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1.
J Hosp Infect ; 136: 8-13, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37011785

RESUMO

BACKGROUND: The complex design of cannulas is a major challenge for reprocessing due to the retention and accumulation of fat residues. AIM: To evaluate the cleaning of liposuction cannulas and the protective effects of the remaining fat residues on Mycobacterium abscessus subspecies bolletii (MASB) and Geobacillus stearothermophilus inactivation during steam sterilization. METHODS: In phase 1, six standard operating procedures were evaluated for cleaning of liposuction cannulas. In phase 2, the sectioned lumens of the liposuction cannulas were contaminated with the largest and smallest volume of human fat found in phase 1, with the addition of MASB. In phase 3, the same volumes of human fat from phase 2 were used to contaminate paper strips containing G. stearothermophilus. FINDINGS: In phase 1 the residual amount of fat ranged from 6 to 52 mg. In phases 2 and 3, the minimum and maximum amounts of fat (6 and 50 mg) protected micro-organisms during steam sterilization at 134 °C for 1.5 and 3 min. CONCLUSION: Effective cleaning and sterilization of liposuction cannulas intentionally contaminated with human fat, MASB and G. stearothermophilus could not be performed.


Assuntos
Lipectomia , Mycobacterium abscessus , Humanos , Cânula , Lipectomia/métodos , Vapor , Esterilização/métodos
3.
NJ; BJOG: Int J Obstet Gy; July, 2022. 10 p. tab. (PCI-277).
Não convencional em Inglês | REPincaP, LIGCSA | ID: biblio-1400934

RESUMO

Objective: To assess, on a population basis, the medical care for pregnant women in specific geographic regions of six countries before and during the first year of the coronavirus disease 2019 (COVID-19) pandemic in relationship to pregnancy outcom. Results: Across all sites, a small but statistically significant increase in home births occurred between the pre-COVID-19 and COVID-19 periods (18.9% versus 20.3%, adjusted relative risk [aRR] 1.12, 95% CI 1.05­1.19). A small but significant decrease in the mean number of antenatal care visits (from 4.1 to 4.0, p = <0.0001) was seen during the COVID-19 period. Of outcomes evaluated, overall, a small but significant decrease in low-birthweight infants in the COVID-19 period occurred (15.7% versus 14.6%, aRR 0.94, 95% CI 0.89­0.99), but we did not observe any significant differences in other outcomes. There was no change observed in maternal mortality or antenatal haemorrhage overall or at any of the sites. Conclusions: Small but significant increases in home births and decreases in the antenatal care services were observed during the initial COVID-19 period; however, there was not an increase in the stillbirth, neonatal mortality, maternal mortality, low birthweight, or preterm birth rates during the COVID-19 period compared with the previous year. Further research should help to elucidate the relationship between access to and use of pregnancy-related medical services and birth outcomes over an extended period


Assuntos
Cuidados Médicos , Gestantes , Pandemias , Estudo Observacional , COVID-19
5.
Clin Exp Dermatol ; 47(1): 43-49, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34236712

RESUMO

BACKGROUND: Vascular malformations of the genitalia often go undetected in clinical examination. These vascular malformations can cause a variety of clinical symptoms such as swelling, pain and bleeding. AIM: To characterize the distribution patterns of genital vascular malformations using magnetic resonance imaging (MRI) and to correlate these patterns with clinical findings in order to guide diagnostic decisions. METHODS: A retrospective analysis of MRIs of the pelvis and legs in 370 patients with vascular malformation was performed to determine the involvement of the internal and external genitalia. RESULTS: In 71 patients (19%), genital involvement could be identified by MRI. Of these, 11.3% (8 of 71) presented with internal involvement, 36.6% (26 of 71) with external involvement and 52.1% (37 of 71) with both internal and external involvement. Over half (57.1%) of the 49 patients with visible external genital signs detected during a clinical examination had additional internal genital involvement. CONCLUSIONS: Genital involvement is a common finding in patients with vascular malformation of the legs and/or pelvis. Based on our data, we recommend MRI of the legs and pelvic region in patients with externally visible signs of a vascular malformation of the external genitalia in order to exclude additional internal involvement.


