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1.
J Toxicol Environ Health A ; 87(12): 497-515, 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38619158

RESUMO

One prominent aspect of Parkinson's disease (PD) is the presence of elevated levels of free radicals, including reactive oxygen species (ROS). Syagrus coronata (S. coronata), a palm tree, exhibits antioxidant activity attributed to its phytochemical composition, containing fatty acids, polyphenols, and flavonoids. The aim of this investigation was to examine the potential neuroprotective effects of S. coronata fixed oil against rotenone-induced toxicity using Drosophila melanogaster. Young Drosophila specimens (3-4 d old) were exposed to a diet supplemented with rotenone (50 µM) for 7 d with and without the inclusion of S. coronata fixed oil (0.2 mg/g diet). Data demonstrated that rotenone exposure resulted in significant locomotor impairment and increased mortality rates in flies. Further, rotenone administration reduced total thiol levels but elevated lipid peroxidation, iron (Fe) levels, and nitric oxide (NO) levels while decreasing the reduced capacity of mitochondria. Concomitant administration of S. coronata exhibited a protective effect against rotenone, as evidenced by a return to control levels of Fe, NO, and total thiols, lowered lipid peroxidation levels, reversed locomotor impairment, and enhanced % cell viability. Molecular docking of the oil lipidic components with antioxidant enzymes showed strong binding affinity to superoxide dismutase (SOD) and glutathione peroxidase (GPX1) enzymes. Overall, treatment with S. coronata fixed oil was found to prevent rotenone-induced movement disorders and oxidative stress in Drosophila melanogaster.


Assuntos
Transtornos dos Movimentos , Rotenona , Animais , Drosophila melanogaster , Simulação de Acoplamento Molecular , Estresse Oxidativo , Antioxidantes/farmacologia , Óxido Nítrico/metabolismo
2.
Exp Parasitol ; 261: 108750, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38614222

RESUMO

Amoebiasis is a disease caused by Entamoeba histolytica, affecting the large intestine of humans and occasionally leading to extra-intestinal lesions. Entamoeba dispar is another amoeba species considered commensal, although it has been identified in patients presenting with dysenteric and nondysenteric colitis, as well as amoebic liver abscess. Amoebic virulence factors are essential for the invasion and development of lesions. There is evidence showing that the association of enterobacteria with trophozoites contributes to increased gene expression of amoebic virulence factors. Enteropathogenic Escherichia coli is an important bacterium causing diarrhea, with high incidence rates in the world population, allowing it to interact with Entamoeba sp. in the same host. In this context, this study aims to evaluate the influence of enteropathogenic Escherichia coli on ACFN and ADO Entamoeba dispar strains by quantifying the gene expression of virulence factors, including galactose/N-acetyl-D-galactosamine-binding lectin, cysteine proteinase 2, and amoebapores A and C. Additionally, the study assesses the progression and morphological aspect of amoebic liver abscess and the profile of inflammatory cells. Our results demonstrated that the interaction between EPEC and ACFN Entamoeba dispar strains was able to increase the gene expression of virulence factors, as well as the lesion area and the activity of the inflammatory infiltrate. However, the association with the ADO strain did not influence the gene expression of virulence factors. Together, our findings indicate that the interaction between EPEC, ACFN, and ADO Entamoeba dispar strains resulted in differences in vitro and in vivo gene expression of Gal/GalNAc-binding lectin and CP2, in enzymatic activities of MPO, NAG, and EPO, and consequently, in the ability to cause lesions.

