pH influence was observed at pH 10.0 on white hair tresses (ΔE=6.8), using an GE concentration of 20 mg mL-1 and room temperature (25 °C). Treated samples showed marked changes on mechanical and morphological properties. The HET-CAM did not show any change, thus demonstrating that using GE is safe. In conclusion, the temperature and concentration of the extract were the variables that mostly influenced the color and hair damage. A new approach for hair dyeing was established where iridoids may potentially be useful as a natural hair dyeing.

5.
Artigo em Inglês | MEDLINE | ID: mdl-37239618

RESUMO

OBJECTIVES: To evaluate the effect of whey protein (WP) supplementation associated with resistance training (RT) on glycemic control, functional tasks, muscle strength, and body composition in older adults living with type 2 diabetes mellitus (T2DM). Secondly, to evaluate the safety of the protocol for renal function. METHODS: The population comprised twenty-six older men living with T2DM (68.5 ± 11.5 years old). The participants were randomly assigned to the Protein Group (PG) and the Control Group (CG). The handgrip test and evolution of exercise loads, according to the Omni Resistance Exercise Scale, evaluated muscle strength. Functional tasks were assessed by force platform in three different protocols: Sit-to-Stand, Step/Quick Turn, and Step Up/Over. Body composition was evaluated by bioimpedance and glycemic control and renal function were assessed by biochemical analyses. Both groups performed RT for 12 weeks, twice a week, prioritizing large muscle groups. Protein supplementation was 20 g of whey protein isolate and the CG was supplemented with an isocaloric drink, containing 20 g of maltodextrin. RESULTS: There was a significant difference in muscle strength, according to the evolution of the exercise loads, but it was not confirmed in the handgrip test. However, there was no significant difference between the groups, regarding performance in functional tasks, glycemic control, or body composition. Renal function showed no alteration. CONCLUSION: The intake of 20 g of WP in older male adults living with T2DM did not increase the effect of RT on muscle strength, functional tasks, and glycemic control. The intervention was proven safe regarding renal function.


Assuntos
Diabetes Mellitus Tipo 2 , Treinamento Resistido , Humanos , Masculino , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Proteínas do Soro do Leite/uso terapêutico , Treinamento Resistido/métodos , Diabetes Mellitus Tipo 2/terapia , Força da Mão , Controle Glicêmico , Músculo Esquelético/fisiologia , Método Duplo-Cego , Força Muscular/fisiologia , Suplementos Nutricionais , Composição Corporal/fisiologia
6.
Rev. Ciênc. Plur ; 9(1): 29450, 27 abr. 2023. tab
Artigo em Português | BBO - Odontologia, LILACS | ID: biblio-1428124

RESUMO

Introdução: O estudo dos fatores sociodemográficos e socioeconômicos de usuários doSistema Único de Saúde éimportante para o planejamento e a avaliação das ações dos serviços de saúde procurados por esta população. Objetivo:Descrever as características demográficas, socioeconômicas e da procura dos usuários adultos com demanda dereabilitação física ortopédica e neurológica emum Centro Especializado em Reabilitação de referência no Estado de Mato Grosso. Metodologia:Estudo observacional descritivo baseado nos prontuários dosetor de acolhimento de um Centro Especializado em Reabilitação de Mato Grosso,de fevereiro a maio de 2021. Foram analisados dados demográficos e socioeconômicos de usuários adultos de ambos os sexos. Utilizou-se o teste de qui-quadrado de Pearson para as associações entre as variáveis segundo eixo de reabilitação (ortopédica e neurológica). Resultados:Dos196 prontuários analisados,94% dos usuários eram procedentes de Cuiabá, comidade média de 50,3 anos, sendo 52,55% do sexo feminino. Aprocura pelo serviçofoi de 69%pela reabilitação ortopédica (69%) e de 31%reabilitação neurológica. Observaram-se diferenças estatisticamente significantes entre as frequências nos dois eixos dereabilitação física estudados nas variáveis idade (p=0,0005), escolaridade (p=0,0031), principal atividade de trabalho (p=0,0045), doenças concomitantes (p=0,0016), tratamento em outro estabelecimento de saúde (p=0,0041) e motivo da procura pela reabilitação (p<0,0001). Conclusões:Osresultados mostraram que os casos neurológicos possuem maior idade, baixo nível de escolaridadeepequeno percentual de trabalho remuneradoem relação aos casos ortopédicos. Tais resultados sugerem que as necessidades de saúde e de reabilitação dependem da singularidade dos casos e podem subsidiara efetivação depolíticas públicas que favoreçam a reorganização dos serviços e a articulação intersetorial entre saúde, educação emercado de trabalho (AU).