Assuntos
Genitália/irrigação sanguínea , Imageamento por Ressonância Magnética , Malformações Vasculares/diagnóstico por imagem , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Malformações Vasculares/patologia , Adulto Jovem
6.
Durham, NC; BJOG; 2022. 9 p. tab, graf. (PCI-278).
Não convencional em Inglês | REPincaP, LIGCSA | ID: biblio-1401039

RESUMO

Objective. We sought to understand knowledge, attitudes and practices (KAP) regarding COVID-19 in pregnant women in seven low and middle-income countries (LMIC). Results. In all, 25 260 women completed the survey. Overall, 56.8% of women named ≥3 COVID-19 symptoms, 34.3% knew ≥2 transmission modes, 51.3% knew ≥3 preventive measures and 79.7% named at least one high-risk condition. Due to COVID-19 exposure concerns, 23.8% had avoided prenatal care and 7.5% planned to avoid hospital delivery. Over half the women in the Guatemalan site and 40% in the Pakistan site reduced care seeking due to COVID-19 exposure concerns. Of the women, 24.0% were afraid of getting COVID-19 from healthcare providers. Overall, 63.3% reported wearing a mask and 29.1% planned to stay at home to reduce COVID-19 exposure risk


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Saúde da Criança , Estudos Transversais , Gestantes , COVID-19
7.
J Eur Acad Dermatol Venereol ; 35(11): 2241-2249, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34273904

RESUMO

BACKGROUND: Cross-cultural differences in healthcare policies and patient-physician communication may influence the quality of care and patients' perceived benefits and satisfaction with psoriasis treatment. OBJECTIVES: To compare the disease burden and patient needs at baseline, and patient benefits and satisfaction with secukinumab treatment across Europe. METHODS: PROSE was an open-label, prospective, non-randomized, stratified multicentre study of 52 weeks of secukinumab treatment, in 16 European countries. Secondary analysis of the PROSE study data by European regions was performed to identify cross-cultural differences in disease burden and patient needs at baseline, and in clinical improvement, patient-reported treatment benefits and satisfaction at 52 weeks post-treatment. RESULTS: At baseline, Dermatology Life Quality Index impairment was reported to be greater in patients from Eastern Europe (EE: 15.4 ± 7.1) vs. Northern Europe (NE: 13.3 ± 6.7) and Western Europe (WE: 13.6 ± 6.9), but while differences were statistically significant (F-test = 5.5, P < 0.001), their clinical significance is uncertain. There were no significant differences between regions in Psoriasis Area and Severity Index at baseline (F-test = 1.6). There were considerable differences in patients' needs (Patient Need Questionnaire) between geographical regions, with WE focused more on reducing physical impairment [vs. Southern Europe (SE)/EE], EE on reducing social impairment (vs. NE/WE) and SE on reducing impairment due to therapy (vs. NE/WE). At Week 52, patients from EE reported more benefits (Patient Benefit Index) with secukinumab treatment (vs. WE/SE), while patients from NE reported higher global treatment satisfaction (vs. SE). CONCLUSIONS: Differences in patients' needs and treatment satisfaction across Europe are likely a result of diverse medical systems, socio-economic status and infrastructural access. A patient-centred approach to treating psoriasis may fulfil patient needs and maximize treatment satisfaction. (NCT02752776).