3.
Arch Sex Behav ; 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38448690

RESUMO

Two components of gender identity are gender similarity, how one's self-concept relates to the major gender collectives (i.e., female, male), and felt pressure to conform to gender norms. The development of these components across ages and contexts has been understudied. The focus of this study was to examine variations in gender similarity and felt pressure across multiple intersecting contexts: developmental stage, gender, and ethnic-racial group. Six data sets were harmonized and means were compared across 2628 participants (51% girls, 49% boys) from four different developmental cohorts (childhood n = 678, early adolescence n = 1322, adolescence n = 415, and young adulthood n = 213) from diverse ethnic-racial backgrounds (45% White, 23% Latinx/Hispanic, 11% Black/African-American, 7% Asian-American, 5% American Indian, and 5% Multiracial). Results revealed nuanced patterns: Gender intensification was supported in early adolescence, primarily for boys. Young adult men reported lower levels of pressure and gender typicality than younger boys, but young adult women's levels were generally not different than younger girls. Surprisingly, young adult women's levels of own-gender similarity and pressure from parents were higher than adolescent girls. Expectations of gender differences in gender typicality and felt pressure were supported for all ages except young adults, with higher levels for boys. Finally, there were more similarities than differences across ethnic-racial groups, though when there were differences, minoritized participants reported heightened gender typicality and pressure (largely accounted for by higher scores for Black and Latinx participants and lower scores for White and Multiracial participants). These results add to what is understood about contextually dependent gender development.

4.
Antibiotics (Basel) ; 13(3)2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38534661

RESUMO

(1) Background: In hospitals, medical and dental clinics, antiseptics or disinfectants play an essential role in the control of nosocomial infections. This study aimed to evaluate R. officinalis and P. paniculata glycolic extracts regarding: (I) their antimicrobial action on planktonic and biofilm (monotypic and cutaneous biofilm model-S. aureus, S. epidermidis and C. acnes); and (II) their cytotoxicity on human keratinocytes (HaCaT). (2) Methods: Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were performed (CLSI protocol M7-A6 and M11-A8). MTT analysis was used to evaluate the antibiofilm activity of the extracts on biofilms and their cytotoxicity on human keratinocytes. (3) Results: The combined glycolic extracts MIX A (75% P. paniculata + 25% R. officinalis); MIX B (50% P. paniculata + 50% R. officinalis); and MIX C (25% P. paniculata + 75% R. officinalis) promoted MBC values by 50 mg/mL on S. aureus, absent on S. epidermidis, and ranged 6.25-50 mg/mL for C. acnes. The cutaneous biofilm model was reduced more than 90%. In addition, it showed biocompatibility with human keratinocytes, resulting in percentages of viability greater than 50%. (4) Conclusions: The combination of extracts promoted antimicrobial action on planktonic cultures, and monotypic and heterotypic biofilms of skin pathogens. Additionally, these extracts are biocompatible against human keratinocytes.

5.
Eval Program Plann ; 103: 102414, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38452410

RESUMO

Brazil ranked third in the number of Monkeypox infected worldwide in early September 2022 and eighth in multiple deaths. Brazilian Ministry of Health prepared a public policy to face the smallpox outbreak. This paper aims to analyze the governmental public policy' impacts on Monkeypox using survival analysis. The information in the database was collected from epidemiological bulletins on the official websites of the Brazilian Ministry of Health and the World Health Organization (WHO). The survival analysis with parametric statistical analysis, semiparametric with Cox regression, and nonparametric analysis were used. The inference of causality was perceived by the impact caused by the national public policy with the proportional reduction in the number of cases in the treatment group (Chi-sq = 117.783, p < 0.001), contrary to what was perceived in the control group, as well as survival about the time of the states that elaborated their plans based on what was made available by the government. The need to evaluate government projects should be within the scope of project management in Brazilian states and provide for more assertive decision-making in the fight against smallpox.


Assuntos
Varíola dos Macacos , Varíola , Humanos , Brasil , Varíola/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Política Pública
6.
Cureus ; 16(2): e54388, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38505452

