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1.
Sci Rep ; 14(1): 6374, 2024 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-38493259

RESUMO

We evaluated the association of cardiovascular autonomic neuropathy (CAN), blood pressure (BP) and Vitamin D (VD) levels before and after high-dose cholecalciferol supplementation (4000/10,000) UI/day) for 12 weeks in patients (N = 67) with type 1 diabetes mellitus (T1DM). Based on this prospective controlled pilot study, patients were divided into group 1 (N = 23 with CAN) and group 2 (N = 44 without CAN). At baseline, group 1 had higher systolic BP (SBP) during sleep (115 ± 14 vs. 107 ± 12 mmHg, p = 0.04) and lower nocturnal dipping (3 ± 5 vs. 8 ± 6%, p = 0.009). Among those with loss of nocturnal dipping, 45.4% (20/44) had CAN, while in normal nocturnal dipping group it occurred only in 13% (3/23) (p = 0.007). Non-dipper group had worse CAN parameters when compared to dipper group [Very low frequency (VLF) (2.5 ± 0.5vs.2.8 ± 0.4 s, p = 0.01), total power (TP) (2.9 ± 0.6 vs. 3.3 ± 0.4 s, p = 0.01), Valsalva coefficient (1.5 ± 0.4 vs. 1.8 ± 0.6, p = 0.06)]. After VD, only group 1 improved CAN parameters [TP (2.5 ± 0.4 vs. 2.8 ± 0.6, p = 0.01) and VLF (2.2 ± 0.4 vs. 2.4 ± 0.5, p = 0.03). Group 1 presented a reduction in morning SBP (120 ± 20 vs. 114 ± 17 mmHg, p = 0.038) and in morning SBP surge (13 ± 13 vs. 5 ± 14, p = 0.04). High-dose VD was associated with improved CAN parameters and reduced awake SBP and morning SBP surge. These findings suggest that VD may benefit patients with cardiovascular autonomic neuropathy. ISRCTN32601947, registration date: 31/07/2017.


Assuntos
Diabetes Mellitus Tipo 1 , Hipertensão , Hipotensão , Humanos , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Colecalciferol/uso terapêutico , Ritmo Circadiano/fisiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/tratamento farmacológico , Suplementos Nutricionais , Estudos Prospectivos
2.
Nanomaterials (Basel) ; 13(20)2023 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-37887889

RESUMO

Nanofluids based on vegetal oil with different wt.% of carbon nanotubes (CNT), hexagonal boron nitride (h-BN), and its hybrid (h-BN@CNT) were produced to investigate the effects of these nano-additives on the thermal conductivity and rheological properties of nanofluids. Stable suspensions of these oil/nanostructures were produced without the use of stabilizing agents. The dispersed nanostructures were investigated by SEM, EDS, XRD, and XPS, while the thermal conductivity and rheological characteristics were studied by a transient hot-wire method and steady-state flow tests, respectively. Increases in thermal conductivity of up to 39% were observed for fluids produced with 0.5 wt.% of the hybrid nanomaterials. As for the rheological properties, it was verified that both the base fluid and the h-BN suspensions exhibited Newtonian behavior, while the presence of CNT modified this tendency. This change in behavior is attributed to the hydrophobic character of both CNT and the base oil, while h-BN nanostructures have lip-lip "bonds", giving it a partial ionic character. However, the combination of these nanostructures was fundamental for the synergistic effect on the increase of thermal conductivity with respect to their counterparts.

3.
Jpn J Infect Dis ; 76(1): 64-68, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36184394

RESUMO

To evaluate the profile of ophthalmological manifestations of patients with chikungunya accompanied by the ophthalmology service at a reference center in the northeast region of Brazil. This retrospective study included the medical records of patients of the Leiria de Andrade Foundation (FLA) who presented ocular manifestations and had a history of prior Chikungunya virus (CHIKV) involvement. The data were collected between August 2018 and March 2019. A total of 230 patients participated in this study, 71.7% were female, and 46.1% were between 61 and 80 years old. Regarding previous pathological history, 71 patients (30%) had comorbidities, and 86 (37%) reported previous ophthalmologic pathology. The most common eye complaint was low visual acuity (LVA). Of the participants, 137 (59.6%) presented ophthalmologic manifestations after CHIKV infection, with cataracts being the most evident. Regarding medication, 85 participants used corticosteroids. The participants were predominantly female, aged between 61 and 80 years, and had previous comorbidities. LVA was the most reported complaint by patients, and cataracts were the main ophthalmological pathology presented.


