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1.
Cell Mol Life Sci ; 79(6): 292, 2022 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-35562545

RESUMO

Correct development of the human placenta and its differentiated epithelial cells, syncytial trophoblasts (STBs) and extravillous trophoblasts (EVTs), is crucial for a successful pregnancy outcome. STBs develop by cell fusion of mononuclear cytotrophoblasts (CTBs) in placental floating villi, whereas migratory EVTs originate from specialized villi anchoring to the maternal decidua. Defects in trophoblast differentiation have been associated with severe pregnancy disorders such as early-onset preeclampsia and fetal growth restriction. However, the evolutionary pathways underlying normal and adverse placentation are poorly understood. Herein, we discuss Wingless (WNT) and NOTCH signaling, two pathways that play pivotal roles in human placenta and trophoblast development. Whereas WNT is necessary for expansion of trophoblast progenitors and stem cells, NOTCH1 is required for proliferation and survival of EVT precursors. Differentiation of the latter is orchestrated by a switch in NOTCH receptor expression as well as by changes in WNT ligands and their downstream effectors.

2.
Wien Klin Wochenschr ; 2022 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-35552810

RESUMO

BACKGROUND: Obesity is associated with adverse health consequences throughout life. Monitoring obesity trends is important to plan and implement public heath interventions adapted to specific target groups. We aimed to analyze the development of obesity prevalence in the Austrian population using data from the most recent representative Austrian Health Interview Surveys. METHODS: The three cross-sectional Austrian health interview surveys from 2006/2007, 2014 and 2019 were used (n = 45,707). Data correction for self-reported body mass index (BMI) was applied. Sex, age, education level, employment status, country of birth, urbanization, and family status were used as sociodemographic factors. Logistic regression models were applied. RESULTS: Prevalence of obesity increased in both sexes in the study period (men 13.7% to 20.0%, women 15.2% to 17.8%, p < 0.001). Adjusted odds ratios (95% confidence interval [CI]) for the increase in obesity prevalence was 1.47 (95% CI: 1.38-1.56). In men, obesity prevalence almost doubled from 2006/2007 to 2019 in subgroups of 15-29-year-olds (4.8% to 9.0%), unemployed (13.5% to 27.6%), men born in non-EU/non-EFTA countries (13.9% to 26.2%), and not being in a relationship (8.1% to 15.4%). In women, the largest increase was found in subgroups of 30-64-year-olds (15.8% to 18.7%), women born in non-EU/non-EFTA countries (19.9% to 22.8%) and in women living in the federal capital Vienna (16.5% to 19.9%). CONCLUSION: Obesity prevalence in the Austrian population continues to rise significantly. We identified distinct subgroups with a fast-growing obesity prevalence in recent years, emphasizing the importance of regular long-term data collection as a basis for sustainable and target group-specific action planning.

3.
Artigo em Inglês | MEDLINE | ID: mdl-35055523

RESUMO

Contemporary performance and accessibility are features that enable mobile devices to be increasingly beneficial in the context of optimizing the treatment of psychiatric disorders. Smartphones have the potential to effectively support psychotherapeutic interventions among adolescents and young adults who require them. In the present study, the use and subjective influence of a smartphone app with content from dialectical behavior therapy (DBT) was investigated among transitional age youth (TAY) with borderline personality disorder, focusing on suicidality and non-suicidal self-injury (NSSI), in a natural setting. A longitudinal qualitative approach was used by means of individual semi-structured interviews, where participants were asked about their experiences and associated emotions before and after a testing period of 30 days. A total of 13 TAY with a diagnosed borderline personality disorder between the ages of 18 and 23 were included. Six overarching themes were identified through qualitative text analysis: (1) experiences with DBT skills, (2) phenomenon of self-harm, (3) feelings connected with self-harm, (4) dealing with disorder-specific symptoms, (5) prevention of self-harm, and (6) attitude toward skills apps. In general, the provision of an app with DBT content achieved a positive response among participants. Despite a small change in the perception of suicidality and NSSI, participants could imagine its benefits by integrating their use of the app as a supportive measure for personal psychotherapy sessions.


