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1.
Rev Port Cardiol ; 2024 May 01.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38701967

RESUMO

INTRODUCTION AND OBJECTIVES: Atrial fibrillation (AF) and heart failure (HF) often coexist. AF catheter ablation improves left ventricular ejection fraction (LVEF), but its impact varies between patients. We aimed to identify predictors of LVEF improvement in HF patients with impaired LVEF undergoing AF ablation. METHODS: We conducted a retrospective single-center study in HF patients with LVEF <50% undergoing AF catheter ablation between May 2016 and May 2022. The primary endpoint was the LVEF recovery rate ('responders'). Secondary endpoints were one-year safety and effectiveness. We also aimed to validate a prediction model for LVEF recovery. RESULTS: The study included 100 patients (79% male, median age 60 years, 70% with probable tachycardia-induced cardiomyopathy [TIC], mean LVEF 37%, 29% with paroxysmal AF). After a median follow-up of 12 months after catheter ablation, LVEF improved significantly (36±10% vs. 53±10%, p<0.001), with an 82% responder rate. A suspected diagnosis of TIC (OR 4.916 [95% CI 1.166-20.732], p=0.030), shorter QRS duration (OR 0.969 [95% CI 0.945-0.994], p=0.015), and smaller left ventricle (OR 0.893 [95% CI 0.799-0.999], p=0.049) were independently associated with LVEF improvement. Freedom from any documented atrial arrhythmia was 86% (64% under antiarrhythmic drugs), and the rate of adverse events was 2%. The prediction model had a good discriminative performance (AUC 0.814 [95% CI 0.681-0.947]). CONCLUSION: In AF patients with HF and impaired LVEF, suspected TIC, shorter QRS duration, and smaller LV diameter were associated with LVEF recovery following AF catheter ablation.

2.
Arq Bras Cardiol ; 121(4): e20230544, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-38695471

RESUMO

BACKGROUND: Ablation Index (AI) software has allowed better atrial fibrillation (AF) ablation results, but recurrence rates remain significant. Specific serum biomarkers have been associated with this recurrence. OBJECTIVES: To evaluate whether certain biomarkers could be used (either individually or combined) to predict arrhythmia recurrence after AI-guided AF ablation. METHODS: Prospective multicenter observational study of consecutive patients referred for AF ablation from January 2018 to March 2021. Hemoglobin, brain natriuretic peptide (BNP), C-reactive protein, high sensitivity cardiac troponin I, creatinine clearance, thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were assessed for their ability to predict arrhythmia recurrence during follow-up. Statistical significance was accepted for p values of<0.05. RESULTS: A total of 593 patients were included - 412 patients with paroxysmal AF and 181 with persistent AF. After a mean follow-up of 24±6 months, overall single-procedure freedom from atrial arrhythmia was 76.4%. Individually, all biomarkers had no or only modest predictive power for recurrence. However, a TSH value >1.8 µUI/mL (HR=1.82 [95% CI, 1.89-2.80], p=0.006) was an independent predictor of arrhythmia recurrence. When assessing TSH, FT4 and BNP values in combination, each additional "abnormal" biomarker value was associated with a lower freedom from arrhythmia recurrence (87.1 % for no biomarker vs. 83.5% for one vs. 75.1% for two vs. 43.3% for three biomarkers, p<0.001). Patients with three "abnormal" biomarkers had a threefold higher risk of AF recurrence compared with no "abnormal" biomarker (HR=2.88 [95% CI, 1.39-5.17], p=0.003). CONCLUSIONS: When used in combination, abnormal TSH, FT4 and BNP values can be a useful tool for predicting arrhythmia recurrence after AI-guided AF ablation.


