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1.
Artigo em Inglês | MEDLINE | ID: mdl-38575248

RESUMO

Type 2 diabetes mellitus (T2D) is a metabolic disease, which occurs largely due to unhealthy lifestyle. As oxidative stress is believed to promote T2D, by inducing damage to lipids, proteins, and DNA, appropriate dietary interventions seem critical to prevent, manage, and even reverse this condition. Brazil nuts (Bertholletia excelsa, H.B.K.) are nature's richest source of selenium, a mineral that has shown several health benefits. Therefore, this study aims to assess the effects of selenium consumption, through Brazil nuts, on biochemical and oxidative stress parameters, and genomic instability in T2D patients. We recruited 133 patients with T2D, registered in the Integrated Clinics of the University of Southern Santa Catarina (Brazil). Participants consumed one Brazil nut a day for six months. Blood samples and exfoliated buccal cells were collected at the beginning and the end of the intervention. The glycemic profile, lipid profile, renal profile and hepatic profile, DNA damage and selenium content were evaluated. A total of 74 participants completed the intervention. Brazil nut consumption increased selenium and GSH levels, GPx, and CAT activity while DCF and nitrites levels decreased. Total thiols increased, and protein carbonyl and MDA levels decreased. Levels of baseline and oxidative DNA damage in T2D patients were significantly decreased, as well as the frequency of micronuclei and nuclear buds. The fasting glucose levels, HDL and LDL cholesterol, and GGT levels that increased significantly in patients with type 2 diabetes were significantly reduced with nut consumption. Our results show an increase in antioxidant activity, along with reductions of protein and lipid oxidation as well as DNA damage, suggesting that Brazil nut consumption could be an ally in reducing oxidative stress and modulating the genomic instability in T2D patients.


Assuntos
Bertholletia , Diabetes Mellitus Tipo 2 , Selênio , Humanos , Bertholletia/química , Selênio/farmacologia , Sobrepeso , Diabetes Mellitus Tipo 2/genética , Mucosa Bucal , Lipídeos , Dano ao DNA , Instabilidade Genômica
2.
Toxics ; 12(3)2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38535934

RESUMO

The characterization of wildland firefighters' occupational exposure must consider different exposures, including those at the fire station. The present study aimed to characterize the occupational exposure of 172 Northern Portuguese wildland firefighters in fire stations during the pre-wildfire season of 2021. The biological impact of estimated inhaled doses of PM10 and PM2.5 (indoor/outdoor) was accessed through a buccal micronucleus cytome (BMCyt) assay in exfoliated buccal cells of a subgroup of 80 firefighters. No significant association was found between estimated inhaled doses of PM10 and PM2.5 (mean 1.73 ± 0.43 µg kg-1 and 0.53 ± 0.21 µg kg-1, respectively) and biological endpoints. However, increased frequencies of cell death parameters were found among subjects of the Permanent Intervention Teams (full-time firefighters). The intake of nutritional supplements was associated with a significant decrease in micronucleus frequencies (i.e., DNA damage or chromosome breakage). In addition, our findings showed a significantly increased frequency of cell death endpoints (i.e., nuclear fragmentation) with coffee consumption, while daily consumption of vegetables significantly decreased it (i.e., nuclear shrinkage). Our results provide data on the occupational exposure of wildland firefighters while working in fire stations during the pre-wildfire season, providing the essential baseline for further studies throughout the wildfire season.

3.
Sci Total Environ ; 926: 171801, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38508274

RESUMO

Human biomonitoring data retrieved from real-life wildland firefighting in Europe and, also, worldwide are scarce. Thus, in this study, 176 Portuguese firefighters were biomonitored pre- and post- unsimulated wildfire combating (average:12-13 h; maximum: 55 h) to evaluate the impact on the levels of urinary polycyclic aromatic hydrocarbons hydroxylated metabolites (OHPAH; quantified by high-performance liquid chromatography with fluorescence detection) and the associated short-term health effects (symptoms, and total and differentiated white blood cells). Correlations between these variables and data retrieved from the self-reported questionnaires were also investigated. Firefighters were organized into four groups according to their exposure to wildfire emissions and their smoking habits: non-smoking non-exposed (NSNExp), non-smoking exposed (NSExp), smoking non-exposed (SNExp), and smoking and exposed (SExp). The most abundant metabolites were 1-hydroxynaphthalene and 1-hydroxyacenaphthene (1OHNaph + 1OHAce) (98-99 %), followed by 2-hydroxyfluorene (2OHFlu) (0.2-1.1 %), 1-hydroxyphenanthrene (1OHPhen) (0.2-0.4 %), and 1-hydroxypyrene (1OHPy) (0.1-0.2 %); urinary 3-hydroxybenzo(a)pyrene was not detected. The exposure to wildfire emissions significantly elevated the median concentrations of each individual and total OHPAH compounds in all groups, but this effect was more pronounced in non-smoking (1.7-4.2 times; p ≤ 0.006) than in smoking firefighters (1.3-1.6 times; p ≤ 0.03). The greatest discriminant of exposure to wildfire emissions was 1OHNaph + 1OHAce (increase of 4.2 times), while for tobacco smoke it was 2OHFlu (increase of 10 times). Post-exposure, white blood cells count significantly increased ranging from 1.4 (smokers, p = 0.025) to 3.7-fold (non-smokers, p < 0.001), which was accompanied by stronger significant correlations (0.480 < r < 0.882; p < 0.04) between individual and total OHPAH and total white blood cells (and lymphocytes > monocytes > neutrophils in non-smokers), evidencing the impact of PAH released from wildfire on immune cells. This study identifies Portuguese firefighters with high levels of biomarkers of exposure to PAH and points out the importance of adopting biomonitoring schemes, that include multiple biomarkers of exposure and biomarkers of effect, and implementing mitigations strategies.