Assuntos
Catarata , Febre de Chikungunya , Oftalmologia , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Masculino , Febre de Chikungunya/complicações , Febre de Chikungunya/epidemiologia , Brasil/epidemiologia , Estudos Retrospectivos , Catarata/complicações
4.
Front Endocrinol (Lausanne) ; 13: 1033809, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36506063

RESUMO

Background: Considering the potential role of miRNAs as biomarkers and their interaction with both nuclear and mitochondrial genes, we investigated the miRNA expression profile in type 1 diabetes (T1DM) patients, including the pathways in which they are involved considering both nuclear and mitochondrial functions. Methods: We analyzed samples of T1DM patients and control individuals (normal glucose tolerance) by high throughput miRNA sequencing (miRNome). Next, five miRNAs - hsa-miR-26b-5p, hsa-let-7i-5p, hsa-miR-143-3p, hsa-miR-501-3p and hsa-miR-100-5p - were validated by RT-qPCR. The identification of target genes was extracted from miRTarBase and mitoXplorer database. We also performed receiver operating characteristic (ROC) curves and miRNAs that had an AUC > 0.85 were considered potential biomarkers. Results: Overall, 41 miRNAs were differentially expressed in T1DM patients compared to control. Hsa-miR-21-5p had the highest number of predicted target genes and was associated with several pathways, including insulin signaling and apoptosis. 34.1% (14/41) of the differentially expressed miRNAs also targeted mitochondrial genes, and 80.5% (33/41) of them targeted nuclear genes involved in the mitochondrial metabolism. All five validated miRNAs were upregulated in T1DM. Among them, hsa-miR-26b-5p showed AUC>0.85, being suggested as potential biomarker to T1DM. Conclusion: Our results demonstrated 41 DE miRNAs that had a great accuracy in discriminating T1DM and control group. Furthermore, we demonstrate the influence of these miRNAs on numerous metabolic pathways, including mitochondrial metabolism. Hsa-miR-26b-5p and hsa-miR-21-5p were highlighted in our results, possibly acting on nuclear and mitochondrial dysfunction and, subsequently, T1DM dysregulation.


Assuntos
Diabetes Mellitus Tipo 1 , MicroRNAs , Humanos , Diabetes Mellitus Tipo 1/genética , MicroRNAs/genética , MicroRNAs/metabolismo , Sequenciamento de Nucleotídeos em Larga Escala , Mitocôndrias/genética , Mitocôndrias/metabolismo , Biomarcadores
5.
BMC Cardiovasc Disord ; 22(1): 294, 2022 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-35761179

RESUMO

BACKGROUND: Little is known about the evolution of peripheral arterial disease (PAD) since diagnosis and its association with glycemic and lipid control in patients with Type 2 Diabetes Mellitus (T2DM). OBJECTIVE: Evaluate the actual criteria to start screening PAD with ankle-brachial index (ABI) in T2DM patients and assess its progression and relationship with glycemic and lipid control since diagnosis. METHODS: We performed a 3-year prospective cohort study with two groups: group 1 (978 individuals with T2DM undergoing drug treatment) and group 2 [221 newly diagnosed drug-naive (< 3 months) patients with T2DM]. PAD diagnosis was by ABI ≤ 0.90, regardless any symptoms. RESULTS: As expected, abnormal ABI prevalence was higher in group 1 vs. Group 2 (87% vs. 60%, p < 0.001). However, abnormal ABI prevalence did not differ between patients over and under 50 years in both groups. Our drug-naive group stabilizes ABI (0.9 ± 0.1 vs 0.9 ± 0.1, p = NS) and improved glycemic and lipid control during follow-up [glycated hemoglobin (HbA1c) = 8.9 ± 2.1 vs 8.4 ± 2.3%, p < 0.05; LDL = 132 ± 45 vs 113 ± 38 mg/dL, p < 0.01, respectively]. When compared, patients who evolved with normalization or maintained normal ABI levels at the end [Group A, N = 60 (42%)] with those who decreased ABI to abnormal levels (ABI basal 1.0 ± 0.1 vs final 0.85 ± 0.1, p < 0.001) [Group B, N = 26 (18%)], an improvement in HbA1c (9 ± 2 vs 8 ± 2%, p < 0.05) and a correlation between the final HbA1c with ABI (r = - 0.3, p = 0.01) was found only in the first. In addition, a correlation was found between albuminuria variation and ABI solely in group A (r = - 0.3; p < 0.05). CONCLUSION: Our study suggests that ABI should be measured at diagnosis in T2DM patients, indicating that current criteria to select patients to screen PAD with ABI must be simplified. An improvement in albuminuria and glycemic and lipid control could be related with ABI normalization in newly diagnosed T2DM drug-naive patients.