Assuntos
Efeitos Psicossociais da Doença , Psoríase , Anticorpos Monoclonais Humanizados , Método Duplo-Cego , Humanos , Satisfação do Paciente , Satisfação Pessoal , Estudos Prospectivos , Psoríase/tratamento farmacológico , Qualidade de Vida , Índice de Gravidade de Doença , Resultado do Tratamento
8.
J Eur Acad Dermatol Venereol ; 35(11): 2166-2184, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33988873

RESUMO

Patients with chronic skin diseases suffer from physical and psychosocial impairments which can lead to a cumulative life-long burden. Therefore, the concept of cumulative life course impairment (CLCI) was introduced, referring to the non-reversible damage due to the persistent life-long burden. This systematic review (PROSPERO registry number: CRD42020179141) aimed at mapping the risk factors and the associated burden over time in patients with psoriasis, atopic dermatitis (AD) and hidradenitis suppurativa (HS). Three electronic databases were searched (date of the last search: December 2019). Studies with a longitudinal study design that assessed the association between a risk factor and the associated burden over time in patients with psoriasis, AD and HS were included. Quality assessment of the included studies was done using Critical Appraisal Skills Programme (CASP) checklists. In total, 40 publications reflecting 25 different studies were included: nine studies addressed patients with psoriasis, 13 patients with AD, two studies included patients with HS and one study enrolled patients with psoriasis and AD, respectively. Twenty-two potential risk factors with underlying evidence were found in this review. These risk factors include mainly sociodemographic (such as age or gender) and clinical (such as disease severity or comorbidities) variables. Disease severity and comorbidities were the most often studied risk factors, while only a few studies evaluated psychosocial risk factors over time. Patients with chronic skin diseases are at high risk to develop a life-long negative impact from the disease. However, there is a lack of data that evaluates the psychosocial burden and its influence on the patients' life course over time. The risk factors found in this review help to identify patients at risk, to treat them adequately and, ultimately, to prevent CLCI. These results can be the basis to develop a highly needed tool to assess the risk for CLCI in the future.


Assuntos
Hidradenite Supurativa , Psoríase , Doença Crônica , Humanos , Estudos Longitudinais , Psoríase/epidemiologia , Fatores de Risco
9.
J Eur Acad Dermatol Venereol ; 35(7): 1553-1561, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33630357

RESUMO

BACKGROUND: 60-90% of patients with psoriasis suffer from pruritus and 65% report itching as one of the most burdensome symptoms, raising significant quality of life (QoL) impairments. However, pruritus is not only an intrapersonal symptom but also a psychosocial interactive phenomenon and little is known about the effects of itching on interpersonal experiences. OBJECTIVES: This study aimed to compare the disease burden and patient needs between patients with none/mild vs. moderate/severe pruritus, and to examine the impact of disease parameters and intrapersonal burden on perceived stigmatization and sexual relationships. METHODS: This cross-sectional study included German patients aged ≥ 18 years with psoriasis vulgaris. Disease severity was assessed with Psoriasis Area and Severity Index; patients reported on intensity of pruritus, skin-generic and pruritus-specific QoL, patient needs and benefits, anxiety and depression symptoms, dysmorphic concerns, perceived stigmatization and sexual dysfunction. RESULTS: A total of 107 patients with psoriasis participated (mean age = 46.3 ± 14.6 years; 52.3% male): 64 with none/mild pruritus (NRS ≤ 3) and 43 with moderate/severe pruritus (NRS ≥ 4). Patients with moderate/severe pruritus reported more QoL impairments, depression and anxiety symptoms and dysmorphic concerns, but less treatment benefits, than those with none/mild pruritus. The patient needs most frequently rated as 'very/quite important' were 'be healed of all skin defects' (88.8%), and 'be free of itching' (87.0%), with no differences between the groups. Younger age, disease severity, frequency of scratching behaviours, dysmorphic concerns and treatment benefits were positively associated with stigmatization experiences; disease severity, sleeping problems and skin-generic QoL impairments were positively associated with sexual dysfunction. CONCLUSIONS: Pruritus induces significant burden in patients with psoriasis. Along with disease severity, intrapersonal burden has a great impact on social and dyadic relationships. Treatment choices that are effective in reducing pruritus should be prioritized in patient-centred healthcare.


