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1.
Auris Nasus Larynx ; 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31272842

RESUMO

OBJECTIVE: Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) is a disease that features a mechanical dysfunction involving chronic inflammation and altered tissue remodeling. In this study, we aim to evaluate the fibroblast morphology and its cellular traction force in primary fibroblasts cell cultures obtained from both healthy individuals (n=7) and patients with CRSwNP (n=8). METHODS: Using a Traction-force Microscopy we analyzed parameters of Force/Tension in fibroblasts cultures in both experimental groups. RESULTS: The analysis of the Projected Area of Cell revealed that fibroblasts derived from nasal mucosa of healthy individuals have an area on average 39.24% larger than the fibroblasts obtained from the nasal polyp tissue. We also observed that the parameters directly related to the force of the cell, Max Cumulative Force and Net Contractile Moment, presented a high Force/Tension per unit of area in the fibroblasts derived from the healthy nasal mucosa (on average 41% and 52.54% higher than the fibroblasts of the nasal polyp respectively). CONCLUSION: Our results demonstrate a cellular mechanism that may be associated with the mechanical dysfunction found in the Nasal Polyp tissue. The weak traction force of nasal polyp-derived fibroblast may, in lower dimensions, impact on the remodeling of nasal mucosa in CRSwNP.

2.
BMC Geriatr ; 19(1): 89, 2019 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-30898161

RESUMO

BACKGROUND: The study objectives were to identify the main predictive factors for long hospital stays and to propose new and improved methods of risk assessment. METHODS: This prospective cohort study was conducted in the clinics and surgical wards of a tertiary hospital and involved 523 elderly patients over 60 years of age. Demographic, clinical, functional, and cognitive characteristics assessed between 48 and 72 h after admission were analyzed to investigate correlations with lengths of stay greater than 10 days. Univariate and multivariate analyses were performed, and in the final model, long-term probability scores were estimated for each variable. RESULTS: Of the 523 patients studied, 33 (6.3%) remained hospitalized for more than 10 days. Multiple regression analysis revealed that both the presence of diabetes and the inability to perform chair-to-bed transfers (Barthel Index) remained significant risk predictors. Diabetes doubled the risk of prolonged hospital stays, while a chair-to-bed transfer score of 0 or 5 led to an eight-fold increase in risk. CONCLUSIONS: In this study, we propose an easy method that can be used, after external validation, to screen for long-term risk (using diabetes and bed/chair transfer) as a first step in identifying hospitalized elderly patients who will require comprehensive assessment to guide prevention plans and rehabilitation programs.


Assuntos
Tempo de Internação/tendências , Limitação da Mobilidade , Movimentação e Reposicionamento de Pacientes/tendências , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Hospitalização/tendências , Humanos , Masculino , Movimentação e Reposicionamento de Pacientes/métodos , Análise Multivariada , Estudos Prospectivos , Medição de Risco
5.
Rev. bras. promoç. saúde (Impr.) ; 31(2): 1-9, 22/06/2018.
Artigo em Inglês, Português | LILACS | ID: biblio-906863

RESUMO

OBJETIVO: Avaliar os efeitos de um programa de exercícios na redução dos fatores de risco cardiovascular em idosos sedentários e hipertensos. MÉTODOS: Trata-se de ensaio clínico não randomizado, realizado em uma clínica escola de fisioterapia em São Paulo, em 2016, com amostra de 34 idosos que realizaram um programa de exercícios de noventa minutos, duas vezes por semana, durante o período de três meses. As variáveis avaliadas foram: pressão arterial, índice de massa corporal, frações de colesterol, colesterol total e triglicérides. Houve comparação dos dados em dois momentos, antes do início e ao término do programa de exercícios, considerando-se p<0,0001 em todos os casos pelo teste de Wilcoxon. RESULTADOS: Encontrou-se idade mediana dos avaliados (intervalo interquartis) de 63 (61-66) anos, sendo 25 (74%) do sexo feminino. Após três meses, houve redução estatisticamente significativa do peso, índice de massa corpórea, pressão arterial sistólica (PAS) e diastólica (PAD) dos idosos avaliados (p < 0,0001 em todos os casos). CONCLUSÃO: O efeito do programa de exercícios foi eficaz na redução dos fatores de risco cardiovascular dos idosos sedentários e hipertensos estudados. (AU)