RESUMO

BACKGROUND: The use of cervical drains to prevent cervical hematoma or seroma after thyroidectomy remains a controversial issue. OBJECTIVE: Identify clinical and surgical risk factors for hematoma or seroma and evaluate the usefulness of routine use of drains following thyroid surgery. MATERIAL AND METHODS: The authors conducted a retrospective multicentric study related to consecutive patients submitted to thyroid surgery in seven Portuguese hospitals between January 2018 and December 2020 (n=945). The data collected included the following parameters: age and gender of the patients, anticoagulation or anti-aggregating therapy, histological diagnoses, type of surgery, the presence or absence of postoperative drains, thyroid weight, length of hospital stay, postoperative complications, and reinterventions. In this study, surgical complications evaluated were limited to the presence of hematoma or seroma. A total of 945 patients who underwent thyroid surgery were included in the study. Twenty-seven patients (2.9%, n=27) experienced complications classified as hematomas or seromas. In the series, significant differences were observed between the two groups according to hypocoagulation or anti-aggregation status (OR=3.62; 95% CI 1.14-11.4) (p=0.001) and the nature of histological diagnosis (toxic vs. non-toxic benign disease) (OR=6.59; 95% CI 1.83-23.7). Hypocoagulation or anti-aggregation status were independently associated with a higher risk of complications. The presence of drains was associated with longer hospitalization periods (p<0.001) and not a decreased need for reintervention. CONCLUSION: Cervical hematoma or seroma are rare complications associated with both hypocoagulation and anti-aggregation therapy and with the presence of benign toxic pathology. The use of drains does not decrease the need for reintervention and is even associated with a longer length of hospital stay; therefore, their routine use should not be advised.

7.
Transpl Int ; 37: 11921, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38420269

RESUMO

[This corrects the article DOI: 10.3389/ti.2022.10528.][This corrects the article DOI: 10.3389/ti.2023.12367.].

8.
J Nat Prod ; 87(3): 456-469, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38395785

RESUMO

The phytochemical investigation of the leaves and trunk bark of a specimen of Ocotea aciphylla collected in the southern portion of the Amazon forest led to the isolation of an oxabicyclo[3.2.2]nonane-type neolignan and 15 bicyclo[3.2.1]octanoid neolignans, 14 of which are unreported compounds (2-15), including one with an unusual oxidation pattern of the side chain at C-1' and two rare 7.1',8.3'-connected bicyclo[3.2.1]octanoid derivatives. Their structures and relative configurations were determined by extensive spectrometric analysis based on 1D- and 2D-NMR spectroscopy and HRESIMS data, while their absolute configurations were unambiguously assigned using electronic and vibrational circular dichroism data assisted by density functional theory calculations. Additionally, known sesquiterpenes, phenylpropanoids, and phytosterols were also isolated.


Assuntos
Lignanas , Ocotea , Lignanas/química , Ocotea/química , Alcanos , Espectroscopia de Ressonância Magnética , Estrutura Molecular , Dicroísmo Circular
9.
Int J Phytoremediation ; : 1-16, 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38391288

RESUMO

The rupture of the Fundão dam (Brazil) spread tailings contaminated with sodium and ether-amine into the Doce River Basin. Aiming at rehabilitating a contaminated riparian site, phytoremediation with native species of the Atlantic Forest was performed under four treatments: ES-1: physical remediation (sediment scraping) + chemical remediation (organic matter) + bioremediation (double inoculation with the arbuscular mycorrhizal fungus (AMF) Rhizophagus irregularis and the plant growth-promoting bacteria Bacillus subtilis); ES-2: chemical remediation + bioremediation; ES-3: physical remediation + chemical remediation; ES-4: chemical remediation. Ether-amine and sodium contents, plant growth and, soil quality parameters were compared among treatments and relative to preserved and degraded sites. Two years after planting, the outstanding plant growth was attributed to the phytoremediation of ether-amine and ammonium, followed by a significant increase in soil microbial biomass (Phospholipid fatty acids-PLFAs), particularly the Gram+ bacteria and total fungi but not AMF, whose response was independent of the inoculation. While sodium and ether-amine declined, soil K, P, NO3- contents, dehydrogenase and acid phosphatase activities, cation exchange capacity (CEC) and soil aggregation increased, especially in ES-1. Thus, such remediation procedures are recommended for the restoration of riparian areas affected by the Fundão tailings, ultimately improving sediment fertility, aggregation and stabilization.


To the best of our knowledge, this is the only successful example of fragment of riparian Atlantic Forest successfully rehabilitated using native trees from the Atlantic Forest in the riparian zone affected by the contaminated Fundão dam tailings. For that, phytoremediation and bioremediation procedures were adopted to alleviate etheramine and sodium toxicity, resulting in the amelioration of soil fertility and particularly the stabilization of such highly disaggregated sediments, ultimately protecting the Doce river basin against these contaminants.