Assuntos
Poluentes Ocupacionais do Ar , Bombeiros , Exposição Ocupacional , Hidrocarbonetos Policíclicos Aromáticos , Humanos , Hidrocarbonetos Policíclicos Aromáticos/análise , Poluentes Ocupacionais do Ar/análise , Exposição Ocupacional/análise , Monitoramento Biológico , Monitoramento Ambiental/métodos , Biomarcadores/análise
4.
Front Public Health ; 12: 1338435, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38510349

RESUMO

Introduction: Available literature has found an association between firefighting and pathologic pathways leading to cardiorespiratory diseases, which have been linked with exposure to polycyclic aromatic hydrocarbons (PAHs). PAHs are highlighted as priority pollutants by the European Human Biomonitoring Initiative in occupational and non-occupational contexts. Methods: This cross-sectional study is the first to simultaneously characterize six creatinine-adjusted PAHs metabolites (OHPAHs) in urine, blood pressure, cardiac frequency, and hemogram parameters among wildland firefighters without occupational exposure to fire emissions (> 7 days), while exploring several variables retrieved via questionnaires. Results: Overall, baseline levels for total OHPAHs levels were 2 to 23-times superior to the general population, whereas individual metabolites remained below the general population median range (except for 1-hydroxynaphthalene+1-hydroxyacenaphtene). Exposure to gaseous pollutants and/or particulate matter during work-shift was associated with a 3.5-fold increase in total OHPAHs levels. Firefighters who smoke presented 3-times higher total concentration of OHPAHs than non-smokers (p < 0.001); non-smoker females presented 2-fold lower total OHPAHs (p = 0.049) than males. 1-hydroxypyrene was below the recommended occupational biological exposure value (2.5 µg/L), and the metabolite of carcinogenic PAH (benzo(a)pyrene) was not detected. Blood pressure was above 120/80 mmHg in 71% of subjects. Firefighters from the permanent intervention team presented significantly increased systolic pressure than those who performed other functions (p = 0.034). Tobacco consumption was significantly associated with higher basophils (p = 0.01-0.02) and hematocrit (p = 0.03). No association between OHPAHs and blood pressure was found. OHPAHs concentrations were positively correlated with monocyte, basophils, large immune cells, atypical lymphocytes, and mean corpuscular volume, which were stronger among smokers. Nevertheless, inverse associations were observed between fluorene and pyrene metabolites with neutrophils and eosinophils, respectively, in non-smokers. Hemogram was negatively affected by overworking and lower physical activity. Conclusion: This study suggests possible associations between urinary PAHs metabolites and health parameters in firefighters, that should be further assessed in larger groups.


Assuntos
Poluentes Ambientais , Bombeiros , Hidrocarbonetos Policíclicos Aromáticos , Masculino , Feminino , Humanos , Hidrocarbonetos Policíclicos Aromáticos/análise , Pressão Sanguínea , Estudos Transversais , Biomarcadores , Estilo de Vida
6.
Nanotoxicology ; 17(6-7): 511-528, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37855675

