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1.
Med Oral Patol Oral Cir Bucal ; 29(2): e273-e279, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-37992142

RESUMO

BACKGROUND: The differentiation between primary and metastatic salivary gland neoplasms (SGNs) helps in determining appropriate management strategies, including the need for additional diagnostic tests, surveillance, or aggressive treatment. The purpose of this study was to identify and quantify the immature and mature dendritic cells (DCs) in metastatic and no metastatic SGNs and determine its association with clinicopathological findings. MATERIAL AND METHODS: Cross-sectional, observational, and descriptive study that includes 33 malignant salivary gland neoplasms [MSGN (6, 18.1% metastatic)], and 22 pleomorphic adenomas (PA), as a control group. Clinical and histopathological characteristics were obtained. Immunohistochemistry for human leukocyte antigen D-related (HLA-DR), CD1a, CD83, and Ki-67 proteins was done. Positive intra- and peritumoral DCs were counted. RESULTS: Individuals with MSGN had a lower density of intratumoral HLA-DR+ cells than those with PA (p=0.001), Ki-67 immunostaining was significantly higher in MSGN than in PA (6% vs. 1.4%, p<0.001). Metastatic MSGN showed less intratumoral CD1a+ than non-metastatic (3.2 vs. 165.1, p=0.001). No differences in intra- and peritumoral CD83+ cells were found between benign and malignant SGN. CONCLUSIONS: These results suggest that the immune-protective function of intratumoral DCs is compromised in MSGNs. DCs markers may represent useful prediction tools for metastases in salivary gland malignancies, with crucial implications in the implementation of appropriate disease management strategies.


Assuntos
Adenoma Pleomorfo , Neoplasias das Glândulas Salivares , Humanos , Estudos Transversais , Antígeno Ki-67 , Células Dendríticas , Antígenos HLA-DR
2.
Actas Urol Esp (Engl Ed) ; 48(4): 289-294, 2024 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38159803

RESUMO

INTRODUCTION: Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems. OBJECTIVE: To identify the quality of care in the Urology outpatient department of a third-level hospital. MATERIALS AND METHODS: The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico. RESULTS: According to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2h in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11-20min in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good. CONCLUSIONS: The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.


Assuntos
Hospitais Públicos , Satisfação do Paciente , Qualidade da Assistência à Saúde , Encaminhamento e Consulta , Urologia , México , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Adulto , Encaminhamento e Consulta/estatística & dados numéricos , Centros de Atenção Terciária , Idoso , Adulto Jovem , Adolescente
3.
Brain Behav Immun Health ; 21: 100442, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35308082

RESUMO

Background: Many of the motor symptoms of Parkinson's disease (PD) impact quality of life and are not fully ameliorated by current pharmacological and surgical treatments. A better understanding of the pathophysiology underlying these symptoms is needed. Previous research has suggested that inflammation may play a significant role in PD pathophysiology and progression, but there is limited research exploring how inflammation directly relates to motor symptoms in PD. Thus, the purpose of this study was to evaluate associations between peripheral immune inflammatory markers and motor symptoms of PD, specifically, tremor, bradykinesia, and postural and gait instability. We hypothesized that peripheral inflammatory cytokines would predict the severity of motor symptoms in persons with PD, and that there will be higher levels of peripheral inflammatory cytokine markers in persons with PD when compared to age-matched healthy older adults. Methods: Twenty-six participants with PD and fourteen healthy older adults completed the study. For participants with PD, the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS) was recorded and scored by two Movement Disorders Neurologists masked to the study. A blood sample was collected from both participants with PD and the healthy older adults. Through the MILLIPLEX® map High Sensitivity Human Cytokine Kit, key inflammation-related markers were analyzed (TNF-α, IFN-γ, IL-1ß, IL-8, IL-2, IL-7, IL-5, IL-13, IL, 4, IL-10 IL-12p70, GM-CSF, and IL-6). Results: Results revealed significantly higher levels of IL-6 in persons with PD when compared to healthy older adults (p â€‹= â€‹0.005). Moreover, results revealed that higher levels of IL-4 (p â€‹= â€‹0.011) and lower levels of IFNγ (p â€‹= â€‹0.003) significantly predicted more severe tremor in persons with PD. No other associations between the peripheral inflammation markers and other motor symptoms were observed. Conclusions: Overall, these results are consistent with a growing body of literature that implicates inflammatory cytokines in the PD, and further suggests that inflammatory cytokines, or lack thereof, may be associated with tremor in persons with PD.