Assuntos
Psoríase , Qualidade de Vida , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prurido , Psoríase/complicações , Índice de Gravidade de Doença , Sexualidade , Estereotipagem
10.
J Dairy Sci ; 104(1): 179-197, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33131813

RESUMO

Cheeses are able to serve as suitable matrices for supplying probiotics to consumers, enabling appropriate conditions for bacteria to survive gastric transit and reach the gut, where they are assumed to promote beneficial processes. The present study aimed to evaluate the microbiological, immunological, and histological changes in the gut of Salmonella Enteritidis-challenged rats fed goat cheese supplemented with the probiotic strain Lactobacillus rhamnosus EM1107. Thirty male albino Wistar rats were randomly distributed into 5 experimental groups with 6 animals each: negative (NC) and positive (PtC) control groups, control goat cheese (CCh), goat cheese added with L. rhamnosus EM1107 (LrCh), and L. rhamnosus EM1107 only (EM1107). All animals, except NC group were challenged with Salmonella Enteritidis (109 cfu in 1 mL of saline through oral gavage). Microbial composition was assessed with high-throughput 16S rRNA sequencing by means of Illumina MiSeq (Illumina, San Diego, CA). Nuclear factor kappa B (NF-κB) from the animal cecum tissue was determined by real-time PCR and interleukins (TNF-α, IL-1ß, IL-10, and IFN-γ) by means of ELISA. Myeloperoxidase and malondialdehyde levels were determined biochemically. The administration of the L. rhamnosus EM1107 probiotic strain, either as a pure culture or added to a cheese matrix, was able to reduce Salmonella colonization in the intestinal lumen and lessen tissue damage compared with rats from PtC group. In addition, the use of cheese for the probiotic strain delivery (LrCh) was associated with a marked shift in the gut microbiota composition toward the increase of beneficial organisms such as Blautia and Lactobacillus and a reduction in NF-κB expression. These findings support our hypothesis that cheeses might be explored as functional matrices for the efficacious delivery of probiotic strains to consumers.


Assuntos
Queijo/microbiologia , Cabras , Intestinos/imunologia , Intestinos/microbiologia , Lacticaseibacillus rhamnosus/metabolismo , Probióticos , Salmonella enteritidis/imunologia , Animais , Ceco/metabolismo , Ceco/microbiologia , Microbioma Gastrointestinal , Masculino , RNA Ribossômico 16S , Ratos , Ratos Wistar
11.
J Reprod Immunol ; 142: 103204, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33130539

RESUMO

Detailed morphological characterization of testicular leukocytes in the adult CX3CR1 gfp/+ transgenic mouse identified two distinct CX3CR1 + mononuclear phagocyte (macrophage and dendritic cell) populations: stellate/dendriform cells opposed to the seminiferous tubules (peritubular), and polygonal cells associated with Leydig cells (interstitial). Using confocal microscopy combined with stereological enumeration of CX3CR1gfp/+ cells established that there were twice as many interstitial cells (68%) as peritubular cells (32%). Flow cytometric analyses of interstitial cells from mechanically-dissociated testes identified multiple mononuclear phagocyte subsets based on surface marker expression (CX3CR1, F4/80, CD11c). These cells comprised 80% of total intratesticular leukocytes, as identified by CD45 expression. The remaining leukocytes were CD3+ (T lymphocytes) and NK1.1+ (natural killer cells). Functional phenotype assessment using CD206 (an anti-inflammatory/M2 marker) and MHC class II (an activation marker) identified a potentially tolerogenic CD206+MHCII+ sub-population (12% of total CD45+ cells). Rare testicular subsets of CX3CR1 +CD11c+F4/80+ (4.3%) mononuclear phagocytes and CD3+NK1.1+ (3.1%) lymphocytes were also identified for the first time. In order to examine the potential for the immunoregulatory cytokine, activin A to modulate testicular immune cell populations, testes from adult mice with reduced activin A (Inhba+/-) or elevated activin A (Inha+/-) were assessed using flow cytometry. Although the proportion of F4/80+CD11b+ leukocytes (macrophages) was not affected, the frequency of CD206+MHCII+cells was significantly lower and CD206+MHCII- correspondingly higher in Inha+/- testes. This shift in expression of MHCII in CD206+ macrophages indicates that changes in circulating and/or local activin A influence resident macrophage activation and phenotype and, therefore, the immunological environment of the testis.