RESUMO

The hazard posed to human health by inhaled amorphous silica nanomaterials (aSiO2 NM) remains uncertain. Herein, we assessed the cyto- and genotoxicity of aSiO2 NM variants covering different sizes (7, 15, and 40 nm) and surface modifications (unmodified, phosphonate-, amino- and trimethylsilyl-modified) on rat alveolar epithelial (RLE-6TN) cells. Cytotoxicity was evaluated at 24 h after exposure to the aSiO2 NM variants by the lactate dehydrogenase (LDH) release and WST-1 reduction assays, while genotoxicity was assessed using different endpoints: DNA damage (single- and double-strand breaks [SSB and DSB]) by the comet assay for all aSiO2 NM variants; cell cycle progression and γ-H2AX levels (DSB) by flow cytometry for those variants that presented higher cytotoxic and DNA damaging potential. The variants with higher surface area demonstrated a higher cytotoxic potential (SiO2_7, SiO2_15_Unmod, SiO2_15_Amino, and SiO2_15_Phospho). SiO2_40 was the only variant that induced significant DNA damage on RLE-6TN cells. On the other hand, all tested variants (SiO2_7, SiO2_15_Unmod, SiO2_15_Amino, and SiO2_40) significantly increased total γ-H2AX levels. At high concentrations (28 µg/cm2), a decrease in G0/G1 subpopulation was accompanied by a significant increase in S and G2/M sub-populations after exposure to all tested materials except for SiO2_40 which did not affect cell cycle progression. Based on the obtained data, the tested variants can be ranked for its genotoxic DNA damage potential as follows: SiO2_7 = SiO2_40 = SiO2_15_Unmod > SiO2_15_Amino. Our study supports the usefulness of multiparametric approaches to improve the understanding on NM mechanisms of action and hazard prediction.


Assuntos
Células Epiteliais Alveolares , Nanoestruturas , Ratos , Humanos , Animais , Dióxido de Silício/toxicidade , Dano ao DNA , Ensaio Cometa , Nanoestruturas/toxicidade
7.
Front Toxicol ; 5: 1116707, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37342468

RESUMO

The environmental impact on health is an inevitable by-product of human activity. Environmental health sciences is a multidisciplinary field addressing complex issues on how people are exposed to hazardous chemicals that can potentially affect adversely the health of present and future generations. Exposure sciences and environmental epidemiology are becoming increasingly data-driven and their efficiency and effectiveness can significantly improve by implementing the FAIR (findable, accessible, interoperable, reusable) principles for scientific data management and stewardship. This will enable data integration, interoperability and (re)use while also facilitating the use of new and powerful analytical tools such as artificial intelligence and machine learning in the benefit of public health policy, and research, development and innovation (RDI). Early research planning is critical to ensuring data is FAIR at the outset. This entails a well-informed and planned strategy concerning the identification of appropriate data and metadata to be gathered, along with established procedures for their collection, documentation, and management. Furthermore, suitable approaches must be implemented to evaluate and ensure the quality of the data. Therefore, the 'Europe Regional Chapter of the International Society of Exposure Science' (ISES Europe) human biomonitoring working group (ISES Europe HBM WG) proposes the development of a FAIR Environment and health registry (FAIREHR) (hereafter FAIREHR). FAIR Environment and health registry offers preregistration of studies on exposure sciences and environmental epidemiology using HBM (as a starting point) across all areas of environmental and occupational health globally. The registry is proposed to receive a dedicated web-based interface, to be electronically searchable and to be available to all relevant data providers, users and stakeholders. Planned Human biomonitoring studies would ideally be registered before formal recruitment of study participants. The resulting FAIREHR would contain public records of metadata such as study design, data management, an audit trail of major changes to planned methods, details of when the study will be completed, and links to resulting publications and data repositories when provided by the authors. The FAIREHR would function as an integrated platform designed to cater to the needs of scientists, companies, publishers, and policymakers by providing user-friendly features. The implementation of FAIREHR is expected to yield significant benefits in terms of enabling more effective utilization of human biomonitoring (HBM) data.

8.
Mutagenesis ; 38(5): 253-263, 2023 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-37233347

RESUMO

Measurement of DNA migration in the comet assay can be done by image analysis or visual scoring. The latter accounts for 20%-25% of the published comet assay results. Here we assess the intra- and inter-investigator variability in visual scoring of comets. We include three training sets of comet images, which can be used as reference for researchers who wish to use visual scoring of comets. Investigators in 11 different laboratories scored the comet images using a five-class scoring system. There is inter-investigator variation in the three training sets of comets (i.e. coefficient of variation (CV) = 9.7%, 19.8%, and 15.2% in training sets I-III, respectively). However, there is also a positive correlation of inter-investigator scoring in the three training sets (r = 0.60). Overall, 36% of the variation is attributed to inter-investigator variation and 64% stems from intra-investigator variation in scoring between comets (i.e. the comets in training sets I-III look slightly different and this gives rise to heterogeneity in scoring). Intra-investigator variation in scoring was also assessed by repeated analysis of the training sets by the same investigator. There was larger variation when the training sets were scored over a period of six months (CV = 5.9%-9.6%) as compared to 1 week (CV = 1.3%-6.1%). A subsequent study revealed a high inter-investigator variation when premade slides, prepared in a central laboratory, were stained and scored by investigators in different laboratories (CV = 105% and 18%-20% in premade slides with comets from unexposed and hydrogen peroxide-exposed cells, respectively). The results indicate that further standardization of visual scoring is desirable. Nevertheless, the analysis demonstrates that visual scoring is a reliable way of analysing DNA migration in comets.