4.
Int J Oral Maxillofac Surg ; 50(1): 54-63, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32690440

RESUMO

Condylar hyperactivity (CH) is a rare condition that entails a progressive deviation and deformation of the mandible. There is no consensus regarding characteristic histopathological features or a standardized diagnostic process; thus, histopathological analysis of the condyle cannot confirm or exclude an active CH after condylectomy is performed. An electronic search was performed in Medline, Embase, Web of Science, LILACS and grey literature up to December 2019. Additionally, a manual search was performed. Risk of bias of the included studies was assessed using the Newcastle-Ottawa Scale and the Institute of Health Economics Quality Appraisal. All analyses were performed independently and in duplicate. Seventeen articles from 660 were included. Six articles were cross-sectional studies and 11 were case series. Almost all the articles (14) described an augmented thickness of the cartilage layer associated with cartilage islands within the subchondral bone in patients affected by CH. Histological findings seem to be mostly related to the age of the sample rather than a characteristic description of CH. No clear association was found between SPECT/scintigram uptake and a specific histological finding. Hence, there is a necessity for the development of specific tools for evaluating and reporting studies where histology is needed for diagnosis confirmation.


Assuntos
Mandíbula , Côndilo Mandibular , Estudos Transversais , Humanos , Hiperplasia/patologia , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Côndilo Mandibular/cirurgia , Tomografia Computadorizada de Emissão de Fóton Único
5.
Neurotoxicology ; 77: 155-168, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31962063

RESUMO

Perfluoroalkyl acids (PFAAs) are man-made organic pollutants that are found ubiquitously in the environment and may impact human health. Here, we review the published literature concerning PFAA impacts on neurobiological, neuroendocrine, and neurobehavioral outcomes. We find that there are many mechanisms through which PFAAs may enter the brain and interact with biochemical endpoints to impact neurological function. These results are supported by epidemiological evidence in humans and experimental evidence in animals that demonstrate numerous and varied PFAA impacts on the nervous system. However, the methods commonly used in animal models of PFAA exposure result in durations of exposure and serum PFAA concentrations in blood that may not appropriately mimic human absorption, distribution, metabolism, and excretion. If animal models lack validity, confidence in mechanistic inferences regarding PFAA exposure and brain function is reduced, limiting these studies' utility. Finally, we end by suggesting some potential impacts of PFAA exposure in human neurological health and disease states whose associations may not readily present themselves in the epidemiological literature.


Assuntos
Encéfalo/efeitos dos fármacos , Fluorocarbonos/toxicidade , Animais , Exposição Ambiental , Poluentes Ambientais/toxicidade , Humanos , Modelos Animais , Neurônios/efeitos dos fármacos , Sistemas Neurossecretores/efeitos dos fármacos , Glândula Tireoide/efeitos dos fármacos
6.
J Intellect Disabil Res ; 64(1): 38-44, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31373080

RESUMO

BACKGROUND: Emerging evidence suggests that parents of children with intellectual disabilities have poorer physical health than parents of typically developing children. However, it is unclear why. The purpose of this study was to examine differences in physical inactivity among a population-based sample of parents of children with and without Down syndrome. METHODS: Data for this analysis come from 11 waves (2005-2016) of the National Health Interview Survey, a U.S. nationally representative survey. Minutes per week of leisure-time physical activity were ascertained by self-report with physical inactivity defined as reporting no leisure-time physical activity. Parents were classified as (1) parents of typically developing children, (2) parents of children with Down syndrome, (3) parents of children with a developmental disability that had a high functional impact (autism, cerebral palsy, vision impairment or hearing impairment), (4) parents of children with an intellectual or developmental disability, but who did not have Down syndrome or a high-impact developmental disabilities, and (5) parents of children with other special health care needs. RESULTS: Parents of children with Down syndrome were more likely to be physically inactive compared with parents of typical children (odds ratio [OR]: 1.51 [95% confidence interval, CI: 1.08, 2.12]) and had the lowest likelihood among all subgroups of parents to children with developmental disabilities or special health care needs. Parents of children with Down syndrome also had a significantly greater likelihood of being physically inactive compared with parents of children with other special health care needs (OR: 1.56 [95% CI: 1.11, 2.19]), with developmental disabilities without high functional impact (OR: 1.58 [95% CI: 1.12, 2.24]) and with developmental disabilities with high functional impact (OR: 1.46 [95% CI: 1.03, 2.08]). CONCLUSION: Parents of children with Down syndrome are more likely to be physically inactive compared with parents of typically developing children and parents of children with other developmental disabilities or special health care needs. These findings suggest that parents of children with Down syndrome are a population in urgent need for interventions/programmes that promote physical activity, particularly as child well-being is linked to caregiver health.


