Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 139
Filtrar
1.
Immunology ; 2022 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-36349514

RESUMO

Severe cases of COVID-19 present hyperinflammatory condition that can be fatal. Little is known about the role of regulatory responses in SARS-CoV-2 infection. In this study, we evaluated the phenotype of regulatory T cells in the blood (peripheral blood mononuclear cell) and the lungs (broncho-alveolar) of adult patients with severe COVID-19 under invasive mechanical ventilation. Our results show important dynamic variation on Treg cells phenotype during COVID-19 with changes in number and functional parameters from the day of intubation (Day 1 of intensive care unit admission) to Day 7. We observed that compared with surviving patients, non-survivors presented lower numbers of Treg cells in the blood. In addition, lung Tregs of non-survivors also displayed higher PD1 and lower FOXP3 expressions suggesting dysfunctional phenotype. Further signs of Treg dysregulation were observed in non-survivors such as limited production of IL-10 in the lungs and higher production of IL-17A in the blood and in the lungs, which were associated with increased PD1 expression. These findings were also associated with lower pulmonary levels of Treg-stimulating factors like TNF and IL-2. Tregs in the blood and lungs are profoundly dysfunctional in non-surviving COVID-19 patients.

2.
BMC Cancer ; 22(1): 1115, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36320019

RESUMO

BACKGROUND: Women with breast cancer are at risk for the development of sarcopenia and occurrence of fractures. The initial and periodic screening of these conditions can prevent the risks of disability, poor quality of life, and death. The present study investigated the association between sarcopenia phenotypes and fracture risk, assessed by the Fracture Risk Assessment Tool (FRAX) in women with breast cancer. METHODS: Cross-sectional study. It included women aged between 40 and 80 years, diagnosed with Luminal subtype breast cancer, with time of diagnosis ≤ 12 months, who had not started endocrine therapy, did not have metastasis, had not been treated for another malignancy, and had no recurrences. Sociodemographic, habits and lifestyle, clinical, anthropometric, and body composition variables were considered. Muscle strength, skeletal muscle mass, and physical performance were investigated using handgrip strength (HGS), appendicular skeletal muscle mass index (ASMI), and Timed Up and Go test (TUGT), respectively. Fracture risk was assessed using FRAX. Multiple linear regression models were conducted to verify the association between exposure variables and sarcopenia phenotypes. A significance level of p < 0.05 was adopted for all tests using the SPPS 25.0 program. RESULTS: Sixty-two women with a mean age of 58.1 ± 10.4 years were evaluated. Of these, 66.1% self-declared to be non-white, 41.9% and 71.0% did not consume alcohol or smoke, respectively, and 61.3% were insufficiently active. A total of 45.2% had clinical stage II carcinoma and 65.5% had the invasive breast carcinoma histological subtype. There was a predominance of adequacy of HGS (88.7%), ASMI (94.5%), and TUGT (96.8%), as well as low risk of hip fractures (85.5%) and major fractures (82.3%). HGS remained associated with FRAX hip fractures (p = 0.007) and FRAX major fractures (p = 0.007) in the adjusted models, while ASMI was associated with body mass (p < 0.001). CONCLUSIONS: Low muscle strength was the sarcopenia phenotype that remained associated with fracture risk in women with breast cancer, independently of sociodemographic factors, level of physical activity, and clinical factors. In addition to the assessment of probable sarcopenia, this measurement may point out the risk of fractures.


Assuntos
Fraturas do Quadril , Neoplasias , Sarcopenia , Feminino , Humanos , Sarcopenia/patologia , Força da Mão/fisiologia , Estudos Transversais , Qualidade de Vida , Equilíbrio Postural , Estudos de Tempo e Movimento , Força Muscular/fisiologia , Fraturas do Quadril/complicações , Fraturas do Quadril/epidemiologia , Medição de Risco , Fatores de Risco , Densidade Óssea/fisiologia , Neoplasias/complicações
3.
Nanoscale Adv ; 4(19): 4080-4093, 2022 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-36285213

RESUMO

Graphene quantum dots (GQDs) with tunable photoluminescence (PL) and hydrophobicity were synthesized from an abundant natural carbon source containing nitrogen, sulfur, and oxygen heteroatoms. Asphaltene and its oxidized and reduced derivatives were used as precursors to produce GQDs in organic solvents (i.e., methanol, toluene, and chloroform) using a facile ultrasonication technique. Asphaltene surface chemistry was tuned by sequential oxidation and reduction to investigate the surface effects on GQD properties. Spectroscopic characterizations confirmed the presence of N, S, and O heteroatoms and different electron-donating and electron-withdrawing groups. Microscopic characterizations revealed that these crystalline carbon nanomaterials have mono-layered or multi-layered structures with lateral sizes in the range of ∼5-15 nm. The asphaltene-derived GQDs exhibit tunable PL with emission colors ranging from blue to orange, depending on the carbon precursor and the organic solvent. Solvent exchange studies also revealed that asphaltene and its derivatives contain hydrophilic and hydrophobic fractions, resulting in varied hydrophobicity of the synthesized GQDs. Adding to the appeal of the present work, PL quenching of GQD-silica hybrid materials upon exposure to nitro-aromatics confirms that these GQDs can be incorporated to different host materials for advanced sensing or optoelectronic applications.