OBJECTIVE: To assess the effects of an exercise program on the reduction of cardiovascular risk factors in sedentary hypertensive older adults. METHODS: This is a nonrandomized clinical trial carried out in a physical therapy teaching clinic in São Paulo in 2016 with a sample of 34 older adults who performed a ninety-minute exercise program twice a week for three months. The analyzed variables were: blood pressure, body mass index, cholesterol fractions, total cholesterol and triglycerides. Data were compared in two stages, before and after the exercise program, with p<0.0001 in all cases using the Wilcoxon test. RESULTS: The median age of the participants (interquartile range) was 63 (61-66) years, with 25 (74%) women. After three months, there was a statistically significant reduction in weight, body mass index, systolic (SBP) and diastolic blood pressure (DBP) in the analyzed older adults (p<0.0001 in all cases). CONCLUSION: The exercise program was effective in reducing cardiovascular risk factors in the sedentary hypertensive older adults analyzed. (AU)


OBJETIVO: Evaluar los efectos de un programa de ejercicios para la disminución de los factores de riesgo cardiovascular de mayores sedentarios e hipertensos. MÉTODOS: Se trata de un ensayo clínico no randomizado realizado en una clínica escuela de fisioterapia de São Paulo, en 2016, con una muestra de 34 mayores que realizaron un programa de ejercicios de noventa minutos, dos veces a la semana durante el período de tres meses. Las variables evaluadas fueron: la presión arterial, el índice de masa corporal, las fracciones de colesterol, el colesterol total y los triglicéridos. La comparación de los datos se dio en dos momentos: antes del inicio y al final del programa de ejercicios con p<0,0001 para todos los casos a través del test de Wilcoxon. RESULTADOS: La edad mediana de los evaluados (intervalo intercuartil) fue de 63 (61-66) años y 25 (74%) años para el sexo femenino. Tras tres meses hubo reducción estadísticamente significativa del peso, el índice de masa corporal y la presión arterial sistólica (PAS) y diastólica (PAD) de los mayores evaluados (p < 0,0001 para todos los casos). CONCLUSIÓN: El efecto del programa de ejercicios ha sido eficaz para la reducción de los factores de riesgo cardiovascular de los mayores sedentarios e hipertensos estudiados. (AU)


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Idoso , Doenças Cardiovasculares , Exercício , Hipertensão
6.
Arq Bras Cardiol ; 108(3): 212-216, 2017 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-28443964

RESUMO

BACKGROUND: The effects of chronic exposure to exercise training on vascular biomarkers have been poorly explored. OBJECTIVE: Our study aimed to compare the amounts of endothelial progenitor cells (EPCs), and endothelial (EMP) and platelet (PMP) microparticles between professional runners and healthy controls. METHODS: Twenty-five half-marathon runners and 24 age- and gender-matched healthy controls were included in the study. EPCs (CD34+/KDR+, CD133+/KDR+, and CD34+/CD133+), EMP (CD51+) and PMP (CD42+/CD31+) were quantified by flow-cytometry. All blood samples were obtained after 12 h of fasting and the athletes were encouraged to perform their routine exercises on the day before. RESULTS: As compared with controls, the CD34+/KDR+ EPCs (p=0.038) and CD133+/KDR+ EPCs (p=0.018) were increased, whereas CD34+/CD133+ EPCs were not different (p=0.51) in athletes. In addition, there was no difference in MPs levels between the groups. CONCLUSION: Chronic exposure to exercise in professional runners was associated with higher percentage of EPCs. Taking into account the similar number of MPs in athletes and controls, the study suggests a favorable effect of exercise on these vascular biomarkers.


Assuntos
Atletas , Plaquetas/fisiologia , Micropartículas Derivadas de Células/fisiologia , Células Progenitoras Endoteliais/fisiologia , Corrida/fisiologia , Antígeno AC133/sangue , Antígenos CD34/sangue , Biomarcadores/sangue , Teste de Esforço , Feminino , Citometria de Fluxo , Humanos , Masculino , Valores de Referência , Espirometria , Estatísticas não Paramétricas , Fatores de Tempo , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/sangue
7.
Einstein (Sao Paulo) ; 15(1): 34-39, 2017.
Artigo em Inglês, Português | MEDLINE | ID: mdl-28444086