Assuntos
Deficiências do Desenvolvimento/enfermagem , Crianças com Deficiência , Síndrome de Down/enfermagem , Exercício Físico , Pais , Comportamento Sedentário , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
7.
J Intellect Disabil Res ; 64(2): 180-184, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31788881

RESUMO

BACKGROUND: Adults with intellectual disabilities (IDs) have higher rates of morbidity and mortality compared with the general population, necessitating a need to identify modifiable targets for intervention to mitigate risk. While the benefits of leisure-time physical activity (PA) are well established in the general population; there is a dearth of evidence confirming its health benefits among adults with IDs. The purpose of this study was to examine the association between leisure-time PA and all-cause mortality among a population-based sample of adults with IDs. METHODS: A total of 413 adults with IDs from 17 waves (1997-2014) of the National Health Interview Survey, a U.S. nationally representative survey, were studied. Minutes per week of leisure-time PA was ascertained by self-report and classified as poor, intermediate or ideal levels of PA. RESULTS: Over a median follow-up of 7.2 years, 60 participants died. In a multivariable-adjusted model, higher levels of leisure-time PA were dose-dependently associated with a lower risk of all-cause mortality (P-trend = 0.008). The multivariable-adjusted hazard ratios (95% confidence interval) for all-cause mortality comparing participants with intermediate and ideal versus poor levels of PA were 0.43 (0.18, 1.04) and 0.30 (0.10, 0.87), respectively. CONCLUSION: These findings show that leisure-time PA confers mortality benefit in adults with IDs and should be considered as a priority target for promoting health and longevity in this population.


Assuntos
Causas de Morte , Exercício Físico , Deficiência Intelectual/epidemiologia , Atividades de Lazer , Pessoas com Deficiência Mental/estatística & dados numéricos , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia
8.
Rev. peru. ginecol. obstet. (En línea) ; 64(3): 331-336, jul.-set. 2018. ilus, tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1014471

RESUMO

Background: Nuchal cystic hygroma is the most frequently identified marker of chromosomal anomalies during first trimester screening. Objective: To determine the association of the nuchal cystic hygroma with chromosomal anomalies diagnosed with karyotyping done between the first and second trimesters of pregnancy. Design: Retrospective study. Setting: Instituto Latinoamericano de Salud Reproductiva (ILSAR), Lima, Peru. Patients. Fetuses with nuchal cystic hygroma. Methods: The data were obtained from the ILSAR database between August 2007 and May 2018, the cases diagnosed by ultrasound from week 11 to 13.6. Nuchal cystic hygroma was defined as the presence of septated liquid content in the nuchal axial section with a thickness above the 95th percentile value for increased nuchal translucency value for the crown-rump length. The karyotype was obtained between the first and second trimesters from material collected by chorionic villus sampling (BVS) or amniocentesis (AMC). Main outcome measures: Karyotyping results were compared between cases with cystic hygroma alone and cases with cystic hygroma in addition to another marker. Results: Out of 459 invasive procedures performed in fetuses with high risk for chromosomal anomalies based on the Fetal test database of Spain, there were 162 cases of chromosomal anomalies (35.3%), and 104 cases of nuchal cystic hygroma (22.7%). Nuchal cystic hygroma was associated with a higher frequency of chromosomal abnormalities, compared to fetuses without cystic hygroma (52.9% vs. 30.1%; p<0.001). Out of 61 cases of hygroma alone, 42.3% had chromosomal anomalies, and when the hygroma was associated with other markers (fetal hydrops, abnormal ductus venosus, heart disease), 65.1% had chromosomal abnormalities. There was a statistically significant difference (p=0.003) for the presence of monosomy X between the group with cystic hygroma alone and the group with hygroma and fetal hydrops. There was no difference in hygroma thickness between the groups with and without chromosomal abnormalities. Conclusions: Nuchal cystic hygroma is a risk marker with high predictive value for chromosomal abnormalities, and its identification during prenatal screening may be considered an indication to a diagnostic test. When cystic hygroma is associated to flow abnormalities of the ductus venosus or fetal hydrops, chromosomal abnormalities significantly increase. The hygroma associated with hydrops was primarily linked to monosomy X, while the hygroma associated with abnormal flow velocity waveforms of the ductus venosus was linked to trisomy 21.