10.
medRxiv ; 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38370791

RESUMO

In this article, we delineate a loosely selected cohort comprising patients with a history of early-onset breast cancer and/or a familial occurrence of cancer. The aim of this study was to gain insights into the presence of breast cancer-related gene variants in a population from a micro-region in southern Brazil, specifically the Metropolitan Region of Curitiba. This area exhibits a highly genetically mixed population, mirroring the general characteristics of the Brazilian people. Comprehensive next-generation sequencing (NGS) multigene panel testing was conducted, involving the evaluation of twelve patients. Two pathogenic variants and one candidate pathogenic variant were identified: BRCA2:c.8878C>T, p.Gln2960Ter; CHEK2:c.1100delAG>A, p.Thr367Metfs*15 and BRCA2:c.3482dupG>GA, p.Asp1161Glufs*3, a novel variant, previously unpublished, is reported.

11.
Nat Commun ; 15(1): 1307, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38346964

RESUMO

Living with extremely low-income is an important risk factor for HIV/AIDS and can be mitigated by conditional cash transfers. Using a cohort of 22.7 million low-income individuals during 9 years, we evaluated the effects of the world's largest conditional cash transfer, the Programa Bolsa Família, on HIV/AIDS-related outcomes. Exposure to Programa Bolsa Família was associated with reduced AIDS incidence by 41% (RR:0.59; 95%CI:0.57-0.61), mortality by 39% (RR:0.61; 95%CI:0.57-0.64), and case fatality rates by 25% (RR:0.75; 95%CI:0.66-0.85) in the cohort, and Programa Bolsa Família effects were considerably stronger among individuals of extremely low-income [reduction of 55% for incidence (RR:0.45, 95% CI:0.42-0.47), 54% mortality (RR:0.46, 95% CI:0.42-0.49), and 37% case-fatality (RR:0.63, 95% CI:0.51 -0.76)], decreasing gradually until having no effect in individuals with higher incomes. Similar effects were observed on HIV notification. Programa Bolsa Família impact was also stronger among women and adolescents. Several sensitivity and triangulation analyses demonstrated the robustness of the results. Conditional cash transfers can significantly reduce AIDS morbidity and mortality in extremely vulnerable populations and should be considered an essential intervention to achieve AIDS-related sustainable development goals by 2030.


Assuntos
Síndrome de Imunodeficiência Adquirida , População da América do Sul , Adolescente , Humanos , Feminino , Estudos de Coortes , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Renda , Pobreza , Brasil/epidemiologia
12.
Sci Rep ; 14(1): 4314, 2024 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-38383742

RESUMO

The Brazilian Organization for Crohn's Disease and Colitis (GEDIIB) established a national registry of inflammatory bowel disease (IBD). The aim of the study was to identify clinical factors associated with disease severity in IBD patients in Brazil. A population-based risk model aimed at stratifying the severity of IBD based on previous hospitalization, use of biologics, and need for surgery for ulcerative colitis (UC) and Crohn's Disease (CD) and on previous complications for CD. A total of 1179 patients (34.4 ± 14.7y; females 59%) were included: 46.6% with UC, 44.2% with CD, and 0.9% with unclassified IBD (IBD-U). The time from the beginning of the symptoms to diagnosis was 3.85y. In CD, 41.2% of patients presented with ileocolic disease, 32% inflammatory behavior, and 15.5% perianal disease. In UC, 46.3% presented with extensive colitis. Regarding treatment, 68.1%, 67%, and 47.6% received biological therapy, salicylates and immunosuppressors, respectively. Severe disease was associated with the presence of extensive colitis, EIM, male, comorbidities, and familial history of colorectal cancer in patients with UC. The presence of Montreal B2 and B3 behaviors, colonic location, and EIM were associated with CD severity. In conclusion, disease severity was associated with younger age, greater disease extent, and the presence of rheumatic EIM.


