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Purpose: To describe the acoustic characteristics of a classroom, voice quality, fatigue, and vocal load of university professors. Methods: Exploratory, observational, longitudinal, and descriptive study with a single group of participants, including vocal monitoring data over two weeks. Acoustic characterization of the classroom, perceptual-auditory evaluation, and acoustic analysis of voice samples were conducted before and after classes. Vocal dosimetry was performed during classes, and the Vocal Fatigue Index (VFI) was assessed at the beginning of each week. Descriptive analysis of the findings was conducted, and randomization test was performed to verify the internal reliability of the judge. Results: All participants reported speaking loudly in the classroom, with the majority reporting vocal changes in the past six months, and only one participant reported a current vocal change. The classroom had acoustical measures and estimations that deviated from established standards. The professors used high vocal intensities during classes. After the classes, an increase in the absolute values of the aggregated data for CAPE-V, jitter, and fundamental frequency was found, varying within the range of normality. Furthermore, there was an observed increase in both post-lesson intensity and VFI when comparing the two-week period. Conclusions: Vocal intensities and VFI were possibly impacted by the acoustics of the classroom. The increase in average VFI between the weeks may be attributed to a cumulative fatigue sensation. Further research with a larger number of participants and in acoustically conditioned classrooms is suggested in order to evaluate collective intervention proposals aimed at reducing the vocal load on teachers.
Objetivo: Describir las características acústicas, calidad vocal, fatiga y carga vocal de profesores universitarios. Métodos: Estudio exploratorio, observacional, longitudinal, descriptivo con un solo grupo de participantes y datos de monitoreo vocal durante dos semanas. Se realizó caracterización acústica de la sala, evaluación auditiva-perceptiva y acústica de muestras de voz antes y después de las clases. Se realizó dosimetría vocal durante las clases y se verificó el Índice de Fatiga Vocal (IFV) en dos semanas. Se realizó un análisis descriptivo de los hallazgos y una prueba de aleatorización para verificar la confiabilidad interna del juez. Resultados: Todos los participantes informaron hablar en voz alta en clase, la mayoría informó cambios vocales en los últimos seis meses y solo uno informó cambios vocales actuales. La sala presentó mediciones y estimaciones acústicas fuera de las normas establecidas. Los profesores utilizaron intensidades vocales altas durante las clases. Hubo un aumento en los valores absolutos de los datos agrupados para CAPE-V, jitter y frecuencia fundamental, variando dentro de los límites normales, después de las clases. La intensidad después de las clases y el IFV, en la comparación entre las dos semanas, mostraron un aumento. Conclusiones: La dosis vocal y el IFV posiblemente se vieron afectados por la acústica del aula. El aumento del IFV medio entre semanas pudo deberse a la sensación de cansancio acumulada. Se sugieren nuevas investigaciones con un mayor número de participantes y que se realicen en la sala acondicionada acústicamente para evaluar propuestas de intervención colectiva, con el objetivo de reducir la carga vocal de los docentes.
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PURPOSE: Previous studies have shown increased prevalence of sleep problems among people who stutter. However, there is a lack of knowledge about what these sleep problems may specifically be. METHOD: Fifty children who stutter (CWS) from 6;0 to 12;9 years of age and 50 age- and gender-matched controls participated in this study. Parents did not report coexisting conditions, excepting stuttering and/or sleep problems. Sleep problems were investigated using a standardized questionnaire answered by parents. The questionnaire shows cut-off scores to identify the risk of sleep problems as a whole and on each one of the six subscales (i.e., disorders of initiating and maintaining sleep; sleep breathing disorders; disorders of arousal; sleep-wake transition disorders; disorders of excessive somnolence; and sleep hyperhidrosis). Scores above the cut-off are suggestive of sleep problems. RESULTS: Twenty-one CWS scored higher than the cut-off on the sleep questionnaire compared to only two controls (p < 0.00001). Specifically, CWS scored higher than controls in disorders of initiating and maintaining sleep, sleep-wake transition disorders (especially jerking, sleep talking, and bruxism), and disorders of excessive somnolence (p < 0.0083, corrected for multiple comparisons). DISCUSSION: Compared to controls, CWS are at greater risk for sleep problems, which are not consequences of coexisting disorders. Present findings confirm and expand current knowledge about sleep problems in CWS. Directionality possibilities and clinical implications are discussed.