Assuntos
Diabetes Mellitus Tipo 2 , Doença Arterial Periférica , Albuminúria , Índice Tornozelo-Braço , Glicemia , Estudos de Coortes , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobinas Glicadas , Humanos , Lipídeos , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/epidemiologia , Estudos Prospectivos , Fatores de Risco
6.
Diabetol Metab Syndr ; 14(1): 46, 2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-35346321

RESUMO

BACKGROUND: Type 1 Diabetes Mellitus (T1DM) impacts health-related quality of life (HRQoL). Cross-sectional studies suggest that low levels of vitamin D (VD) may impair HRQoL, however, the effect of VD supplementation on quality of life in T1DM patients has not yet been clarified. Our study evaluated the effects of high-dose VD supplementation on HRQoL in T1DM. METHODS: We performed a prospective study with 64 patients receiving cholecalciferol (4000 IU/day for patients with 25-OH-vitamin D [25(OH)D] between 30 and 60 ng/mL, and 10,000 IU/day for those with 25(OH)D below 30 ng/mL) for 12 weeks, as part of a research protocol. HRQoL was assessed with EuroQol instruments (EQ-5D and EQ-VAS). RESULTS: There was an improvement in global EQ-5D index, and analysing specifically the EQ-5D domains, we observed an improvement in mobility (1.3 ± 0.6 versus 1.1 ± 0.3, p < 0.01). Evaluating possible outcome influencing variables, we detected a reduction in albuminuria at the end of the trial, without changes in BMI, lipids, blood pressure, glycemic control and insulin doses. We found correlations between final albuminuria and the dimensions: mobility (r = 0.6; p < 0.01), personal care (r = 0.7; p < 0.01), pain and discomfort (r = 0.6; p < 0.01) and habitual activities (r = 0.6; p < 0.01), suggesting an association between albuminuria reduction and the impact of VD supplementation on HRQoL. CONCLUSION: Our data showed that high doses of cholecalciferol supplementation can improve HRQoL in patients with T1DM, and the reduction of albuminuria seems to be an important factor in this context. TRIAL REGISTRATION: (ISRCTN32601947), 03/06/2017 retrospectively registered.

7.
Curr Diabetes Rev ; 18(1): e010521189964, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33413064

RESUMO

BACKGROUND: Some authors evaluated the effect of VD on hyperglycemia in T1DM, but the results remain controversial. This study aims to analyze the effects of high-dose VD supplementation on T1DM patients' glycemic levels, maintaining stable doses of insulin. METHODS: Prospective, 12-week clinical trial including 67 T1DM patients, supplemented with high doses of cholecalciferol according to participants' VD value. Patients with VD levels below 30 ng/mL received 10,000 IU/day; those with levels between 30-60 ng/mL received 4,000 IU/day. Patients who had not achieved 25(OH)D levels > 30 ng/ml or presented insulin dose variation during the study were not analyzed. RESULTS: Only 46 out of 67 patients accomplished the criteria at the end of the study. There was no general improvement in the glycemic control evaluated by HbA1c (9.4 ± 2.4 vs 9.4 ± 2.6, p=NS) after VD supplementation. However, a post-hoc analysis, based on HbA1c variation, identified patients who had HbA1c reduced at least 0.6% (group 1, N = 13 (28%)). In addition, a correlation between 25(OH)D levels with HbA1c and total insulin dose at the end of the study was observed (r = -0.3, p<0.05; r=-0.4, p<0.05, respectively), and a regression model demonstrated that 25(OH)D was independent of BMI, duration of T1DM and final total insulin dose, being capable of determining 9.2% of HbA1c final levels (Unstandardized B coefficient = -0.033 (CI 95%: -0.064 to -0.002), r2 = 0.1, p <0.05). CONCLUSION: Our data suggest that VD is not widely recommended for glycemic control. Nevertheless, specific patients might benefit from this approach.