Assuntos
Colite Ulcerativa , Doença de Crohn , Doenças Inflamatórias Intestinais , Feminino , Humanos , Masculino , Doença de Crohn/diagnóstico , Brasil/epidemiologia , Dados de Saúde Coletados Rotineiramente , Doenças Inflamatórias Intestinais/epidemiologia , Colite Ulcerativa/epidemiologia , Colite Ulcerativa/diagnóstico
13.
Comput Methods Programs Biomed ; 246: 108052, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38350188

RESUMO

BACKGROUND AND OBJECTIVE: Atrial Fibrillation (AF) is a supraventricular tachyarrhythmia that can lead to thromboembolism, hearlt failure, ischemic stroke, and a decreased quality of life. Characterizing the locations where the mechanisms of AF are initialized and maintained is key to accomplishing an effective ablation of the targets, hence restoring sinus rhythm. Many methods have been investigated to locate such targets in a non-invasive way, such as Electrocardiographic Imaging, which enables an on-invasive and panoramic characterization of cardiac electrical activity using recording Body Surface Potentials (BSP) and a torso model of the patient. Nonetheless, this technique entails some major issues stemming from solving the inverse problem, which is known to be severely ill-posed. In this context, many machine learning and deep learning approaches aim to tackle the characterization and classification of AF targets to improve AF diagnosis and treatment. METHODS: In this work, we propose a method to locate AF drivers as a supervised classification problem. We employed a hybrid form of the convolutional-recurrent network which enables feature extraction and sequential data modeling utilizing labeled realistic computerized AF models. Thus, we used 16 AF electrograms, 1 atrium, and 10 torso geometries to compute the forward problem. Previously, the AF models were labeled by assigning each sample of the signals a region from the atria from 0 (no driver) to 7, according to the spatial location of the AF driver. The resulting 160 BSP signals, which resemble a 64-lead vest recording, are preprocessed and then introduced into the network following a 4-fold cross-validation in batches of 50 samples. RESULTS: The results show a mean accuracy of 74.75% among the 4 folds, with a better performance in detecting sinus rhythm, and drivers near the left superior pulmonary vein (R1), and right superior pulmonary vein (R3) whose mean sensitivity bounds around 84%-87%. Significantly good results are obtained in mean sensitivity (87%) and specificity (83%) in R1. CONCLUSIONS: Good results in R1 are highly convenient since AF drivers are commonly found in this area: the left atrial appendage, as suggested in some previous studies. These promising results indicate that using CNN-LSTM networks could lead to new strategies exploiting temporal correlations to address this challenge effectively.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Humanos , Fibrilação Atrial/diagnóstico , Qualidade de Vida , Memória de Curto Prazo , Átrios do Coração/cirurgia , Redes Neurais de Computação , Ablação por Cateter/métodos
14.
Sci Total Environ ; 917: 170230, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38278234

RESUMO

This research comprehensively assesses the aftermath of Cyclonic Storm Mocha, focusing on the coastal zones of Rakhine State and the Chittagong Division, spanning Myanmar and Bangladesh. The investigation emphasizes the impacts on coastal ecology, shoreline dynamics, flooding patterns, and meteorological variations. Employed were multiple vegetation indices-Normalized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI), Modified Vegetation Condition Index (mVCI), Disaster Vegetation Damage Index (DVDI), and Fractional Vegetation Cover (FVC)-to evaluate ecological consequences. The Digital Shoreline Assessment System (DSAS) aided in determining shoreline alterations pre- and post-cyclone. Soil exposure and flood extents were scrutinized using the Bare Soil Index (BSI) and Modified Normalized Difference Water Index (MNDWI), respectively. Additionally, the study encompassed an analysis of microclimatic variables, comparing meteorological data across pre- and post-cyclone periods. Findings indicate significant ecological impacts: an estimated 8985.46 km2 of dense vegetation (NDVI >0.6) was adversely affected. Post-cyclone, there was a discernible reduction in EVI values. The mean mVCI shifted negatively from -0.18 to -0.33, and the mean FVC decreased from 0.39 to 0.33. The DVDI underscored considerable vegetation damage in various areas, underscoring the cyclone's extensive impact. Meteorological analysis revealed a 245 % increase in rainfall (20.22 mm on May 14, 2023 compared to the May average of 5.86 mm), and significant increases in relative humidity (14 %) and wind speed (205 %). Erosion was observed along 74.60 % of the studied shoreline. These insights are pivotal for developing comprehensive strategies aimed at the rehabilitation and conservation of critical coastal ecosystems. They provide vital data for emergency response initiatives and offer resources for entities engaged in enhancing coastal resilience and protecting local community livelihoods.