RESUMO

Objective: To investigate whether the urine dipstick screening test can be used to predict urine culture results. Methods: A retrospective study conducted between January and December 2014 based on data from 8,587 patients with a medical order for urine dipstick test, urine sediment analysis and urine culture. Sensitivity, specificity, positive and negative predictive values were determined and ROC curve analysis was performed. Results: The percentage of positive cultures was 17.5%. Nitrite had 28% sensitivity and 99% specificity, with positive and negative predictive values of 89% and 87%, respectively. Leukocyte esterase had 79% sensitivity and 84% specificity, with positive and negative predictive values of 51% and 95%, respectively. The combination of positive nitrite or positive leukocyte esterase tests had 85% sensitivity and 84% specificity, with positive and negative predictive values of 53% and 96%, respectively. Positive urinary sediment (more than ten leukocytes per microliter) had 92% sensitivity and 71% specificity, with positive and negative predictive values of 40% and 98%, respectively. The combination of nitrite positive test and positive urinary sediment had 82% sensitivity and 99% specificity, with positive and negative predictive values of 91% and 98%, respectively. The combination of nitrite or leukocyte esterase positive tests and positive urinary sediment had the highest sensitivity (94%) and specificity (84%), with positive and negative predictive values of 58% and 99%, respectively. Based on ROC curve analysis, the best indicator of positive urine culture was the combination of positives leukocyte esterase or nitrite tests and positive urinary sediment, followed by positives leukocyte and nitrite tests, positive urinary sediment alone, positive leukocyte esterase test alone, positive nitrite test alone and finally association of positives nitrite and urinary sediment (AUC: 0.845, 0.844, 0.817, 0.814, 0.635 and 0.626, respectively). Conclusion: A negative urine culture can be predicted by negative dipstick test results. Therefore, this test may be a reliable predictor of negative urine culture. Objetivo: Verificar se a triagem de urina por fitas reativas é capaz de predizer a cultura de urina. Métodos Estudo retrospectivo realizado entre janeiro e dezembro de 2014 com 8.587 pacientes, com solicitação médica de triagem de urina (fita), sedimento urinário e cultura de urina. Foram analisados: sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e curva ROC. Resultados: Foram positivas 17,5% das culturas. O nitrito apresentou sensibilidade de 28% e especificidade de 99%. O valor preditivo positivo foi de 89% e o valor preditivo negativo de 87%. Esterase apresentou sensibilidade de 79% e especificidade de 84%. Valor preditivo positivo e valor preditivo negativo foram de 51% e 95%, respectivamente. A combinação de nitrito ou esterase positivos apresentou sensibilidade de 85% e especificidade de 84%. Valor preditivo positivo e valor preditivo negativo foram, respectivamente, 53% e 96%. O sedimento positivo (mais de dez leucócitos por microlitro) apresentou sensibilidade de 92% e especificidade de 71%. O valor preditivo positivo foi 40% e o negativo, 98%. A combinação de nitrito e sedimento urinário positivos apresentou sensibilidade de 82% e especificidade de 99%. Os valores preditivos positivo e negativo foram 91% e 98%, respectivamente. Para o nitrito ou esterase positivos mais os leucócitos positivos, a sensibilidade foi de 94% e a especificidade de 84%. O valor preditivo positivo foi de 58% e o negativo foi de 99%. Com base na curva ROC, o melhor indicador de urocultura positiva foi a associação entre a esterase ou nitrito positivos na fita mais os leucócitos positivos no sedimento, seguido por nitrito e esterase positivos, sedimento urinário positivo isolado, esterase positiva isolada, nitrito positivo isolado e, finalmente, pela associação entre nitrito e sedimento urinário positivos (AUC: 0,845, 0,844, 0,817, 0,814, 0,635 e 0,626, respectivamente). Conclusão: Uma urocultura negativa pode ser prevista com resultados negativos na fita. Portanto, este teste pode ser um preditor confiável de urocultura negativa.


Assuntos
Bacteriúria/urina , Urinálise/instrumentação , Urinálise/métodos , Adulto , Análise de Variância , Pré-Escolar , Contagem de Colônia Microbiana , Esterases/urina , Humanos , Leucócitos , Masculino , Pessoa de Meia-Idade , Nitritos/urina , Padrões de Referência , Valores de Referência , Estudos Retrospectivos , Sensibilidade e Especificidade , Infecções Urinárias/urina , Urina/microbiologia
8.
Arq. bras. cardiol ; 108(3): 212-216, Mar. 2017. graf
Artigo em Inglês | LILACS-Express | ID: biblio-838711

RESUMO

Abstract Background: The effects of chronic exposure to exercise training on vascular biomarkers have been poorly explored. Objective: Our study aimed to compare the amounts of endothelial progenitor cells (EPCs), and endothelial (EMP) and platelet (PMP) microparticles between professional runners and healthy controls. Methods: Twenty-five half-marathon runners and 24 age- and gender-matched healthy controls were included in the study. EPCs (CD34+/KDR+, CD133+/KDR+, and CD34+/CD133+), EMP (CD51+) and PMP (CD42+/CD31+) were quantified by flow-cytometry. All blood samples were obtained after 12 h of fasting and the athletes were encouraged to perform their routine exercises on the day before. Results: As compared with controls, the CD34+/KDR+ EPCs (p=0.038) and CD133+/KDR+ EPCs (p=0.018) were increased, whereas CD34+/CD133+ EPCs were not different (p=0.51) in athletes. In addition, there was no difference in MPs levels between the groups. Conclusion: Chronic exposure to exercise in professional runners was associated with higher percentage of EPCs. Taking into account the similar number of MPs in athletes and controls, the study suggests a favorable effect of exercise on these vascular biomarkers.