9.
Mutagenesis ; 38(5): 283-294, 2023 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-37228081

RESUMO

The comet assay is a simple and versatile method for measurement of DNA damage in eukaryotic cells. More specifically, the assay detects DNA migration from agarose gel-embedded nucleoids, which depends on assay conditions and the level of DNA damage. Certain steps in the comet assay procedure have substantial impact on the magnitude of DNA migration (e.g. electric potential and time of electrophoresis). Inter-laboratory variation in DNA migration levels occurs because there is no agreement on optimal assay conditions or suitable assay controls. The purpose of the hCOMET ring trial was to test potassium bromate (KBrO3) as a positive control for the formamidopyrimidine DNA glycosylase (Fpg)-modified comet assay. To this end, participating laboratories used semi-standardized protocols for cell culture (i.e. cell culture, KBrO3 exposure, and cryopreservation of cells) and comet assay procedures, whereas the data acquisition was not standardized (i.e. staining of comets and image analysis). Segregation of the total variation into partial standard deviation (SD) in % Tail DNA units indicates the importance of cell culture procedures (SD = 10.9), comet assay procedures (SD = 12.3), staining (SD = 7.9) and image analysis (SD = 0.5) on the overall inter-laboratory variation of DNA migration (SD = 18.2). Future studies should assess sources of variation in each of these steps. On the positive side, the hCOMET ring trial demonstrates that KBrO3 is a robust positive control for the Fpg-modified comet assay. In conclusion, the hCOMET ring trial has demonstrated a high reproducibility of detecting genotoxic effects by the comet assay, but inter-laboratory variation of DNA migration levels is a concern.

10.
Bioengineering (Basel) ; 10(4)2023 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-37106680

RESUMO

Schizophrenia is a mental illness that affects an estimated 21 million people worldwide. The literature establishes that electroencephalography (EEG) is a well-implemented means of studying and diagnosing mental disorders. However, it is known that speech and language provide unique and essential information about human thought. Semantic and emotional content, semantic coherence, syntactic structure, and complexity can thus be combined in a machine learning process to detect schizophrenia. Several studies show that early identification is crucial to prevent the onset of illness or mitigate possible complications. Therefore, it is necessary to identify disease-specific biomarkers for an early diagnosis support system. This work contributes to improving our knowledge about schizophrenia and the features that can identify this mental illness via speech and EEG. The emotional state is a specific characteristic of schizophrenia that can be identified with speech emotion analysis. The most used features of speech found in the literature review are fundamental frequency (F0), intensity/loudness (I), frequency formants (F1, F2, and F3), Mel-frequency cepstral coefficients (MFCC's), the duration of pauses and sentences (SD), and the duration of silence between words. Combining at least two feature categories achieved high accuracy in the schizophrenia classification. Prosodic and spectral or temporal features achieved the highest accuracy. The work with higher accuracy used the prosodic and spectral features QEVA, SDVV, and SSDL, which were derived from the F0 and spectrogram. The emotional state can be identified with most of the features previously mentioned (F0, I, F1, F2, F3, MFCCs, and SD), linear prediction cepstral coefficients (LPCC), linear spectral features (LSF), and the pause rate. Using the event-related potentials (ERP), the most promissory features found in the literature are mismatch negativity (MMN), P2, P3, P50, N1, and N2. The EEG features with higher accuracy in schizophrenia classification subjects are the nonlinear features, such as Cx, HFD, and Lya.

11.
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1436699

RESUMO

Prune Belly syndrome, also known as Eagle-Barret syndrome, is a rare disease, with a prevalence of 3.8 live births per 100,000 births. Its main characteristic is the hypoplasia of the abdominal muscles, giving rise to the name "prune belly syndrome". The gold standard treatment is surgery, ideally with correction of cryptorchidism and phimosis between 6 to 18 months of life. Correction of urinary malformations and abdominoplasty should be performed up to 4 years of age. Little evidence exists in the literature about late treatment and its implications for prognosis. The context mentioned above led us to present an uncommon case of a six years old child in which a surgical approach was performed later than usual.