15.
J Equine Vet Sci ; 132: 104976, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38056727

RESUMO

Horse pythiosis is considered an endemic disease in the Brazilian Pantanal region, causing devastating health and economic losses. This study aimed to enhance the understanding of pythiosis epidemiology, map the distribution of horse body lesions, and investigate the correlation between these lesions and warm body surface areas, potentially implicating hematophagous vectors in the disease's transmission. A prospective study was conducted on equids in the Pantanal Mato-grossense and adjacent areas from 2012 to 2022, with 112 horses and three mules diagnosed with pythiosis. Clinical and epidemiological data, lesions' photographic records, and healthy equids' thermal imaging were collected. Most pythiosis cases occurred between January and March, correlating with regional flood cycles. Most lesions were found on limbs and the ventral abdomen, with dark-colored horses exhibiting a higher frequency of lesions. Interestingly, the thermal mapping revealed that warm areas on a healthy horse's body overlapped significantly with lesion distribution - blood-sucking insects also prefer these areas. The results suggest that pythiosis lesions in horses correlate with warmer areas of the animal body, reinforcing the hypothesis of vector involvement in disease transmission. This study underscores the need for further observational research to fully understand the complex epidemiological dynamics of pythiosis in horses.


Assuntos
Doenças dos Cavalos , Parasitos , Pitiose , Cavalos , Animais , Doenças dos Cavalos/epidemiologia , Doenças dos Cavalos/patologia , Pitiose/epidemiologia , Pitiose/patologia , Brasil/epidemiologia , Estudos Prospectivos
16.
Transplantation ; 108(3): 759-767, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38012862

RESUMO

BACKGROUND: Kidney transplant (KT) candidates with HIV face higher mortality on the waitlist compared with candidates without HIV. Because the HIV Organ Policy Equity (HOPE) Act has expanded the donor pool to allow donors with HIV (D + ), it is crucial to understand whether this has impacted transplant rates for this population. METHODS: Using a linkage between the HOPE in Action trial (NCT03500315) and Scientific Registry of Transplant Recipients, we identified 324 candidates listed for D + kidneys (HOPE) compared with 46 025 candidates not listed for D + kidneys (non-HOPE) at the same centers between April 26, 2018, and May 24, 2022. We characterized KT rate, KT type (D + , false-positive [FP; donor with false-positive HIV testing], D - [donor without HIV], living donor [LD]) and quantified the association between HOPE enrollment and KT rate using multivariable Cox regression with center-level clustering; HOPE was a time-varying exposure. RESULTS: HOPE candidates were more likely male individuals (79% versus 62%), Black (73% versus 35%), and publicly insured (71% versus 52%; P < 0.001). Within 4.5 y, 70% of HOPE candidates received a KT (41% D + , 34% D - , 20% FP, 4% LD) versus 43% of non-HOPE candidates (74% D - , 26% LD). Conversely, 22% of HOPE candidates versus 39% of non-HOPE candidates died or were removed from the waitlist. Median KT wait time was 10.3 mo for HOPE versus 60.8 mo for non-HOPE candidates ( P < 0.001). After adjustment, HOPE candidates had a 3.30-fold higher KT rate (adjusted hazard ratio = 3.30, 95% confidence interval, 2.14-5.10; P < 0.001). CONCLUSIONS: Listing for D + kidneys within HOPE trials was associated with a higher KT rate and shorter wait time, supporting the expansion of this practice for candidates with HIV.