4.
Curr Med Chem ; 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36154587

RESUMO

Systemic arterial hypertension (SAH) is a major risk factor for several secondary diseases, especially those involving cardiovascular and renal conditions. SAH has a high prevalence worldwide and its precise and early recognition is important to prevent the development of secondary outcomes. In this field, the study of biomarkers represents an important approach to diagnose and predict the disease and its associated conditions. The use of biomarkers in hypertension and hypertension-related disorders, such as ischemic stroke, intracerebral hemorrhage, transient ischemic attack, acute myocardial infarction, angina pectoris and chronic kidney disease, are discussed in this review. Establishing a potential pool of biomarkers may contribute to a non-invasive and improved approach for their diagnosis, prognosis, risk assessment, therapy management and pharmacological responses to a therapeutic intervention, in order to improve quality of life in patients and prevent unfavorable outcomes.

5.
Epidemiol Health ; : e2022074, 2022 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-36108670

RESUMO

Objectives: To analyze the influence of anthropometric indices of adiposity on the physical performance of middle-aged and older women. Methods: A cross-sectional study conducted with 368 women from 50 to 80 years old. Anthropometric, biochemical dosage and physical performance evaluation were performed. Statistical analysis used measures of central tendency and dispersion for descriptive data; Pearson correlation to demonstrate the initial association between the variables and canonical correlation (CC) to evaluate the relationship between the set of anthropometric adiposity indices and the variables that make up the performance. Results: The participants had a mean age of 58.57 years (8.21), a visceral adiposity index (VAI) of 7.09 (4.23), a body mass index (BMI) of 29.20 kg/m2 (4.94) and conicity index of 1.33 (0.07). The average handgrip strength was 25.06 kgf (4.89), gait speed was 1.07 m∕s (0.23) and the mean of the Short Physical Perfomance Battery (SPPB) score was 10.83 (1.36). The first canonical function presented the highest shared variance, CC and redundancy index (cumulative percentage of variance = 82.52, Wilks Lambda = 0.66, CC = 0.532, p value <0.001). From the analysis of this canonical function, an inverse correlation was observed between the conicity index (-0.59), the handgrip strength (0.84) and the SPPB (0.68), as well as a direct correlation with gait speed (-0.43). Conclusion: Our findings showed that in middle-aged and older women there was an inverse relationship between the conicity index and muscle strength and power, while a direct relationship was found between the same index and gait speed.

6.
Mol Biol Rep ; 49(10): 9509-9520, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35980532

RESUMO

BACKGROUND: About 5-10% of breast cancer cases are related to genetic and hereditary factors. The application of Next Generation Sequencing (NGS) in oncology has allowed the identification of genetic variants present in several genes related to the increased risk of breast cancer. This study aimed to determine the frequency of germline genetic variants in patients with a family and/or personal history of breast cancer. METHODS: An analysis of positive reports from NGS panels was carried out in female individuals with a personal and/or family history of breast cancer, present in the database of a private laboratory in Brazil. RESULTS: From about 2000 reports, 183 individuals presented 219 different germline genetic variants. The genes with the highest number of variants were BRCA2 (16.0%), ATM (15.0%) and BRCA1 (12.8%). Among the variants found, 78 were either pathogenic or probably pathogenic, accounting for 35% of all variants discovered. The gene with the highest proportion of pathogenic/probably pathogenic variants was TP53 (80%) and the most frequent pathogenic variant was also reported in this gene (c.1010G > A p.(Arg337His)). Furthermore, the study obtained a high proportion of variants of uncertain significance (VUS) (65%) and approximately 32% of the variants found were in genes of moderate penetrance. CONCLUSIONS: Our results could improve the risk estimation and clinical follow-up of Brazilian patients with a history of breast cancer.