Introdução: A síndrome de Prune Belly é uma doença rara, com prevalência de 3,8 nascidos vivos a cada 100 mil nascimentos. Tem como principal caraterística a hipoplasia da musculatura abdominal gerando a origem do nome "síndrome da barriga de ameixa". O tratamento padrão ouro é cirúrgico, idealmente com correção da criptorquidia e fimose entre 6 a 18 meses e a correção das malformações urinárias e abdominoplastia devem ser realizadas até os 4 anos. Aqui descreve-se um caso ainda menos comum, em que foi realizada abordagem cirúrgica de forma mais tardia que o habitual. Há pouca evidência na literatura acerca do tratamento tardio e suas implicações em relação ao prognóstico.

12.
GE Port J Gastroenterol ; 30(1): 4-19, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36743984

RESUMO

Background and Aims: Laparoscopic and endoscopic cooperative surgery (LECS) combines advantages of endoscopy and laparoscopy in order to resect upper gastrointestinal lesions. Our aim was to evaluate the efficacy and safety of LECS in patients with EGJ (esophagogastric junction), gastric and duodenal lesions, as well as to compare LECS with pure endoscopic and pure laparoscopic procedures. Methods: PubMed, Scopus, and ISI Web of Knowledge were searched. Efficacy (R0, recurrence) and safety (conversion rate, procedure and hospitalization time, adverse events, mortality) outcomes were extracted and pooled (odds ratio or mean difference) using a random-effects model. Study quality was assessed with Newcastle-Ottawa Scale and heterogeneity by Cochran's Q test and I2 . Subgroup analysis according to location was performed. Results: This meta-analysis included 24 studies/1,336 patients (all retrospective cohorts). No significant differences were found between LECS and preexisting techniques (endoscopic submucosal dissection (ESD)/laparoscopy) regarding any outcomes. However, there was a trend to shorter hospitalization time, longer procedure duration, and fewer adverse events in LECS versus Laparoscopy and ESD. R0 tended to be higher in the LECS group. Hospitalization time was significantly shorter in gastric versus EGJ lesions (mean 7.3 vs. 13.7 days, 95% CI: 6.6-7.9 vs. 8.9-19.3). There were no significant differences in conversion rate, adverse events, or mean procedural time according to location. There was a trend to higher conversion rate and longer procedure durations in EGJ and higher rate of adverse events in duodenal lesions. Conclusion: LECS is a valid, safe, and effective treatment option in patients with EGJ, gastric, and duodenal lesions, although existing studies are retrospective and prone to selection bias. Prospective studies are needed to assess if LECS is superior to established techniques. Key Messages: LECS is safe and effective in the treatment of upper gastrointestinal lesions, but there is no evidence of superiority over established techniques.


Introdução e objetivos: A Cirurgia cooperativa laparoscópica e endoscópica (LECS) combina vantagens da endoscopia e laparoscopia na resseção de lesões gastrointestinais superiores. O nosso objetivo é avaliar a eficácia e segurança da LECS em pacientes com lesões na junção esofagogástrica (EGJ), estômago e duodeno, e comparar a LECS com procedimentos puramente endoscópicos e laparoscópicos. Métodos: PubMed, Scopus, ISI Web of Knowledge foram pesquisadas. Dados sobre eficácia (R0, recorrência) e segurança (taxa de conversão, duração do procedimento e hospitalização, recorrência, eventos adversos, mortalidade) foram colhidos e agrupados (odds ratio ou média das diferenças), usando modelo de efeitos randomizados. Qualidade dos estudos foi avaliada pela Escala Newcastle-Ottawa e heterogeneidade pelos testes Q da Cochran e I2. Foi realizada análise de subgrupos, consoante a localização. Resultados: Esta meta-análise incluiu 24 estudos/1336 pacientes (todos coortes retrospetivos). Não encontramos diferenças significativas entre LECS e as técnicas pré-existentes (Disseção endoscópica da submucosa (ESD)/Laparoscopia) em nenhum aspeto. Porém, encontramos uma tendência para hospitalização mais curta, procedimentos mais longos e menos efeitos adversos na LECS versus Laparoscopia e ESD. R0 tende a ser maior no grupo LECS. Hospitalização foi significativamente menor em lesões gástricas versus EGJ (média 7.3 vs. 13.7 dias, 95% CI: 6.6­7.9 vs. 8.9­19.3). Não encontramos diferenças significativas na taxa de conversão, eventos adversos nem tempo médio de procedimento. Porém encontramos uma tendência para taxas de conversão maiores e procedimentos mais longos na EGJ e maior taxa de eventos adversos no duodeno. Conclusão: LECS é um tratamento válido, seguro e eficaz em pacientes com lesões na EGJ, estômago e duodeno, apesar dos estudos retrospetivos existentes estarem propensos a viés de seleção. São necessários estudos prospetivos para avaliar a superioridade da LECS face às técnicas existentes. Mensagens-chave: LECS é um tratamento seguro e eficaz para lesões gastrointestinais superiores, mas sem evidência de superioridade face às técnicas existentes.