FUNDAMENTO: O software ablation index (AI) permitiu melhorar os resultados da ablação de fibrilação atrial (FA), mas as taxas de recorrência permanecem significativas. Biomarcadores séricos específicos têm sido associados a essa recorrência. OBJETIVOS: Avaliar se certos biomarcadores podem ser utilizados (individualmente ou combinados) para predizer a recorrência de FA pós ablação guiada pelo AI. MÉTODOS: Estudo multicêntrico, observacional, prospectivo de pacientes consecutivos, encaminhados para ablação de FA de janeiro de 2018 a março de 2021. Hemoglobina, peptídeo natriurético cerebral (BNP), proteína C reativa, troponina I ultrassensível, clearance de creatinina, Hormônio Tireoestimulante (TSH), e Tiroxina livre (T4) foram avaliados quanto à capacidade de prever a recorrência de arritmias durante o acompanhamento. Valores de p <0,05 foram aceitos como estatisticamente significativos. RESULTADOS: Um total de 593 pacientes foram incluídos ­ 412 com FA paroxística e 181 com FA persistente. Durante o seguimento médio de 24±6 meses, 76,4% não apresentaram recidiva após ablação. Individualmente, os biomarcadores demonstraram um valor preditivo baixo ou nulo para recorrência. No entanto, TSH >1,8 µUI/mL [HR=1,82 (IC95%, 1,89-2,80), p=0,006] foi um preditor independente de recorrência. Avaliando-se a combinação de TSH, FT4 e BNP, a adição de cada valor "anormal" foi associada a uma menor sobrevida livre de recorrência (87,1% se nenhum vs. 83,5% se um vs. 75,1% se dois vs. 43,3% se três biomarcadores, p<0,001). Doentes com três biomarcadores "anormais" apresentaram três vezes maior probabilidade de recorrência de FA, comparativamente aos que não apresentaram nenhum biomarcador "anormal" (HR=2,88 [IC95%, 1,39-5,17], p=0,003). CONCLUSÕES: Quando combinados, valores anormais de TSH, FT4 e BNP podem ser uma ferramenta útil para prever a recorrência de FA pós ablação guiada pelo AI.


Assuntos
Fibrilação Atrial , Biomarcadores , Ablação por Cateter , Recidiva , Tireotropina , Humanos , Fibrilação Atrial/cirurgia , Fibrilação Atrial/sangue , Biomarcadores/sangue , Masculino , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Ablação por Cateter/métodos , Idoso , Tireotropina/sangue , Peptídeo Natriurético Encefálico/sangue , Valor Preditivo dos Testes , Proteína C-Reativa/análise , Resultado do Tratamento , Tiroxina/sangue , Fatores de Risco , Troponina I/sangue
3.
Sci Data ; 11(1): 512, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38760418

RESUMO

Given the high prevalence of lung cancer, an accurate diagnosis is crucial. In the diagnosis process, radiologists play an important role by examining numerous radiology exams to identify different types of nodules. To aid the clinicians' analytical efforts, computer-aided diagnosis can streamline the process of identifying pulmonary nodules. For this purpose, medical reports can serve as valuable sources for automatically retrieving image annotations. Our study focused on converting medical reports into nodule annotations, matching textual information with manually annotated data from the Lung Nodule Database (LNDb)-a comprehensive repository of lung scans and nodule annotations. As a result of this study, we have released a tabular data file containing information from 292 medical reports in the LNDb, along with files detailing nodule characteristics and corresponding matches to the manually annotated data. The objective is to enable further research studies in lung cancer by bridging the gap between existing reports and additional manual annotations that may be collected, thereby fostering discussions about the advantages and disadvantages between these two data types.


Assuntos
Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Bases de Dados Factuais , Nódulo Pulmonar Solitário/diagnóstico por imagem , Diagnóstico por Computador
4.
Artif Intell Med ; 149: 102814, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38462277

RESUMO

Machine Learning models need large amounts of annotated data for training. In the field of medical imaging, labeled data is especially difficult to obtain because the annotations have to be performed by qualified physicians. Natural Language Processing (NLP) tools can be applied to radiology reports to extract labels for medical images automatically. Compared to manual labeling, this approach requires smaller annotation efforts and can therefore facilitate the creation of labeled medical image data sets. In this article, we summarize the literature on this topic spanning from 2013 to 2023, starting with a meta-analysis of the included articles, followed by a qualitative and quantitative systematization of the results. Overall, we found four types of studies on the extraction of labels from radiology reports: those describing systems based on symbolic NLP, statistical NLP, neural NLP, and those describing systems combining or comparing two or more of the latter. Despite the large variety of existing approaches, there is still room for further improvement. This work can contribute to the development of new techniques or the improvement of existing ones.