Antecedentes. El higroma quístico retronucal es el marcador de anomalías cromosómicas identificado con mayor frecuencia en el tamizaje del primer trimestre. Objetivo. Evaluar la asociación del higroma quístico retronucal y anomalías cromosómicas diagnosticadas con el cariotipo, entre el primer y segundo trimestre del embarazo. Diseño. Estudio retrospectivo. Institución. Instituto Latinoamericano de Salud Reproductiva (ILSAR), Lima, Perú. Pacientes. Fetos con higroma quístico retronucal. Método. Estudio de fetos con higroma quístico retronucal, obtenidos de la base de datos de ILSAR, entre agosto del 2007 y mayo del 2018, diagnosticados por ecografía entre las 11 y 13,6 semanas. El higroma quístico retronucal se definió como la presencia de contenido líquido tabicado en el corte axial retronucal con un grosor mayor al percentil 95 del valor de translucencia nucal aumentada para la longitud corona-nalga. Se obtuvo el cariotipo entre el primer y segundo trimestre en material obtenido por biopsia de vellosidades coriales (BVC) o amniocentesis (AMC). Principales medidas de resultados. Los resultados del cariotipo fueron comparados entre los casos de higroma quístico solo y los casos que tuvieron higroma y adicionalmente otro marcador. Resultados. De un total de 459 procedimientos invasivos realizados en fetos con alto riesgo para anomalías cromosómicas en base al Fetal test de España, hubieron 162 casos de anomalías cromosómicas (35,3%) y se identificó 104 casos de higroma quístico retronucal (22s7%). El hallazgo de higroma quístico retronucal se asoció con mayor presencia de anomalías cromosómicas, comparado con los fetos sin higroma quístico (52,9% vs. 30,1%; p<0,001). De 61 casos de higroma solo, 42,3% tenían anomalía cromosómica, y cuando el higroma estaba asociado a otros marcadores (hidrops fetal, ductus venoso anormal, cardiopatía, ausencia de hueso nasal), hubo 65,1% de anomalías cromosómicas. Hubo diferencia estadística significativa (p=0,003) para la presencia de monosomía X, entre el grupo con higroma solo y el de higroma + hidrops fetal. No hubo diferencia en el grosor del higroma entre el grupo con y sin anomalía cromosómica. Conclusiones. El higroma quístico retronucal es un marcador de riesgo con alto valor predictivo para anomalías cromosómicas. Su identificación en el tamizaje prenatal podría ser indicación para recomendar una prueba diagnóstica. Cuando se asocia a anormalidad del flujo del ductus venoso o hidrops fetal, aumentan significativamente las anomalías cromosómicas. El higroma asociado con hidrops se vinculó mayoritariamente a la monosomía X, mientras que el higroma asociado con onda de velocidad de flujo-OVF de ductus venoso anormal a la trisomía 21.

9.
IBM J Res Dev ; 62(1)2018.
Artigo em Inglês | MEDLINE | ID: mdl-29875505

RESUMO

An increasing number of people use mobile devices to monitor their behavior, such as exercise, and record their health status, such as psychological stress. However, these devices rarely provide ongoing support to help users understand how their behavior contributes to changes in their health status. To address this challenge, we aim to develop an interpretable policy for physical activity recommendations that reduce a user's perceived psychological stress, over a given time horizon. We formulate this problem as a sequential decision-making problem and solve it using a new method that we refer to as threshold Q-learning (TQL). The advantage of the TQL method over traditional Q-learning is that it is "doubly robust" and interpretable. This interpretability is achieved by making model assumptions and incorporating threshold selection into the learning process. Our simulation results indicate that the TQL method performs better than the Q-learning method given model misspecification. Our analyses are performed on data collected from 79 healthy adults over a 7 week period, where the data comprise physical activity patterns collected from mobile devices and self-assessed stress levels of the users. This work serves as a first step toward a computational health coaching solution for mobile device users.

10.
Fisioterapia (Madr., Ed. impr.) ; 38(2): 78-84, mar.-abr. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-151720

RESUMO

Antecedentes: Las características del hogar, escuela y comunidad tienen impacto en el uso de dispositivos y en los métodos de movilidad en niños con parálisis cerebral. Objetivo: Describir el número de dispositivos que poseían los pacientes, su utilización, su método de movilidad preferido en distintos ambientes y si requerían o no de la asistencia de un adulto. Método: Estudio descriptivo, prospectivo y analítico. Se incluyeron pacientes con parálisis cerebral de los niveles iii a v del Sistema de Clasificación de la Función Motora Gruesa (SCFMG). La información sobre el tipo de movilidad y dispositivo utilizado fue obtenida mediante cuestionario. Resultados: Se obtuvo una muestra de 103 pacientes con un rango de 2 a 19 años (9,9 ± 3,9); 45,6% del sexo femenino y 54,4% del masculino. En el SCFMG, 23,3% nivel iii, 26,2% nivel iv y 50,5% nivel v. El 34% cuentan con más de un dispositivo; el 83,5% cuentan con silla de ruedas; el 30,1%, con andadera; el 15,5%, con carriola, y el 2,9%, con otros dispositivos. La mayoría de los pacientes utilizan sus dispositivos de movilidad, y dicho uso se modifica acorde al ambiente. Existen diferencias significativas entre los tipos de movilidad de los pacientes en el hogar respecto a la escuela y la comunidad, ya que los niños son más independientes en el hogar comparado con los otros ambientes. Conclusiones: La prescripción adecuada de los dispositivos para la movilidad debe considerar el ambiente, el contexto cultural, las preferencias de movilidad del paciente y su familia, así como la facilidad de adquisición