Assuntos
Diabetes Mellitus Tipo 1 , Deficiência de Vitamina D , Diabetes Mellitus Tipo 1/tratamento farmacológico , Suplementos Nutricionais , Controle Glicêmico , Humanos , Estudos Prospectivos , Vitamina D , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/tratamento farmacológico
8.
Front Endocrinol (Lausanne) ; 12: 723502, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34690928

RESUMO

Background: The effect of glycemic control on diabetic kidney disease (DKD) is well known. Recent evidence has suggested that Vitamin D (VD) may have a nephroprotective effect in diabetes, but the relationship between VD, glycemic control, and albuminuria has yet to be clarified. Objective: Evaluate the relationship between 25-hydroxy-vitamin D [25(OH)D], HbA1c, and albuminuria in Diabetes Mellitus (DM). Patients and Methods: Cross-sectional study with 1576 individuals with DM who had 25(OH)D, HbA1c, and albuminuria levels measured. Patients with abnormal creatinine levels were excluded, in order to avoid interference on VD levels by impaired kidney function. Results: Patients with HbA1c ≥7% had lower 25(OH)D when compared to patients with HbA1c <7% (29.7 ± 10.2 vs 28.1 ± 9.9 ng/ml, p = 0.003) and 25(OH)D levels seems to predict 1.5% of HbA1c behavior. The 25(OH)D concentrations in patients with normoalbuminuria were higher than the levels observed in those with micro or macroalbuminuria (29.8 ± 9.0 vs 26.8 ± 8.6 and 25.1 ± 7.6, respectively, p = 0.001), patients who had 25(OH)D <20 ng/ml and 25(OH)D <30 ng/ml were at a higher risk of presenting albuminuria [OR = 2.8 (95% CI = 1.6 - 4.9), p<0.001, and OR = 2.1 (95% CI = 1.3 - 4.6), p<0.001, respectively]. In our regression model, albuminuria was influenced by HbA1c (r² = 0.076, p<0.00001) and 25(OH)D (r² = 0.018, p = 0.002) independently. Conclusion: Our study found an association between vitamin D levels, HbA1c and DKD. Additionally, our data suggest that the association between urinary albumin excretion and vitamin D levels is independent of glycemic control in patients with diabetes. Even though our patients presented normal creatinine levels, it is necessary further prospective studies to confirm if this association precedes or not the loss of renal function.


Assuntos
Albuminúria/sangue , Diabetes Mellitus/sangue , Hemoglobinas Glicadas/metabolismo , Vitamina D/análogos & derivados , Idoso , Albuminúria/epidemiologia , Albuminúria/etiologia , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Nefropatias Diabéticas/sangue , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/etiologia , Feminino , Controle Glicêmico/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia
9.
Front Endocrinol (Lausanne) ; 12: 667029, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34290667