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Distúrbios do Sono por Sonolência Excessiva , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Transtornos da Transição Sono-Vigília , Gagueira , Criança , Humanos , Pessoa de Meia-Idade , Gagueira/complicações , Gagueira/epidemiologia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia , FalaRESUMO
OBJECTIVES: Patients undergoing hematopoietic stem cell transplantation may present with metabolic alterations that can have an effect on their energy expenditure and nutritional status. This project aimed to compare the pre- and posttransplant energy expenditures of patients undergoing hematopoietic stem cell transplantation as well as related factors. METHODS: This prospective study was conducted at a single center. Patients, undergoing autograft or allograft, were evaluated before transplantation and on the 10th and 17th d posttransplantation. Energy expenditure was measured by indirect calorimetry. Diet intake was assessed by a 24-h dietary recall. Infectious and noninfectious complications were analyzed between days 1 to 10 after transplantation and days 11 to 17 after transplantation. Paired model analyses were carried out to identify the pretransplantation and posttransplantation periods. RESULTS: Twenty patients were evaluated with a mean age of 45.6 ± 17.2 y; a majority were male sex (65%), and the most frequent diagnoses were chronic myeloid leukemia (25%) and multiple myeloma (25%). Energy expenditure increased by 15% posttransplantation, and the energy requirement per kilogram of weight was 23 kcal/kg at day 10 after transplantation. Throughout the posttransplantation period, 45% of the patients required nutritional therapy. Negative energy and negative protein balance were observed at all analyzed times. Phase angle (P = 0.018), fever (P = 0.014), mucositis grades I to II (P = 0.018), and the total number of infectious and noninfectious events (P = 0.043) were associated with an increase in energy expenditure at day 10 after transplantation. CONCLUSIONS: Energy expenditure increased after transplantation compared with pretransplantation in 50% of patients. Phase angle, fever, grades I to II mucositis, and infectious and noninfectious events were associated with increased energy expenditure at day 10 after transplantation.
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Transplante de Células-Tronco Hematopoéticas , Mucosite , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estudos Prospectivos , Estado Nutricional , Metabolismo Energético , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Calorimetria IndiretaRESUMO
Dystrophinopathies are muscle diseases caused by pathogenic variants in DMD, the largest gene described in humans, representing a spectrum of diseases ranging from asymptomatic creatine phosphokinase elevation to severe Duchenne muscular dystrophy (DMD). Several therapeutic strategies are currently in use or under development, each targeting different pathogenic variants. However, little is known about the genetic profiles of northeast Brazilian patients with dystrophinopathies. We describe the spectrum of pathogenic DMD variants in a single center in northeast Brazil. This is an observational, cross-sectional study carried out through molecular-genetic analysis of male patients diagnosed with dystrophinopathies using Multiplex Ligation-dependent Probe Amplification (MLPA) followed by Next-Generation Sequencing (NGS)-based strategies. A total of 94 male patients were evaluated. Deletions (43.6%) and duplications (10.6%) were the most recurring patterns of pathogenic variants. However, small variants were present in 47.1% of patients, most of them nonsense variants (27.6%). This is the largest South American single-center case series of dystrophinopathies to date. We found a higher frequency of treatment-amenable nonsense single-nucleotide variants than most previous studies. These findings may have implications for diagnostic strategies in less-known populations, as a higher frequency of nonsense variants may mean a higher possibility of treating patients with disease-modifying drugs.
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Studies indicate EGFL7 as an important gene in controlling angiogenesis and cancer growth, including in colorectal cancer (CRC). Anti-EGFL7 agents are being explored, yet without promising results. Therefore, the role of EGFL7 in CRC carcinogenesis should be investigated. This study aimed to evaluate the prognostic value of EGFL7 expression in CRC and the signaling pathways influenced by this gene. EGFL7 expression was evaluated through immunohistochemistry in 463 patients diagnosed with CRC and further associated with clinicopathological data, angiogenesis markers and survival. In silico analyzes were performed with colon adenocarcinoma data from The Cancer Genome Atlas. Analysis of enriched gene ontology and pathways were performed using the differentially expressed genes. 77.7% of patients presented low EGFL7 expression, which was associated with higher lymph node spread and invasion of lymphatic vessels, with no impact on survival. Additionally, low EGFL7 expression was associated with high VEGFR2 expression. Finally, we found in silico that EGFL7 expression was associated with cell growth, angiogenesis, and important pathways such as VEGF, Rap-1, MAPK and PI3K/Akt. Expression of EGFL7 in tumor cells may be associated with important pathways that can alter functions related to tumor invasive processes, preventing recurrence and metastatic process.