Assuntos
Transtorno da Personalidade Borderline , Terapia do Comportamento Dialético , Aplicativos Móveis , Comportamento Autodestrutivo , Suicídio , Adolescente , Adulto , Terapia Comportamental , Transtorno da Personalidade Borderline/terapia , Humanos , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/terapia , Ideação Suicida , Suicídio/prevenção & controle , Suicídio/psicologia , Resultado do Tratamento , Adulto Jovem
4.
J Epidemiol Community Health ; 76(3): 209-215, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34452953

RESUMO

BACKGROUND: Frailty is a geriatric syndrome closely linked to a variety of adverse health outcomes. Thus, it is important to identify factors associated with the development of frailty. It was the aim of this study to examine, if, and to what extent partner loss, a highly stressful life event, affects frailty trajectories of community dwelling adults aged 50 or older. METHODS: Using six waves of panel data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigated the effect of partner loss on frailty trajectories estimating growth curve models. Our sample included 183 502 observations of 83 494 community-dwelling individuals aged 50 or older from 21 European countries collected between 2004 and 2017. Frailty was measured using the validated sex-specific SHARE-Frailty-Instrument including muscular weakness, unintended weight loss, decrease in walking capacity, low physical activity and exhaustion. RESULTS: Our sample contained 79 874 participants who lived in a partnership during their entire observational period and 3620 participants who lost their partner during their observational period. Both men (ß=0.184 (95% CI: -0.017 to 0.386), p=0.073) and women (ß=0.237 (95% CI: 0.106 to 0.369), p<0.001) showed initial effects of partner loss on frailty, but while only women gradually recovered over time (ß=-0.023 (95% CI: -0.039 to -0.008), p=0.002), among men, the effect of partner loss persisted (ß<0.001 (95% CI: -0.029 to 0.029), p=0.998). CONCLUSION: This study revealed that partner loss is followed by elevated frailty. However, while women's frailty tended to recover from partner loss over time, men's frailty remained elevated. Notable individual differences in the response of frailty trajectories to partner loss suggest the existence of effect modifiers.


Assuntos
Fragilidade , Idoso , Envelhecimento/fisiologia , Europa (Continente)/epidemiologia , Feminino , Seguimentos , Idoso Fragilizado , Fragilidade/epidemiologia , Avaliação Geriátrica , Humanos , Masculino , Pessoa de Meia-Idade , Aposentadoria
5.
Artigo em Inglês | MEDLINE | ID: mdl-34574833

RESUMO

BACKGROUND: Not smoking, performing >150 min of aerobic physical activity (PA) and muscle strengthening exercises/week, and consuming >5 portions of fruit and vegetables/day are lifestyle recommendations for both the general population and people with diabetes mellitus (DM). METHODS: A total of 15,771 and 15,461 persons from the Austrian Health Interview Surveys 2014 and 2019, respectively, including 4.9% and 6.0% of people with DM, were analysed in terms of their smoking, PA, and nutritional behaviours. Logistic regression models were performed for the lifestyle factors, adjusted for socio-demographic and health-related factors. Adjusted interactions between the survey year and DM on the lifestyle factors were computed. RESULTS: The proportions of smokers were 23.9% and 20.2%, of people complying with the PA recommendations were 24.9% and 21.4%, and with fruit and vegetables recommendations were 7.1% and 5.5%, respectively, with significantly lower proportions of smokers and persons complying with the PA recommendations among people with DM. The fully adjusted odds ratios (95% confidence interval) for people with DM were 1.09 (0.94-1.26), 1.44 (1.23-1.69), and 0.90 (0.71-1.13) for smoking, not complying with PA recommendations, and not complying with fruit and vegetables recommendations, respectively. The proportion of people complying with PA recommendations decreased to a greater extent (p < 0.001) in people with DM (16.5% to 8.3%) compared to people without DM (25.3% to 22.3%). CONCLUSION: Diabetogenic lifestyle behaviours increased in the general Austrian population in recent years, which was especially true for people with DM regarding PA.


Assuntos
Diabetes Mellitus , Estilo de Vida , Adulto , Áustria/epidemiologia , Diabetes Mellitus/epidemiologia , Exercício Físico , Humanos , Verduras
6.
Proc Natl Acad Sci U S A ; 118(37)2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34507999

RESUMO

Multiple placental pathologies are associated with failures in trophoblast differentiation, yet the underlying transcriptional regulation is poorly understood. Here, we discovered msh homeobox 2 (MSX2) as a key transcriptional regulator of trophoblast identity using the human trophoblast stem cell model. Depletion of MSX2 resulted in activation of the syncytiotrophoblast transcriptional program, while forced expression of MSX2 blocked it. We demonstrated that a large proportion of the affected genes were directly bound and regulated by MSX2 and identified components of the SWItch/Sucrose nonfermentable (SWI/SNF) complex as strong MSX2 interactors and target gene cobinders. MSX2 cooperated specifically with the SWI/SNF canonical BAF (cBAF) subcomplex and cooccupied, together with H3K27ac, a number of differentiation genes. Increased H3K27ac and cBAF occupancy upon MSX2 depletion imply that MSX2 prevents premature syncytiotrophoblast differentiation. Our findings established MSX2 as a repressor of the syncytiotrophoblast lineage and demonstrated its pivotal role in cell fate decisions that govern human placental development and disease.