Assuntos
Neoplasias da Mama , Proteína BRCA1/genética , Brasil/epidemiologia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Feminino , Genes BRCA2 , Predisposição Genética para Doença , Células Germinativas , Mutação em Linhagem Germinativa/genética , Humanos
7.
Epilepsia Open ; 7(4): 616-632, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35908275

RESUMO

OBJECTIVE: Eslicarbazepine acetate (ESL) is a once-daily (QD), oral anti-seizure medication for the treatment of focal (partial-onset) seizures. Here, we evaluate risk factors for the development of psychiatric treatment-emergent adverse events (TEAEs) in clinical trials of adjunctive ESL in adults with focal seizures. METHODS: This post-hoc analysis evaluated data pooled from three Phase III, randomized, double-blind, placebo-controlled trials (BIA-2093-301, -302, -304). After an 8-week baseline period, patients were randomized equally to receive placebo, ESL 400 mg (not reported here), 800 mg, or 1200 mg QD (up to 2-week titration; 12-week maintenance; optional open-label extension [OLE]). Incidences of psychiatric TEAEs were evaluated according to three separate criteria: medical history of psychiatric disorders (yes/no); baseline use of psychotropic drugs (yes/no); Montgomery-Åsberg Depression Rating Scale (MADRS) score at baseline (0-6: normal; 7-19: mild depression; 20-34: moderate depression). RESULTS: The analysis populations comprised 1251 patients for the controlled study period and 1137 patients for the 1-year OLE. Psychiatric TEAE incidence was similar between patients taking ESL and placebo in the controlled and OLE study periods and was not related to ESL dose. Psychiatric TEAEs generally occurred more frequently in patients with a medical history of psychiatric disorders, using psychotropic drugs, or with depressive symptoms than in those without a history, not using psychotropic drugs, or with no depressive symptoms. Depression and anxiety were the most frequently reported psychiatric TEAEs. SIGNIFICANCE: Overall, in clinical trials of ESL in adults with focal seizures, incidences of psychiatric events were not statistically different between patients taking ESL and placebo, were not related to ESL dose, and generally occurred more frequently in patients with baseline psychiatric symptoms or a history of psychiatric disorders. Long-term exposure to ESL was not associated with a marked increase in the incidence of psychiatric TEAEs.


Assuntos
Anticonvulsivantes , Dibenzazepinas , Adulto , Humanos , Anticonvulsivantes/uso terapêutico , Resultado do Tratamento , Dibenzazepinas/efeitos adversos , Convulsões/tratamento farmacológico
8.
Food Chem ; 391: 133228, 2022 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-35640332

RESUMO

This paper describes studies for the determination of total concentration and bioaccessible fraction of minerals in peaches by MIP OES. The PCA analysis identified 3 distinct groups of elements concerning the total concentration, which was attributed to the origin of each cultivar. Among the macroelements, K presented higher values for total concentration, while B and Fe predominated among the microelements. Regarding the bioaccessible fraction, Mn presented the highest percentage (46-84%), followed by Zn and B (10-63% and 33-57%, respectively). Pearson's correlation coefficient revealed that reducing sugars and titratable acidity can influence the mineral bioaccessibility, highlighting the strong positive correlations between reducing sugars with Mn and total acidity with Fe. Peach cultivars have satisfactory nutritional value, but the total and bioaccessible concentrations of minerals obtained do not meet the recommended daily needs, requiring the consumption of other fruits and vegetables to complement the diet.


Assuntos
Prunus persica , Oligoelementos , Frutas/química , Minerais , Açúcares , Oligoelementos/análise , Verduras
9.
PLoS Negl Trop Dis ; 16(5): e0010105, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35499991

RESUMO

BACKGROUND: Epidemiological and experimental studies have shown a protective effect of helminth infections in weight gain and against the development of metabolic dysfunctions in the host. However, the mechanisms Treg cells exert in the helminth-obesity interface has been poorly investigated. The present study aimed to verify the influence of Heligmosomoides polygyrus infection in early stages of high fat diet-induced obesity. PRINCIPAL FINDINGS: The presence of infection was able to prevent exacerbated weight gain in mice fed with high fat diet when compared to non-infected controls. In addition, infected animals displayed improved insulin sensitivity and decreased fat accumulation in the liver. Obesity-associated inflammation was reduced in the presence of infection, demonstrated by lower levels of leptin and resistin, lower infiltration of Th1 and Th17 cells in adipose tissue, higher expression of IL10 and adiponectin, increased infiltration of Th2 and eosinophils in adipose tissue of infected animals. Of note, the parasite infection was associated with increased Treg frequency in adipose tissue which showed higher expression of cell surface markers of function and activation, like LAP and CD134. The infection could also increase adipose Treg suppressor function in animals on high fat diet. CONCLUSION: These data suggest that H. polygyrus modulates adipose tissue Treg cells with implication for weight gain and metabolic syndrome.