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Adenocarcinoma , Neoplasias do Colo , Neoplasias Colorretais , Vasos Linfáticos , Humanos , Fosfatidilinositol 3-Quinases/metabolismo , Fatores de Crescimento Endotelial/genética , Família de Proteínas EGF/metabolismo , Processos Neoplásicos , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Fatores de Transcrição/metabolismo , Linfonodos/metabolismo , Vasos Linfáticos/metabolismo , Neoplasias Colorretais/genética , Proteínas de Ligação ao Cálcio/genéticaRESUMO
Purpose: Post-inflammatory hyperpigmentation (PIH) and solar lentigines are dark spots of skin from excessive melanin production due to injury or UV exposure. This 12-week single-center study assessed the efficacy and tolerability of a novel targeted pigment-correcting spot treatment gel suspension cream (Dark Spot Treatment) for improving mild-to-moderate PIH or solar lentigines. Patients and Methods: Female participants (N = 41) aged 25-65 with mild-to-moderate facial dark spots applied Dark Spot Treatment daily for 12 weeks. Investigators assessed overall hyperpigmentation, skin tone evenness, and dark spot intensity, contrast, and size at Weeks 2, 4, 8, and 12. Participant self-assessments occurred at Weeks 1, 2, 4, 8, and 12. Tolerability was assessed by clinical grading and participant reporting. Results: Dark Spot Treatment improved overall hyperpigmentation, skin tone evenness, and dark spot intensity and contrast at Weeks 2 through 12, and dark spot size at Weeks 4 through 12 (all p < 0.001 compared to baseline). Participant self-assessments showed high overall satisfaction. Dark Spot Treatment was well tolerated. Conclusion: The novel pigment-correcting Dark Spot Treatment significantly improved the appearance of PIH and solar lentigines, had high participant satisfaction, and was well tolerated.
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EGFL7 is a proangiogenic factor. It has been widely described with having a vital role in tubulogenesis and regulation of angiogenesis, mainly during embryogenesis and organogenesis. It has been mainly associated with NOTCH pathway, but there are reports showing association with MAPK and integrin pathways. Given its association with angiogenesis and these other pathways, there are several studies associating EGFL7 with carcinogenesis. In fact, most of the studies have pointed to EGFL7 as an oncogene, and some of them suggest EGFL7 expression as a possible biomarker of prognosis or use for a patient's follow-up. Here, we review the molecular pathways which EGFL7 is associated and highlight several studies describing the role of EGFL7 in tumorigenesis, separated by tumor type. Besides its role on angiogenesis, EGFL7 may act in other pathways as oncogene, which makes it a possible biomarker and a candidate to targeted therapy.
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Proteínas de Ligação ao Cálcio , Neoplasias , Humanos , Proteínas de Ligação ao Cálcio/genética , Proteínas de Ligação ao Cálcio/metabolismo , Transdução de Sinais , Fatores de Crescimento Endotelial , Família de Proteínas EGF/genética , Família de Proteínas EGF/metabolismo , Movimento Celular , Neoplasias/genética , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , BiomarcadoresRESUMO
In the last decades, the growth of world agricultural activity has significantly contributed to the increased presence of emerging pollutants such as atrazine (ATZ) in aquatic ecosystems. Due to its high stability to the natural or artificial degradation processes, the ATZ environmental remediation by adsorption has been investigated. In this study, a graphitic-porous-carbon- (GPC) based material with magnetic domains was applied to remove ATZ from aqueous solution. ATZ high adsorption efficiency in a reduced time was achieved in the presence of the GPC adsorbent, leading to a detailed investigation of the mechanisms involved in the adsorption processes. Pseudo-first-order (PFO), pseudo-second-order (PSO), Ritchie, Elovich, and Weber-Morris models were applied to calculate the kinetic process efficiency. Likewise, adsorption isotherms based on Langmuir, Freundlich, Temkin, and Redlich-Peterson models were applied for a detailed understanding of the adsorption mechanisms. GPC was successfully applied for ATZ remediation in natural waters, confirming its high potential for treating natural waters contaminated by ATZ using adsorption process. The material can also be recovered and reused for up to 4 application cycles due to its magnetic properties, showing that in addition to ATZ adsorption efficiency, its sustainable use can be achieved.