Assuntos
Processamento de Linguagem Natural , Radiologia , Aprendizado de Máquina
5.
Enferm. nefrol ; 27(1): 12-19, ene.-mar. 2024. tab
Artigo em Inglês | IBECS | ID: ibc-232070

RESUMO

Introdução:Os enfermeiros que prestam cuidados à pessoa com doença renal crónica em hemodiálise devem ter formação específica em técnicas dialíticas. Assim, os Enfermeiros de Diálise deverão desenvolver competências específicas e diferenciadas ao longo do seu percurso profissional. O b-learning desempenha um papel fundamental na modernização do ensino, tornando-o mais acessível, flexível e adaptado às necessidades dos enfermeiros. Oferece oportunidades para melhorar a quali-dade da aprendizagem e promover a colaboração e a inovação no processo educativo.Objetivos:Os objetivos do estudo foram: avaliar a influência das variáveis sociodemográficas (idade e habilitações literárias) e da formação adquirida (frequência e duração) no perfil de competências e avaliar a eficácia de um programa de formação em técnicas de HD, na perceção de competência do Enfermeiro de Diálise. Material e Métodos:Estudo quase-experimental, pré e pós-teste, sem grupo controle. Resultados:A idade, a frequência e a duração da formação influenciam a perceção de competência do enfermeiro de diálise. Os participantes apresentaram uma melhoria significativa em alguns domínios da perceção de competência do Enfermeiro de Diálise após a implementação de um programa de formação em técnicas de HD. Conclusões:A existência de um programa de formação para Enfermeiros de Diálise, devidamente estruturado e padronizado, é uma mais-valia na aquisição, consolidação e atualização de conhecimentos. (AU)


Introduction: Nurses providing care to individuals with chronic kidney disease undergoing hemodialysis must have specific training in dialysis techniques. Therefore, Dialysis Nurses should develop specific and differentiated competencies throughout their professional career. Blended learning plays a fundamental role in modernizing education, making it more accessible, flexible, and tailored to the needs of nurses. It offers opportunities to improve the quality of learning and promote collaboration and innovation in the educational process. Objectives: The study’s objectives were to assess the influence of sociodemographic variables (age and education) and acquired training (frequency and duration) on the competence profile and to evaluate the effectiveness of a training program in HD techniques on the perception of competence of Dialysis Nurses. Material and Methods: Quasi-experimental, pre and post-test study without a control group. Results: Age, frequency, and duration of training influence dialysis nurses’ perceptions of competence. Participants showed a significant improvement in some domains of dialysis nurses’ perceptions of competence after the implementation of a training program in HD techniques. Conclusions: A properly structured and standardized training program for dialysis nurses is an asset in acquiring, consolidating, and updating knowledge. (AU)


Assuntos
Humanos , Educação/métodos , Capacitação Profissional , Enfermeiras e Enfermeiros , Diálise , Papel do Profissional de Enfermagem , Estudos de Avaliação como Assunto , Ensaios Clínicos Controlados não Aleatórios como Assunto
6.
Int J Biol Macromol ; 265(Pt 2): 130933, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38508554

RESUMO

Glucans, a polysaccharide naturally present in the yeast cell wall that can be obtained from side streams generated during the fermentation process, have gained increasing attention for their potential as a skin ingredient. Therefore, this study focused on the extraction method to isolate and purify water-insoluble glucans from two different Saccharomyces cerevisiae strains: an engineered strain obtained from spent yeast in an industrial fermentation process and a wild strain produced through lab-scale fermentation. Two water-insoluble extracts with a high glucose content (> 90 %) were achieved and further subjected to a chemical modification using carboxymethylation to improve their water solubility. All the glucans' extracts, water-insoluble and carboxymethylated, were structurally and chemically characterized, showing almost no differences between both yeast-type strains. To ensure their safety for skin application, a broad safety assessment was undertaken, and no cytotoxic effect, immunomodulatory capacity (IL-6 and IL-8 regulation), genotoxicity, skin sensitization, and impact on the skin microbiota were observed. These findings highlight the potential of glucans derived from spent yeast as a sustainable and safe ingredient for cosmetic and skincare formulations, contributing to the sustainability and circular economy.