Introduction: Assessing sociodemographic and socioeconomic factors related to Unified Health System's users is essential to plan and evaluate the actions by the health services sought by them.Aim: Describing the demographic and socioeconomic features of adult users, and their search for having their orthopedic and neurological-physical rehabilitation demands fulfilled by a Specialized Center in Orthopedic and Neurological Rehabilitation in Mato Grosso State.Methodology: Observational descriptive study based on medical records collected between February and March 2021, provided by the welcoming sector of a Specialized Center in Rehabilitation in Mato Grosso State. Demographic and socioeconomic records of adult users belonging to both sexes were analyzed. Person's chi-square test was adopted to associate the variables based on the orthopedic and neurological rehabilitation axes.Results: In total, 94% of the 196 analyzed medical records regard patients from Cuiabá, in the mean age group 50.3 years; 52.55% of them belonged to the female sex. The search for orthopedic rehabilitation reached 69% and that for neurological rehabilitation recorded 31%. There were significant statistical differences between frequencies on the two assessed physical rehabilitation axes based on variables such as age (p=0.0005), schooling (p=0.0031), main labor activity (p=0.0045), concomitant diseases (p=0.0016), treatment provided in another health establishment (p=0.0041) and reason for seeking rehabilitation (p<0.0001). Conclusions: Results have shown that neurological cases are linked to older age, low schooling and low rate of paid work in comparison to orthopedic cases. These results have suggested that health and rehabilitation needs depend on cases' particularities; moreover, they can subsidize the process to make public policies to reinforce services'organization, as well as inter-sectoral articulation among health, education and labor market, effective (AU).


Introducción: El estudio de los factores sociodemográficos y socioeconómicos de los usuarios del Sistema Único de Salud es importante para planificar y evaluar las acciones de los servicios de salud buscados por esta población.Objetivo: Describir las características demográficas, socioeconómicas y de demanda de usuarios adultos con demanda de rehabilitación física ortopédica y neurológica en un Centro Especializado de Rehabilitación de Referencia en el Estado de Mato Grosso.Metodología: Estudio observacional descriptivo basado en las historias clínicas del sector de acogimiento de un Centro Especializado de Rehabilitación en Mato Grosso, de febrero a mayo de 2021. Se analizaron datos demográficos y socioeconómicos de usuarios adultos de ambos sexos. Se utilizóla prueba de chi-cuadrado de Pearson para las asociaciones entre las variables según el eje de rehabilitación (ortopédico y neurológico).Resultados: De las 196 historias clínicas analizadas, 94% de los usuarios provenían de Cuiabá, con una edad promedio de 50,3 años, de los cuales 52,55% eran de sexo femenino. La demanda del servicio fue del 69% para la rehabilitación ortopédica (69%) y del 31% para la rehabilitación neurológica. Se observaron diferencias estadísticamente significativas entre las frecuencias en los dos ejes de rehabilitación física estudiados en las variables edad (p=0,0005), escolaridad (p=0,0031), actividad laboral principal (p=0,0045), enfermedades concomitantes (p=0,0016), tratamiento en otro establecimiento de salud (p=0,0041) y motivo de búsqueda de rehabilitación (p <0,0001). Conclusiones:Los resultados mostraron que los casos neurológicos tienen mayor edad, bajo nivel de educación y un pequeño porcentaje de trabajo remunerado en relación con los casos ortopédicos. Estos resultados sugieren que las necesidades de salud y rehabilitación dependen de la singularidad de los casos y pueden apoyar la implementación de políticas públicas que favorezcan la reorganización de los servicios y la articulación intersectorial entre salud, educación y mercado laboral (AU).