13.
J Toxicol Environ Health B Crit Rev ; 26(2): 67-96, 2023 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-36692141

RESUMO

Several studies have been conducted to address the potential adverse health risks attributed to exposure to nanoscale materials. While in vivo studies are fundamental for identifying the relationship between dose and occurrence of adverse effects, in vitro model systems provide important information regarding the mechanism(s) of action at the molecular level. With a special focus on exposure to inhaled (nano)particulate material toxicity assessment, this review provides an overview of the available human respiratory models and exposure systems for in vitro testing, advantages, limitations, and existing investigations using models of different complexity. A brief overview of the human respiratory system, pathway and fate of inhaled (nano)particles is also presented.


Assuntos
Nanopartículas , Sistema Respiratório , Humanos , Poeira , Exposição por Inalação/efeitos adversos , Nanopartículas/toxicidade
14.
Artigo em Inglês | MEDLINE | ID: mdl-36673703

RESUMO

(1) Background: Nursing Home (NH) residents are a population with health and social vulnerabilities, for whom emergency department visits or hospitalization near the end of life can be considered a marker of healthcare aggressiveness. With the present study, we intend to identify and characterize acute care transitions in the last year of life in Portuguese NH residents, to characterize care integration between the different care levels, and identify predictors of death at hospital and potentially burdensome transitions; (2) Methods: a retrospective after-death study was performed, covering 18 months prior to the emergence of the COVID-19 pandemic, in a nationwide sample of Portuguese NH with 614 residents; (3) Results: 176 deceased patients were included. More than half of NH residents died at hospital. One-third experienced a potentially burdensome care transition in the last 3 days of life, and 48.3% in the last 90 days. Younger age and higher technical staff support were associated with death at hospital and a higher likelihood of burdensome transitions in the last year of life, and Palliative Care team support with less. Advanced Care planning was almost absent; (4) Conclusions: The studied population was frail and old without advance directives in place, and subject to frequent hospitalization and potentially burdensome transitions near the end of life. Unlike other studies, staff provisioning did not improve the outcomes. The results may be related to a low social and professional awareness of Palliative Care and warrant further study.


Assuntos
COVID-19 , Assistência Terminal , Humanos , Estudos Retrospectivos , Pandemias , Portugal/epidemiologia , COVID-19/epidemiologia , Hospitalização , Casas de Saúde
15.
J Ethnopharmacol ; 302(Pt A): 115830, 2023 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-36243295

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Thymus mastichina (L.) L. (TM) and Cistus ladanifer L. (CL) are two Portuguese autochthonous species with traditional skin application in folk medicine. TM is majorly known for its antiseptic and wound healing properties, as an external anti-inflammatory agent and for its application in folk cosmetics and hygiene products. Its use in acne vulgaris has also been reported. CL is traditionally used in remedies for wounds, ulcers and other skin ailments such as psoriasis and eczema. Its application has been found useful due to its anti-inflammatory, astringent, wound healing and antiseptic properties. AIM OF THE STUDY: With this work, we aimed to investigate relevant bioactivities related with the traditional application of TM and CL essential oils (EOs) and hydrolates (by-products of EO production) in skin ailments. Specifically their in vitro antioxidant, anti-inflammatory, cytotoxic, wound healing and antimicrobial properties were evaluated. The chemical composition of both EOs and respective hydrolates was also characterized. MATERIALS AND METHODS: Chemical characterization of EOs and hydrolates was performed by GC-FID and GC-MS. Cellular biocompatibility was evaluated using the MTT assay in macrophages (RAW 264.7) and fibroblasts (L929) cell lines. Anti-inflammatory activity was investigated by studying nitric oxide (NO) production by macrophages with Griess reagent. Wound healing potential was evaluated with the scratch-wound assay. The antioxidant potential was studied by the DPPH scavenging method. Antimicrobial activity was evaluated by broth microdilution assay against relevant microbial strains and skin pathogens, namely Staphylococcus aureus, Staphylococcus epidermidis, Cutibacterium acnes, Pseudomonas aeruginosa, Escherichia coli, Candida albicans and Aspergillus brasiliensis. RESULTS: The major compounds present in TM and CL EOs were 1,8-cineole and α-pinene, respectively. 1,8-cineole and E-pinocarveol were the major compounds in the correspondent hydrolates. CL EO presented the highest anti-inflammatory potential [EC50 = 0.002% (v/v)], still with significant cytotoxicity [IC50 = 0.012% (v/v)]. TM preparations presented anti-inflammatory potential, also presenting higher biocompatibility. The same profile was present on fibroblasts regarding biocompatibility of the tested preparations. CL EO and hydrolate increased fibroblasts' migration by 155.7% and 148.4%, respectively. TM hydrolate presented a milder activity than CL hydrolate, but wound healing potential was still present, increasing cell migration by 125.1%. All preparations presented poor antioxidant capacity. CL EO presented higher antimicrobial activity, with MICs ranging from 0.06% (v/v) to 2% (v/v), against different microorganisms. CONCLUSIONS: Anti-inflammatory and skin repairing potential were present for CL preparations. TM hydrolate presented an interesting biocompatible profile on both cell lines, also presenting anti-inflammatory potential. Furthermore, EOs from both species presented antimicrobial activity against a panel of different microorganisms. These in vitro bioactivities support some of their traditional skin applications, specifically regarding their antiseptic, wound healing and anti-inflammatory uses.