RESUMO

Introduction: While soy is suggested as a possible risk factor, exclusive breastfeeding (EBF) has a likely protective effect in precocious puberty. Our aim was to evaluate the association between both of these variables with central precocious puberty (CPP). Methods: We performed a retrospective, case-control study. A total of 161 girls were divided into two groups: 84 patients diagnosed with CPP composed the case group and 77 patients without the diagnosis of CPP (had gone through normal onset of puberty) were the control group. Results: Our control group had a higher presence of EBF >6 months, which was an important protective factor for CPP (OR: 0.5; IC 95%: 0.3-0.9, p = 0.05) and also correlated negatively with the presence of it (r = -0.2; p < 0.05). Oppositely, the use of soy was significantly higher in the CPP group, (OR: 3.8; IC 95%: 1.5-6, p < 0.05) and positively correlating (r = 0.2; p < 0.01) with the presence of CPP. Duration of soy intake (years) correlated with bone age (r = 0.415; p < 0.05). A logistic regression was performed to evaluate the effects of EBF duration and soy on CPP. The model was significant (x² (2) = 20,715, p = <0.001) and explained 12.2% (Nagelkerke R2) of the variance, correctly classifying 62.5% of cases. EBF was associated with a reduction of likelihood of having CPP [OR = 0,187 (CI = 0.055-0,635); Wald = 7,222, p = 0.007], while soy intake increased the risk [OR = 3.505 (CI) = 1,688-7,279, Wald = 11,319, p = 0.001]. Conclusion: Our data found the use of soy was associated with CPP. Additionally, EBF was pointed as a protective factor. However, future prospective studies are needed to clarify this issue.


Assuntos
Aleitamento Materno/métodos , Fatores de Proteção , Puberdade Precoce/prevenção & controle , Estudos de Casos e Controles , Criança , Feminino , Seguimentos , Humanos , Prognóstico , Puberdade Precoce/induzido quimicamente , Puberdade Precoce/patologia , Estudos Retrospectivos
10.
Curr Diabetes Rev ; 17(3): 378-386, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32729423

RESUMO

BACKGROUND: Vitamin D (VD) deficiency has been related to several endocrine metabolic and cardiovascular diseases. The effect of VD supplementation on blood pressure (BP) in patients with diabetes is controversial. OBJECTIVE: The aim of this study was to evaluate high-dose vitamin D supplementation effects on blood pressure of normotensive patients with diabetes mellitus 1 (DM1) patients by 24-hour ambulatory blood pressure monitoring (ABPM). METHODS: We performed a clinical trial including 35 DM1 normotensive patients, who received doses of 4,000 or 10,000 IU/day of cholecalciferol for 12 weeks according to previous VD levels. They underwent 24-hour ABPM, along with glycated hemoglobin, creatine, lipids profile and PCRus dosage before and after VD supplementation. RESULTS: We found an expressive reduction of systolic and diastolic morning blood pressures (117±14 vs 112±14, p<0,05; 74±9 vs 70±10 mmHg, p<0,05, respectively) with no changes in other pressoric markers. Besides, we noticed a relationship between levels of VD after supplementation and diastolic morning blood pressure (r= -0,4; p<0.05). CONCLUSION: Our study suggests an association between supplementation of high doses of vitamin D and the reduction of morning blood pressure in normotensive DM1 patients.


Assuntos
Colecalciferol , Deficiência de Vitamina D , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Suplementos Nutricionais , Humanos , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/tratamento farmacológico
11.
Front Endocrinol (Lausanne) ; 11: 605681, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33329405

RESUMO

Background: Cardiovascular autonomic neuropathy (CAN) is associated with diabetes mellitus, increasing morbidity and mortality. Some cross-sectional studies associated CAN with low 25-hydroxyvitamin D levels. The aim of our study was to evaluate the effect of high-dose vitamin D (VD) supplementation on CAN in Type 1 Diabetes Mellitus (T1DM) patients. Methods: We performed a prospective study with 23 patients diagnosed with T1DM and CAN. Subjects with VD levels <30 ng/ml received 10,000 IU/day; the ones with VD levels between 30-60 ng/ml were given 4,000 IU/day for 12 weeks. Results: There was an improvement in CAN parameters related to resting heart rate variability, such as time domain parameters [Maximum RR interval (0.77 ± 0.11 vs 0.94 ± 0.51 s, p <0.05), Mean length of regular RR intervals (0.71 ± 0.10 vs 0.76 ± 0.09 s, p <0.05) and Standard deviation of all NN intervals (0.02 ± 0.01 vs 0.03 ± 0.02 s; p <0.01)] and frequency domain parameters [Low Frequency (1.9 ± 0.5 vs 2.5 ± 0.9 s, p < 0.001), Total Power (2.5 ± 0.4 vs 2.8 ± 0.6 s, p <0.05)]. In addition, there was a correlation between absolute VD level variation and posttreatment High Frequency (%), as well as among percent variation in VD level and end-of-study Low Frequency/High Frequency ratio (r=0.6, p<0.01; r= -0.5, p<0.05, respectively). Conclusion: Our pilot study is the first to suggest a strong association between high-dose vitamin D supplementation and improved cardiovascular autonomic neuropathy in T1DM patients. It occurred without any variation in HbA1C, blood pressure levels, lipids, and insulin dose. Clinical Trial Registration: http://www.isrctn.com/ISRCTN32601947, identifier ISRCTN32601947.