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Centros de Reabilitação , Indicadores Básicos de Saúde , Pessoas com Deficiência/psicologia , Acessibilidade aos Serviços de Saúde , Política Pública , Fatores Socioeconômicos , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Prontuários Médicos , Estudos Observacionais como Assunto/métodos
7.
Oncología (Guayaquil) ; 33(1): 31-39, 4 de Abril 2023.
Artigo em Espanhol | LILACS | ID: biblio-1427716

RESUMO

Introducción: Los pacientes con cáncer presentan dolor en un 40% y el 38% de ellos lo califica como moderado a intenso. Casi el 85% de los pacientes con dolor por cáncer pueden lograr un buen control con medicamentos orales convencionales. Caso clínico: masculino de 57 años con triple neoplasia maligna primaria metacrónica asociada a tres tipos de dolor con incremento progresivo de la intensidad y requerimiento de varias líneas de tratamiento analgésico opioide. Conclusión: Las neoplasias malignas primarias triples son infrecuentes y están asociadas a dolor complejo, siendo los opioides la opción terapéutica más adecuada.


Introduction: Pain is an unpleasant sensory and emotional experience associated with real or potential tissue damage, which treatment is more difficult in patients with multiple and advanced cancer, influencing their functionality, mood, sleep, and quality of life. Clinical case: 57-year-old male with metachronous triple primary malignancy associated with three types of pain with a progressive increase in intensity and requiring several lines of opioid analgesic treatment. Conclusion: Triple primary malignancies are uncommon and primarily associated with complex pain; opioids are the most appropriate therapeutic option.


Assuntos
Humanos , Pessoa de Meia-Idade , Dor do Câncer , Neoplasias Primárias Múltiplas , Receptores Opioides
8.
Rev. Psicol., Divers. Saúde ; 12(1)fev. 2023. tab
Artigo em Espanhol, Português | LILACS | ID: biblio-1523541

RESUMO

INTRODUÇÃO: A obesidade é uma doença crônica e de causa multifatorial caracterizada pelo acúmulo excessivo de gordura no corpo. A cirurgia bariátrica é um dos procedimentos indicados para o tratamento da obesidade. OBJETIVO: Este estudo teve como objetivo analisar a satisfação física de mulheres submetidas à cirurgia bariátrica, avaliando a incidência de alterações psicológicas pós-operatórias, comportamentos alimentares, escores de autoestima e compulsão alimentar. MÉTODOS: Este projeto foi aprovado pelo Comitê de Ética da Universidade São Judas Tadeu (CAAE 46628521.5.0000.0089). Trata-se de um estudo de caráter quantitativo com delineamento transversal que foi realizado em um grupo de 39 indivíduos do sexo feminino, com idade entre 27 e 56 anos, que se submeteram à cirurgia bariátrica do tipo Bypass Gástrico em Y de Roux há pelo menos 2 anos. Foi utilizado um formulário (Google Forms - http://gg.gg/pesquisacirurgiabariatrica) para a coleta dos dados. RESULTADOS: A análise dos dados evidenciou que as participantes apresentam sobrepeso e insatisfação corporal, mas manifestam autoestima satisfatória. A maioria das participantes afirma experimentar sentimentos positivos ou negativos quando comem, além de não fazer acompanhamento psicológico. CONCLUSÃO: Nota-se a importância do acompanhamento multidisciplinar antes, durante e depois da cirurgia bariátrica para que os resultados sejam duradouros. A terapia cognitivo-comportamental pode ser extremamente eficaz nesse processo, pois atua na modificação de pensamentos e comportamentos disfuncionais diante das necessidades individuais.


INTRODUCTION: Obesity is a chronic, multifactorial disease characterized by the excessive accumulation of fat in the body. Bariatric surgery is one of the procedures indicated for the treatment of obesity. OBJECTIVE: This study aimed to analyze the physical satisfaction of women undergoing bariatric surgery, assessing the incidence of postoperative psychological changes, eating behaviors, self-esteem scores, and binge eating. METHODS: This project was approved by the Ethics Committee of São Judas Tadeu University (CAAE 46628521.5.0000.0089). This is a quantitative cross-sectional study that was carried out on a group of 39 females aged between 27 and 56 who had undergone Roux-en-Y gastric bypass surgery at least two years previously. A form (Google Forms - http://gg.gg/pesquisacirurgiabariatrica) was used to collect the data. RESULTS: Analysis of the data showed that the participants were overweight and had body dissatisfaction but expressed satisfactory self-esteem. Most of the participants said that they experience positive or negative feelings when they eat, and that they do not receive psychological counseling. CONCLUSION: It is important to have multidisciplinary support before, during, and after bariatric surgery so that the results are long-lasting. Cognitive-behavioral therapy can be extremely effective in this process, as it works to modify dysfunctional thoughts and behaviors in the face of individual needs.