Assuntos
Diferenciação Celular , Proteínas Cromossômicas não Histona/metabolismo , Histonas/metabolismo , Proteínas de Homeodomínio/metabolismo , Placenta/citologia , Células-Tronco Pluripotentes/citologia , Fatores de Transcrição/metabolismo , Trofoblastos/citologia , Proteínas Cromossômicas não Histona/genética , Feminino , Histonas/genética , Proteínas de Homeodomínio/genética , Humanos , Placenta/metabolismo , Placentação , Células-Tronco Pluripotentes/metabolismo , Gravidez , Fatores de Transcrição/genética , Trofoblastos/metabolismo
7.
Artigo em Inglês | MEDLINE | ID: mdl-34501758

RESUMO

Measures implemented to reduce the spread of SARS-CoV-2 have resulted in a decrease in physical activity (PA) while sedentary behaviour increased. The aim of the present study was to explore associations between PA and mental health in Austria during COVID-19 social restrictions. In this web-based cross-sectional study (April-May 2020) moderate-to-vigorous physical activity (MVPA), sitting time, and time spent outdoors were self-reported before and during self-isolation. Mental well-being was assessed with the Warwick-Edinburgh Mental Well-being Scale, and the Beck depression and anxiety inventories. The majority of the participants (n = 652) were female (72.4%), with a mean age of 36.0 years and a standard deviation (SD) of 14.4. Moreover, 76.5% took part in ≥30 min/day of MVPA, 53.5% sat ≥10 h/day, and 66.1% spent ≥60 min/day outdoors during self-isolation. Thirty-eight point five percent reported high mental well-being, 40.5% reported depressive symptoms, and 33.9% anxiety symptoms. Participating in higher levels of MVPA was associated with higher mental well-being (odds ratio = OR: 3.92; 95% confidence interval = 95%CI: 1.51-10.15), less depressive symptoms (OR: 0.44; 95%CI: 0.29-0.66) and anxiety symptoms (OR = 0.62; 95%CI: 0.41-0.94), and less loneliness (OR: 0.46; 95%CI: 0.31-0.69). Participants sitting <10 h/day had higher odds of mental well-being (OR: 3.58; 95%CI: 1.13-11.35). Comparable results were found for spending ≥60 min/day outdoors. Maintaining one's MVPA levels was associated with higher mental well-being (OR = 8.61, 95%CI: 2.68-27.62). In conclusion, results show a positive association between PA, time spent outdoors and mental well-being during COVID-19 social restrictions. Interventions aiming to increase PA might mitigate negative effects of such restrictions.


Assuntos
COVID-19 , Postura Sentada , Adulto , Áustria , Controle de Doenças Transmissíveis , Estudos Transversais , Exercício Físico , Feminino , Humanos , Masculino , Saúde Mental , SARS-CoV-2
8.
Artigo em Inglês | MEDLINE | ID: mdl-33920981

RESUMO

BACKGROUND: Little is known about the implementation of lifestyle interventions in frail, community-dwelling people. This study highlights different domains of adherence to explain an effectively delivered home-based intervention. METHODS: Eighty prefrail and frail persons (≥65 years) participated in a physical training, nutritional, and social support intervention over 24 weeks. A detailed log book was kept for comprehensive documentation in order to assess adherence and further organizational, exercise, and nutritional parameters. RESULTS: Participants reached an adherence rate (performed home visits/number of planned visits) of 84.0/80.5% from week 1-12/13-24. Out of those, 59% carried out ≥75% of the offered visits. Older age was associated with a higher adherence rate. A mean of 1.5 (0.6) visits/week (2 were planned) were realized lasting for a mean of 1.5 (0.9) hours (154% of the planned duration). Per visit, 1.2 (0.6) circuits of strength training were performed (60.5% of the planned value) and 0.5 (0.3) nutritional interventions (47%). After twelve months, 4.2% still carried out the home visits regularly and 25.0% occasionally. CONCLUSION: Adherence is much more than "being there". Adherence rate and category are limited parameters to describe the implementation of a complex lifestyle intervention, therefore a comprehensive documentation is needed.