Assuntos
Doenças do Sistema Nervoso Autônomo/tratamento farmacológico , Doenças Cardiovasculares/tratamento farmacológico , Diabetes Mellitus Tipo 1/complicações , Neuropatias Diabéticas/tratamento farmacológico , Suplementos Nutricionais , Vitamina D/administração & dosagem , Adolescente , Adulto , Doenças do Sistema Nervoso Autônomo/etiologia , Doenças do Sistema Nervoso Autônomo/patologia , Glicemia/análise , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/patologia , Criança , Neuropatias Diabéticas/etiologia , Neuropatias Diabéticas/patologia , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Vitaminas/administração & dosagem , Adulto Jovem
12.
Endocr Connect ; 9(7): 667-675, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32567548

RESUMO

OBJECTIVE: Investigate the prevalence of vitamin D deficiency in an equatorial population through a large-sample study. METHODS: Cross-sectional study with 30,224 healthy individuals from the North Region, in Brazil (Amazônia - state of Pará), who had 25-hydroxy-vitamin D (25(OH)D) and intact parathyroid hormone (PTH) serum levels measured by immunoassay method. Those with history of acute or chronic diseases were excluded. Abnormal levels of calcium, creatinine, glycemia and albumin were also exclusion criteria. RESULTS: 25(OH)D levels were 29.1 ± 8.2 ng/mL and values <12.7 ng/mL were equal to < -2 s.d. below average. Hypovitaminosis D was present in 10% of subjects according to the Institute of Medicine (values <20 ng/mL) and in 59%, in consonance with Endocrine Society (values 20-30 ng/mL as insufficiency and <20 ng/mL as deficiency) criteria. Individuals were divided according to four age brackets: children, adolescents, adults and elderly, and their 25(OH)D levels were: 33 ± 9; 28.5 ± 7.4; 28.3 ± 7.7; 29.3 ± 8.5 ng/mL, respectively. All groups differed in 25(OH)D, except adolescents vs adults. Regression model showed BMI, sex, living zone (urban or rural) and age as independent variables to 25(OH)D levels. Comparing subjects with vitamin D deficiency (<20 ng/mL) to those with vitamin D insufficiency (20-30 ng/mL), a difference between PTH levels in these two groups was observed (95.9 ± 24.7 pg/mL vs 44.2 ± 64.5 pg/mL; P < 0.01). Additionally, the most accurate predictive vitamin D level for subclinical hyperparathyroidism in ROC curve was 26 ng/mL. CONCLUSION: Our equatorial population showed low prevalence of vitamin D hypovitaminosis ranging with age bracket. The insufficient category by Endocrine Society was corroborated by our PTH data.