Assuntos
Infecções por HIV , Transplante de Rim , Humanos , Masculino , Listas de Espera , Rim , Doadores de Tecidos , Transplante de Rim/efeitos adversos , Doadores Vivos , Transplantados , Infecções por HIV/diagnóstico
17.
Eur Arch Otorhinolaryngol ; 281(1): 351-357, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37776343

RESUMO

PURPOSE: The use of tracheoesophageal prostheses has become the gold standard in vocal rehabilitation of patients undergoing total laryngectomy. However, this method also has limitations, such as the need for frequent replacement of prostheses due to leakage or other complications. We have designed a study to access the clinical profile of patients using tracheoesophageal prostheses as vocal rehabilitation after total laryngectomy and to determine the average rate of changes, as well as the main causes of prostheses replacement. METHODS: A retrospective cohort study was performed based on patients who underwent rehabilitation with voice prostheses after total laryngectomy between 2008 and 2017. RESULTS: The sample consisted of 93 patients and 432 vocal prostheses replacement events. The median change of prostheses per patient was 210.25 days, (range 57.33 to 651.50). The most frequent cause of prostheses replacement was leakage through the prostheses, 218 (50.46%). Lower level of education was associated to higher prostheses replacement rate. CONCLUSION: The results of this study show that the median of prostheses durability is higher than that presented in the literature, the main cause of replacement was protheses leakage and that low educational level is associated to higher replacement rate.


Assuntos
Neoplasias Laríngeas , Laringe Artificial , Humanos , Laringectomia/reabilitação , Estudos Retrospectivos , Falha de Prótese , Neoplasias Laríngeas/cirurgia
18.
Saúde debate ; 48(140): e8383, 2024. tab
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1551062

RESUMO

RESUMO Este artigo analisa a dimensão de qualidade clareza metodológica do Cadastro Nacional de Estabelecimentos de Saúde (CNES), considerando a abordagem das formas de contratação inseridas no sistema. Trata-se de uma pesquisa documental com abordagem qualitativa, que analisou o CNES e seus documentos. Foram selecionados os documentos que contemplaram os descritores: tabela de vínculos de profissionais e/ou formas de contratação. A partir do conceito adotado para a dimensão de qualidade clareza metodológica, foram delineadas as categorias acessibilidade, conteúdo, variáveis, linguagem e usabilidade. No período de 2005 a 2020, foram publicados 17 documentos. Desses, três documentos se sobressaíram: o Leia-me da versão, a Tabela de Domínios e o Manual de preenchimento do CNES. O site do CNES passava por uma reestruturação, e nem todas as funcionalidades estavam devidamente implementadas. O site atual apresentou uma interface mais moderna e de fácil compreensão. A mudança da variável esfera administrativa para natureza jurídica, em 2015, pode dificultar a análise em série histórica. Evidencia-se que o CNES carece de melhor atenção quanto à clareza metodológica, considerando a abordagem das formas de contratação dos profissionais de saúde, inseridas no sistema.


ABSTRACT This article analyzes the quality dimension of methodological clarity of the National Registry of Health Establishments (CNES), considering the approach to forms of contracting in the system. This is a documentary research with a qualitative approach, which analyzed the CNES and its documents. Documents that included the following were selected: table of professional relationships and/or forms of hiring. Based on the concept adopted for the dimension of methodological clarity quality, the categories accessibility, content, variables, language, and usability were outlined. In the period from 2005 to 2020, 17 documents were published. Of those, three documents stood out: The version's Readme, the Domain Table, and the CNES Filling Manual. The CNES website underwent restructuring and not all features were completed. The current website has a more modern and easy-to-understand interface. The change from the administrative sphere variable to the legal nature, in 2015, may make historical series analysis difficult. It is evident that the CNES pays more attention to methodological clarity, considering the approach to the ways of hiring health professionals, included in the system.