Assuntos
Idoso Fragilizado , Vida Independente , Idoso , Exercício Físico , Terapia por Exercício , Avaliação Geriátrica , Humanos , Apoio Social
9.
Artigo em Inglês | MEDLINE | ID: mdl-33671784

RESUMO

Background: The performance of physical activity (PA) in different domains varies between different occupational groups and they contribute differently to the prevention and management of chronic diseases. This study aimed to give a fuller picture of the potential influence occupational categories have on the different domains of PA among the Austrian population of working age. Methods: A total of 8251 gainfully employed persons in 9 major and 39 sub-major occupational groups from the Austrian Health Interview Survey 2014 were analyzed. PA was measured with the Physical Activity Questionnaire of the European Health Interview Survey (EHIS-PAQ) and the prevalence of 17 chronic diseases was obtained. Results: A total of 48.2% were mostly active when working, 18.4% reported transport-related PA in the upper quintile, 50.4% performed at least 150 min per week of moderate PA or cycling, 32.7% performed muscle-strengthening PA at least twice a week, and 76.3% were either mostly physically active when working or complied with the aerobic PA guidelines. As a general rule, people in physically active occupational groups tended to perform less PA in their leisure time and vice versa. Occupational groups with especially low amount of PA were Information Technology workers, directors, and secretarial staff. People with a chronic disease tended to perform less PA, but there was an interaction between occupation and chronic disease on PA. Conclusions: Domain-specific programs to promote PA should be developed for various occupational categories.


Assuntos
Exercício Físico , Atividades de Lazer , Áustria , Doença Crônica , Estudos Transversais , Inquéritos Epidemiológicos , Humanos , Inquéritos e Questionários
10.
Nicotine Tob Res ; 23(4): 625-634, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-32939543

RESUMO

INTRODUCTION: Reports of the effectiveness of e-cigarettes (ECs) for smoking cessation vary across different studies making implementation recommendations hard to attain. We performed a systematic review and meta-analysis to assess the current evidence regarding effectiveness of ECs for smoking cessation. METHODS: PubMed, PsycInfo, and Embase databases were searched for randomized controlled trials comparing nicotine ECs with non-nicotine ECs or with established smoking cessation interventions (nicotine replacement therapy [NRT] and or counseling) published between 1 January 2014 and 27 June 2020. Data from eligible studies were extracted and used for random-effects meta-analyses (PROSPERO registration number: CRD42019141414). RESULTS: The search yielded 13 950 publications with 12 studies being identified as eligible for systematic review (N = 8362) and 9 studies for random-effects meta-analyses (range: 30-6006 participants). The proportion of smokers achieving abstinence was 1.71 (95 CI: 1.02-2.84) times higher in nicotine EC users compared with non-nicotine EC users. The proportion of abstinent smokers was 1.69 (95 CI: 1.25-2.27) times higher in EC users compared with participants receiving NRT. EC users showed a 2.04 (95 CI: 0.90-4.64) times higher proportion of abstinent smokers in comparison with participants solely receiving counseling. CONCLUSIONS: Our results suggest that nicotine ECs may be more effective in smoking cessation when compared with placebo ECs or NRT. When compared with counseling alone, nicotine ECs are more effective short term, but its effectiveness appears to diminish with later follow-ups. Given the small number of studies, heterogeneous design, and the overall moderate to low quality of evidence, it is not possible to offer clear recommendations. IMPLICATIONS: The results of this study do not allow for a conclusive argument. However, pooling current evidence points toward a potential for ECs as a smoking cessation tool. Though, given the overall quality of evidence, future studies should aim for more clarity in terms of interventions and larger study populations.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Abandono do Hábito de Fumar/métodos , Fumar/terapia , Dispositivos para o Abandono do Uso de Tabaco/estatística & dados numéricos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Wien Klin Wochenschr ; 133(19-20): 1020-1027, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32691214

