Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 72
Filtrar
1.
Int Immunopharmacol ; 128: 111523, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38219440

RESUMO

Since the Orthoflavivirus zikaense (ZIKV) has been considered a risk for Zika congenital syndrome development, developing a safe and effective vaccine has become a high priority. Numerous research groups have developed strategies to prevent ZIKV infection and have identified the domain III of the ZIKV envelope protein (zEDIII) as a promising target. Subunit antigens are often poorly immunogenic, necessitating the use of adjuvants and/or delivery systems to induce optimal immune responses. The subject of nanotechnology has substantial expansion in recent years in terms of research and applications. Nanoparticles could be used as drug delivery systems and to increase the immunogenicity and stability of a given antigen. This work aims to characterize and validate the potential of a vaccine formulation composed of domain zEDIII and bovine serum albumin nanoparticles containing polyinosinic-polycytidylic acid (NPPI). NPPI were uptake in vitro by immature bone marrow dendritic cells and histological analysis of the skin of mice treated with NPPI showed an increase in cellularity. Immunization assay showed that mice immunized with zEDIII in the presence of NPPI produced neutralizing antibodies. Through the passive transfer of sera from immunized mice to ZIKV-infected neonatal mice, it was demonstrated that these antibodies provide protection, mitigating weight loss, clinical or neurological signs induced by infection, and significantly increased survival rates. Protection was further substantiated by the reduction in the number of viable infectious ZIKV, as well as a decrease in inflammatory cytokines and tissue alterations in the brains of infected mice. Taken together, data presented in this study shows that NPPI + zEDIII is a promising vaccine candidate for ZIKV.


Assuntos
Vacinas Virais , Infecção por Zika virus , Zika virus , Animais , Camundongos , Anticorpos Neutralizantes , Infecção por Zika virus/prevenção & controle , Poli I-C , Soroalbumina Bovina , Anticorpos Antivirais , Proteínas do Envelope Viral
2.
Int J Paleopathol ; 44: 85-89, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38176088

RESUMO

OBJECTIVE: X-ray fluorescence (XRF) is a non-destructive technique that measures the elemental concentration of different materials, including human bone. Recently, it began to be applied to paleopathological studies due to the development of portable devices and their relative ease of use. However, the lack of uniform procedures hampers comparability and reproducibility. This paper aims to provide guidelines for an efficient and standardized evaluation of bone elemental composition with a portable XRF (pXRF) device. MATERIALS: This technical note is based on the application of the Thermo Scientific Niton XL3t 900 GOLDD+. METHODS: This work includes suggestions for the choice and preparation of human bone samples, both from archaeological context and documented collections, and methodological procedures in pXRF setup, such as choice of calibration, assessment of accuracy, and analysis run time. Additionally, recommendations for data validation and statistical analysis are also included. CONCLUSIONS: This technique has great potential in paleopathology since bone chemical variations may be associated with different pathological conditions, environmental contamination (e.g., lead), and/or administered treatments, such as mercury. Following an expected increase in the number of studies, it is essential to establish good practices that allow results from different researchers to be comparable. SIGNIFICANCE: X-ray fluorescence is a non-destructive technique that measures small concentrations (ppm) of elements from magnesium (12Mg) through bismuth (83Bi). LIMITATIONS: pXRF does not detect elements lighter than Mg, and its lower energy excitation penetrates less than other techniques. SUGGESTIONS FOR FURTHER RESEARCH: Other research groups should test these guidelines and comment on their usefulness and replicability.


Assuntos
Monitoramento Ambiental , Humanos , Raios X , Reprodutibilidade dos Testes , Espectrometria por Raios X/métodos , Monitoramento Ambiental/métodos , Radiografia
3.
Tuberculosis (Edinb) ; 143S: 102394, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38012924