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Atrazina , Recuperação e Remediação Ambiental , Grafite , Poluentes Químicos da Água , Carbono , Adsorção , Água , Porosidade , Ecossistema , Poluentes Químicos da Água/análise , Ferro , Cinética , Concentração de Íons de HidrogênioRESUMO
BACKGROUND: Despite the advances in glioblastoma (GBM) treatment, the average life span of patients is 14 months. Therefore, it is urgent to identity biomarkers of prognosis, treatment response, or development of novel treatment strategies. We previously described the association of high epidermal growth factor-like domain multiple 7 (EGFL7) expression and unfavorable outcome of pilocytic astrocytoma patients. The present study aims to analyze the prognostic potential of EGFL7 in GBM isocitrate dehydrogenase (IDH)-wildtype, using immunohistochemistry and in silico approaches. METHODS: Spearman's correlation analysis of The Cancer Genome Atlas RNA sequencing data was performed. The genes strongly correlated to EGFL7 expression were submitted to enrichment gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Additionally, EGFL7 expression was associated with patient overall survival. The expression of EGFL7 was analyzed through immunohistochemistry in 74 GBM IDH-wildtype patients' samples, and was associated with clinicopathological data and overall survival. RESULTS: In silico analysis found 78 genes strongly correlated to EGFL7 expression. These genes were enriched in 40 biological processes and eight KEGG pathways, including angiogenesis/vasculogenesis, cell adhesion, and phosphoinositide 3-kinase-Akt, Notch, and Rap1 signaling pathways. The immunostaining showed high EGFL7 expression in 39 cases (52.7%). High immunolabelling was significantly associated with low Karnofsky Performance Status and poor overall survival. Cox analysis showed that GBMs IDH-wildtype with high EGFL7 expression presented a higher risk of death compared to low expression (hazard ratio, 1.645; 95% confidence interval, 1.021 to 2.650; p = .041). CONCLUSIONS: This study gives insights regarding the genes that are correlated with EGFL7, as well as biological processes and signaling pathways, which should be further investigated in order to elucidate their role in glioblastoma biology.
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The cocoa bean shell is a residue rich in bioactive compounds and its use as an ingredient in the food industry has been studied. This work had the objective of proposing the elaboration of chocolate cake with substitution of wheat flour by cocoa bean shell powder (CSp). Five formulations with different percentages of CSp were used: 25%, 50%, 75%, 100% and 0% (control). The cakes were evaluated by technological characteristics (volume, texture profile, firmness and colour), antioxidant profile (DPPH, ß-carotene/linoleic acid system, phenolic compounds, anthocyanins and tannins) and sensory tests (TDS and acceptance). The technological characteristics and antioxidant activity of the cakes were influenced by the different concentrations of CSp compared to the control sample. The cakes containing up to 75% CSp presented satisfactory sensory acceptance. Therefore, CSp has been revealed to be a prominent alternative substitute ingredient to be used promisingly in the food industry.
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Cacau , Chocolate , Antocianinas , Cacau/química , Farinha , Pós , TriticumRESUMO
PURPOSE: We aimed to investigate the effects of photobiomodulation therapy combined with static magnetic field (PBMT-sMF) on the length of intensive care unit (ICU) stay and mortality rate of severe COVID-19 patients requiring invasive mechanical ventilation and assess its role in preserving respiratory muscles and modulating inflammatory processes. PATIENTS AND METHODS: We conducted a prospectively registered, triple-blinded, randomized, placebo-controlled trial of PBMT-sMF in severe COVID-19 ICU patients requiring invasive mechanical ventilation. Patients were randomly assigned to receive either PBMT-sMF or a placebo daily throughout their ICU stay. The primary outcome was length of ICU stay, defined by either discharge or death. The secondary outcomes were survival rate, diaphragm muscle function, and the changes in blood parameters, ventilatory parameters, and arterial blood gases. RESULTS: Thirty patients were included and equally randomized into the two groups. There were no significant differences in the length of ICU stay (mean difference, MD = -6.80; 95% CI = -18.71 to 5.11) between the groups. Among the secondary outcomes, significant differences were observed in diaphragm thickness, fraction of inspired oxygen, partial pressure of oxygen/fraction of inspired oxygen ratio, C-reactive protein levels, lymphocyte count, and hemoglobin (p < 0.05). CONCLUSION: Among severe COVID-19 patients requiring invasive mechanical ventilation, the length of ICU stay was not significantly different between the PBMT-sMF and placebo groups. In contrast, PBMT-sMF was significantly associated with reduced diaphragm atrophy, improved ventilatory parameters and lymphocyte count, and decreased C-reactive protein levels and hemoglobin count. TRIAL REGISTRATION NUMBER CLINICAL TRIALSGOV: NCT04386694.