RESUMO

BACKGROUND: There has been growing concern over the use of electronic cigarettes (e-cigarettes) in recent years. Although advocated as an aid to smoking cessation, there is increasing evidence of harm not just to the respiratory system, but to all other organs in the body. To give a clearer picture on how e­cigarettes can affect our health, we gathered an overview of the literature on the various health effects of e­cigarettes and categorized them into how they specifically affect organ systems. E­cigarette exposure has produced a range of stress and inflammatory reactions in the pulmonary system, including shortness of breath, coughing, wheezing, bronchial and pulmonary irritations, and impaired pulmonary function. In the oral and gastrointestinal system, gingival inflammation, sore throat, nausea, vomiting, and diarrhea have been reported. Increased tachycardia and blood pressure were reported reactions in the cardiovascular system. In the neurological system headaches, irritability, anxiety, dependence and insomnia were observed. Other effects included ocular irritation, contact dermatitis, acute renal insufficiency, toxicity and potential carcinogenicity. Nevertheless, studies have found improvements in time-based memory and nicotine withdrawal associated with the cessation of conventional cigarette smoking and switching to e­cigarette use. Also, toxic and carcinogenic metabolites were reportedly lower in e­cigarette smokers than in conventional cigarette smokers. CONCLUSION: A growing number of studies are showing the adverse effects caused by e­cigarettes on all human organ systems. Further research on the chemical components, the diverse flavors, and the long-term effects on active and passive users are needed to clarify the implications of e­cigarette use on individual and public health.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Vaping , Humanos , Nicotina , Saúde Pública , Vaping/efeitos adversos
12.
IEEE Trans Biomed Eng ; 68(8): 2368-2376, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33201804

RESUMO

OBJECTIVE: 3D optical coherence tomography (OCT) is used for analyses of human placenta organoids in situ without sample preparation. METHODS: The trophoblast organoids analyzed were derived from primary human trophoblast. In this study a custom made ultra-high-resolution spectral domain OCT system with uniform spatial and axial resolution of 2.48 µm in organoid tissue was used. The obtained OCT results align to differentiation status tested via quantitative polymerase chain reaction, Western blot analyses, immunohistochemistry, and immunofluorescence of histological sections. RESULTS: 3D OCT enables a more detailed placenta organoid monitoring compared to brightfield microscopy. Inner architecture with light scattering "bridges" surrounding cavities were visualized and quantified in situ for the first time. The formation of these bridges and cavities is congruent to differentiated trophoblast organoids having developed syncytiotrophoblasts. CONCLUSION: Using 3D OCT in living placenta organoids is a fast tool to assess the differentiation status and resolve internal structures in situ, which is not possible with standard live cell imaging modality. SIGNIFICANCE: Only recently human placenta-derived organoids were established, allowing to have a highly reproducible and stable in vitro model to investigate not only developmental but also physiological and pathophysiological processes during early pregnancy. To our knowledge, this work is the first to analyze living human placenta organoids using 3D OCT. Thereby, the rapid and especially non-endpoint OCT qualitative analyses align to the differentiation stage of organoids, which will aid future advancement in this field.


Assuntos
Organoides , Trofoblastos , Diferenciação Celular , Feminino , Humanos , Placenta/diagnóstico por imagem , Gravidez , Tomografia de Coerência Óptica
13.
Artigo em Inglês | MEDLINE | ID: mdl-33287268

RESUMO

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease, which is associated with low levels of physical activity (PA). However, the factors related to low physical activity levels have rarely been studied. Methods: In this cross-sectional study, 70 seropositive RA patients were included. Physical activity was objectively assessed with an ActiGraph GT3X+ accelerometer. In addition, body mass index, smoking status, work ability, and clinical parameters (functional disabilities, disease activity, disease duration, pain, and inflammation parameters) were measured. Results: RA patients performed a mean of 215.2 (SD: 136.6) min a week of moderate physical activity and 9.1 (SD: 26.3) min of vigorous physical activity. The total amount of moderate and vigorous physical activity (MVPA) was associated with BMI, and functional disabilities. In addition, non-smokers and patients with better work ability did more MVPA. No association could be seen with disease activity, disease duration, pain, and inflammatory markers. After mutual adjusting of all the variables, only BMI showed a significant relationship with MVPA. Conclusions: RA patients perform de facto no physical activity with vigorous intensity. Factors related to low physical activity are BMI, functional disabilities, workability and smoking status, whereas due to the study design no causal and temporal link could be made.