Background: Home, school and community characteristics have a great impact on the method and mobility devices used by children with cerebral palsy. Objective: The aim of this study was to describe the number of mobility devices owned by the patients, if the patient use them or not, their preferred mobility method in different environments and their dependence or not on adult help. Method: This is a descriptive, prospective and analytic study. Patients diagnosed with levels iii to v of cerebral palsy on the Gross Motor Function Classification System (GMFCS) who used a mobility device were included. Data related to the type of mobility and devices used were obtained from a questionnaire. Results: A study sample of 103 patients was obtained, patient age ranging from 2 to 19 years of age (9.9 ± 3.9). A total of 45.6% were female and 54.4% male. According to the GMFCS, 23.3% of patients were in level iii, 26.2% in level iv, and 50.5% in level v. Of these, 34% owned more than one mobility device, 83.5% had wheelchairs, 30.1% walkers, 15% strollers, and 2.9% reported other devices. Most patients use their mobility devices, this use changing in regards to each environmental setting. There was a significant difference regarding mobility types in the home in regards to the school and community since the children were more independent at home compared to other settings. Conclusions: Environmental setting, cultural context, mobility method preferences of patient and family and easy of availability must be considered when making an adequate prescription of any mobility device in patients with cerebral palsy


Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Paralisia Cerebral/reabilitação , Modalidades de Fisioterapia , Crianças com Deficiência , Limitação da Mobilidade , Tecnologia Assistiva , Estudos Prospectivos , Meio Ambiente
11.
Ann Dermatol Venereol ; 143(2): 103-7, 2016 Feb.
Artigo em Francês | MEDLINE | ID: mdl-26795136

RESUMO

BACKGROUND: In Africa, studies primarily devoted to chronic leg ulcer due to sickle cell disease are rare. The objectives of the study were to determine the epidemiology, diagnosis and progression of chronic leg ulcers in sickle cell disease. PATIENTS AND METHODS: A 5-year multicentre, retrospective study was conducted in three university hospitals in Dakar. We included all patients with chronic leg ulcers occurring in a setting of sickle cell disease. RESULTS: We identified 40 cases of chronic leg ulcers associated with sickle cell disease, representing 3.4% of the current population of sickle cell patients in our institutions. The average patient age was 25.9 years and the sex ratio was 2.33. Chronic leg ulcer was the presenting feature enabling diagnosis of sickle cell disease in one third of the cases. The average time to consultation from onset was 5.4 years. Pain was reported in 22 cases (48%). Ulcers were isolated in 76% and multiple in 24% of cases. The most common site was the medial malleolus (39%). A CBC allowed identification of anaemia in 35 cases. Haemoglobin electrophoresis was performed and homozygous sickle cell SS disease was identified in 39 cases and heterozygous SC disease in 1 case. Local treatments included physiologic serum, topical antibiotics and skin grafting. Systemic treatment included supplementation with folic acid in all patients, blood transfusion in 16 cases, vasodilators in 11 cases and antibiotics in 25 cases. The outcome was favourable in 61.8% of cases. DISCUSSION: In Dakar, sickle cell disease is a common cause of chronic leg ulcer and is frequently revealed by chronic leg ulcer.


Assuntos
Anemia Falciforme/complicações , Úlcera da Perna/etiologia , Adolescente , Adulto , Anemia Falciforme/diagnóstico , Anemia Falciforme/epidemiologia , Criança , Feminino , Humanos , Úlcera da Perna/epidemiologia , Úlcera da Perna/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Senegal/epidemiologia , Adulto Jovem
12.
J Dent Res ; 95(4): 372-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26701350