INTRODUCCIÓN: La obesidad es una enfermedad crónica y multifactorial caracterizada por la acumulación excesiva de grasa en el organismo. La cirugía bariátrica es uno de los procedimientos indicados para el tratamiento de la obesidad. OBJETIVO: Este estudio tuvo como objetivo analizar la satisfacción física de mujeres sometidas a cirugía bariátrica, evaluando la incidencia de cambios psicológicos postoperatorios, comportamientos alimentarios, puntuaciones de autoestima y atracones. MÉTODOS: Este proyecto fue aprobado por el Comité de Ética de la Universidad São Judas Tadeu (CAAE 46628521.5.0000.0089). Se trata de un estudio cuantitativo, transversal, realizado en un grupo de 39 mujeres con edades comprendidas entre 27 y 56 años que habían sido sometidas a cirugía de bypass gástrico en Y de Roux al menos dos años antes. Para la recogida de datos se utilizó un formulario (Google Forms - http://gg.gg/pesquisacirurgiabariatrica). RESULTADOS: El análisis de los datos mostró que los participantes tenían sobrepeso e insatisfacción corporal, pero expresaron una autoestima satisfactoria. La mayoría de los participantes dijeron que experimentan sentimientos positivos o negativos cuando comen, y que no reciben asesoramiento psicológico. CONCLUSIÓN: Es importante recibir asesoramiento multidisciplinar antes, durante y después de la cirugía bariátrica para que los resultados sean duraderos. La terapia cognitivo-conductual puede ser extremadamente eficaz en este proceso, ya que trabaja para modificar los pensamientos y comportamientos disfuncionales frente a las necesidades individuales.


Assuntos
Cirurgia Bariátrica , Mulheres , Obesidade
9.
Sci Rep ; 13(1): 641, 2023 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-36635347

RESUMO

Global climate changes affect biodiversity and cause species distribution shifts, contractions, and expansions. Climate change and disease are emerging threats to primates, and approximately one-quarter of primates' ranges have temperatures over historical ones. How will climate changes influence Atlantic Forest primate ranges? We used habitat suitability models and measured potential changes in area and distributions shifts. Climate change expected in 2100 may change the distribution area of Atlantic Forest primates. Fourteen species (74%) are predicted to lose more than 50% of their distribution, and nine species (47%) are predicted to lose more than 75% of their distribution. The balance was negative, indicating a potential future loss, and the strength of the reduction in the distribution is related to the severity of climate change (SSP scenarios). Directional shifts were detected to the south. The projected mean centroid latitudinal shift is ~ 51 km to the south for 2100 SSP5-8.5 scenario. The possibility of dispersal will depend on suitable routes and landscape configuration. Greenhouse gas emissions should be urgently reduced. Our results also emphasize that no more forest loss is acceptable in Atlantic Forest, and restoration, canopy bridges, friendly agroecosystems, and monitoring of infrastructure projects are urgent to enable dealing with climate change.


Assuntos
Distribuição Animal , Mudança Climática , Florestas , Primatas , Animais , Biodiversidade
10.
Front Nutr ; 10: 1183058, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38235441

RESUMO

Introduction: The aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over. Methods: This cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD). Results: The K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD. Conclusion: Handgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.

11.
J Pers Med ; 12(5)2022 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-35629250

RESUMO

BACKGROUND: In 2020, the world was surprised by the spread and mass contamination of the new Coronavirus (COVID-19). COVID-19 produces symptoms ranging from a common cold to severe symptoms that can lead to death. Several strategies have been implemented to improve the well-being of patients during their hospitalization, and virtual reality (VR) has been used. However, whether patients hospitalized for COVID-19 can benefit from this intervention remains unclear. Therefore, this study aimed to investigate whether VR contributes to the control of pain symptoms, the sensation of dyspnea, perception of well-being, anxiety, and depression in patients hospitalized with COVID-19. METHODS: A randomized, double-blind clinical trial was designed. Patients underwent a single session of VR and usual care. The experimental group (n = 22) received VR content to promote relaxation, distraction, and stress relief, whereas the control group (n = 22) received non-specific VR content. RESULTS: The experimental group reported a significant decrease in tiredness, shortness of breath, anxiety, and an increase in the feeling of well-being, whereas the control group showed improvement only in the tiredness and anxiety. CONCLUSIONS: VR is a resource that may improve the symptoms of tiredness, shortness of breath, anxiety, and depression in patients hospitalized with COVID-19. Future studies should investigate the effect of multiple VR sessions on individuals with COVID-19.