RESUMO

Considering that before antibiotics and vaccination the course of tuberculosis depended mostly on the patient's immune response, this study tested the hypothesis that the mortality profile remained similar during the transition from the 19th to 20th century. The biographical data of the individuals buried in the Coimbra Municipal Cemetery of Conchada were analysed, and the records of those who were born in the city and had tuberculosis registered as the cause of death were analysed using SPSS. The years of death were grouped: 1861-1870 (n = 124, 22.5%), 1871-1880 (n = 234, 42.4%), and 1910-1914 (5 years, n = 194, 35.1%). Mortality by tuberculosis has increased over the years. A total of 552 individuals, 242 females (43.8%) and 310 males (56.2%) died of tuberculosis (p < 0.05). The mean age at death (min = 11 days, max = 86 years) decreased over time, respectively 51.8, 53.1, and 35.8 years-old for individuals >20. Deaths by pulmonary tuberculosis (n = 38, 1861-1870; n = 115, 1910-1914) and meningeal tuberculosis (n = 0, 1861-1870; n = 48, 1910-1914) increased over time, whereas scrofula decreased (n = 23, 1861-1870; n = 3, 1910-1914). Only a 12 years-old male (0.2%) died of bone tuberculosis. Infant (0-3 years-old) mortality occurred mainly (50.5%,48/95) between July and October. The hypothesis tested was not confirmed. Death by tuberculosis has increased, which may be a consequence of population growth, deterioration of the living conditions, and/or changes in bacterial virulence and/or in the host immune system.


Assuntos
Mycobacterium tuberculosis , Tuberculose dos Linfonodos , Tuberculose Osteoarticular , Tuberculose Pulmonar , Lactente , Feminino , Humanos , Masculino , Criança , Recém-Nascido , Pré-Escolar , Portugal/epidemiologia , Tuberculose Pulmonar/epidemiologia
4.
Rev Esp Enferm Dig ; 2023 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-37204089

RESUMO

A 38-year-old female with medical history of breast cancer, hypertension, diabetes mellitus and obesity (body max index 55kg/m2), was admitted to the emergency room with complains of nausea and vomits. Three weeks prior to the presentation, she placed an intragastric balloon (IGB) (Orbera365™, Apollo endosurgery Inc., Austin, TX), for weight loss, filled with 600ml solution of saline and methylene blue dye. Upon physical examination, she was dehydrated and presented with a bulging of the upper abdominal wall associated with mild abdominal pain. Laboratory tests showed severe metabolic alkalosis, hypocalcemia and hypokalemia. Abdominal x-ray revealed gastric distension with an increased size IGB, measuring 164.3*145.6*144.1 mm (estimated volume of 1800mL), with an air-fluid level. Upper endoscopy revealed the balloon stuck in the antrum. A catheter needle was used to puncture and deflate the balloon. Once deflated it was removed with endoscopic forceps. The fluid was not sent for microbiologic culture. After IGB removal, hydroelectrolytic disturbances were resolved and oral feeding was promptly resumed without further complications.

5.
Proc Natl Acad Sci U S A ; 120(4): e2209472120, 2023 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-36649426

RESUMO

Climate change is an indisputable threat to human health, especially for societies already confronted with rising social inequality, political and economic uncertainty, and a cascade of concurrent environmental challenges. Archaeological data about past climate and environment provide an important source of evidence about the potential challenges humans face and the long-term outcomes of alternative short-term adaptive strategies. Evidence from well-dated archaeological human skeletons and mummified remains speaks directly to patterns of human health over time through changing circumstances. Here, we describe variation in human epidemiological patterns in the context of past rapid climate change (RCC) events and other periods of past environmental change. Case studies confirm that human communities responded to environmental changes in diverse ways depending on historical, sociocultural, and biological contingencies. Certain factors, such as social inequality and disproportionate access to resources in large, complex societies may influence the probability of major sociopolitical disruptions and reorganizations-commonly known as "collapse." This survey of Holocene human-environmental relations demonstrates how flexibility, variation, and maintenance of Indigenous knowledge can be mitigating factors in the face of environmental challenges. Although contemporary climate change is more rapid and of greater magnitude than the RCC events and other environmental changes we discuss here, these lessons from the past provide clarity about potential priorities for equitable, sustainable development and the constraints of modernity we must address.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Humanos , Mudança Climática , Desenvolvimento Sustentável , Probabilidade
6.
Rev Esp Enferm Dig ; 115(7): 385-386, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-35704358

RESUMO

A 71-year-old male was admitted on intensive care unit after endovascular aneurysm repair of ruptured infrarenal abdominal aortic aneurysm. 2 weeks later, he had multiple episodes of bloody diarrhea. Colonoscopy revealed diffuse dusky mucosal coloration with loss of vasculature pattern, diseased haustrations, and diffuse areas of pneumatosis, suggestive of severe colonic ischemia.