RESUMO

At the present time, peri-implantitis has become a global burden that occurs with a frequency from 1% to 47% at implant level. Therefore, we aimed herein at assessing the impact of peri-implant maintenance therapy (PIMT) on the prevention of peri-implant diseases. Electronic and manual literature searches were conducted by 3 independent reviewers using several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, for articles up to June 2015 without language restriction. Articles were included if they were clinical trials aimed at demonstrating the incidence of peri-implant diseases under a strict regime or not of PIMT. Implant survival and failure rate were studied as secondary outcomes. A meta-analysis was conducted to evaluate the influence of PIMT and other reported variables upon peri-implant diseases. Thirteen and 10 clinical trials were included in the qualitative and quantitative analysis, respectively. Mucositis was affected by history of periodontitis and mean PIMT at implant and patient levels, respectively. Similarly, significant effects of history of periodontal disease were obtained for peri-implantitis for both implant and patient levels. Furthermore, mean PIMT interval was demonstrated to influence the incidence of peri-implantitis at implant but not patient level. PIMT interval showed significance at both levels. For implant survival, implants under PIMT have 0.958 the incident event than those with no PIMT. Within the limitations of the present systematic review, it can be concluded that implant therapy must not be limited to the placement and restoration of dental implants but to the implementation of PIMT to potentially prevent biologic complications and hence to heighten the long-term success rate. Although it must be tailored to a patient's risk profiling, our findings suggest reason to claim a minimum recall PIMT interval of 5 to 6 mo. Additionally, it must be stressed that even in the establishment of PIMT, biologic complications might occur. Thus, patient-, clinical-, and implant-related factors must be thoroughly explored.


Assuntos
Implantes Dentários/efeitos adversos , Mucosite/prevenção & controle , Peri-Implantite/prevenção & controle , Falha de Restauração Dentária , Humanos , Incidência , Mucosite/epidemiologia , Peri-Implantite/epidemiologia , Doenças Periodontais/complicações , Fatores de Risco
13.
J Hum Hypertens ; 28(9): 521-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24573133

RESUMO

'Masked hypertension' is defined as having non-elevated clinic blood pressure (BP) with elevated out-of-clinic average BP, typically determined by ambulatory BP monitoring. Approximately 15-30% of adults with non-elevated clinic BP have masked hypertension. Masked hypertension is associated with increased risks of cardiovascular morbidity and mortality compared with sustained normotension (non-elevated clinic and ambulatory BP), which is similar to or approaching the risk associated with sustained hypertension (elevated clinic and ambulatory BP). The confluence of increased cardiovascular risk and a failure to be diagnosed by the conventional approach of clinic BP measurement makes masked hypertension a significant public health concern. However, many important questions remain. First, the definition of masked hypertension varies across studies. Further, the best approach in the clinical setting to exclude masked hypertension also remains unknown. It is unclear whether home BP monitoring is an adequate substitute for ambulatory BP monitoring in identifying masked hypertension. Few studies have examined the mechanistic pathways that may explain masked hypertension. Finally, scarce data are available on the best approach to treating individuals with masked hypertension. Herein, we review the current literature on masked hypertension including definition, prevalence, clinical implications, special patient populations, correlates, issues related to diagnosis, treatment and areas for future research.


Assuntos
Anti-Hipertensivos/uso terapêutico , Determinação da Pressão Arterial , Pressão Sanguínea/efeitos dos fármacos , Hipertensão Mascarada , Determinação da Pressão Arterial/métodos , Humanos , Hipertensão Mascarada/diagnóstico , Hipertensão Mascarada/epidemiologia , Hipertensão Mascarada/fisiopatologia , Hipertensão Mascarada/terapia , Valor Preditivo dos Testes , Prevalência , Fatores de Risco , Resultado do Tratamento
14.
J Hum Hypertens ; 27(11): 671-7, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23615389

RESUMO

The purpose of this study was to investigate the association of visit-to-visit and 24-h blood pressure (BP) variability with markers of endothelial injury and vascular function. We recruited 72 African Americans who were non-diabetic, non-smoking and free of cardiovascular (CV) and renal disease. Office BP was measured at three visits and 24-h ambulatory BP monitoring was conducted to measure visit-to-visit and 24-h BP variability, respectively. The 5-min time-course of brachial artery flow-mediated dilation and nitroglycerin-mediated dilation were assessed as measures of endothelial and smooth muscle function. Fasted blood samples were analyzed for circulating endothelial microparticles (EMPs). Significantly lower CD31+CD42- EMPs were found in participants with high visit-to-visit systolic blood pressure (SBP) variability or high 24-h diastolic blood pressure (DBP) variability. Participants with high visit-to-visit DBP variability had significantly lower flow-mediated dilation and higher nitroglycerin-mediated dilation at multiple time-points. When analyzed as continuous variables, 24-h mean arterial pressure variability was inversely associated with CD62+ EMPs; visit-to-visit DBP variability was inversely associated with flow-mediated dilation normalized by smooth muscle function and was positively associated with nitroglycerin-mediated dilation; and 24-h DBP variability was positively associated with nitroglycerin-mediated dilation. All associations were independent of age, gender, body mass index and mean BP. In conclusion, in this cohort of African Americans visit-to-visit and 24-h BP variability were associated with measures of endothelial injury, endothelial function and smooth muscle function. These results suggest that BP variability may influence the pathogenesis of CV disease, in part, through influences on vascular health.