Resumo Fundamento: Os efeitos da exposição crônica ao exercício sobre biomarcadores vasculares foram pouco estudados. Objetivo: Nosso estudo teve como objetivo comparar as quantidades de células progenitoras endoteliais (CPEs), e de micropartículas endoteliais (MPEs) e plequetárias (MPPs) de corredores profissionais com controles sadios. Métodos: Vinte e cinco corredores de meia maratona e 24 controles pareados quanto à idade e ao sexo foram incluídos no estudo. CPEs (CD34+/KDR+, CD133+/KDR+ e CD34+/CD133+), MPE (CD51+) e MPPs (CD42+/CD31+) foram quantificadas por citometria de fluxo. Todas as amostras de sangue foram obtidas após 12 horas de jejum, e os atletas foram incentivados a realizar seus exercícios de rotina no dia anterior à coleta. Resultados: Em comparação aos controles, CPEs CD34+/KDR+ (p=0,038) e CD133+/KDR+ (p=0,018) estavam aumentados, e CPEs CD34+/CD133+ não foram diferentes (p=0,51) nos atletas. As concentrações de MP não diferiram entre os grupos. Conclusão: A exposição crônica ao exercício em corredores profissionais associou-se a uma maior porcentagem de CPEs. Considerando o número similar de MPs entre atletas e controles, o estudo sugere um efeito favorável do exercício sobre esses biomarcadores vasculares.

9.
Einstein (Säo Paulo) ; 15(1): 34-39, Jan.-Mar. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-840287

RESUMO

ABSTRACT Objective To investigate whether the urine dipstick screening test can be used to predict urine culture results. Methods A retrospective study conducted between January and December 2014 based on data from 8,587 patients with a medical order for urine dipstick test, urine sediment analysis and urine culture. Sensitivity, specificity, positive and negative predictive values were determined and ROC curve analysis was performed. Results The percentage of positive cultures was 17.5%. Nitrite had 28% sensitivity and 99% specificity, with positive and negative predictive values of 89% and 87%, respectively. Leukocyte esterase had 79% sensitivity and 84% specificity, with positive and negative predictive values of 51% and 95%, respectively. The combination of positive nitrite or positive leukocyte esterase tests had 85% sensitivity and 84% specificity, with positive and negative predictive values of 53% and 96%, respectively. Positive urinary sediment (more than ten leukocytes per microliter) had 92% sensitivity and 71% specificity, with positive and negative predictive values of 40% and 98%, respectively. The combination of nitrite positive test and positive urinary sediment had 82% sensitivity and 99% specificity, with positive and negative predictive values of 91% and 98%, respectively. The combination of nitrite or leukocyte esterase positive tests and positive urinary sediment had the highest sensitivity (94%) and specificity (84%), with positive and negative predictive values of 58% and 99%, respectively. Based on ROC curve analysis, the best indicator of positive urine culture was the combination of positives leukocyte esterase or nitrite tests and positive urinary sediment, followed by positives leukocyte and nitrite tests, positive urinary sediment alone, positive leukocyte esterase test alone, positive nitrite test alone and finally association of positives nitrite and urinary sediment (AUC: 0.845, 0.844, 0.817, 0.814, 0.635 and 0.626, respectively). Conclusion A negative urine culture can be predicted by negative dipstick test results. Therefore, this test may be a reliable predictor of negative urine culture.