Assuntos
Aneurisma da Aorta Abdominal , Implante de Prótese Vascular , Colite Isquêmica , Procedimentos Endovasculares , Pneumatose Cistoide Intestinal , Masculino , Humanos , Idoso , Aneurisma da Aorta Abdominal/cirurgia , Colite Isquêmica/diagnóstico por imagem , Colite Isquêmica/cirurgia , Isquemia/diagnóstico por imagem , Isquemia/etiologia , Pneumatose Cistoide Intestinal/diagnóstico por imagem
7.
Anthropol Anz ; 80(4): 439-469, 2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-36278910

RESUMO

Sex estimation is essential in both bioarchaeological and forensic research. Based on bibliographical research, this study aims to systematize and compare the existing methods and glance at the future on this research topic. The survey in Web of Science and Google Scholar revealed 37 papers describing the generation of original procedures, and 25 validation studies. The results show that the pelvis, namely the ilium, is the most analyzed anatomical region, followed by the deciduous teeth, the cranium, the mandible, and the long bones. The morphometric approaches are addressed in greater proportion, both as original methods (n = 19) or validations (n = 24). Only one of the 19 approaches that require expensive equipment (conventional radiology, computer tomography, geometric morphometrics and 3D modelling) was tested. Most of them were generated during the 21st century; however, 24 have not been tested yet. Comparing all the methods tested, the percentages of correctly estimated cases are always lower in validation studies. It is suggested that the most promising ones be tested in documented samples by a group of researchers. Thus, the interobserver error would be evaluated and may also lead to new methodological proposals and refinements.


Assuntos
Determinação do Sexo pelo Esqueleto , Humanos , Criança , Determinação do Sexo pelo Esqueleto/métodos , Antropologia Forense/métodos , Crânio , Ílio/anatomia & histologia , Mandíbula
9.
GE Port J Gastroenterol ; 29(6): 393-400, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36545188

RESUMO

Background: Recent studies suggest that follow-up paracentesis (FuP) in cases of spontaneous bacterial peritonitis (SBP) should only be performed if there is a clinical and/or analytic worsening. We aimed to evaluate which patients with SBP would benefit from the FuP. Métodos: This retrospective study included consecutive patients diagnosed with SBP between January 2011 and June 2018 in our tertiary center. Clinical and analytical data were obtained at baseline and on the third day of antibiotic therapy. An adequate response on the third day of treatment was defined by a decrease of ≥25% in the neutrophil count of the ascitic fluid (AF). Results: Ninety-six episodes of PBE in 75 patients (79% male sex, mean age 61 ± 11 years old) were included. At admission, a higher serum neutrophil count (p = 0.043), a lower level of serum total proteins (p = 0.040), a positive culture in AF (p < 0.001) and a previous diagnosis of diabetes mellitus (p = 0.035) were related to inadequate response (IR). At day 3, acute kidney injury (p = 0.023), C-reactive protein >100 mg/L (p < 0.001), the presence of fever (p = 0.047) and abdominal pain (p < 0.001) were also associated with IR. In multivariate analysis, the presence of respiratory insufficiency (OR = 16.403; 95% CI: 2.315-116.222; p = 0.005) and abdominal pain (OR = 10.381; 95% CI: 1.807-59.626; p = 0.009) at admission, serum white blood cell count >9 × 109 (OR = 5.832; 95% CI: 1.275-26.669; p = 0.023), and CRP >100 mg/L (OR = 5.043; 95% CI: 1.267-20.076; p = 0.022) at day 3 of antibiotic therapy were predictors of IR. The predictive model presented good accuracy [AUROC of 0.893 (p < 0.001)] - a cutoff of 0.090 had a sensitivity, specificity, positive predictive value, and negative predictive value for IR of 97, 46, 83, and 77%, respectively. Conclusions: The performance of FuP on day 3 after the beginning of empiric therapy should be individualized, according to clinical and analytic variables of this predictive model.