Assuntos
Negro ou Afro-Americano , Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Endotélio Vascular/fisiopatologia , Hipertensão/diagnóstico , Músculo Liso Vascular/fisiopatologia , Biomarcadores/sangue , Artéria Braquial/fisiopatologia , Micropartículas Derivadas de Células/metabolismo , Selectina E/sangue , Endotélio Vascular/metabolismo , Feminino , Humanos , Hipertensão/sangue , Hipertensão/etnologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Músculo Liso Vascular/metabolismo , Nitroglicerina , Philadelphia/epidemiologia , Molécula-1 de Adesão Celular Endotelial a Plaquetas/sangue , Complexo Glicoproteico GPIb-IX de Plaquetas/metabolismo , Valor Preditivo dos Testes , Fatores de Tempo , Vasodilatação , Vasodilatadores
15.
J Environ Manage ; 104: 62-6, 2012 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-22484706

RESUMO

A new mathematic model to estimate bed porosity as a function of Reynolds and Archimedes numbers was developed based in experimental data. Experiments were performed using an inverse fluidized bed bioreactor filled with polypropylene particles, Lactobacillus acidophillus as the immobilized strain and fluidized with a Man-Rogosa-Sharpe culture medium under controlled temperature and pH conditions. Bed porosity was measured at different flow rates, starting from 0.95 to 9.5 LPM. The new model has several advantages when compared with previously reported. Among them, advantages such as standard deviation values ≤ 1% between experimental and calculated bed porosity, its applicability in traditional and inverse fluidization, wall effects do not take account, it gives excellent agreement with spherical particles with or without biofilm, and inertial drag coefficient allow extend the new model a non-spherical particles.


Assuntos
Biofilmes/crescimento & desenvolvimento , Reatores Biológicos/microbiologia , Modelos Teóricos , Lactobacillus acidophilus , Porosidade
16.
Int J Exerc Sci ; 4(4): 247-256, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-24340124

RESUMO

PURPOSE: The purpose of this study was to investigate the oxidative stress response to a short duration bout of submaximal exercise in a cohort of healthy young adults. METHODS: 15 apparently healthy college age males and females completed a modified Bruce-protocol treadmill test to 75-80% of their heart rate reserve. Blood samples collected immediately before (pre-exercise), immediately after, 30, 60 and 120 minutes post-exercise were assayed for total antioxidant capacity (TAC), superoxide disumutase (SOD), thiobarbituric acid-reactive substances (TBARS), and protein carbonyls (PC). RESULTS: SOD activity was significantly increased from pre-exercise levels at 30 minutes (77%), 60 minutes (33%), and 120 minutes (37%) post-exercise. TAC levels were also significantly increased from pre-exercise levels at 60 minutes (30%) and 120 minutes (33%) post-exercise. There were no significant changes in biomarkers for reactive oxygen/nitrogen species (RONS) mediated damage (TBARS and PC) across all post-exercise time points. CONCLUSIONS: In a cohort of healthy young adults, a short duration bout of submaximal aerobic exercise elicited increases in antioxidant activity/concentration, but did not evoke changes in oxidative stress-induced damage. These results may suggest that: (1) short duration bouts of submaximal aerobic exercise are sufficient to induce RONS generation; and (2) the antioxidant defense system is capable of protecting against enhanced RONS production induced by a short duration, submaximal exercise bout in healthy young adults.

17.
Appl Radiat Isot ; 59(4): 263-6, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14522234

RESUMO

A neutron irradiator has been assembled at IPEN facilities to perform qualitative-quantitative analysis of many materials using thermal and fast neutrons outside the nuclear reactor premises. To establish the prototype specifications, the neutron flux distribution and the absorbed dose rates were calculated using the MCNP computer code. These theoretical predictions then allow one to discuss the optimum irradiator design and its performance.


Assuntos
Amerício , Berílio , Terapia por Captura de Nêutron de Boro/métodos , Nêutrons , Radiometria/instrumentação , Radiometria/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Simulação por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , Marcação por Isótopo/instrumentação , Marcação por Isótopo/métodos , Modelos Químicos , Doses de Radiação , Compostos Radiofarmacêuticos/análise , Compostos Radiofarmacêuticos/síntese química , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
18.
Rev. argent. transfus ; 28(3/4): 133-142, jul.-dic. 2002. tab
Artigo em Espanhol | LILACS | ID: lil-361176