Assuntos
Glucanos , Saccharomyces cerevisiae , Glucanos/química , Saccharomyces cerevisiae/química , Polissacarídeos/química , Água
7.
J Appl Stat ; 51(5): 958-992, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38524799

RESUMO

Considering the context of functional data analysis, we developed and applied a new Bayesian approach via the Gibbs sampler to select basis functions for a finite representation of functional data. The proposed methodology uses Bernoulli latent variables to assign zero to some of the basis function coefficients with a positive probability. This procedure allows for an adaptive basis selection since it can determine the number of bases and which ones should be selected to represent functional data. Moreover, the proposed procedure measures the uncertainty of the selection process and can be applied to multiple curves simultaneously. The methodology developed can deal with observed curves that may differ due to experimental error and random individual differences between subjects, which one can observe in a real dataset application involving daily numbers of COVID-19 cases in Brazil. Simulation studies show the main properties of the proposed method, such as its accuracy in estimating the coefficients and the strength of the procedure to find the true set of basis functions. Despite having been developed in the context of functional data analysis, we also compared the proposed model via simulation with the well-established LASSO and Bayesian LASSO, which are methods developed for non-functional data.

8.
Vaccines (Basel) ; 12(2)2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38400177

RESUMO

Carditis in childhood is a rare disease with several etiologies. We report a case of infant death due to pericarditis and myocarditis after the mRNA vaccine against COVID-19 (COVIDmRNAV). A 7-year-old male child received the first dose of the COVIDmRNAV and presented with monoarthritis and a fever non-responsive to oral antibiotics. The laboratory investigation showed signs of infection (leukocytosis, high levels of c-reactive protein). His condition rapidly deteriorated, and the patient died. The autopsy identified pericardial fibrin deposits, hemorrhagic areas in the myocardium, and normal valves. A diffuse intermyocardial inflammatory infiltrate composed of T CD8+ lymphocytes and histiocytes was identified. An antistreptolysin O (ASO) dosage showed high titers. The presence of arthritis, elevated ASO, and carditis fulfills the criteria for rheumatic fever. However, valve disease and Aschoff's nodules, present in 90% of rheumatic carditis cases, were absent in this case. The temporal correlation with mRNA vaccination prompted its inclusion as one of the etiologies. In cases of myocardial damage related to COVID-19mRNAV, it appears to be related to the expression of exosomes and lipid nanoparticles, leading to a cytokine storm. The potential effects of the COVID-19mRNAV must be considered in the pathogenesis of this disease, whether as an etiology or a contributing factor to a previously initiated myocardial injury.

9.
Port J Card Thorac Vasc Surg ; 30(4): 67-70, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38345884

RESUMO

Thoracic duct embolization has been increasingly adopted as a first-line therapy of chylothorax and this procedure includes lipiodol lymphangiography, thoracic duct access and embolization. Lymphangiography itself has a therapeutic role, with volume-dependent success rates of 37%-97% and even a reported 100% success rate in outputs of < 500 mL/day. We present a clinical case of a 48-years-old man diagnosed with esophageal squamous cell carcinoma, who underwent esophagectomy and presented with post-operative high-output (> 1L/day) chylothorax; thoracic duct embolization was proposed. Even though thoracic duct access and embolization were not achieved due to technical and anatomical factors, lipiodol lymphangiography and possibly thoracic duct maceration (after several punctures/attempts) contributed to the clinical success of the procedure, and this chylothorax with output values superior to those reported in the literature resolved within three days. As such, the therapeutic role of intranodal lymphangiography and thoracic duct disruption should be taken into account.


Assuntos
Quilotórax , Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Humanos , Masculino , Pessoa de Meia-Idade , Quilotórax/diagnóstico por imagem , Neoplasias Esofágicas/cirurgia , Óleo Etiodado , Linfografia/métodos , Ducto Torácico/diagnóstico por imagem
10.
Healthcare (Basel) ; 12(2)2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38255075

RESUMO

The biopsychosocial development of individuals is influenced by body image and physical exercise. This study aimed to evaluate seven hypotheses regarding the impact of positive affect, negative affect, self-consciousness of appearance, and positive body image on the practice of physical exercise. The data were processed using the statistical package SmartPLS 4.0.9.5. Using an exploratory methodology based on structural equation modeling (SEM) of structural equations applied to small sample sizes, a tentative model has been generated to define the drivers of physical activity. The survey used the Body Mass Index, Body Appreciation Scale-Revised, and Derriford Appearance Scale-14 items. The study involved 129 men and 279 women (N = 408). The model demonstrated a distinct internal consistency in that, out of the seven hypotheses analyzed, only one was rejected. The findings of the multigroup analysis indicate that there are no statistically significant discrepancies between the constructed measures and the practice of physical activity. The conclusions of this study showed that, although positive and negative affect, and self-consciousness influence positive body image, there were no statistically significant differences between those who exercise and those who do not exercise. Various factors influence biopsychosocial development. Future studies should explore the influence of psychological and social variables on understanding body image and physical exercise.