13.
Artigo em Inglês | MEDLINE | ID: mdl-31616374

RESUMO

Purpose: Serum IGF-1 (Insulin like growth factor 1) and Growth Hormone (GH) provocative tests are reasonable tools for screening and diagnosis of idiopathic GH Deficiency (IGHD). However, the average cut-off points applied on these tests have a lower level of evidence and produce large amounts of false results. The aim of this study is to evaluate the sensitivity, specificity, and accuracy of IGF-1 and GH stimulation tests as diagnostic tools for IGHD, using clinical response to recombinant human GH (rhGH) treatment as diagnostic standard [increase of at least 0.3 in height standard deviation (H-SD) in 1 year]. Methods: We performed a prospective study with 115 children and adolescents presenting short stature (SS), without secondary SS etiologies such as organic lesions, genetic syndromes, thyroid disorders. They were separated into Group 1 [patients with familial SS or constitutional delay of growth and puberty (CDGP), not treated with rhGH], Group 2 (patients with suspicion of IGHD with clinical response to rhGH treatment), and Group 3 (patients with suspicion of IGHD without growth response to rhGH treatment). Then, they were assessed for diagnostic performance of IGF-1, Insulin Tolerance Test (ITT) and clonidine test (CT) alone and combined at different cut-off points. Results: Based on the ROC curve, the best cut-off points found for IGF-1, ITT, and CT when they were used isolated were -0.492 SDS (sensitivity: 50%; specificity: 53.8%; accuracy: 46.5%), 4.515 µg/L (sensitivity: 75.5%; specificity: 45.5%; accuracy: 52.7%), and 4.095 µg/L (sensitivity: 54.5%; specificity: 52.6%; accuracy: 56.9%), respectively. When we had combined IGF-1 with-2SD as cut-off alongside ITT or CT, we found 7 µg/L as the best cut-off point. In this situation, ITT had sensitivity, specificity and accuracy of 93.9, 81.8, and 90.1%, while CT had 93.2, 68.4, and 85.7%, respectively. Conclusion: Our data suggest that diagnosis of IGHD should be established based on a combination of clinical expertise, auxologic, radiologic, and laboratorial data, using IGF-1 at the -2SD threshold combined, with ITT or CT at the cut-off point of 7 µg/L. Additional studies, similar to ours, are imperative to establish cut-off points based on therapeutic response to rhGH in IGHD, which would be directly related to a better treatment outcome.

14.
Cien Saude Colet ; 23(10): 3337-3346, 2018 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30365853

RESUMO

This paper aims to analyze the narratives about abortion experiences available in an online community to discuss the methods and strategies to which women resort, facing the legal impossibility of voluntarily interrupting a pregnancy and the effects of the criminalization of induced abortion. The methodology used was virtual ethnography, observing the platform Women on Web, collection and analysis of 18 narratives publicly available without restrictions, selected between November 2016 and January 2017. The narratives report mixed methods to perform an abortion, with widespread use of Cytotec. Some cases include hospitals and medical clinics in the paths, whether to conduct examinations or attend to intercurrences. The internet appears as a popular tool to gather information, negotiate and even purchase abortive drugs, as well as a platform to share experiences. We concluded that the narratives point to insecurities, risks, and violence to which women are submitted in clandestine setting; they show the relevance of debate on decriminalizing abortion in Brazil, and also reinforce the existence of a shared abortion culture, as stated in other studies.


O objetivo deste artigo é analisar narrativas sobre as experiências de abortar disponíveis em uma comunidade online, buscando discutir os métodos e estratégias aos quais as mulheres recorrem frente à impossibilidade legal de interrupção voluntária de gravidez e os efeitos da criminalização do aborto induzido. Como método, utilizou-se a etnografia virtual, com observação da plataforma Women on Web, coleta e análise de 18 narrativas, disponíveis publicamente e sem restrições, selecionadas entre novembro de 2016 e janeiro de 2017. As narrativas informam métodos mesclados para a realização de aborto, com prevalência de utilização do medicamento Cytotec. Em alguns casos, hospitais e consultórios médicos são incluídos nos itinerários, seja para realização de exames ou para atendimento de intercorrências. A internet se revela uma ferramenta de informação, negociação e mesmo aquisição de medicamento abortivo bastante comum, além de uma plataforma de troca de experiências. Conclui-se que as narrativas sinalizam as inseguranças, riscos e violências às quais estão submetidas as mulheres no contexto da clandestinidade, indicam a importância do debate sobre a descriminalização do aborto no Brasil, e também reforçam a existência de uma cultura compartilhada do aborto, já apontada em estudos anteriores.