12.
BMJ Open ; 12(2): e053852, 2022 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-35177450

RESUMO

PURPOSE: Hydroxychloroquine (HCQ) is an important medication for patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and other rheumatic diseases. Although it is well-tolerated and cost-effective, the risk of HCQ retinal toxicity is of increasing concern. The aim of this study is to re-examine the HCQ retinal toxicity incidence rate, risk factors and clinical course after discontinuation. METHODS: We designed a prospective population-based cohort study in adult patients with SLE or RA, currently receiving HCQ for five or more years, who are residents of British Columbia (BC), Canada. Based on administrative data, we identified 5508 eligible participants (1346 SLE and 4162 RA). They will participate in annual or biannual retinal screening over 5 years in alignment with the recently revised American Academy of Ophthalmology guidelines. To standardise procedures for retinal screening, imaging, diagnostic criteria, severity staging and data transfer, a consensus meeting was convened in December 2019 with participation of BC retinal specialists and the research team. Agreement was attained on: use of spectral domain-optical coherence tomography as the primary objective screening modality; classification of images into categories of normal, equivocal or abnormal; and transferring the equivocal and abnormal images plus corresponding subjective test results via cloud-based server from each clinic to a reading centre. Confirmation of HCQ retinal toxicity diagnoses and severity staging will be performed by three independent and masked reviewers. The incidence of HCQ retinal toxicity will be calculated, accounting for the competing risk of death. Hazard ratios for each risk factor will be calculated for the risk of HCQ retinopathy, after adjusting for confounders. We will also estimate the risk of HCQ retinal toxicity progression over 5 years. ETHICS AND DISSEMINATION: This study has received approval from the University of British Columbia Clinical Research Ethics Board (H20-00736) and the Vancouver Coastal Health Research Institute.


Assuntos
Antirreumáticos , Artrite Reumatoide , Lúpus Eritematoso Sistêmico , Doenças Retinianas , Adulto , Antirreumáticos/efeitos adversos , Artrite Reumatoide/induzido quimicamente , Artrite Reumatoide/tratamento farmacológico , Colúmbia Britânica/epidemiologia , Estudos de Coortes , Humanos , Hidroxicloroquina/efeitos adversos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Estudos Prospectivos , Doenças Retinianas/induzido quimicamente , Doenças Retinianas/diagnóstico , Doenças Retinianas/epidemiologia , Tomografia de Coerência Óptica
13.
Forensic Sci Res ; 7(4): 628-632, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36817249

RESUMO

This article presents a forensic case of an unusual illegal cremation of a person using a process colloquially known as the "microwave oven" practice in Brazil. The microwave process involves two actions: placing the victim in a tire stack and then setting the structure on fire using flammable substances to accelerate the progression. A similar practice, identified as "necklacing", has also been reported in other countries such as South Africa. This report presents a case of microwave oven cremation of a body found in a rural area of Minas Gerais, Brazil. The forensic work helped determine the biological profile and identity of the victim using radiological comparisons. Although the microwave oven cremation practice is rare, it can impose challenges for investigators. Therefore, fully understanding this practice can be helpful to the academic and forensic communities.

14.
Estud. Interdiscip. Psicol ; 12(3): 03-21, set-dez.2021. Tab, Ilus
Artigo em Português | LILACS | ID: biblio-1358319

RESUMO

Objetivou-se avaliar a relação entre sintomas de depressão, risco nutricional e capacidade funcional com características sociais, econômicas, demográficas e de saúde, em idosos longevos. Trata-se de uma pesquisa transversal, realizada em quatro municípios do estado de São Paulo. A relação entre as variáveis foi obtida por meio da técnica de Análise de Correspondência Múltipla. Foram avaliados 103 idosos, a maioria do sexo feminino, com idade entre 80 e 90 anos e com até quatro anos de estudo. Os resultados evidenciam a correspondência entre a presença de sintomas de depressão, risco nutricional, comprometimento funcional, baixa escolaridade e inadequada autoavaliação de saúde. Nota-se, portanto, a necessidade de uma abordagem interdisciplinar, e o desenvolvimento de políticas públicas direcionadas aos muito idosos, oferecendo atenção necessária para a redução do risco de depressão, de desnutrição e na melhoria da funcionalidade dos idosos longevos, que levem a um impacto positivo em sua qualidade de vida (AU).