Assuntos
Artrite Reumatoide , Exercício Físico , Acelerometria , Artrite Reumatoide/epidemiologia , Estudos Transversais , Feminino , Força da Mão , Humanos , Masculino
14.
Cell Rep ; 33(8): 108419, 2020 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-33238118

RESUMO

Human trophoblast stem cells (hTSCs) derived from blastocysts and first-trimester cytotrophoblasts offer an unprecedented opportunity to study the placenta. However, access to human embryos and first-trimester placentas is limited, thus preventing the establishment of hTSCs from diverse genetic backgrounds associated with placental disorders. Here, we show that hTSCs can be generated from numerous genetic backgrounds using post-natal cells via two alternative methods: (1) somatic cell reprogramming of adult fibroblasts with OCT4, SOX2, KLF4, MYC (OSKM) and (2) cell fate conversion of naive and extended pluripotent stem cells. The resulting induced/converted hTSCs recapitulated hallmarks of hTSCs including long-term self-renewal, expression of specific transcription factors, transcriptomic signature, and the potential to differentiate into syncytiotrophoblast and extravillous trophoblast cells. We also clarified the developmental stage of hTSCs and show that these cells resemble day 8 cytotrophoblasts. Altogether, hTSC lines of diverse genetic origins open the possibility to model both placental development and diseases in a dish.


Assuntos
Células-Tronco Pluripotentes/metabolismo , Trofoblastos/metabolismo , Diferenciação Celular , Feminino , Humanos , Gravidez
15.
Int J Geriatr Psychiatry ; 35(11): 1285-1291, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32805754

RESUMO

The aim of the present study was to assess the effects of nutritional supplementation on neuropsychiatric symptoms among people with dementia. METHODS/DESIGN: Randomized controlled trials (RCTs) were searched in the Databases PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov from inception until January 31, 2020. Studies of RCTs carried out on people with any type of dementia who were taking nutritional supplements and had neuropsychiatric symptoms were included in this systematic review and meta-analysis. Neuropsychiatric symptoms were assessed with the validated Neuropsychiatric Inventory (NPI). Effect sizes were calculated with standardized mean differences (SMD) and 95% confidence intervals (95%CI), applying a random effect model. RESULTS: The search yielded 1034 studies with four studies being included in the meta-analysis with a total of 377 people with dementia (mean age 69.3 [SD: 7.7] years). The diagnoses comprised mild to late Alzheimer's disease and frontotemporal dementia. Two studies included a multicomponent supplementation, one an omega-3, and one a special supplement tailored for cognitive impairment. The median follow-up was 18 weeks, with a range from 12 to 24 weeks. Pooled data showed that nutritional supplementation did not improve NPI (SMD = -0.33; [95%CI: -0.74 to 0.08]; P = 0.11; I2 = 45%). CONCLUSIONS: The findings of this meta-analysis demonstrated no significant impact on NPI through nutritional supplementation. However, the generalization of the results is limited, as different supplements were used in different stages of dementia with a short follow-up time.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Demência , Idoso , Demência/terapia , Suplementos Nutricionais , Humanos
16.
Gesundheitswesen ; 82(S 03): S207-S216, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32854118

RESUMO

STUDY AIM: The aim of this study was to examine the association between the proportion of the population that fulfilled the endurance-based recommendations for health-enhancing physical activity and the proportion with correct knowledge of these recommendations, exercise-friendly culture and environment, and health status in the federal states of Austria. METHODS: The analysis is based on data from the Austrian Physical Activity Monitoring 2017, the Austrian Health Interview Survey 2014, the Austrian Mortality Register 2015, the database of Fit Sports Austria, the Austrian Chamber of Commerce, the Federal Ministry for Traffic, and an online platform for running events. Correlation coefficients (Pearson) for the various parameters and the proportion of the population that fulfilled the endurance-based recommendations for health-enhancing physical activity are presented. RESULTS: There is a significant correlation between endurance-based physical activity and the knowledge regarding the recommended extent of physical activity (0.91), the number of offers in sports clubs (0.87), the subjective accessibility of sports clubs (0.85), the accessibility of green spaces (0.84), the number of sports clubs with certified health-promoting programs (0.76), and the perceived possibilities to go running (0.72). In addition, endurance-based physical activity is significantly and negatively correlated with age-adjusted cardiovascular mortality (-0.96), total mortality (-0.95), the prevalence of obesity (-0.83), ischemic heart mortality (-0.76), and the prevalence of chronic diseases in total (-0.68), and is positively correlated with subjective health (0.79). CONCLUSIONS: The correlations show the significant associations between exercise behavior and health knowledge, the infrastructure for exercise, and culture. In addition, they show the significant correlation between exercise behavior and health status in the Austrian federal states. This information is important for tailored recommendations for the individual federal states.