Assuntos
Anti-Infecciosos Locais , Anti-Infecciosos , Cistus , Óleos Voláteis , Thymus (Planta) , Antioxidantes/farmacologia , Antioxidantes/química , Eucaliptol , Thymus (Planta)/química , Óleos Voláteis/farmacologia , Óleos Voláteis/química , Anti-Infecciosos/farmacologia , Anti-Infecciosos/química , Testes de Sensibilidade Microbiana , Escherichia coli , Anti-Inflamatórios/farmacologia
16.
Gerontology ; 69(6): 684-693, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36538907

RESUMO

INTRODUCTION: Immunosenescence and inflammaging have been implicated in the pathophysiology of frailty. Torquetenovirus (TTV), a single-stranded DNA anellovirus, the major component of the human blood virome, shows an increased replication rate with advancing age. An elevated TTV viremia has been associated with an impaired immune function and an increased risk of mortality in the older population. The objective of this study was to analyze the relation between TTV viremia, physical frailty, and cognitive impairment. METHODS: TTV viremia was measured in 1,131 nonfrail, 45 physically frail, and 113 cognitively impaired older adults recruited in the MARK-AGE study (overall mean age 64.7 ± 5.9 years), and then the results were checked in two other independent cohorts from Spain and Portugal, including 126 frail, 252 prefrail, and 141 nonfrail individuals (overall mean age: 77.5 ± 8.3 years). RESULTS: TTV viremia ≥4log was associated with physical frailty (OR: 4.69; 95% CI: 2.06-10.67, p < 0.0001) and cognitive impairment (OR: 3.49, 95% CI: 2.14-5.69, p < 0.0001) in the MARK-AGE population. The association between TTV DNA load and frailty status was confirmed in the Spanish cohort, while a slight association with cognitive impairment was observed (OR: 1.33; 95% CI: 1.000-1.773), only in the unadjusted model. No association between TTV load and frailty or cognitive impairment was found in the Portuguese sample, although a negative association between TTV viremia and MMSE score was observed in Spanish and Portuguese females. CONCLUSIONS: These findings demonstrate an association between TTV viremia and physical frailty, while the association with cognitive impairment was observed only in the younger population from the MARK-AGE study. Further research is necessary to clarify TTV's clinical relevance in the onset and progression of frailty and cognitive decline in older individuals.


Assuntos
Disfunção Cognitiva , Fragilidade , Torque teno virus , Feminino , Idoso , Humanos , Idoso de 80 Anos ou mais , Fragilidade/epidemiologia , Torque teno virus/fisiologia , Viremia/complicações , Idoso Fragilizado/psicologia , Avaliação Geriátrica , Disfunção Cognitiva/complicações , Disfunção Cognitiva/epidemiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-36462793

RESUMO

Recent studies exploring the relationship between DNA damage measured by the comet assay (single-cell gel electrophoresis) and cognitive function in both animal models and humans are reviewed and summarized. This manuscript provides an overview of studies exploring cognitive dysfunction related to DNA damage due to biological ageing process, cancer treatment, adverse environmental or occupational exposures, and prenatal genotoxic exposure. The review confirms the potential of comet assay to further explore the link between DNA damage, as indicative of genomic instability, and cognitive impairment in different research and clinical areas. Analysed studies support, in fact, the significant relationship between DNA damage and cognitive impairment, mainly affecting attention, working memory and executive functions. These cognitive domains are crucial to daily functioning and occupational performance, with important clinical implications. Although evidence support the relationship between DNA damage measured by the comet assay and cognitive function in different settings, further longitudinal research is needed to disentangle the temporal relationship between them over time, and to explore the potential of comet assay-detected DNA lesions to predict response to interventions.