RESUMO Objetivo Verificar se a triagem de urina por fitas reativas é capaz de predizer a cultura de urina. Métodos Estudo retrospectivo realizado entre janeiro e dezembro de 2014 com 8.587 pacientes, com solicitação médica de triagem de urina (fita), sedimento urinário e cultura de urina. Foram analisados sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e curva ROC. Resultados Foram positivas 17,5% das culturas. O nitrito apresentou sensibilidade de 28% e especificidade de 99%. O valor preditivo positivo foi de 89% e o valor preditivo negativo de 87%. Esterase apresentou sensibilidade de 79% e especificidade de 84%. Valor preditivo positivo e valor preditivo negativo foram de 51% e 95%, respectivamente. A combinação de nitrito ou esterase positivos apresentou sensibilidade de 85% e especificidade de 84%. Valor preditivo positivo e valor preditivo negativo foram, respectivamente, 53% e 96%. O sedimento positivo (mais de dez leucócitos por microlitro) apresentou sensibilidade de 92% e especificidade de 71%. O valor preditivo positivo foi 40% e o negativo, 98%. A combinação de nitrito e sedimento urinário positivos apresentou sensibilidade de 82% e especificidade de 99%. Os valores preditivos positivo e negativo foram 91% e 98%, respectivamente. Para o nitrito ou esterase positivos mais os leucócitos positivos, a sensibilidade foi de 94% e a especificidade de 84%. O valor preditivo positivo foi de 58% e o negativo foi de 99%. Com base na curva ROC, o melhor indicador de urocultura positiva foi a associação entre a esterase ou nitrito positivos na fita mais os leucócitos positivos no sedimento, seguido por nitrito e esterase positivos, sedimento urinário positivo isolado, esterase positiva isolada, nitrito positivo isolado e, finalmente, pela associação entre nitrito e sedimento urinário positivos (AUC: 0,845, 0,844, 0,817, 0,814, 0,635 e 0,626, respectivamente). Conclusão Uma urocultura negativa pode ser prevista com resultados negativos na fita. Portanto, este teste pode ser um preditor confiável de urocultura negativa.


Assuntos
Humanos , Masculino , Pré-Escolar , Adulto , Pessoa de Meia-Idade , Bacteriúria/urina , Urinálise/instrumentação , Urinálise/métodos , Padrões de Referência , Valores de Referência , Infecções Urinárias/urina , Urina/microbiologia , Contagem de Colônia Microbiana , Estudos Retrospectivos , Análise de Variância , Sensibilidade e Especificidade , Esterases/urina , Leucócitos , Nitritos/urina
10.
PLoS One ; 12(2): e0171272, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28170419

RESUMO

Rivaroxaban is an oral direct factor Xa inhibitor, therapeutically indicated in the treatment of thromboembolic diseases. As other new oral anticoagulants, routine monitoring of rivaroxaban is not necessary, but important in some clinical circumstances. In our study a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was validated to measure rivaroxaban plasmatic concentration. Our method used a simple sample preparation, protein precipitation, and a fast chromatographic run. It was developed a precise and accurate method, with a linear range from 2 to 500 ng/mL, and a lower limit of quantification of 4 pg on column. The new method was compared to a reference method (anti-factor Xa activity) and both presented a good correlation (r = 0.98, p < 0.001). In addition, we validated hemolytic, icteric or lipemic plasma samples for rivaroxaban measurement by HPLC-MS/MS without interferences. The chromogenic and HPLC-MS/MS methods were highly correlated and should be used as clinical tools for drug monitoring. The method was applied successfully in a group of 49 real-life patients, which allowed an accurate determination of rivaroxaban in peak and trough levels.


Assuntos
Testes de Coagulação Sanguínea , Cromatografia Líquida de Alta Pressão , Inibidores do Fator Xa/farmacocinética , Rivaroxabana/farmacocinética , Espectrometria de Massas em Tandem , Monitoramento de Medicamentos , Inibidores do Fator Xa/uso terapêutico , Humanos , Reprodutibilidade dos Testes , Rivaroxabana/uso terapêutico , Sensibilidade e Especificidade
11.
Rev. bras. ciênc. saúde ; v.21(n.4): 307-312, 2017. ilus
Artigo em Português | LILACS | ID: biblio-1006860

RESUMO

Objetivo: Avaliar o nível de estresse em alunos do quarto (último) ano de graduação, na fase de elaboração do Trabalho de Conclusão de Curso. Material e Métodos: Foram incluídos 51 alunos dos cursos de Graduação em Fisioterapia, Biologia e Sistemas de Informação de uma universidade de São Paulo - SP, que foram avaliados por meio de questionário de coleta de dados e pelo Inventário para Sintomas de Estresse em Adultos de Lipp. Resultados: Observou-se que o grupo Fisioterapia referiu com maior frequência (n= 10, 76,9%) que tem que fazer as atividades com muita rapidez e 69,2% (n= 9) do mesmo grupo afirmou que o trabalho exige frequentemente habilidades ou conhecimentos especializados (p = 0,002 e p = 0,02, respectivamente, Teste de Kruskal-Wallis). O grupo Biologia pareceu ter o pior relacionamento com os chefes e o melhor com os colegas e também referiu o maior número de sintomas associados ao estresse em 24 horas, uma semana e um mês (p < 0,0001, p < 0,0001 e p = 0,009, respectivamente, Teste de KruskalWallis). Conclusão: O grupo Sistemas de Informação apresentou menor número de sintomas associados ao estresse, sugerindo maior adaptabilidade às exigências e problemas do dia-a-dia por esse grupo, comparado à Fisioterapia e Biologia.(AU)