Assuntos
Exercício Físico , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Áustria , Correlação de Dados , Alemanha , Fidelidade a Diretrizes , Nível de Saúde , Humanos
17.
Proc Natl Acad Sci U S A ; 117(24): 13562-13570, 2020 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-32482863

RESUMO

Various pregnancy complications, such as severe forms of preeclampsia or intrauterine growth restriction, are thought to arise from failures in the differentiation of human placental trophoblasts. Progenitors of the latter either develop into invasive extravillous trophoblasts, remodeling the uterine vasculature, or fuse into multinuclear syncytiotrophoblasts transporting oxygen and nutrients to the growing fetus. However, key regulatory factors controlling trophoblast self-renewal and differentiation have been poorly elucidated. Using primary cells, three-dimensional organoids, and CRISPR-Cas9 genome-edited JEG-3 clones, we herein show that YAP, the transcriptional coactivator of the Hippo signaling pathway, promotes maintenance of cytotrophoblast progenitors by different genomic mechanisms. Genetic or chemical manipulation of YAP in these cellular models revealed that it stimulates proliferation and expression of cell cycle regulators and stemness-associated genes, but inhibits cell fusion and production of syncytiotrophoblast (STB)-specific proteins, such as hCG and GDF15. Genome-wide comparisons of primary villous cytotrophoblasts overexpressing constitutively active YAP-5SA with YAP KO cells and syncytializing trophoblasts revealed common target genes involved in trophoblast stemness and differentiation. ChIP-qPCR unraveled that YAP-5SA overexpression increased binding of YAP-TEAD4 complexes to promoters of proliferation-associated genes such as CCNA and CDK6 Moreover, repressive YAP-TEAD4 complexes containing the histone methyltransferase EZH2 were detected in the genomic regions of the STB-specific CGB5 and CGB7 genes. In summary, YAP plays a pivotal role in the maintenance of the human placental trophoblast epithelium. Besides activating stemness factors, it also directly represses genes promoting trophoblast cell fusion.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Placentação , Fatores de Transcrição/metabolismo , Trofoblastos/citologia , Trofoblastos/metabolismo , Proteínas Adaptadoras de Transdução de Sinal/genética , Diferenciação Celular , Proliferação de Células , Quinase 6 Dependente de Ciclina/genética , Quinase 6 Dependente de Ciclina/metabolismo , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Feminino , Humanos , Proteínas Musculares/genética , Proteínas Musculares/metabolismo , Placenta/metabolismo , Gravidez , Ligação Proteica , Transdução de Sinais , Células-Tronco/citologia , Células-Tronco/metabolismo , Fatores de Transcrição/genética
18.
Eur J Public Health ; 30(2): 340-346, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31665261

RESUMO

BACKGROUND: Frailty is a geriatric condition associated with adverse health outcomes. As physical inactivity, low protein intake and poor social network are known risk factors, we aimed to assess the influence of these parameters and their interaction in an 11-year follow-up study on a Europe-wide level. METHODS: Data from the Study on Health, Ageing and Retirement in Europe were used, including 22 226 community-dwelling robust and prefrail persons aged ≥50 years, from 11 countries. Frailty was assessed with the 'Frailty Instrument for Primary care of the Survey of Health, Ageing and Retirement in Europe'. Additionally, self-reported physical activity (PA), protein intake and satisfaction with social network were assessed. The impact of these parameters on the development of frailty was calculated using multivariate cox regressions. RESULTS: Performing no regular PA, was associated with higher hazards ratio (HRs) for frailty compared with performing regular PA [men: 1.90 (95%CI: 1.50-2.42); women: 1.65 (95%CI: 1.25-2.18)]; HRs for low protein intake were 1.16 (95%CI: 0.93-1.46) for men and 1.05 (95%CI: 0.80-1.37) for women. And HR for poor social network were 0.92 (95%CI: 0.74-1.15) for men and 1.72 (95%CI: 1.31-2.27)] for women. In general, persons with a combination of two of the assessed risk factors had a higher risk for frailty compared with those with no or only one of the risk factors. However, no significant synergy index could be found. CONCLUSION: The results illustrate the importance of PA, but also of nutritional and social network to prevent frailty.