11.
Cardiol Young ; 34(4): 782-787, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37828640

RESUMO

INTRODUCTION: Cardiac arrhythmias are a major concern in patients with CHD. The purpose of this study was to evaluate the long-term outcomes in patients with CHD submitted to catheter ablation. MATERIALS AND METHODS: Observational retrospective study of patients with CHD referred for catheter ablation from January 2016 to December 2021 in a tertiary referral centre. Acute procedural endpoints and long-term outcomes were assessed. RESULTS: A total of 44 ablation procedures were performed in 36 CHD patients (55% male, mean age 43 ±3 years). Fifty-four arrhythmias were ablated: 23 cavotricuspid isthmus atrial flutters, 10 atrial re-entrant tachycardias, eight focal atrial tachycardias, eight atrial fibrillations, three atrioventricular re-entrant tachycardias, and two ventricular tachycardias. During a median follow-up time of 37 months (interquartile range 12-51), freedom from arrhythmia recurrence was achieved in 93%, with 1.2 procedures per patient (18% with anti-arrhythmic drugs). There were no adverse events related to catheter ablation. No predictors of recurrence were identified. CONCLUSION: In patients with CHD, catheter ablation presents a high mid-term efficacy while maintaining a safe profile.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Cardiopatias Congênitas , Taquicardia Supraventricular , Taquicardia Ventricular , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Feminino , Estudos Retrospectivos , Cardiopatias Congênitas/cirurgia , Fibrilação Atrial/etiologia , Taquicardia Supraventricular/cirurgia , Ablação por Cateter/métodos , Taquicardia Ventricular/etiologia , Resultado do Tratamento
12.
BMC Cardiovasc Disord ; 23(1): 609, 2023 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-38087189

RESUMO

BACKGROUND: There is a lack of evidence regarding contemporary implantable cardioverter-defibrillator (ICD) battery longevity. Our aim was to assess battery longevity in ICDs in a real-world setting. METHODS: Retrospective cross-sectional single center study of a prospectively collected database of consecutive patients who underwent ICD implantation from January 2010 to December 2015. Clinical data and battery longevity of all manufacturers were collected. RESULTS: A total of 351 patients (84.6% males, mean age of 61 ± 12 years) were included in the study (292 VVI; 6 VDD; 53 DDD). All manufacturers (Abbott, Biotronik, Boston, Medtronic and Microport) were equally represented in the study (p = 0.110). Median battery longevity was 10.8 years (11 years for VVI and 8.5 for DDD). After a follow-up time of 5 years, 98% of VVI and DDD were still in service (vs. industry-projected longevity of 98%). During this time, 89 patients (25.4%) underwent device replacement - 69 patients (77.5%) due to battery depletion, 6 patients due to infection, 3 patients due to dysfunction and 13 patients due to upgrade to CRT-D. Patients with Medtronic or Biotronik ICDs had a greater probability of being replaced earlier due to battery depletion (Biotronik HR 6.87, 95% CI 2.54-18.58, p < 0.001; Medtronic HR 6.08, 95% CI 2.45-15.06 p < 0.001). CONCLUSIONS: VVI and DDD ICD battery longevity matched industry-projected longevity after 5 years of follow-up. Medtronic and Biotronik ICDs appeared to have an earlier battery depletion. Further randomized studies are required to ensure optimal care.


Assuntos
Desfibriladores Implantáveis , Insuficiência Cardíaca , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Feminino , Falha de Equipamento , Estudos Retrospectivos , Estudos Prospectivos , Estudos Transversais , Desenho de Equipamento , Estimativa de Kaplan-Meier , Fatores de Tempo , Remoção de Dispositivo
13.
JBI Evid Implement ; 21(S1): S19-S27, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38037445