Objective: To evaluate the level of stress among fourthyear undergraduate students in preparation of their course term projects. Materials and Methods: 51 students of Physiotherapy, Biology and Information Systems from a university in São Paulo were included. The student were evaluated using a questionnaire and the Lipp's Stress Symptoms Inventory for adults. Results: The Physiotherapy group reported most frequently having to do the activities very quickly (n= 10, 76.9%). Of these, 69.2% (n=9) reported that the work often requires skill or specialized knowledge (p=0.002 and p=0.02, respectively, Kruskal-Wallis Test). The Biology group seemed to have the worst relationship with the bosses and the best with colleagues and also reported the highest number of symptoms associated with stress in 24 hours, one week and one month (p<0.0001, p<0.0001 and p=0.009 respectively, Kruskal-Wallis Test). Conclusion: The Information Systems group presented a lower number of symptoms related to stress, suggesting more adaptability to the demands and day-by-day problems as compared to Physiotherapy and Biology.(AU)


Assuntos
Humanos , Masculino , Adulto , Esgotamento Profissional , Transtornos de Estresse Traumático , Estudantes , Universidades , Monografia
12.
PLoS One ; 11(11): e0166009, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27835659

RESUMO

To evaluate the effects of long-term exposure to high-intensity training among professional runners on cardiac hypertrophy and subclinical atherosclerosis. Prospective study included runners of both sexes (n = 52) and age and gender matched controls (n = 57), without classical cardiovascular risk factors. Ventricular hypertrophy was quantified by echocardiography by linear method and carotid intima-media thickness (cIMT) by 2-D images obtained by ultrasonography. Endothelial function was evaluated by flow-mediated dilation (FMD). Steroid hormones were quantified by HPLC followed by LC-MS/MS. Higher left ventricular (LV) mass index was found in male athletes (p<0.0001 vs. other groups). When adjusted for gender, the degree of left ventricular mass index classified as mildly, moderately or severely abnormal was obtained in 26%, 35%, and 30%, respectively, of female athletes, and in 39%, 14%, and 21%, respectively, of male athletes. Higher ratio of the early (E) to late (A) ventricular filling velocities was found in athletes of both genders. Male athletes presented lower cIMT in the right (p = 0.012 vs. male controls) and left (p<0.0001 vs. male controls) common carotid arteries, without differences in cIMT between female athletes and controls. FMD results were similar among groups. Higher serum testosterone levels were found in male athletes (p<0.0001 vs. other groups) and they were correlated with LV mass (r = 0.50, p<0.0001). The chronic exposure of high-intensity training among professional runners of both genders was associated with increased ventricular mass and adaptive remodeling. Less subclinical atherosclerosis was found in male athletes. Differences in steroid hormones may account in part for these findings.


Assuntos
Aterosclerose/diagnóstico por imagem , Cardiomegalia/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Corrida/fisiologia , Adulto , Aterosclerose/sangue , Aterosclerose/fisiopatologia , Atletas , Cardiomegalia/sangue , Cardiomegalia/fisiopatologia , Espessura Intima-Media Carotídea , Estudos de Casos e Controles , Corticosterona/sangue , Cortodoxona/sangue , Ecocardiografia , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Resistência Física , Estudos Prospectivos , Testosterona/sangue , Ultrassonografia , Função Ventricular Esquerda
13.
Rev Inst Med Trop Sao Paulo ; 58: 69, 2016 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-27680174

RESUMO

Cryptococcosis is a leading invasive fungal infection in immunocompromised patients. Considering the high prevalence and severity of these infections in immunocompromised patients attended at HC-FMRP-USP, the present research aimed to characterize the clinical isolates of Cryptococcus strains by biochemical and molecular methods and evaluate antifungal susceptibility of clinical isolates. Fifty isolates from 32 HIV-positive patients were obtained at HC-FMRP-USP. Most of the isolates (78.1%) were identified as C. neoformans, and 100% of C. neoformans and C. gattii strains were susceptible to amphotericin B, ketoconazole and fluconazole. All isolates were classified as serotype A (grubbii variety) by PCR and most of them were characterized in mating type MATa. PCR analysis of specific M13 microsatellite sequence revealed that VNI type was predominant among C. neoformans, while VGII was predominant among C. gattii. The strains did not show a significant resistance to the antifungals tested, and Canavanine-Glycine-Bromthymol Blue Agar (CGB) proved to be a reliable test presenting a good correlation with the molecular characterization. C. neoformans isolated from disseminated infections in the same patient showed molecular identity when different anatomical sites were compared; besides, the studied strains did not present a significant increase in resistance to antifungal agents. In addition, the homogeneity of the molecular types and detection of the mating types suggested a low possibility of crossing among the strains.