Assuntos
Fragilidade , Idoso , Europa (Continente)/epidemiologia , Exercício Físico , Feminino , Seguimentos , Idoso Fragilizado , Fragilidade/epidemiologia , Avaliação Geriátrica , Humanos , Masculino , Rede Social
19.
Clin Infect Dis ; 70(9): 1809-1815, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-31401650

RESUMO

BACKGROUND: Our aim was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies and physical health outcomes associated with human immunodeficiency virus (HIV) but not acquired immunodeficiency syndrome. METHODS: We performed an umbrella review of observational studies. Evidence was graded as convincing, highly suggestive, suggestive, weak, or nonsignificant. RESULTS: From 3413 studies returned, 20 were included, covering 55 health outcomes. Median number of participants was 18 743 (range 403-225 000 000). Overall, 45 (81.8%) of the 55 unique outcomes reported nominally significant summary results (P < .05). Only 5 outcomes (9.0%; higher likelihood of presence of breathlessness, higher chronic obstructive pulmonary disease [COPD] prevalence, maternal sepsis, higher risk of anemia, and higher risk of all fractures among people living with HIV [PLWHIV]) showed suggestive evidence, with P values < 10-3; only 3 (5.5%; higher prevalence of cough in cross-sectional studies, higher incidence of pregnancy-related mortality, and higher incidence of ischemic heart disease among PLWHIV in cohort studies) outcomes showed stronger evidence using a stringent P value (<10-6). None of the unique outcomes presented convincing evidence (Class I), yet 3 outcomes presented highly suggestive evidence, 5 outcomes presented suggestive evidence, and 37 outcomes presented weak evidence. CONCLUSIONS: Results show highly suggestive and suggestive evidence for HIV and the presence of a cough, COPD, ischemic heart disease, pregnancy-related mortality, maternal sepsis, and bone fractures. Public health policies should reflect and accommodate these changes, especially in light of the increases in the life expectancy and the incidence of comorbidities in this population.


Assuntos
Infecções por HIV , Pré-Eclâmpsia , Doença Pulmonar Obstrutiva Crônica , Estudos Transversais , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Incidência , Metanálise como Assunto , Estudos Observacionais como Assunto , Gravidez , Revisões Sistemáticas como Assunto
20.
J Sex Med ; 17(1): 60-68, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31812682

RESUMO

INTRODUCTION: Physical activity is likely to be associated with sexual activity. However, to date, there is no literature on the relationship between overweight/obesity and sexual activity outcomes. AIM: Thus, the present study assessed the associations among physical activity, sedentary behavior, and weight status with sexual activity and number of previous sexual partners in a representative sample of U.S. adults. METHODS: Data on leisure time physical activity, total sitting time, weight status, sexual behavior outcomes, and other characteristics were extracted from the National Health and Nutrition Study cycle 2007 to 2016. Logistic regression models were used to evaluate associations among body mass index, leisure time physical activity, and total sitting time with past-year sexual activity and number of sexual partners. MAIN OUTCOME MEASURE: Self reported frequency of past-year sexual activity and number of sex partners in the past year. RESULTS: In a sample of 7,049 men (mean age: 38.3 ± 0.3 years) and 7,005 women (mean age: 38.7 ± 0.2 years) being overweight was associated with higher odds of frequent sexual activity (OR = 1.5; 95% CI = 1.2-1.7) among men, but lower odds among women (OR = 0.8; 95% CI = 0.6-0.9). Sufficient physical activity was associated with higher odds of frequent sexual activity among both men (OR = 1.3; 95% CI = 1.1-1.5) and women (OR = 1.2; 95% CI = 1.0-1.4). In those living alone, being obese was associated with lower odds of having at least 1 sexual partner for men (OR = 0.7; 95% CI = 0.5-0.9) and women (OR = 0.6; 95% CI = 0.4-0.8). Being sufficiently physically active was associated with higher odds of having at least 1 sexual partner only in men (OR = 1.6; 95% CI = 1.2-2.2). CLINICAL IMPLICATIONS: Healthcare professionals need to be made aware of these results, as they could be used to plan tailored interventions. STRENGTHS & LIMITATIONS: Strengths include the large, representative sample of U.S. adults and objective measures of anthropometry. Limitations include the cross-sectional design of the study and that all variables on sexual history were self-reported. CONCLUSION: The present study identifies novel modifiable behavioral and biological antecedents of sexuality outcomes. Grabovac I, Cao C, Haider S, et al. Associations Between Physical Activity, Sedentary Behavior and Weight Status With Sexuality Outcomes: Analyses from National Health and Nutrition Examination Survey. J Sex Med 2020;17:60-68.


Assuntos
Peso Corporal/fisiologia , Exercício Físico , Comportamento Sedentário , Comportamento Sexual , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Atividade Motora , Inquéritos Nutricionais , Obesidade/epidemiologia , Autorrelato , Parceiros Sexuais , Sexualidade
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