Assuntos
Ativinas/metabolismo , Subunidades beta de Inibinas/metabolismo , Leucócitos Mononucleares/imunologia , Ativação de Macrófagos , Testículo/imunologia , Ativinas/análise , Ativinas/genética , Animais , Receptor 1 de Quimiocina CX3C/genética , Receptor 1 de Quimiocina CX3C/metabolismo , Separação Celular , Citometria de Fluxo , Subunidades beta de Inibinas/análise , Subunidades beta de Inibinas/genética , Leucócitos Mononucleares/metabolismo , Masculino , Camundongos , Camundongos Transgênicos , Testículo/citologia
12.
Epidemiol Infect ; 148: e180, 2020 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-32364094

RESUMO

Raw milk cheeses are commonly consumed in France and are also a common source of foodborne outbreaks (FBOs). Both an FBO surveillance system and a laboratory-based surveillance system aim to detect Salmonella outbreaks. In early August 2018, five familial FBOs due to Salmonella spp. were reported to a regional health authority. Investigation identified common exposure to a raw goats' milk cheese, from which Salmonella spp. were also isolated, leading to an international product recall. Three weeks later, on 22 August, a national increase in Salmonella Newport ST118 was detected through laboratory surveillance. Concomitantly isolates from the earlier familial clusters were confirmed as S. Newport ST118. Interviews with a selection of the laboratory-identified cases revealed exposure to the same cheese, including exposure to batches not included in the previous recall, leading to an expansion of the recall. The outbreak affected 153 cases, including six cases in Scotland. S. Newport was detected in the cheese and in the milk of one of the producer's goats. The difference in the two alerts generated by this outbreak highlight the timeliness of the FBO system and the precision of the laboratory-based surveillance system. It is also a reminder of the risks associated with raw milk cheeses.


Assuntos
Queijo/microbiologia , Surtos de Doenças , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/microbiologia , Infecções por Salmonella/microbiologia , Salmonella/classificação , Animais , Controle de Doenças Transmissíveis , Doenças Transmitidas por Alimentos/epidemiologia , França/epidemiologia , Cabras , Humanos , Infecções por Salmonella/epidemiologia
13.
Oper Dent ; 45(4): 352-358, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32053455

RESUMO

CLINICAL RELEVANCE: The Monobond Etch & Prime seems to be an efficient option for adhesive cementation of ultrathin veneers and full crown ceramic with good properties after two years of clinical follow-up. SUMMARY: The use of the self-etching ceramic primer combines the stages of acid conditioning and silanization in cementation procedures of ceramic restorations. The protocol is a simpler and safer alternative to the conventional protocol for surface treatment of silica-based ceramics. This case report describes the steps of an esthetic rehabilitation with ultrathin veneers and full crown based on lithium disilicate treated with a ceramic primer (Monobond Etch & Prime, Ivoclar Vivadent, Schaan, Liechtenstein). After two years of clinical follow-up, the restorations presented satisfactory esthetic and functional performance, color stability, surface and marginal integrity, and absence of cracks and debonding. More research is needed to investigate the clinical performance and longevity of the ceramic restorations treated with self-etching ceramic primers.