19.
J Appl Microbiol ; 135(1)2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38126104

RESUMO

AIM: To assess the effectiveness of Bacillus subtilis strain LN8B as a biocollector for recovering pyrite (Py) and chalcopyrite (CPy) in both seawater (Sw) and deionized water (Dw), and to explore the underlying adhesion mechanism in these bioflotation experiments. MATERIALS AND METHODS: The bioflotation test utilized B. subtilis strain LN8B as the biocollector through microflotation experiments. Additionally, frother methyl isobutyl carbinol (MIBC) and conventional collector potassium amyl xanthate (PAX) were introduced in some experiments. The zeta potential (ZP) and Fourier-transform infrared spectroscopy (FTIR) was employed to explore the adhesion mechanism of Py and CPy interacting with the biocollector in Sw and Dw. The adaptability of the B. subtilis strain to different water types and salinities was assessed through growth curves measuring optical density. Finally, antibiotic susceptibility tests were conducted to evaluate potential risks of the biocollector. RESULTS: Superior outcomes were observed in Sw where Py and CPy recovery was ∼39.3% ± 7.7% and 41.1% ± 5.8%, respectively, without microorganisms' presence. However, B. subtilis LN8B potentiate Py and CPy recovery, reaching 72.8% ± 4.9% and 84.6% ± 1.5%, respectively. When MIBC was added, only the Py recovery was improved (89.4% ± 3.6%), depicting an adverse effect for CPy (81.8% ± 1.1%). ZP measurements indicated increased mineral surface hydrophobicity when Py and CPy interacted with the biocollector in both Sw and Dw. FTIR revealed the presence of protein-related amide peaks, highlighting the hydrophobic nature of the bacterium. The adaptability of this strain to diverse water types and salinities was assessed, demonstrating remarkable growth versatility. Antibiotic susceptibility tests indicated that B. subtilis LN8B was susceptible to 23 of the 25 antibiotics examined, suggesting it poses minimal environmental risks. CONCLUSIONS: The study substantiates the biotechnological promise of B. subtilis strain LN8B as an efficient sulfide collector for promoting cleaner mineral production. This effectiveness is attributed to its ability to induce mineral surface hydrophobicity, a result of the distinct characteristics of proteins within its cell wall.


Assuntos
Bacillus subtilis , Cobre , Ferro , Minerais , Bacillus subtilis/metabolismo , Água do Mar , Sulfetos/farmacologia , Sulfetos/metabolismo , Água/metabolismo , Antibacterianos/farmacologia , Antibacterianos/metabolismo
20.
Physiother Theory Pract ; : 1-10, 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-38044840

RESUMO

BACKGROUND: Elderly patients under invasive mechanical ventilation (IMV) are more susceptible to muscle weakness. In the out-of-hospital environment, there are benefits to transcutaneous electrical diaphragmatic stimulation (TEDS), which is an easy-to-apply and low-cost technique. OBJECTIVE: To evaluate the effect of TEDS on respiratory muscle strength, diaphragm thickness (DT), and IMV time in critically ill elderly patients. METHODS: This was a randomized controlled trial in which patients were divided into an experimental group (EG) and a control group (CG). TEDS started 24 h after orotracheal intubation and lasted until the end of weaning. Both groups underwent the following assessments during the spontaneous breathing test after weaning from mechanical ventilation (MV): measurement of respiratory muscle strength by pressure gauge, analysis of DT by lung ultrasound, and extubation failure prevention checklist. RESULTS: There were 23 participants in the EG and 21 in the CG. The median age was 66 (60-79) years. The mean values of the diaphragmatic thickening index in the EG and CG participants were 99.13 ± 26.75 and 66.88 ± 31.77, respectively (p = .001, Cohen's d = 1.094). The mean values of maximum inspiratory pressure in the EG and CG were 22.04 ± 3.41 and 19.34 ± 4.23 cmH2O, respectively (p = .005, Cohen's d = 0.698). The Tobin index and the integrative weaning index were similar between groups (p = .584 and p = .102, respectively). The duration of MV in the EG and CG was 6.28 ± 2.68 and 9.21 ± 2.76 days, respectively (p = .001, Cohen's d = -1.075). CONCLUSION: Critically ill elderly patients receiving TEDS had shorter MV time, greater inspiratory muscle strength, and greater diaphragmatic contraction capacity according to their thickness fraction.

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