RESUMO

OBJECTIVES: To improve postdischarge telephone follow-up in the context of chronic disease management (peripheral artery disease), in a vascular surgery service. INTRODUCTION: Patients with chronic diseases, such as peripheral artery disease, present a higher risk of complications and greater constraints regarding their adherence to treatment, leading to an increasing mortality rate and decreased functional capacity. Comprehensive discharge planning plus postdischarge telephone follow-up may reduce 30-day re-hospitalization rates. METHODS: The project used the JBI audit and feedback methodological approach to implement the best available evidence into practice. Two audit criteria were used: existence of comprehensive discharge planning and timely telephone follow-up. A baseline audit was conducted, followed by analysis of barriers, which led to the implementation of several strategies, namely, a targeted training program, the development of educational resources and standardized procedures for the discharge process, and postdischarge telephone follow-up. RESULTS: Results from the baseline and first follow-up audits showed improvement for both criteria. Compliance for criterion 1 (comprehensive discharge planning, including postdischarge telephone follow-up) increased from 0% to 40.7%, and for criterion 2 (patient is followed up by telephone within 2 weeks of discharge) increased from 0% to 44.4%. These two criteria sustained improvements in the second follow-up audit: compliance increased to 45% (criterion 1) and 60% (criterion 2). CONCLUSIONS: This implementation project contributed to the optimization of the chronic disease management, including improved compliance with discharge planning and early postdischarge telephone follow-up.


Assuntos
Alta do Paciente , Doença Arterial Periférica , Humanos , Assistência ao Convalescente , Seguimentos , Doença Crônica , Telefone , Procedimentos Cirúrgicos Vasculares
14.
Biodivers Data J ; 11: e110415, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38098784

RESUMO

Background: With the increasing recognition of the significance of arachnid conservation, it is crucial to allocate greater efforts towards implementing targeted monitoring programmes. Despite recent studies, our understanding of arachnid populations in Portugal remains limited. This study serves as the initial inventory of arachnids (Araneae and Opiliones) within the Castro Verde Special Protection Area (SPA) located in Beja, southern Portugal. The surveys were conducted during the spring of 2012 across 80 open grasslands that were grazed by cattle and sheep. New information: A total of 71 species of Araneae and two species of Opiliones have been identified. Notably, three spider species, namely Argennasubnigra, Civizelotesibericus and Walckenaeriacucullata, are documented for the first time in Portugal. Additionally, two harvestmen species (Dasylobusibericus and Homalenotusbuchneri) and 14 spider species (Cheiracanthiumpennatum, Haplodrassusrhodanicus, Marinarozelotesminutus, Tapinocybaalgirica, Agraecinalineata, Tibellusmacellus, Talaverapetrensis, Tetragnathaintermedia, Dipoenaumbratilis, Enoplognathadiversa, Neottiurauncinata, Ruborridionmusivum, Theridionpinastri and Xysticusgrallator) are recorded for the first time in the Beja District. The occurrence of each documented species within the SPA, including family and species details, is presented, underscoring the significance of the Castro Verde SPA for arachnid conservation. These findings contribute novel insights into the biodiversity of the Castro Verde SPA, emphasising the necessity of incorporating this area into arachnid diversity conservation efforts.

15.
Cureus ; 15(10): e47680, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38022115

RESUMO

Placenta accreta spectrum disorder is a pregnancy-related disorder responsible for important post-partum morbimortality, associated with intractable or massive hemorrhage, leading to uterine loss in up to 64% of women. Despite international recommendations advocating planned preterm cesarean hysterectomy for the management of these patients, uterus preservation management is being continuously reported with the implementation of minimally invasive bleeding reduction strategies, such as prophylactic balloon-assisted occlusion. We present the case of a 40-year-old pregnant woman with a previous cesarean, diagnosed with placenta previa and suspected placenta accreta on magnetic resonance after having second-trimester vaginal bleeding. A peri-operative multidisciplinary panel was involved, in collaboration with the interventional radiologist, and the c-section was scheduled for 36 weeks of gestation. The prophylactic balloon-assisted occlusion was successfully performed, minimizing the blood loss and allowing a uterus-preserving approach.