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BACKGROUND & AIMS: This longitudinal, qualitative, descriptive, and exploratory study aimed to identify and understand the food preferences and aversions arising from hematopoietic stem cell transplantation (HSCT), chemotherapy, and/or radiotherapy treatment. METHODS: An open and individual interview was carried out with patients diagnosed with hematological diseases or cancer, submitted to HSCT, chemotherapy, and/or radiotherapy treatment. The participants answered the following questions: "Have you experienced any changes in taste since the beginning of radiotherapy/chemotherapy?"; "Have you experienced any strange taste in your mouth, aversion or preference for a certain food that did not exist before the beginning of radiotherapy/chemotherapy?" The software IRAMUTEQ (R Interface for Multidimensional Analysis of Texts and Questionnaires) version 0.7 alpha 2 was used for textual analysis, with similarity analysis and word cloud. RESULTS: One hundred and forty six patients were included in the study, 50% (n = 73) female and 73% (n = 50) elderly. The main words reported by the participants in regards to food aversions were "meat", "beef" and "chicken", which are related to dysphagia. Regarding food preferences, the most mentioned words were "fruits", "juices" and "soups", whose consumption was associated with an improvement in gastrointestinal symptoms, especially nausea. CONCLUSION: Adjustments in the diet plan based on this information can contribute to a better acceptance of the diet, and clinical and nutritional prognosis.
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Preferências Alimentares , Transplante de Células-Tronco Hematopoéticas , Idoso , Dieta , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Carne , PaladarRESUMO
Imatinib, a specific Bcr-Abl tyrosine kinase inhibitor, is the most commonly used drug in the treatment of chronic myeloid leukemia. However, optimal response is not achieved in up to 33% of patients. Therefore, development of novel therapeutic strategies for chronic myeloid leukemia is critical. Betulinic (1) and ursolic (2) acids are natural pentacyclic triterpenes that exhibit antileukemic activities. In this study, we evaluated the effects of pharmacomodulations at the C-3 position of the triterpene moiety of betulinic and ursolic acids on their activity against K562 leukemia cells. Six new derivatives (1a-2c) were synthesized and evaluated for pro-apoptotic and anti-proliferative effects in mammalian and leukemic cells. 2c derivative containing an amine group at the C-3 position of ursolic acid was the most active against leukemia cells with an IC50 value of 5.2 µM after 48 h of treatment. 2c did not exhibit cytotoxic effects against VERO and HepG2 cells and human lymphocytes, showing a good selectivity index for cancer over normal cells. Induced cell death by apoptosis via caspases 3 and 8, and also caused cell cycle arrest as evidenced by accumulation of cells in the G1 phase and decreased cell population in the G2 phase. Furthermore, co-treatment of 2c with imatinib, the chemotherapy drug most commonly used to treat leukemia, resulted in a synergistic effect. Our findings provide a strong rationale for further investigation of combination therapy using the 2c derivative and imatinib in pre-clinical studies.
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Antineoplásicos/farmacologia , Mesilato de Imatinib/farmacologia , Triterpenos/farmacologia , Animais , Antineoplásicos/síntese química , Apoptose/efeitos dos fármacos , Caspase 3/metabolismo , Caspase 8/metabolismo , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Chlorocebus aethiops , Ensaios de Seleção de Medicamentos Antitumorais , Sinergismo Farmacológico , Pontos de Checagem da Fase G1 do Ciclo Celular/efeitos dos fármacos , Pontos de Checagem da Fase G2 do Ciclo Celular/efeitos dos fármacos , Humanos , Triterpenos/síntese química , Células Vero , Ácido UrsólicoRESUMO
Several factors affect the vegetative growth of fungi, such as temperature, pH, and culture medium. In addition to mycelial growth, these factors affect metabolite production. There are limited studies that have identified the metabolites produced by the fungus Bjerkandera adusta, which have potential biotechnological applications. Here, we evaluated the effects of temperature, culture medium, and incubation time on the production of mycelial mass and metabolites of B. adusta isolated from Pinus taeda. The highest mycelial mass was obtained at 24 °C, in the potato dextrose and malt extract media, upon incubation for 28 and 35 days. The disaccharide α-α-trehalose was for the first time isolated and identified by X-ray diffraction in this fungal genus.