Assuntos
Colagem Dentária , Cerâmica , Coroas , Porcelana Dentária , Facetas Dentárias , Seguimentos , Teste de Materiais , Cimentos de Resina , Propriedades de Superfície
14.
Chirurg ; 91(6): 474-480, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32103292

RESUMO

BACKGROUND: Intraoperative ultrasound is a routine procedure in abdominal surgery. Not only detection of focal lesions but also perfusion and elasticity analyses using color-coded Doppler sonography, contrast-enhanced ultrasound and elastography enable highly sensitive and highly specific diagnostics, especially in oncological surgery. OBJECTIVE: This article provides an overview on current techniques of intraoperative ultrasound and gives an outlook on future possibilities and applications. MATERIAL AND METHODS: Literature-based presentation of evidence-based intraoperative ultrasound, discussion of current basic research and expert recommendations. RESULTS: Modern intraoperative ultrasound is a highly efficient technique for detection and characterization of focal space-occupying lesions in surgery of benign and malignant diseases. CONCLUSION: Intraoperative ultrasound is a highly sensitive and specific diagnostic tool, providing real-time diagnostics with a manageable amount of technical equipment. Thus, preoperative diagnostics can be refined, partly resulting in a modification of intraoperative treatment management. Future developments in the fields of digital image fusion with preoperative sectional imaging, optical guidance of surgical instruments and molecular targeted tumor therapy will increase the importance of intraoperative sonography even more.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Ultrassonografia Doppler em Cores , Meios de Contraste , Humanos , Ultrassonografia
15.
J Eur Acad Dermatol Venereol ; 34(5): 1010-1018, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31715033

RESUMO

BACKGROUND: Establishing romantic relationships involving cohabitation and/or sexual intercourse is an overriding task for many people during emerging adulthood, i.e. from their late teens through the twenties. The diagnosis of anogenital psoriasis may hinder social/intimate relationships, resulting in higher disease burden in this age group. OBJECTIVES: To compare the disease burden and patient needs/benefits between emerging adults (18-30 years) and adults (>30 years) with psoriasis, with and without anogenital involvement; and to identify sociodemographic/clinical variables accounting for better patient-reported outcomes. METHODS: Patients aged ≥18 years with psoriasis vulgaris were recruited within a cross-sectional nationwide survey randomly assigning 157 dermatology practices/clinics in Germany. Anogenital involvement was established based on a high-resolution grid on the topology of psoriasis. The main outcome measures were the Psoriasis Area and Severity Index (PASI), the EuroQoL visual analogue scale (EQ-VAS), the Dermatology Life Quality Index (DLQI) and the Patient Benefit Index (PBI). RESULTS: Participants were 1921 patients: 173 emerging adults and 1749 adults >30 years. Anogenital involvement was observed in 621 patients (32.3%). Patient with anogenital psoriasis reported decreased health and more QoL impairments compared with those without anogenital lesions. Emerging adults presented more QoL impairments and less treatment benefits than older patients, and they were more prone to underrate a wide range of needs, except when the anogenital area was affected. Beyond anogenital involvement and higher disease severity, less treatment benefits were associated with more QoL impairments, particularly for emerging adults. CONCLUSIONS: The developmental instability of many emerging adults may result in difficulties to establish/adhere to treatment goals and thus in decreased perception of treatment benefit and more QoL impairments. Anogenital involvement is a risk factor for increased disease burden regardless of age. Assessing anogenital involvement in all patients and helping younger patients to define/adhere to treatment goals should be prioritized in patient-centred healthcare for psoriasis.


Assuntos
Efeitos Psicossociais da Doença , Psoríase , Adolescente , Adulto , Estudos Transversais , Atenção à Saúde , Alemanha , Humanos , Psoríase/terapia , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários
16.
JAMA cardiol. (Online) ; 4(5): 408-417, Mai. 2019. grafico, tabela
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1022826