Introdução: Estudos recentes têm sugerido a realização de paracentese de seguimento ao 3° dia, na peritonite bacteriana espontânea (PBE), apenas em doentes com agravamento clínico e/ou analítico. Este trabalho pretende avaliar quais os doentes em que a paracenteses ao 3° dia se mantém essencial. Methods: Estudo retrospetivo realizado em centro terciário, com inclusão dos doentes com PBE entre janeiro de 2011 e junho de 2018. Dados clínicos e analíticos foram obtidos à data de admissão e ao 3° dia de antibioterapia. A resposta terapêutica foi considerada adequada quando a contagem de neutrófilos no líquido ascítico era ≥25%. Resultados: Foram incluídos 96 episódios de PBE correspondentes a 75 doentes (79% homens, com idade media de 61 ± 11 anos). À admissão, a presença de diabetes mellitus (p = 0.035), uma maior contagem de neurófilos séricos (p = 0.043), nível inferior de proteínas séricas totais (p = 0.040) e positividade nas culturas de líquido ascítico total (p < 0.001) relacionaram-se com inadequada resposta (IR). Ao 3° dia de antibioterapia, a presença de lesão renal aguda (p = 0.023), proteína C reativa >100 mg/L (p < 0.001), febre (p = 0.047) e dor abdominal (p < 0.001) foram também associados a IR. Na análise multivariada, a presença de insuficiência respiratória (OR = 16.403; 95% CI: 2.315­116.222; p = 0.005) e dor abdominal (OR = 10.381; 95% CI: 1.807­59.626; p = 0.009) à admissão, contagem séria de leucócitos >9 ×109 (OR = 5.832; 95% CI: 1.275­26.669; p = 0.023) e PCR >100 mg/L (OR = 5.043; 95% CI: 1.267­20.076; p = 0.022) ao 3° dia de antibioterapia foram preditores de IR. O modelo preditivo apresentado apresenta boa acuidade [AUROC de 0.893 (p < 0.001)] ­ para um cutoff de 0.090 tem uma sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo para IR de 97, 46, 83, e 77%, respetivamente. Conclusões: De acordo com o nosso modelo, a realização de paracenteses de seguimento ao 3 dia após início de antibioterapia empírica deverá ser individualizada, de segundo as variáveis clínicas e analíticas apresentadas.

10.
Rev. esp. enferm. dig ; 114(7): 425-427, julio 2022. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-205683

RESUMO

Gastrointestinal involvement occurs in approximately 4% of cases of systemic amyloidosis. The most common site of amyloid deposition is small bowel, followed by stomach, colorectum and esophagus. Although rare, gastrointestinal amyloidosis may be associated with severe complications including gastrointestinal bleeding or perforation and may be mistaken for malignancy. (AU)


Assuntos
Humanos , Amiloidose/complicações , Amiloidose/diagnóstico por imagem , Gastroenteropatias/complicações , Gastroenteropatias/diagnóstico por imagem , Estômago/patologia , Pacientes
12.
Int J Paleopathol ; 37: 77-86, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35576812

RESUMO

OBJECTIVE: To investigate if there were changes in mortality knowing that industrialization was a slow and late process in Portugal. MATERIALS: The biographic information (1) of the individuals buried at the Coimbra Municipal Cemetery, considering three quinquennia: 1861-1865 (n = 1111, 18.3%), 1870-1974 (n = 2602, 42.7%), 1910-1914 (n = 2374, 39.0%), related to the periods before, during and at the end of the second industrialization and (2) of the Coimbra identified osteological collections (CIOC, N = 1796) composed of individuals who were born and died in the city. METHODS: Excel databases with the biographic information were analyzed with SPSS. RESULTS: Data from the cemetery show statistically significant differences between sexes and age-at-death mortalities. Non-adult mortality (higher in the age range from 1 to 7 years) has decreased over time which has increased mean age-at-death. The main adult occupations are domestic work (females) and craft activities (males). Child labor is common after the age of 14. The main causes of death (in both cemetery and CIOC records) were infections, respiratory diseases, heart disease, and malignant neoplasm. Among the communicable diseases, tuberculosis accounted for the highest number of deaths. The identified individuals have lesions compatible with tuberculosis and sinusitis while malignant neoplasms are more difficult to identify. The high prevalence of heart disease can overshadow other causes of death. CONCLUSIONS: In the absence of industrialization, tuberculosis, heart disease, and malignant neoplasms increased over time, while respiratory diseases decreased. SIGNIFICANCE: Mortality profile changed between 1861-1864 and 1910-1914 in Coimbra. LIMITATIONS: The causes of death were studied, but not all diseases. SUGGESTIONS FOR FURTHER RESEARCH: Study of other cemetery records for further comparison.