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Coriolaceae , Trealose , Meios de CulturaRESUMO
Pilocytic astrocytoma (PA) is the most frequent solid neoplasm in childhood. It has a good 5-year overall survival (90% in childhood and 52% in adults). However, up to 20% of patients experience residual tumor growth, recurrence, and death. Although the main genetic alteration of PAs, including KIAA1549:BRAF fusion, involves chromosome 7q34, we previously found frequent loss in chr9q34.3 locus in a small subset of these tumors. Among the genes present in this locus, EGFL7 is related to poor prognosis in several tumor types. In this study, we aimed to assess EGFL7 expression through immunohistochemistry, and to evaluate its prognostic value in a series of 64 clinically and molecularly well-characterized pilocytic astrocytomas. We found high expression of EGFL7 in 71.9% of patients. Low EGFL7 expression was associated with older patients, the mean age mainly older than 11 years (P = 0.027). EGFL7 expression was not associated with presence of KIAA1549:BRAF fusion, BRAF mutation, FGFR1 mutation, nor FGFR1 duplication. Moreover, high EGFL7 expression was associated with high FGFR1 (P = 0.037) and 5'-deoxy-5'-methyltioadenosine phosphorylase (MTAP) (P = 0.005) expression, and with unfavorable outcome of patients (P = 0.047). Multivariate analysis revealed low EGFL7 expression related to older patients and high EGFL7 expression related to retained expression of MTAP. In addition, we found a borderline significance of unfavorable outcome and high EGFL7 expression. Finally, EGFL7 expression was not associated with overall or event-free survival of PA patients. Our findings point to EGFL7 expression as a novel candidate prognostic marker in PA, which should be further investigated.
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Astrocitoma/diagnóstico , Astrocitoma/metabolismo , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/metabolismo , Proteínas de Ligação ao Cálcio/biossíntese , Família de Proteínas EGF/biossíntese , Adolescente , Adulto , Astrocitoma/genética , Neoplasias Encefálicas/genética , Proteínas de Ligação ao Cálcio/genética , Criança , Pré-Escolar , Família de Proteínas EGF/genética , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Mutação/genética , Prognóstico , Adulto JovemRESUMO
Our main objective was to evaluate the ophthalmic artery Doppler behavior in twin pregnancies and compare with singleton pregnancies. We studied 64 healthy twin pregnant women between 12 to 38 weeks of gestation. Resistance index (RI), pulsatility index (PI), and peak ratio (PR) were determined. The control group consisted of 289 singletons. Linear regression analysis was performed to evaluate the association between gestational age and the ophthalmic indexes. Student t test was used to compare the means and standard deviation of the Doppler indexes. There was a decrease in RI and PI and an increase in PR with advancing gestational age (ρ < 0.0001, 0.0052, and 0.0033). The means ± SDs for RI, PI, and PR were 0.77 ± 0.07, 1.79 ± 0.46, and 0.53 ± 0.12, in women with twin pregnancies and 0.75 ± 0.05, 1.88 ± 0.43, and 0.52 ± 0.10 in singletons. No significant difference was found between the PI and PR values, but significant difference was found in the RI values between the groups (P = 0.0332). We concluded that there are no significant differences in ophthalmic artery behavior in twins and the same reference values established in singleton pregnancies can be applied for PI and PR indexes in the evaluation of twin pregnancies. These indexes were the best to evaluate twin pregnancies.