Assuntos
Disfunção Cognitiva , Dano ao DNA , Animais , Humanos , Feminino , Gravidez , Ensaio Cometa , Cognição , Disfunção Cognitiva/genética , Instabilidade Genômica
18.
Cost Eff Resour Alloc ; 20(1): 71, 2022 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-36527052

RESUMO

BACKGROUND: Governments in Latin America are constantly facing the problem of managing scarce resources to satisfy alternative needs, such as housing, education, food, and healthcare security. Those needs, combined with increasing crime levels, require financial resources to be solved. OBJECTIVE: The objective of this review was to characterizar the health system and health expenditure of a large country (Brazil) and a small country (Chile) and identify some of the challenges these two countries face in improving the health services of their population. METHODS: A literature review was conducted by searching journals, databases, and other electronic resources to identify articles and research publications describing health systems in Brazil and Chile. RESULTS: The review showed that the economic restriction and the economic cycle have an impact on the funding of the public health system. This result was true for the Brazilian health system after 2016, despite the change to a unique health system one decade earlier. In the case of Chile, there are different positions about which one is the best health system: a dual public and private or just public one. As a result, a referendum on September 4, 2022, of a new constitution, which incorporated a unique health system, was rejected. At the same time, the Government ended the copayment in the public health system in September 2022, excluding illnesses referred to the private sector. Another issue detected was the fragility of the public and private sector coverage due to the lack of funding. CONCLUSIONS: The health care system in Chile and Brazil has improved in the last decades. However, the public healthcare systems still need additional funding and efficiency improvement to respond to the growing health requirements needed from the population.

19.
Chemosphere ; 307(Pt 4): 136139, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36007734

RESUMO

The challenge-comet assay is a simple but effective approach that provides a quantitative and functional determination of DNA repair ability, and allows to monitor the kinetics of repair process. Peripheral blood mononuclear cells (PBMC) are the cells most frequently employed in human biomonitoring studies using the challenge-comet assay, but having a validated alternative of non-invasive biomatrix would be highly convenient for certain population groups and circumstances. The objective of this study was to validate the use of salivary leucocytes in the challenge-comet assay. Leucocytes were isolated from saliva samples and challenged (either in fresh or after cryopreservation) with three genotoxic agents acting by different action mechanisms: bleomycin, methyl methanesulfonate, and ultraviolet radiation. Comet assay was performed just after treatment and at other three additional time points, in order to study repair kinetics. The results obtained demonstrated that saliva leucocytes were as suitable as PBMC for assessing DNA damage of different nature that was efficiently repaired over the evaluated time points, even after 5 months of cryopreservation (after a 24 h stimulation with PHA). Furthermore, a new parameter to determine the efficacy of the repair process, independent of the initial amount of damage induced, is proposed, and recommendations to perform the challenge-comet assay with salivary leucocytes depending on the type of DNA repair to be assessed are suggested. Validation studies are needed to verify whether the method is reproducible and results reliable and comparable among laboratories and studies.


Assuntos
Monitoramento Biológico , Leucócitos Mononucleares , Bleomicina , Ensaio Cometa/métodos , Dano ao DNA , Reparo do DNA , Humanos , Metanossulfonato de Metila , Raios Ultravioleta
20.
Toxics ; 10(7)2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35878249

RESUMO

The establishment of self-disinfecting surfaces is an important method to avoid surface contamination. Recently, paints with antimicrobial properties have been developed to be applied on different surfaces, avoiding contamination with pathogens. In this work, self-disinfecting paints containing Chloroxylenol (CLX), Terpineol (TRP), and a mixture of both substances were developed. The goal was to evaluate and validate these paints using international standards for eventual commercialization and application in scenarios where surface contamination represents a problem. The paints were challenged with five different bacteria, Gram-positive and Gram-negative, before and after a scrub resistance test, where the long-term efficacy of the paints was evaluated. The antibacterial activity assessment was performed following ISO 22196 and JIS Z2801. In general, the paints showed very promising results, demonstrating their antibacterial activity, before and after scrub resistance test. The paint incorporating the mixture of CLX and TRP (CLX+TRP) stood out by revealing consistent results of antibacterial activity both before and after the scrub resistance test for most of the tested bacteria. The cytotoxicity of the developed paints was assessed in vitro by performing tests by direct contact with a human skin cell line, HaCaT, and testes on extracts with HaCaT and a pulmonary cell line, A549. The methodologies for cytotoxicity assessment were developed based in ISO 10993. For genotoxicity assessment, alkaline comet assay was conducted on both cell lines. The cytotoxicity assessment revealed promising results with the paints, demonstrating values of cellular viability above 70% and values of lactate dehydrogenase (LDH) leakage below 30%. The genotoxic assessment also revealed acceptable values of primary DNA damage for the developed antibacterial paints. In general, the selected methodologies presented good potential to be applied in the validation of both efficacy and safety of the antimicrobial paints, aiming to be applied in real scenarios.

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