This is study aimed to evaluate the relationship between depression symptoms, nutritional risk, and functional capacity, with social, economic, demographic and health characteristics in in long-lived elderly. It is a cross-sectional survey carried out in four municipalities in the state of São Paulo. The relationships among the studied variables were investigated through the technique of Multiple Correspondence Analysis. A total of 103 elderly were evaluated, most of whom were female, aged between 80 and 90 years and up to four years of schooling. The results evidence the correspondence between depression symptoms, nutritional risk, functional impairment, low schooling, and inadequate health self-assessment. Therefore, there is need a broad and interdisciplinary approach and the development of public policies directed at the very elderly are necessary, to reduce the risk of depression, malnutrition and improve the functioning of the long-lived elderly, that have a positive impact on their quality of life (AU).


Objetivo evaluar la relación entre síntomas de depresión, riesgo nutricional y capacidad funcional, con recursos sociales, económicos, demográficos y de salud, en ancianos de larga vida. Esta es un estudio transversal realizada en cuatro municipios del estado de São Paulo. Las relaciones entre las variables se investigaron utilizando la técnica de Análisis de Correspondencia Múltiple. 103 personas mayores fueron grabadas, la mayoría mujeres, con edades comprendidas entre 80 y 90 años y hasta cuatro años de estudio. Los resultados muestran una correspondencia entre la presencia de síntomas de depresión, riesgo nutricional, deterioro funcional, baja educación y salud inadecuada. Nota la necesidad de un enfoque interdisciplinario y el desarrollo de políticas públicas dirigidas a las personas mayores, ayuda a prestar atención para reducir los riesgos de depresión, desnutrición y mejorar la funcionalidad de las personas mayores de edad, lo que tiene un impacto positivo en su calidad de vida (AU).


Assuntos
Humanos , Idoso de 80 Anos ou mais , Risco , Comportamento de Redução do Risco , Desnutrição , Depressão , Fatores Sociológicos , Qualidade de Vida , Autoteste
15.
Nutrients ; 13(10)2021 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-34684632

RESUMO

Advanced glycated albumin (AGE-albumin) impairs cholesterol efflux and contributes to inflammation in macrophages. The current study evaluated: (1) the persistence of the deleterious effect of AGE-albumin in cholesterol efflux and in inflammation, and (2) how metabolic control in diabetes mellitus (DM) contributes to attenuate the deleterious role of AGE-albumin in macrophage cholesterol homeostasis. Methods: AGE-albumin was produced in vitro or isolated from uncontrolled DM subjects' serum before (bGC) and after improved glycemic control (aGC). Albumin samples were incubated with bone marrow-derived macrophages and 14C-cholesterol efflux or LPS- induced cytokine secretion were determined immediately, or after cell resting in culture media alone. The ABCA-1 degradation rate was determined after cell incubation with cycloheximide, and ABCA1 protein level by immunoblot. Oil Red O staining was used to assess intracellular lipid accumulation. Results: A persistent effect of AGE-albumin was observed in macrophages in terms of the secretion of inflammatory cytokines and reduced cholesterol efflux. HDL-mediated 14C-cholesterol efflux was at least two times higher in macrophages treated with aCG-albumin as compared to bGC-albumin, and intracellular lipid content was significantly reduced in aGC-albumin-treated cells. As compared to bGC-albumin, the ABCA-1 protein content in whole cell bulk was 94% higher in aCG-albumin. A 20% increased ABCA-1 decay rate was observed in macrophages treated with albumin from poorly controlled DM. AGE-albumin has a persistent deleterious effect on macrophage lipid homeostasis and inflammation. The reduction of AGEs in albumin ameliorates cholesterol efflux.


Assuntos
Transportador 1 de Cassete de Ligação de ATP/metabolismo , Colesterol/metabolismo , Macrófagos/metabolismo , Albumina Sérica/metabolismo , Transporte Biológico , Técnicas de Cultura de Células , Citocinas/metabolismo , Diabetes Mellitus/metabolismo , Produtos Finais de Glicação Avançada , Controle Glicêmico , Homeostase/fisiologia , Humanos , Inflamação , Lipídeos de Membrana/metabolismo , Albumina Sérica Glicada
16.
Arq. ciências saúde UNIPAR ; 25(3): 231-235, set-out. 2021.
Artigo em Português | LILACS | ID: biblio-1348219