RESUMO

El uso extensivo en la práctica clínica del factor de transferencia (FT) se ha visto limitado por aspectos relacionados con su caracterización bioquímica y la garantía de seguridad, pues este producto debre cumplir con las regulaciones que aseguran la inocuidad de los productos hemoderivados. El hecho de que su proceso de obtención dependa del procesamiento de donaciones de sangre con menos de 24 horas de almacenamiento limita su disponibilidad. Con el objetivo de incrementar la cantidad de unidades de FT disponibles para el tratamiento clínico, se realizó la caracterización de varios lotes de FT obtenidos de donaciones de hasta 48 horas; el producto fue pasteurizado, como garantía de la inactivación de posibles contaminantes virales. La evaluación de sus propiedades bioquímicas y de sus efectos biológicos permitió demostrar la identidad y potencia de este producto. Se demostró además su inocuidad mediante ensayos preclínicos de tolerancia local y toxicidad.


Assuntos
Humanos , Doadores de Sangue , Vírus Sendai , Fator de Transferência , Remoção de Componentes Sanguíneos , Transfusão de Componentes Sanguíneos , Leucaférese/métodos
19.
Rev. argent. transfus ; 28(3/4): 133-142, jul.-dic. 2002. tab
Artigo em Espanhol | BINACIS | ID: bin-4737

RESUMO

El uso extensivo en la práctica clínica del factor de transferencia (FT) se ha visto limitado por aspectos relacionados con su caracterización bioquímica y la garantía de seguridad, pues este producto debre cumplir con las regulaciones que aseguran la inocuidad de los productos hemoderivados. El hecho de que su proceso de obtención dependa del procesamiento de donaciones de sangre con menos de 24 horas de almacenamiento limita su disponibilidad. Con el objetivo de incrementar la cantidad de unidades de FT disponibles para el tratamiento clínico, se realizó la caracterización de varios lotes de FT obtenidos de donaciones de hasta 48 horas; el producto fue pasteurizado, como garantía de la inactivación de posibles contaminantes virales. La evaluación de sus propiedades bioquímicas y de sus efectos biológicos permitió demostrar la identidad y potencia de este producto. Se demostró además su inocuidad mediante ensayos preclínicos de tolerancia local y toxicidad. (AU)


Assuntos
Humanos , Fator de Transferência/uso terapêutico , Doadores de Sangue , Vírus Sendai , Leucaférese/métodos , Remoção de Componentes Sanguíneos , Transfusão de Componentes Sanguíneos
20.
J Pept Res ; 59(6): 264-76, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12010517

RESUMO

The human monoclonal antibody, mAb 2F5, has broad HIV-1 neutralizing activity and binds a conserved linear epitope within the envelope glycoprotein gp41 having a core recognition sequence ELDKWA. In this study, the structural requirements of this epitope for high-affinity binding to mAb 2F5 were explored using peptide synthesis and competitive enzyme-linked immunosorbant assay (ELISA). Expansion of the minimal epitope to an end-capped, linear nonapeptide, Ac-LELDKWASL-amide, was sufficient to attain maximal affinity within the set of native gp41-sequence peptides assayed. Scanning single-residue alanine and d-residue substitutions then confirmed the essential recognition requirements of 2F5 for the central DKW sequence, and also established the importance of the terminal leucine residues in determining high-affinity binding of the linear nonapeptide. Further studies of side-chain and backbone-modified analogs revealed a high degree of structural specificity for the DK sequence in particular, and delineated the steric requirements of the Leu(3) and Trp(6) residues. The nine-residue 2F5 epitope, flanked by pairs of serine residues, retained a high affinity for 2F5 when it was conformationally constrained as a 15-residue, disulfide-bridged loop. However, analogs with smaller or larger loop sizes resulted in lower 2F5 affinities. The conformational effects of the gp41 C-peptide helix immediately adjacent to the N-terminal end of the ELDKWA epitope were examined through the synthesis of helix-initiated analogs. Circular dichroism (CD) studies indicated that the alpha-helical conformation was propagated efficiently into the LELDKWASL epitope, but without any significant effect on its affinity for 2F5. This study should guide the design of a second generation of conformationally constrained ELDKWA analogs that might elicit an immune response that mimics the HIV-neutralizing actions of 2F5.


Assuntos
Anticorpos Monoclonais/imunologia , Afinidade de Anticorpos , Epitopos/química , Epitopos/imunologia , Proteína gp41 do Envelope de HIV/química , Proteína gp41 do Envelope de HIV/imunologia , HIV-1/imunologia , Sequência de Aminoácidos , Substituição de Aminoácidos , Ensaio de Imunoadsorção Enzimática , Proteína gp41 do Envelope de HIV/genética , Humanos , Dados de Sequência Molecular , Conformação Proteica , Análise de Sequência , Relação Estrutura-Atividade
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