Assuntos
Cemitérios , Doenças Transmissíveis/mortalidade , Cardiopatias/mortalidade , Neoplasias/mortalidade , Doenças Respiratórias/mortalidade , Adulto , Fatores Etários , Causas de Morte , Cemitérios/estatística & dados numéricos , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Lactente , Masculino , Ocupações/classificação , Portugal/epidemiologia , Fatores Sexuais , Tuberculose/mortalidade
13.
Motrivivência (Florianópolis) ; 34(65): {1-17}, 20220316.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1411173

RESUMO

Buscou-se relatar a experiência de um profissional de educação física no desenvolvimento de Projetos Terapêuticos Singulares (PTS) utilizados no acompanhamento de usuários em sofrimento mental de um CAPSad da região metropolitana Fortaleza-CE. Trata-se de uma pesquisa do tipo relato de experiência com abordagem qualitativa realizada de janeiro de 2021 a fevereiro de 2022. Os resultados indicam que a participação do profissional de educação física residente foi de grande importância desde o planejamento do PTS junto às equipes multidisciplinares aos acompanhamentos individuais e/ou coletivos dos usuários e seus familiares no contexto de recuperação. O cuidado integral e participativo contribuiu no desenvolvimento da autonomia dos sujeitos rumo à responsabilização do próprio cuidado.


It was sought to report the experience of a physical education professional in the development of Singular Therapeutic Projects (PTS) used in the follow-up of users in mental suffering of a CAPSad in the metropolitan region of Fortaleza-CE. This is an experience report type research with a qualitative approach carried out from January 2021 to February 2022. The results indicate that the participation of the resident physical education professional was of great importance from the planning of the PTS with the multidisciplinary teams to the individual and/or collective follow-ups of users and their families in the context of recovery. Comprehensive and participatory care contributed to the development of subjects' autonomy towards accountability for their own care.


Buscamos relatar la experiencia de un profesional de educación física en el desarollo de Proyectos Terapéuticos Singulares (PTS) utilizados en el acompañamiento de usuarios en sufrimiento psíquico de un CAPSad en la región metropolitana de Fortaleza-CE. Se trata de una investigación tipo relato de experiencia con abordaje cualitativo realizada de enero de 2021 a febrero de 2022. Los resultados indican que la participación del profesional residente de educación física fue de gran importancia desde la planificación del PTS con los equipos multidisciplinarios hasta el individual y /o seguimientos colectivos de usuarios y sus familias en el contexto de la recuperación. El cuidado integral y participativo contribuyó al desarrollo de la autonomía de los sujetos hacia la responsabilidad por su propio cuidado.

14.
Rev Esp Enferm Dig ; 114(7): 425-427, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35105152

RESUMO

Gastrointestinal involvement occurs in approximately 4% of cases of systemic amyloidosis. The most common site of amyloid deposition is small bowel, followed by stomach, colorectum and esophagus. Although rare, gastrointestinal amyloidosis may be associated with severe complications including gastrointestinal bleeding or perforation and may be mistaken for malignancy.


Assuntos
Amiloidose , Gastroenteropatias , Amiloidose/complicações , Amiloidose/diagnóstico por imagem , Gastroenteropatias/complicações , Gastroenteropatias/diagnóstico por imagem , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/etiologia , Humanos , Estômago/patologia
15.
Am J Biol Anthropol ; 178 Suppl 74: 54-114, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-36790761