RESUMO

RESULTS Of the 1619 included patients,1029 (63.6%) weremale,1327(82.0%) had coronary artery disease (843[52.1%] with prioracutemyo cardial infarction),355(21.9%)had priorischemicstroke ortransientischemicattack,and197 (12.2%) had peripheral vascular disease,andthemean( SD) age was 65.6 (10.5) years. Among randomized clusters, 30 (75%) were cardiology sites, 6 (15%) were primary careunits,and 26 (65%) were teaching institutions.Amonge ligible patients,thosein intervention clusters were more like ly to receive aprescription of evidence-based therapies thant hose in control clusters (73.5%[515of701] vs58.7% [493of840];oddsratio,2.30;95%CI,1.14-4.65). There were no differences between the intervention and control group swithregard storisk factor control(ie,hyperlipidemia,hypertension,ordiabetes).Ratesofeducationforsmokingcessationwere higher among current smokers in the intervention group thanin the control group (51.9%[364of701] vs18.2%[153of840];oddsratio,11.24;95%CI,2.20-57.43).Therateofcardiovascularmortality,acute myocardial infarction,andstrokewas2.6%for patients from intervention cluster sand 3.4%forthose in the control group (hazardratio, 0.76;95%CI,0.43-1.34). (AU)


Assuntos
Humanos , Doenças Cardiovasculares/tratamento farmacológico , Medicina Baseada em Evidências/métodos , Prevenção de Doenças
17.
Med Oral Patol Oral Cir Bucal ; 24(3): e314-e318, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31012437

RESUMO

BACKGROUND: This study evaluated the efficiency of masticatory cycles by means of the linear envelope of the electromyographic signal of the masseter and temporalis muscles in individuals with Parkinson's disease. MATERIAL AND METHODS: Twenty-four individuals were assigned into two groups: with Parkinson's disease, average ± SD 66.1 ± 3.3 years (n = 12) and without the disease, average ± SD: 65.8 ± 3.0 years (n = 12). The MyoSystem-I P84 electromyograph was used to analyze the activity of masticatory cycles through the linear envelope integral in habitual mastication of peanuts and raisins and non-habitual mastication of Parafilm M®. RESULTS: There was statistically significant difference (P ≤ 0.05) between individuals with Parkinson's disease and without the disease in non-habitual mastication of Parafilm M®, in the right temporal muscle (P = 0.01); habitual mastication of peanuts, in the right temporal muscle (P = 0.02), left temporal muscle (P = 0.03), and right masseter muscle (P = 0.01); and habitual mastication of raisins in the right temporal muscle (P = 0.001), left temporal muscle (P= 0.001), right masseter muscle (P= 0.001) and left masseter muscle (P= 0.03). CONCLUSIONS: These results suggest that Parkinson's disease interferes in the electromyographic activity of the masticatory cycles by reducing muscular efficiency.


Assuntos
Doença de Parkinson , Eletromiografia , Humanos , Músculo Masseter , Mastigação , Músculo Temporal
18.
Arch Ital Biol ; 157(4): 105-110, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32323294

RESUMO

Parkinson's disease is a neurodegenerative disease with manifestations related to oxidative stress and damage to the skeletal striated musculature. This study evaluated the electromyographic fatigue of the masseter and temporal muscles in individuals with Parkinson's disease. The median frequency of the normotensive electromyographic signal was analyzed in 16 individuals, aged between 50 and 70 years, with Parkinson's disease in stages I and III of the Hoehn and Yahr disability scale (n=8) or without the disease (n=8). The data were tabulated and analyzed statistically (t-test, p .05). Compared with the group without Parkinson's disease, the group with the disease showed an increase in the median frequency, with significant differences for the right masseter (p=.05) and the right temporal (p=.03) muscles. The results suggest that there is a link between Parkinson's disease and functional alterations of the masticatory system, especially when electromyographic fatigue is assessed.