16.
Eur J Investig Health Psychol Educ ; 13(11): 2546-2560, 2023 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-37998067

RESUMO

The COVID-19 pandemic has caused substantial disruptions in the lives of higher education students, with detrimental repercussions for academic performance and overall mental health. Therefore, we aimed to evaluate the prevalence of depression, anxiety, and stress symptoms among Portuguese higher education students during the first wave of the coronavirus pandemic and investigate DASS-21's psychometric characteristics and whether it functions effectively during a pandemic. A convenience sampling procedure was used to recruit 1522 participants (75.1% women and 79.2% undergraduate students) for this cross-sectional research. Participants completed an e-survey created using DASS-21. The results revealed a considerable prevalence of symptoms of depression [≥10] (N = 434, 28.5%), anxiety [≥7] (N = 551, 36.2%), and stress [≥11] (N = 544, 35.7%). Confirmatory factor analysis (CFA) revealed the scale's three-factor structure, which matched the three DASS-21 subscales. Subsequently, the heterotrait-monotrait (HTMT) correlation ratio evaluated the scale's discriminant validity, which was relatively good. Cronbach's alpha measured the internal consistency of the DASS subscales, which was excellent (Cronbach's α > 0.90). DASS-21 was shown to be a reliable and appropriate measure for assessing students' mental health. Furthermore, DASS-21 is recommended for use by academics and healthcare professionals in measuring students' psychological distress. Further validation studies of this scale are needed with larger and more representative samples.

17.
Artigo em Inglês | LILACS | ID: biblio-1551254

RESUMO

Introduction: SARS-CoV-2 has rapid dissemination and high infectivity and can evolve into Severe Respiratory Distress Syndrome (SARS), which led to a high number of deaths and hospitalizations in the recent pandemic. Computed tomography (CT) of the chest has demonstrated an essential role in the initial evaluation and evolution of these patients. Methodology: This was a retrospective observational study at a single center, University Hospital in Northeastern Brazil, evaluating 97 patients hospitalized for COVID-19 with laboratory confirmation to evaluate and quantify the chest CT findings, comparing the findings with the severity of the case and relating them to the morbidities presented. The CT scans were performed by radiologists from the hospital and the data were evaluated by the university's statistics laboratory. Results: Among the main alterations, ground-glass opacities were present in more than 90% of the patients. The study observed that the magnitude of the pulmonary involvement of this finding had a relationship with the outcome of higher hospitalization. Conclusion: In this sense, the relevance of chest CT to suggest the diagnosis of Covid-19 and establish the prognosis of the disease is observed. However, further studies are still needed to confirm these finding (AU).


Introdução: O SARS-CoV-2 possui rápida disseminação e alta infectividade, podendo evoluir com Síndrome da Angústia Respiratória Grave (SARS), o que levou a um número elevado de mortes e internações na recente pandemia. A Tomografia Computadorizada (TC) de tórax demonstrou um papel essencial na avaliação inicial e evolução desses pacientes. Metodologia: Este foi um estudo observacional retrospectivo em centro único - Hospital Universitário no Nordeste do Brasil - avaliando 97 pacientes internados por COVID-19 com confirmação laboratorial, a fim de avaliar e quantificar os achados de TC de tórax, comparando os achados com a gravidade do caso e relacionando-os com as morbidades apresentadas. As TCs foram laudadas por radiologistas do próprio hospital. Após isso, os dados foram avaliados pelo laboratório de estatística da universidade para serem analisados e discutidos. Resultados: Dentre as principais alterações, o vidro fosco estava presente em mais de 90% dos pacientes. Foi observado que a magnitude do comprometimento pulmonar deste achado apresentou relação desfavorável com o desfecho da internação. Conclusão: Neste sentido, observa-se a relevância da TC de tórax para sugerir o diagnóstico de Covid-19 e estabelecer o prognóstico da doença. No entanto, ainda são necessários mais estudos para destrinchar estes achado (AU).


Assuntos
Humanos , Pneumonia , Tomografia , COVID-19/complicações
18.
Artigo em Inglês | LILACS | ID: biblio-1551161

RESUMO

Objective: Evaluate the spirometry pattern of patients who persisted with respiratory symptoms after infection with SARS-Cov-2. Methods: Cross-sectional, observational, retrospective study in a single center, approved by the local Ethics Committee (registration number: 5,120,720). Patients who underwent spirometry due to Post-Covid Syndrome were evaluated to analyze the spirometric pattern presented. The following were collected: exam identification data, sex, age, symptom time, the need for mechanical ventilation, and quality of spirometry, in addition to the following exam parameters: FVC, FEV1, FEV1/FVC, FEV 25-75/FVC, and FEV 75, evaluating the Lower Limit of Normality, pre-bronchodilator and post-bronchodilator values. Results: Data from 72 patients were collected. Of these, 55.5% of patients had spirometry results within normal limits. The most frequent respiratory alteration was obstructive respiratory disorder, present in 29.2% of the patients. Conclusions: The presence of dyspnea in patients with normal spirometry may indicate further evaluation of lung function and other etiologies for dyspnea (AU).