15.
Clin Chim Acta ; 446: 263-6, 2015 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-25952166

RESUMO

BACKGROUND: We evaluated the clinical correlation between the CardioChek PA analyzer and a clinical laboratory reference method to use for screening program purposes. METHODS: Fasting blood samples were collected on 516 patients (age 20-85 y). One venous sample was collected using a serum tube for the evaluation on a COBAS reference analyzer. A second venous sample was collected in a lithium heparin tube and was evaluated on the CardioChek PA analyzer (CCPA venous). A fingerstick sample (CCPA fingerstick) was evaluated only on the CardioChek PA analyzer. Linear regression analyses were performed for each measured analyte, total cholesterol, HDL-cholesterol and triglycerides. RESULTS: The correlation between the CCPA fingerstick and CCPA venous was extremely high for HDL-C and triglycerides, and good for total cholesterol. Our results demonstrated a good clinical agreement for total cholesterol, HDL-C and triglycerides between 97.7% and 94.6% in the comparison of the CCPA to the reference analyzer. CONCLUSIONS: We identified the pre-analytic phase as an important step to guarantee the quality of results and indicate that the CardioChek PA is a reliable lipid point-of-care testing system that can be used for the application of clinical screening anywhere.


Assuntos
Automação Laboratorial/normas , Doenças Cardiovasculares/sangue , HDL-Colesterol/sangue , Testes Imediatos/normas , Triglicerídeos/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/diagnóstico , Jejum/sangue , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto
17.
Arq. bras. cardiol ; 104(2): 169-174, 02/2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-741150

RESUMO

Primary prevention of cardiovascular disease is a choice of great relevance because of its impact on health. Some biomarkers, such as microparticles derived from different cell populations, have been considered useful in the assessment of cardiovascular disease. Microparticles are released by the membrane structures of different cell types upon activation or apoptosis, and are present in the plasma of healthy individuals (in levels considered physiological) and in patients with different pathologies. Many studies have suggested an association between microparticles and different pathological conditions, mainly the relationship with the development of cardiovascular diseases. Moreover, the effects of different lipid-lowering therapies have been described in regard to measurement of microparticles. The studies are still controversial regarding the levels of microparticles that can be considered pathological. In addition, the methodologies used still vary, suggesting the need for standardization of the different protocols applied, aiming at using microparticles as biomarkers in clinical practice.


A prevenção primária da doença cardiovascular constitui uma opção de grande relevância pelos seus impactos na saúde. Alguns biomarcadores têm sido considerados úteis na avaliação da doença cardiovascular, dentre eles micropartículas originadas de diferentes populações de células. Micropartículas são estruturas liberadas pela membrana de diferentes tipos celulares após ativação ou apoptose, presentes tanto no plasma de indivíduos saudáveis (níveis considerados fisiológicos) quanto em portadores de diferentes doenças. Muitos estudos têm sugerido uma associação entre micropartículas e diferentes condições patológicas, destacando-se a relação com o desenvolvimento das doenças cardiovasculares. Além disso, têm sido descritos os efeitos de diferentes terapias hipolipemiantes na mensuração de micropartículas. Os estudos ainda são controversos quanto aos níveis de micropartículas que possam ser considerados patológicos, e os métodos utilizados ainda são variados, o que sugere a necessidade da padronização dos diferentes protocolos utilizados, visando à utilização de micropartículas como biomarcadores úteis na prática clínica.


Assuntos
Humanos , Doenças Cardiovasculares/patologia , Micropartículas Derivadas de Células/patologia , Biomarcadores , Plaquetas/patologia , Diabetes Mellitus/patologia , Células Endoteliais/patologia , Endotélio/patologia , Ilustração Médica , Monócitos/patologia
18.
Arq Bras Cardiol ; 104(2): 169-74, 2015 Feb.
Artigo em Inglês, Português | MEDLINE | ID: mdl-25626759

RESUMO

Primary prevention of cardiovascular disease is a choice of great relevance because of its impact on health. Some biomarkers, such as microparticles derived from different cell populations, have been considered useful in the assessment of cardiovascular disease. Microparticles are released by the membrane structures of different cell types upon activation or apoptosis, and are present in the plasma of healthy individuals (in levels considered physiological) and in patients with different pathologies. Many studies have suggested an association between microparticles and different pathological conditions, mainly the relationship with the development of cardiovascular diseases. Moreover, the effects of different lipid-lowering therapies have been described in regard to measurement of microparticles. The studies are still controversial regarding the levels of microparticles that can be considered pathological. In addition, the methodologies used still vary, suggesting the need for standardization of the different protocols applied, aiming at using microparticles as biomarkers in clinical practice.