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Artéria Oftálmica/fisiologia , Ultrassonografia Doppler/métodos , Ultrassonografia Pré-Natal/métodos , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Estudos Transversais , Feminino , Humanos , Gravidez , Gravidez de GêmeosRESUMO
Bile acids (BA), with their large hydrophobic steroid nucleus and polar groups are amphipathic molecules. In bile, these exist as micelles above their critical micellar concentration (CMC). In blood at low concentrations, these exist as monomers, initiating cellular signals. This micellar to monomer transition may involve complex thermodynamic interactions between bile salts alone or with phospholipids, i.e. mixed micelles and the aqueous environment. We therefore went on to test if therapeutically relevant changes in temperature could influence micellar behavior of bile salts, and in turn whether this affected the biological responses in cells, and in vivo. Sodium taurocholate (STC) belongs to a major class of bile salts. STC has a CMC in the 5-8 mM range and its infusion into the pancreatic duct is commonly used to study pancreatitis. We thus studied micellar breakdown of STC using isothermal titration calorimetry (ITC), dynamic light scattering and cryogenic transmission electron microscopy. Under conditions relevant to the in vivo environment (pH 7.4, Na 0.15 M), ITC showed STC to have a U shaped reduction in micellar breakdown between 37 °C and 15 °C with a nadir at 25 °C approaching ≈90% inhibition. This temperature dependence paralleled pancreatic acinar injury induced by monomeric STC. Mixed micelles of STC and 1-palmitoyl, 2-oleyl phosphatidylcholine, a phospholipid present in high proportions in bile, behaved similarly, with ≈75% reduction in micellar breakdown at 25 °C compared to 37 °C. In vivo pancreatic cooling to 25 °C reduced the increase in circulating BAs after infusion of 120 mM (5%) STC into the pancreatic duct, and duct ligation. Lower BA levels were associated with improved cardiac function, reduced myocardial damage, shock, lung injury and improved survival independent of pancreatic injury. Thus micellar breakdown of bile salts is essential for their entry into the systemic circulation, and thermodynamic interference with this may reduce their systemic entry and consequent injury during cholestasis, such as from biliary pancreatitis.
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Ácidos e Sais Biliares/metabolismo , Colestase/complicações , Inflamação/prevenção & controle , Lesão Pulmonar/prevenção & controle , Micelas , Contusões Miocárdicas/prevenção & controle , Choque/prevenção & controle , Animais , Humanos , Inflamação/etiologia , Inflamação/metabolismo , Inflamação/patologia , Lesão Pulmonar/etiologia , Lesão Pulmonar/metabolismo , Lesão Pulmonar/patologia , Masculino , Camundongos , Contusões Miocárdicas/etiologia , Contusões Miocárdicas/metabolismo , Contusões Miocárdicas/patologia , Choque/etiologia , Choque/metabolismo , Choque/patologia , Temperatura , TermodinâmicaRESUMO
Introdução: Há um grande percentual de idosos inseridos no mercado de trabalho e essa estimativa tende a crescer devido ao aumento significativo dessa população, acreditando que, em 2020, 15% da população será idosa, e 13% estará inserida no mercado de trabalho. Objetivo: Avaliar as condições de vida e saúde em idosos que exerçam atividade profissional. Métodos: Estudo transversal, quantitativo, censitário, descritivo, realizado em uma Instituição de Ensino Superior com idosos de ambos os sexos, funcionários da instituição. Foram aplicados os questionários sociodemográfico, Mini-exame do estado mental, Escala de Katz, Escala de Lawton e Instrumento sobre doenças crônicas autorreferidas. Os dados foram analisados no Software SPSS v. 25.0. Resultados: Participaram do estudo 12 idosos, a maioria do sexo feminino (58,3%), aposentados (58,3%), não tabagistas (16,6%) e etilistas (75,0%). As patologias com maior índice foram a hipertensão (41,7%) e diabetes (25%). Mostraram-se independentes para atividade básica e instrumental de vida diária (91,7%) e (75%), respectivamente. Conclusão: Percebe-se que os idosos estão ativos no mercado de trabalho, mesmo recebendo aposentadoria. Apresentam alguma doença crônica e hábitos de vida que são fatores de risco para outras doenças. (AU)