Assuntos
Eletromiografia , Músculo Masseter , Fadiga Muscular , Doença de Parkinson , Músculo Temporal , Idoso , Estudos de Casos e Controles , Humanos , Músculo Masseter/patologia , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/patologia , Músculo Temporal/patologia
19.
Eur J Nucl Med Mol Imaging ; 45(6): 1031-1040, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29478081

RESUMO

PURPOSE: PET using radiolabelled amino acids has become a promising tool in the diagnostics of gliomas and brain metastasis. Current research is focused on the evaluation of amide proton transfer (APT) chemical exchange saturation transfer (CEST) MR imaging for brain tumour imaging. In this hybrid MR-PET study, brain tumours were compared using 3D data derived from APT-CEST MRI and amino acid PET using O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET). METHODS: Eight patients with gliomas were investigated simultaneously with 18F-FET PET and APT-CEST MRI using a 3-T MR-BrainPET scanner. CEST imaging was based on a steady-state approach using a B1 average power of 1µT. B0 field inhomogeneities were corrected a Prametric images of magnetisation transfer ratio asymmetry (MTRasym) and differences to the extrapolated semi-solid magnetisation transfer reference method, APT# and nuclear Overhauser effect (NOE#), were calculated. Statistical analysis of the tumour-to-brain ratio of the CEST data was performed against PET data using the non-parametric Wilcoxon test. RESULTS: A tumour-to-brain ratio derived from APT# and 18F-FET presented no significant differences, and no correlation was found between APT# and 18F-FET PET data. The distance between local hot spot APT# and 18F-FET were different (average 20 ± 13 mm, range 4-45 mm). CONCLUSION: For the first time, CEST images were compared with 18F-FET in a simultaneous MR-PET measurement. Imaging findings derived from18F-FET PET and APT CEST MRI seem to provide different biological information. The validation of these imaging findings by histological confirmation is necessary, ideally using stereotactic biopsy.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Glioma/diagnóstico por imagem , Espectroscopia de Prótons por Ressonância Magnética , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prótons , Tirosina , Adulto Jovem
20.
J Dairy Sci ; 101(5): 4158-4167, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29454688

RESUMO

We investigated the effects of different types and doses of inoculants for ensiling rehydrated corn grain. Shelled corn was finely ground and rehydrated to 35% moisture. Treatments were as follows: (1) control (no additives); (2) Lactobacillus plantarum and Pediococcus acidilactici (LPPA) at a theoretical application rate of 1 × 105 cfu/g; (3) LPPA at 5 × 105 cfu/g; (4) LPPA at 1 × 106 cfu/g; (5) Lactobacillus buchneri (LB) at 1 × 105 cfu/g; (6) LB at 5 × 105 cfu/g; and (7) LB at 1 × 106 cfu/g. We detected no effect of inoculant dose. Gas losses were greater in silages treated with LB compared with control and LPPA silages. Treating silages with LB reduced the concentrations of lactic acid and ethanol and increased silage pH and concentrations of acetic acid, propionic acid, and 1,2-propanediol. At silo opening, silages treated with LB had higher counts of lactic acid bacteria but lower yeast counts than the control silage. Aerobic stability was greater for silages treated with LB and lower for silages treated with LPPA compared with the control. The LB reduced dry matter (DM) losses during aerobic exposure, whereas LPPA increased them. Prolamin content was lower in silages treated with LB compared with the control, resulting in greater ruminal in situ DM degradability. Inoculating LB to a dose of 1 × 105 cfu/g increased aerobic stability and ruminal in situ DM degradability of rehydrated corn grain silage. The addition of LPPA did not alter the fermentation process and worsened the aerobic stability of rehydrated corn grain silage. Further studies are warranted to confirm these conclusions in other corn hybrids, inoculants, and their combinations.


Assuntos
Ração Animal/microbiologia , Manipulação de Alimentos/métodos , Lactobacillus plantarum/metabolismo , Lactobacillus/metabolismo , Pediococcus acidilactici/metabolismo , Silagem/microbiologia , Zea mays/microbiologia , Ácido Acético/análise , Ácido Acético/metabolismo , Aerobiose , Ração Animal/análise , Etanol/análise , Etanol/metabolismo , Fermentação , Ácido Láctico/análise , Ácido Láctico/metabolismo , Silagem/análise , Leveduras/crescimento & desenvolvimento , Leveduras/metabolismo , Zea mays/química
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