Objetivo: Avaliar o padrão de espirometria de pacientes que persistiram com sintomas respiratórios após a infecção pelo SARS-CoV-2. Métodos: Estudo transversal, observacional e retrospectivo realizado em um único centro, aprovado pelo Comitê de Ética local (número do parecer: 5.120.720). Foram avaliados pacientes submetidos a espirometria devido à Síndrome Pós-Covid, a fim de analisar o padrão espirométrico apresentado. Os seguintes dados foram coletados: identificação do exame, sexo, idade, tempo de sintomas, necessidade de ventilação mecânica, qualidade da espirometria, além dos seguintes parâmetros do exame: CVF, VEF1, VEF1/CVF, VEF 25-75/CVF e VEF 75, avaliando o Limite Inferior da Normalidade, valores pré-broncodilatador e pós-broncodilatador. Resultados: Foram coletados dados de 72 pacientes. Destes, 55,5% apresentaram resultados espirométricos dentro dos limites normais. A alteração respiratória mais frequente foi o distúrbio ventilatório obstrutivo, presente em 29,2% dos pa-cientes. Conclusões: A presença de dispneia em pacientes com espirometria dentro da normalidade pode indicar uma avaliação adicional da função pulmonar, assim como outras etiologias para a dispneia (AU).


Assuntos
Humanos , Masculino , Feminino , Testes de Função Respiratória , Espirometria , Dispneia , Síndrome de COVID-19 Pós-Aguda
19.
Carbohydr Polym ; 322: 121329, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-37839841

RESUMO

ß-Glucans, which are naturally present in cereals, yeast, and mushrooms, have gained attention as a potential natural source for functional foods and pharmaceuticals. Due to the availability of ß-glucans from several sources, different extraction methods can be employed to obtain high purity extracts that can be further modified to enhance their solubility or other biological properties. Apart from their known ability to interact with the immune system, ß-glucans possess specific properties that could benefit overall skin health and prevent age-related signs, including soothing and antioxidant activities. As a result, the use of ß-glucans to mitigate damage caused by environmental stressors or skin-related issues that accelerate skin aging or trigger chronic inflammation may represent a promising, natural, eco-friendly, and cost-effective approach to maintaining skin homeostasis balance. This review outlines ß-glucan extraction methodologies, molecular structure, functionalization approaches, and explores skin-related benefits of ß-glucans, along with an overview of related products in the market.


Assuntos
Agaricales , beta-Glucanas , beta-Glucanas/uso terapêutico , beta-Glucanas/química , Agaricales/química , Pele , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Solubilidade
20.
Biosensors (Basel) ; 13(10)2023 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-37887106

RESUMO

Modern drug discovery relies on combinatorial screening campaigns to find drug molecules targeting specific disease-associated proteins. The success of such campaigns often relies on functional and structural information of the selected therapeutic target, only achievable once its purification is mastered. With the aim of bypassing the protein purification process to gain insights on the druggability, ligand binding, and/or characterization of protein-protein interactions, herein, we describe the Extract2Chip method. This approach builds on the immobilization of site-specific biotinylated proteins of interest, directly from cellular extracts, on avidin-coated sensor chips to allow for the characterization of molecular interactions via surface plasmon resonance (SPR). The developed method was initially validated using Cyclophilin D (CypD) and subsequently applied to other drug discovery projects in which the targets of interest were difficult to express, purify, and crystallize. Extract2Chip was successfully applied to the characterization of Yes-associated protein (YAP): Transcriptional enhancer factor TEF (TEAD1) protein-protein interaction inhibitors, in the validation of a ternary complex assembly composed of Dyskerin pseudouridine synthase 1 (DKC1) and RuvBL1/RuvBL2, and in the establishment of a fast-screening platform to select the most suitable NUAK family SNF1-like kinase 2 (NUAK2) surrogate for binding and structural studies. The described method paves the way for a potential revival of the many drug discovery campaigns that have failed to deliver due to the lack of suitable and sufficient protein supply.


Assuntos
Descoberta de Drogas , Ressonância de Plasmônio de Superfície , Ressonância de Plasmônio de Superfície/métodos , Descoberta de Drogas/métodos , Proteínas , Cromatografia de Afinidade , Ligação Proteica
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