RESUMO

This article presents outcomes from a Workshop entitled "Bioarchaeology: Taking Stock and Moving Forward," which was held at Arizona State University (ASU) on March 6-8, 2020. Funded by the National Science Foundation (NSF), the School of Human Evolution and Social Change (ASU), and the Center for Bioarchaeological Research (CBR, ASU), the Workshop's overall goal was to explore reasons why research proposals submitted by bioarchaeologists, both graduate students and established scholars, fared disproportionately poorly within recent NSF Anthropology Program competitions and to offer advice for increasing success. Therefore, this Workshop comprised 43 international scholars and four advanced graduate students with a history of successful grant acquisition, primarily from the United States. Ultimately, we focused on two related aims: (1) best practices for improving research designs and training and (2) evaluating topics of contemporary significance that reverberate through history and beyond as promising trajectories for bioarchaeological research. Among the former were contextual grounding, research question/hypothesis generation, statistical procedures appropriate for small samples and mixed qualitative/quantitative data, the salience of Bayesian methods, and training program content. Topical foci included ethics, social inequality, identity (including intersectionality), climate change, migration, violence, epidemic disease, adaptability/plasticity, the osteological paradox, and the developmental origins of health and disease. Given the profound changes required globally to address decolonization in the 21st century, this concern also entered many formal and informal discussions.


Assuntos
Arqueologia , Instituições Acadêmicas , Humanos , Estados Unidos , Teorema de Bayes , Universidades , Arizona
16.
Anthropol Anz ; 79(1): 95-100, 2022 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-34487134

RESUMO

Condylus tertius (CT) is a developmental condition affecting the craniovertebral junction. Its prevalence was estimated to be less than 5% and can be asymptomatic or debilitating. This study aims to search for CT in the Coimbra Identified Skeletal Collection (CISC) and to do a bibliographic review of this neglected developmental defect. Two hundred individuals, from both sexes, and with ages at death between 30 and 59 years old from the CISC were observed macroscopically to search for CT. A bibliographic survey of the bioarcheological and clinical literature was conducted. One female individual (0.5%) had CT with irregular margins and porosity. In addition to the CT, the odontoid process of the axis had an increase in its retroversion angle and looked enlarged. The vertebra L1 showed hypoplasia of the right transverse process and the sacrum presented incomplete sacralization of the vertebra L5. In archaeological derived individuals only eight cases of CT were recognized in the literature survey, the oldest dating from the Pleistocene. This study draws attention to this trait and its diagnosis in skeletal individuals and alerts to the possible coexistence with other developmental defects in transitional vertebrae.


Assuntos
Osso e Ossos , Sacro , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Acta Med Port ; 35(3): 216-218, 2022 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33945464

RESUMO

Sibutramine is a serotonin-norepinephrine-dopamine reuptake inhibitor, initially developed as a potential antidepressant and later approved for the management of obesity. Sibutramine use is also associated with psychiatric symptoms, namely mania, panic attacks, and, less frequently, psychosis. We report the case of a 32-year-old man, admitted to our hospital due to a suicide attempt in the context of sibutramine-associated psychosis. The symptoms remitted completely after discontinuation of sibutramine and a brief period of antipsychotic medication. The aim of this manuscript is to highlight the importance of the recognition of sibutramine-associated psychosis, to discuss the possible pathophysiology and the proper clinical and therapeutic management.


A sibutramina é um inibidor não seletivo da recaptação de serotonina-noradrenalina-dopamina, inicialmente desenvolvido como potencial antidepressivo e posteriormente aprovado para o tratamento da obesidade. O uso de sibutramina está também associado ao aparecimento de sintomas psiquiátricos como mania, ataques de pânico e, com menor frequência, psicose. Relatamos um caso de um homem de 32 anos, internado no nosso hospital devido a uma tentativa de suicídio no contexto de uma psicose associada à sibutramina. Os sintomas remitiram completamente após a descontinuação da sibutramina e um breve período de terapêutica antipsicótica. O objetivo deste artigo é destacar a importância do reconhecimento da psicose associada à sibutramina, discutir a sua possível fisiopatologia e o seu apropriado manejo clínico e terapêutico.