Assuntos
Doenças Cardiovasculares/patologia , Micropartículas Derivadas de Células/patologia , Biomarcadores , Plaquetas/patologia , Diabetes Mellitus/patologia , Células Endoteliais/patologia , Endotélio/patologia , Humanos , Ilustração Médica , Monócitos/patologia
19.
Clin Med Res ; 13(2): 58-64, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25380611

RESUMO

OBJECTIVE: Detect the main predictive non-motor factors related to independent community ambulation after stroke. Furthermore, we propose a scale to estimate the probability of a stroke patient achieving independent community ambulation after 6 months of rehabilitation. DESIGN AND SETTINGS: Prospective cohort. Subjects treated in a rehabilitation center in a large metropolitan area. Independent community ambulation was evaluated after rehabilitation according to the Hoffer classification. Functional ambulation was assessed at four levels: nonambulatory, nonfunctional ambulation, household ambulation, and community ambulation. PARTICIPANTS: Patients (n=201) with a moderate disability after stroke. RESULTS: The average time of hospitalization was 19.3 days. However, only 32.8% of the patients started the rehabilitation program during the first 6 months after stroke. We found that 121 patients achieved community ambulation (60.2%), 40 achieved household ambulation (19.9%), 12 achieved therapeutic ambulation (5.9%), and 28 were non-ambulatory after 6 months of treatment. Based on our final model, a scoring scale was created in order to evaluate the probability of stroke patients achieving independent community ambulation after 6 months of rehabilitation. Higher scores were associated with better chances of community ambulation within 6 months. CONCLUSIONS: The scale that evaluated these factors proved to have acceptable sensitivity and specificity to establish the prognosis of community ambulation after 6 months of rehabilitation.


Assuntos
Atividades Cotidianas , Reabilitação do Acidente Vascular Cerebral , Caminhada , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico
20.
Atherosclerosis ; 236(2): 400-10, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25150938

RESUMO

OBJECTIVE: Obstructive sleep apnoea (OSA) has been implicated as a risk factor for atherosclerosis. The aim of our study was to examine the effects of chronic intermittent hypoxia in apoE-/- mice serving as model of OSA on endothelial dysfunction and oxidative stress and to evaluate the reversibility of hypoxia-induced changes under anti-inflammatory infliximab and anti-oxidative l-glutathione. METHODS: ApoE-/- mice were divided into 4 groups (n = 9 each): 1. intermittent hypoxia 8 h/day for 6 weeks, 2. intermittent hypoxia + injections of infliximab, 3. intermittent hypoxia + injections of l-glutathione, 4. normoxia = control. RESULTS: Endothelial function was impaired under hypoxia compared to control. Application of infliximab and l-glutathione improved it to a level of control. The percentage of endothelial microparticles increased under hypoxia compared to other groups. Levels of NADPH oxidase 2-derived reactive oxygen species were approximately 9 times higher in the hypoxia group. The number of sca-1/flk-1+ endothelial progenitor cells was higher in bone marrow and lower in blood under hypoxia vs. other groups. Stromal cell derived factor-1alpha- and matrix metalloproteinase-9-dependent release of these cells from bone marrow was attenuated under hypoxia. The number of DilacLDL+/lectin + early outgrowth progenitor cells and that of colony forming units from these cells were higher under hypoxia. Atherosclerotic plaques in the aorta were more frequent under hypoxia and control in comparison with both drug groups. CONCLUSION: Intermittent hypoxia contributes to endothelial dysfunction by the local increase in reactive oxygen species and reduction of the peripheral repair capacity. Infliximab and l-glutathione prevent hypoxia-induced vascular and extravascular changes.


Assuntos
Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Antioxidantes/uso terapêutico , Endotélio Vascular/fisiopatologia , Glutationa/uso terapêutico , Hipóxia/fisiopatologia , Animais , Doenças da Aorta/etiologia , Apolipoproteínas E/deficiência , Medula Óssea/fisiopatologia , Micropartículas Derivadas de Células , Células Cultivadas , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Células Progenitoras Endoteliais/fisiologia , Feminino , Hipóxia/sangue , Hipóxia/tratamento farmacológico , Infliximab , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Estresse Oxidativo , Placa Aterosclerótica/etiologia , Espécies Reativas de Oxigênio/sangue , Apneia Obstrutiva do Sono , Baço/citologia
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