Introduction: There is a large percentage of older people entering the labor market and this estimate tends to grow due to the significant increase of this population, believing that in 2020 15% of the population will be elderly, and 13% will be inserted in the labor market. Objective: To evaluate the life and health conditions of elderly who exercise professional activity. Methods: Cross-sectional, quantitative, census-based, descriptive study carried out in a Higher Education Institution with elderly people of both sexes, employees of the institution. Socio-demographic questionnaires, Mini Mental State Exam, Katz Scale, Lawton Scale, and Self-reported Chronic Diseases Instrument were applied. The data were analyzed in SPSS v. 25.0. Results: Twelve elderly people attended the study, the majority of whom were female (58.3%), retired (58.3%), non- smokers (16.6%) and alcoholics (75.0%). The most frequent pathologies were hypertension (41.7%) and diabetes (25%). They were independent for basic and instrumental activity of daily life (91.7% and 75%, respectively). Conclusion: The elderly are active in the labor market, even receiving retirement. They present some chronic illness and life habits that are risk factors for other diseases. (AU)
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Humanos , Condições Sociais , Idoso , Mercado de Trabalho , SaúdeRESUMO
Visceral adipose tissue plays a critical role in numerous diseases. Although imaging studies often show adipose involvement in abdominal diseases, their outcomes may vary from being a mild self-limited illness to one with systemic inflammation and organ failure. We therefore compared the pattern of visceral adipose injury during acute pancreatitis and acute diverticulitis to determine its role in organ failure. Acute pancreatitis-associated adipose tissue had ongoing lipolysis in the absence of adipocyte triglyceride lipase (ATGL). Pancreatic lipase injected into mouse visceral adipose tissue hydrolyzed adipose triglyceride and generated excess nonesterified fatty acids (NEFAs), which caused organ failure in the absence of acute pancreatitis. Pancreatic triglyceride lipase (PNLIP) increased in adipose tissue during pancreatitis and entered adipocytes by multiple mechanisms, hydrolyzing adipose triglyceride and generating excess NEFAs. During pancreatitis, obese PNLIP-knockout mice, unlike obese adipocyte-specific ATGL knockouts, had lower visceral adipose tissue lipolysis, milder inflammation, less severe organ failure, and improved survival. PNLIP-knockout mice, unlike ATGL knockouts, were protected from adipocyte-induced pancreatic acinar injury without affecting NEFA signaling or acute pancreatitis induction. Therefore, during pancreatitis, unlike diverticulitis, PNLIP leaking into visceral adipose tissue can cause excessive visceral adipose tissue lipolysis independently of adipocyte-autonomous ATGL, and thereby worsen organ failure.
Assuntos
Adipócitos/enzimologia , Gordura Intra-Abdominal/enzimologia , Lipase/metabolismo , Pancreatite/enzimologia , Transdução de Sinais , Doença Aguda , Adipócitos/patologia , Animais , Ácidos Graxos não Esterificados/genética , Ácidos Graxos não Esterificados/metabolismo , Feminino , Humanos , Inflamação/enzimologia , Inflamação/genética , Inflamação/patologia , Gordura Intra-Abdominal/patologia , Lipase/genética , Masculino , Camundongos , Camundongos Knockout , Pancreatite/genética , Pancreatite/patologiaRESUMO
RESEARCH QUESTION: What are the main research interests among patients of assisted reproductive technologies (ART)? DESIGN: Cross-sectional study consisting of an anonymous online survey sent to 2112 patients from eight centres in four countries in 2018. Patients were asked to identify research questions relevant to them in the field of infertility and ART. Answers were categorized into topics and ranked by frequency. A long list of the top 30 research topics was extracted from the aggregate results, from which a short list of the top 10 research topics was created. Ten research questions were finally formulated. RESULTS: A total of 945 responses were analysed. Main interests were side-effects, success rates, infertility prevention and emotional support. The 10 research questions were: 1. What are the side-effects of drugs used in ART treatments? (51.6%). 2. What are the most effective methods to cope with infertility from the psychological point of view? (35.7%). 3. What effects could diet have on fertility? (25.9%). 4. What are ART success rates per clinical profile? (24.8%). 5. Are there some habits and lifestyle factors that could prevent infertility? (20.0%). 6. What are the long-term risks associated with ART in mother and child? (18.5%). 7. Are alternative therapies such as acupuncture, yoga and meditation effective to treat/prevent infertility? (18.5%). 8. What is the impact of exercise on fertility? (15.4%). 9. How does oocyte quantity and quality affect fertility? (9.5%). 10. What are the genetic patterns or hereditary conditions causing/related to infertility? (9.5%). CONCLUSIONS: Researchers and clinicians should keep in mind that, in addition to success rates and safety, patients greatly value research into causes, prevention and emotional aspects of infertility.