Assuntos
Abortivos não Esteroides/administração & dosagem , Aborto Criminoso/estatística & dados numéricos , Aborto Induzido/estatística & dados numéricos , Misoprostol/administração & dosagem , Aborto Induzido/legislação & jurisprudência , Adolescente , Brasil , Feminino , Humanos , Internet , Narração , Gravidez , Adulto Jovem
15.
Ciênc. Saúde Colet. (Impr.) ; 23(10): 3337-3346, Out. 2018. tab
Artigo em Português | LILACS | ID: biblio-974687

RESUMO

Resumo O objetivo deste artigo é analisar narrativas sobre as experiências de abortar disponíveis em uma comunidade online, buscando discutir os métodos e estratégias aos quais as mulheres recorrem frente à impossibilidade legal de interrupção voluntária de gravidez e os efeitos da criminalização do aborto induzido. Como método, utilizou-se a etnografia virtual, com observação da plataforma Women on Web, coleta e análise de 18 narrativas, disponíveis publicamente e sem restrições, selecionadas entre novembro de 2016 e janeiro de 2017. As narrativas informam métodos mesclados para a realização de aborto, com prevalência de utilização do medicamento Cytotec. Em alguns casos, hospitais e consultórios médicos são incluídos nos itinerários, seja para realização de exames ou para atendimento de intercorrências. A internet se revela uma ferramenta de informação, negociação e mesmo aquisição de medicamento abortivo bastante comum, além de uma plataforma de troca de experiências. Conclui-se que as narrativas sinalizam as inseguranças, riscos e violências às quais estão submetidas as mulheres no contexto da clandestinidade, indicam a importância do debate sobre a descriminalização do aborto no Brasil, e também reforçam a existência de uma cultura compartilhada do aborto, já apontada em estudos anteriores.


Abstract This paper aims to analyze the narratives about abortion experiences available in an online community to discuss the methods and strategies to which women resort, facing the legal impossibility of voluntarily interrupting a pregnancy and the effects of the criminalization of induced abortion. The methodology used was virtual ethnography, observing the platform Women on Web, collection and analysis of 18 narratives publicly available without restrictions, selected between November 2016 and January 2017. The narratives report mixed methods to perform an abortion, with widespread use of Cytotec. Some cases include hospitals and medical clinics in the paths, whether to conduct examinations or attend to intercurrences. The internet appears as a popular tool to gather information, negotiate and even purchase abortive drugs, as well as a platform to share experiences. We concluded that the narratives point to insecurities, risks, and violence to which women are submitted in clandestine setting; they show the relevance of debate on decriminalizing abortion in Brazil, and also reinforce the existence of a shared abortion culture, as stated in other studies.


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto Jovem , Abortivos não Esteroides/administração & dosagem , Aborto Criminoso/estatística & dados numéricos , Misoprostol/administração & dosagem , Aborto Induzido/estatística & dados numéricos , Brasil , Aborto Induzido/legislação & jurisprudência , Internet , Narração
16.
Univ. Ci. Saúde ; 9(1): 77-99, jan.-jun. 2011.
Artigo em Português | MOSAICO - Saúde integrativa | ID: biblio-879332

RESUMO

O câncer, nas suas diversas formas, é uma doença que atinge o mundo todo e, no Brasil, é a segunda maior causa de mortes em adultos. O seu aparecimento e desenvolvimento estão ligados ao estilo de vida das pessoas e aos fatores ambientais a que elas se expõem. Dentre os diversos usos terapêuticos atribuídos às plantas medicinais, a fitoterapia é o tratamento das doenças pelo uso de plantas frescas ou dessecadas e pelos seus extratos naturais. Nos últimos anos, ela vem sendo retomada pela medicina convencional como uma forma mais acessível e alternativa de tratamento, e sua importância vem crescendo consideravelmente, inclusive no combate ao câncer. Porém é grande a preocupação quanto ao uso caseiro das plantas medicinais, pois sua utilização inadequada e sem critério pode trazer graves consequências. Por esse fato, pesquisas nessa área e formas de controle e orientação à população em geral devem ser desenvolvidas. Assim, o objetivo deste trabalho é realizar uma breve revisão quanto à utilização de plantas medicinais no tratamento do câncer.(AU)


Assuntos
Humanos , Neoplasias/terapia , Fitoterapia , Plantas Medicinais , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Fitoterapia/efeitos adversos
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