RESUMO

Objetivo: descrever a aplicação da Sistematização da Assistência de Enfermagem a um paciente com Fratura de Colo de Fêmur no período perioperatório. Metodologia: Relato de experiência realizado no centro cirúrgico de um hospital geral, o qual atende demanda espontânea da capital e do interior do estado da Bahia. O período de realização do estudo foi em agosto de 2019, na cidade de Feira de Santana- BA. Esta experiência foi fruto da vivência de acadêmicos de enfermagem do sexto semestre da Universidade Estadual de Feira de Santana. Foram respeitados os aspectos éticos da Resolução 466/2012. Resultados: Foi aplicada a Sistematização da Assistência de Enfermagem no Perioperatório a paciente idoso com fratura de colo de fêmur, conforme cinco fases do processo de enfermagem: Histórico, Diagnóstico, Planejamento, Implementação e Avaliação. Ressalta-se que o referido caso foi analisado de acordo com as Diretrizes Terapêuticas para Fratura de Colo de Fêmur, que demostraram a importância da aplicação da sistematização para um cuidado diferenciado ao paciente idoso com diagnóstico de fratura de fêmur, considerando que a população idosa cada vez mais vem alcançando a longevidade e as quedas são um dos eventos adversos que mais acometem essa população, seguido pela fratura. Conclusão: Este estudo pretende contribuir como instrumento gerencial e de cuidado relevante para a instituição no centro cirúrgico que visem acelerar o tempo de alta, minimizar o risco de complicações, reduzir os custos e favorecer a qualidade de vida dos pacientes idosos com fratura de fêmur a partir da sistematização da assistência de enfermagem perioperatória.


Objective: Describe the application of Nursing Care Systematization to a patient with a femoral neck fracture during the perioperative period. Methodology: Report of an experience carried out in the operating room of a general hospital, which cares for the spontaneous demand of the capital city and the interior of the state of Bahia. The study was held in August 2019 in the city of Feira de Santana, in the state of Bahia. This was the result of the academic experience of nursing students in the sixth semester at the State University of Feira de Santana. The ethical aspects of Resolution 466/2012 were respected. Results: Perioperative Nursing Care Systematization was applied to an elderly patient with a femoral neck fracture, according to five phases of the nursing process: History, Diagnosis, Planning, Implementation, and Evaluation. It emphasizes whether the case was analyzed according to the Therapeutic Guidelines for Femoral Neck Fractures, which demonstrated the importance of applying systematization for differentiated care for elderly patients diagnosed with femoral fractures, considering that the elderly population is living longer, and falls are one of the adverse events most frequently affecting such population, followed by fracture. Conclusion: This study aims at contributing as a relevant management and care instrument for the institution of any surgical center that aims at speeding up discharge time, minimizing the risk of complications, reducing costs, and favoring the quality of life of elderly patients with femur fracture from the systematization of perioperative nursing care.


Assuntos
Humanos , Masculino , Idoso , Estudantes de Enfermagem , Fraturas do Fêmur , Processo de Enfermagem , Qualidade de Vida , Enfermagem Perioperatória/educação , Centros Cirúrgicos/provisão & distribuição , Acidentes por Quedas , Idoso , Período Perioperatório/enfermagem , Anestesia/enfermagem , Cuidados de Enfermagem/organização & administração
18.
Acta Ortop Bras ; 29(2): 87-91, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34248407

RESUMO

OBJECTIVE: To investigate the relationship between anthropometry and body composition with dynamic postural balance in elderly women with low bone mineral density (BMD). METHODS: 45 older women (≥ 60 years), low BMD and nutritional diagnosis of low weight to overweight. For the assessment of body composition, Dual energy X-ray emission densitometry and anthropometric examination were used to measure: body mass (kg), height (cm) and BMI (k/m2). The assessment of dynamic postural balance was performed by the mini Balance Master Evaluation System clinical test and the computerized Balance Master® System test by the Sit to Stand and Step Up/Over tests. RESULTS: There was a negative correlation between miniBESTest (r = - 0.566; p ≤ 0.001) and time to ascend and descend step (r = - 0.393; p ≤ 0.007) with fat mass, and positive correlation with miniBESTest (r = 0.526; p ≤0.001) and time to go up and down a step with muscle mass (r = 0.297; p ≤ 0.04). As for anthropometric variables, only height showed a positive correlation (r = 0.296; p ≤ 0.04) with the speed in the sit and stand test. CONCLUSION: Lean mass reduces postural oscillations; in contrast, fat mass negatively interfered with dynamic postural balance in women with low BMD. Height was related to dynamic postural balance, the taller the elderly, the worse their balance. Level of Evidence II, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.