Assuntos
Antipsicóticos , Ciclobutanos , Transtornos Psicóticos , Adulto , Antipsicóticos/efeitos adversos , Ciclobutanos/efeitos adversos , Humanos , Masculino , Transtornos Psicóticos/tratamento farmacológico , Tentativa de Suicídio
19.
Gastrointest Endosc ; 95(2): 339-348, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34508767

RESUMO

BACKGROUND AND AIMS: The diagnosis and characterization of biliary strictures (BSs) is challenging. The introduction of digital single-operator cholangioscopy (DSOC) that allows direct visual inspection of the lesion and targeted biopsy sampling significantly improved the diagnostic yield in patients with indeterminate BSs. However, the diagnostic efficiency of DSOC remains suboptimal. Convolutional neural networks (CNNs) have shown great potential for the interpretation of medical images. We aimed to develop a CNN-based system for automatic detection of malignant BSs in DSOC images. METHODS: We developed, trained, and validated a CNN-based on DSOC images. Each frame was labeled as a normal/benign finding or as a malignant lesion if histopathologic evidence of biliary malignancy was available. The entire dataset was split for 5-fold cross-validation. In addition, the image dataset was split for constitution of training and validation datasets. The performance of the CNN was measured by calculating the area under the receiving operating characteristic curve (AUC), sensitivity, specificity, and positive and negative predictive values. RESULTS: A total of 11,855 images from 85 patients were included (9695 malignant strictures and 2160 benign findings). The model had an overall accuracy of 94.9%, sensitivity of 94.7%, specificity of 92.1%, and AUC of .988 in cross-validation analysis. The image processing speed of the CNN was 7 ms per frame. CONCLUSIONS: The developed deep learning algorithm accurately detected and differentiated malignant strictures from benign biliary conditions. The introduction of artificial intelligence algorithms to DSOC systems may significantly increase its diagnostic yield for malignant strictures.


Assuntos
Inteligência Artificial , Neoplasias do Sistema Biliar , Neoplasias do Sistema Biliar/complicações , Neoplasias do Sistema Biliar/diagnóstico , Constrição Patológica/diagnóstico , Constrição Patológica/etiologia , Endoscopia do Sistema Digestório/métodos , Humanos , Projetos Piloto
20.
Front Physiol ; 12: 749735, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34899383

RESUMO

Sperm cryopreservation can be a helpful tool in reproductive management and preservation of biodiversity. However, the freezing methodologies lead to some damage in structure and function of cells that may compromise post-thaw sperm activity. Cryoprotectant supplementation with sugars proved to be a successful strategy to reduce cryodamage in sperm of several species, once allowing to stabilize the plasma membrane constituents. Therefore, this study intends to understand the effects of sugars in the plasma membrane, DNA integrity, and oxidative response during Portuguese oyster sperm cryopreservation. Three cryoprotectants solutions with an initial concentration of 20% dimethyl sulfoxide (DMSO) and 20% DMSO complemented with 0.9 M trehalose or sucrose in artificial seawater were employed. Sperm samples of mature males were individually collected and diluted 1:10 (v/v) in artificial seawater followed by addition of cryoprotectants [1:1 (v/v)]. Thereafter, sperm was loaded into 0.5 ml straws, maintained at 4°C for 10 min, frozen in a programmable biofreezer at -6°C/min from 0 to -70°C, and stored in liquid nitrogen. Samples were thawed in a 37°C bath for 10 s. Several techniques were performed to evaluate post-thaw quality. Sperm motility and DNA integrity were analyzed by using computer-assisted sperm analysis (CASA) software and comet assay. Flow cytometry was employed to determine membrane and acrosome integrity and to detect intracellular reactive oxygen species (ROS) and apoptosis activity. Lipid peroxidation was determined by malondialdehyde (MDA) detection by using spectrophotometry. Sperm antioxidant capacity was evaluated through glutathione peroxidase, glutathione reductase, and superoxide dismutase. Motility was not affected by the extenders containing sugars; these compounds did not reduce the DNA damage. However, both the trehalose and sucrose protected plasma membrane of cells by increasing cell viability and significantly reducing MDA content. The same finding was observed for the ROS, where live cells registered significantly lower levels of ROS in samples cryopreserved with sugars. The activity of antioxidant enzymes was higher in treatments supplemented with sugars, although not significant. In conclusion, the addition of sugars seems to play an important role in protecting the Crassostrea angulata sperm membrane during cryopreservation, showing potential to improve the post-thaw sperm quality and protect the cells from cryoinjuries.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...