OBJETIVO: Investigar a relação da antropometria e composição corporal com o equilíbrio postural dinâmico em idosas com baixa Densidade Mineral Óssea (DMO). MÉTODOS: 45 idosas (≥ 60 anos), baixa DMO e diagnóstico nutricional entre baixo peso e sobrepeso. Para a avaliação da composição corporal utilizou-se a densitometria por emissão de raios x de dupla energia e exame antropométrico para aferir: massa corporal (kg), estatura (cm) e índice de massa corporal (IMC) (k/m2). A avaliação do equilíbrio postural dinâmico foi realizada pelo teste clínico mini Balance Master Evaluation System, pelo teste computadorizado Balance Master ® System e pelos testes Sit-to-Stand e Step Up/Over. Resultados: Houve correlação negativa do miniBESTest (r = − 0,566; p ≤ 0,001) e tempo de subir e descer um degrau (r = − 0,393; p ≤ 0,007) com a massa gorda, e correlação positiva do miniBESTest (r = 0,526; p ≤ 0,001) e tempo de subir e descer um degrau com a massa muscular (r = 0,297; p ≤ 0,04). Quanto às variáveis antropométricas, apenas a estatura apresentou correlação positiva (r = 0,296; p ≤ 0,04) com a velocidade no teste de sentar-se e levantar-se. CONCLUSÃO: A massa magra reduz as oscilações posturais. Em contrapartida, a massa gorda interfere de forma negativa no equilíbrio postural dinâmico de mulheres com baixa DMO. A estatura esteve relacionada ao equilíbrio postural dinâmico: quanto mais altas as idosas pior era seu equilíbrio. Nível de Evidência II, Estudos prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

20.
J Diabetes Complications ; 35(9): 107969, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34183248

RESUMO

BACKGROUND AND AIMS: Abnormalities in lipid metabolism, accumulation of uremic toxins and advanced glycation end products may contribute to worsening atherosclerosis. This study characterized the glycation and carbamoylation profile of serum albumin isolated from individuals with diabetic kidney disease and its influence on cholesterol efflux. MATERIAL AND METHODS: 49 patients with type 2 diabetes (T2DM) and different eGFR evaluated glycation and carbamoylation profile by measurement of carboxymethyl lysine (CML) and carbamoylated proteins (CBL) in plasma by ELISA, homocitrulline (HCit) in plasma by colorimetry. In the isolated albumins, we quantified CBL (ELISA) and total AGE and pentosidine by fluorescence. Macrophages were treated with albumin isolated, and 14C-Cholesterol efflux mediated by HDL2 or HDL3 was measured. Kruskal-Wallis test, Jonckheere-Terpstra test and Brunner's posttest were used for comparisons among groups. RESULTS: Determination of CML, HCit, CBL in plasma, as total AGE and pentosidine in albumins, did not differ between groups; however, CBL in the isolated albumins was higher in the more advanced stages of CKD (p=0.0414). There was reduction in the 14C-cholesterol efflux after treatment for 18h with albumin isolated from patients with eGFR<60mL/min/1.73m2 compared with control group mediated by HDL2 (p=0.0288) and HDL3 (p<0.0001), as well as when compared with eGFR ≥60mL/min/1.73m2 per HDL2 (p=0.0001) and HDL3 (p<0.0001). Treatment for 48h showed that eGFR<15mL/min/1.73m2 had a lower percentage of 14C-cholesterol efflux mediated by HDL2 compared to control and other CKD groups (p=0.0274). CONCLUSIONS: Albumins isolated from individuals with T2DM and eGFR<60mL/min/1.73m2 suffer greater carbamoylation, and they impair the cholesterol efflux mediated by HDL2 and HDL3. In turn, this could promote lipids accumulation in macrophages and disorders in reverse cholesterol transport.


Assuntos
Colesterol/metabolismo , Nefropatias Diabéticas/metabolismo , Macrófagos , Insuficiência Renal Crônica , Albumina Sérica , Diabetes Mellitus Tipo 2/complicações , Humanos , Macrófagos/metabolismo , Carbamilação de Proteínas , Insuficiência Renal Crônica/metabolismo , Albumina Sérica/metabolismo , Toxinas Urêmicas
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