Assuntos
Dieta Hiperlipídica , Resistência à Insulina , Tecido Adiposo , Animais , Dieta Hiperlipídica/efeitos adversos , Resistência à Insulina/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/metabolismo , Aumento de Peso
10.
J Geriatr Phys Ther ; 2022 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-35470303

RESUMO

BACKGROUND AND PURPOSE: The Short Physical Performance Battery (SPPB) is widely used for older adults since it has a high level of validity, reliability, and responsiveness in measuring function in this population. However, only a few studies of diagnostic accuracy have assessed SPPB capacity in detecting frailty and prefrailty by estimating more detailed measurement properties. Thus, the present study aimed to evaluate the SPPB's diagnostic accuracy in detecting frailty and prefrailty, in addition to identifying cut-off points for walking time and chair stand time. METHODS: This is a cross-sectional study composed of 786 community-dwelling older adults 60 years or older, in which sociodemographic and anthropometric data, frailty phenotype, and total SPPB score, as well as walking time and chair stand time, were assessed. Analysis of a receiver operating characteristic curve was performed to identify the cut-off point, sensitivity, and specificity in the total SPPB score, as well as the walking time and chair stand time for frailty and prefrailty screening. Accuracy and positive and negative predictive values were subsequently calculated. RESULTS AND DISCUSSION: The cut-off points identified for the total SPPB score, walking time, and chair stand time were 9 points or less (accuracy of 72.6%), 5 seconds or less, and 13 seconds or less, respectively, for frailty screening and 11 points or less (accuracy of 58.7%), 4 seconds or less, and 10 seconds or less, respectively, for prefrailty screening. The walking time showed greater frailty discriminatory capacity compared with the chair stand time (effect size = 1.24 vs 0.64; sensitivity = 69% vs 59%; and specificity = 84% vs 75%). CONCLUSIONS: The total SPPB score has good diagnostic accuracy to discriminate between nonfrail and frail older adults using a cut-off point of 9 or less, being better to identify the true negatives (older adults who are not frail). Although the SPPB's diagnostic accuracy measures for detecting prefrailty were low to moderate, this instrument can help in screening prefrail older adults from the cutoff point of 11 or less in the total SPPB score. Identification of prefrail older adults enables implementing early treatment in this target audience and can prevent their advance to frailty.

11.
Public Health Nurs ; 39(4): 752-759, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-34935199

RESUMO

OBJECTIVE: There is still a lack of health indicators for monitoring and evaluating health planning at the local level. In Portugal, local health plans (LHP) include a prioritized set of health priorities, which should be monitored and evaluated. This study is an example of a low-resource method to identify and reuse indicators for LHP monitoring and evaluation already collected for other purposes. DESIGN AND SAMPLE: A modified Delphi consensus method was applied, with three rounds of email rating questionnaires and a final meeting, between January 2018 and January 2019. The Delphi panel consisted of eight members from the Planning and Administration Group of the Espinho/Gaia Local Public Health Unit. MEASUREMENTS: Panelists were asked to assess the indicators' validity for monitoring diseases/determinants from a pre-selected list of potential binomials between 140 PHC indicators and 15 diseases/determinants. RESULTS: After four rounds, there was consensus in considering 141 binomials (34.0%) as appropriate, diabetes mellitus being the disease with more appropriate indicators. CONCLUSION: This study portrays the applicability of a commonly used, easy and low-resource method in a Portuguese Local Public Health Unit to select and reuse primary health care indicators for LHP monitoring and evaluation.


Assuntos
Planejamento em Saúde , Indicadores de Qualidade em Assistência à Saúde , Consenso , Técnica Delfos , Humanos , Inquéritos e Questionários
12.
Innov Clin Neurosci ; 19(10-12): 29-34, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36591546

RESUMO

Background: Deep brain stimulation (DBS) is considered an alternative treatment for patients with rapidly developing Parkinson's disease (PD). DBS can cause cognitive changes, and it is necessary to perform an executive assessment before and after DBS to better define the prognosis. Objective: The aim of this study was to analyze the use of the Stroop test for assessment of cognitive functions in patients with PD undergoing DBS. Methods: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pubmed, Scopus, PsycInfo, and Web of Science were used as electronic databases. All included studies assessed the cognitive ability of patients with PD undergoing DBS through the application of the Stroop test. Results: Thirty-five articles met the inclusion criteria. Among the studies, there were different formats of Stroop applications. Twenty-three articles presented negative results in relation to the individuals' performances in Stroop, compared to the control groups. The results suggested that there was no correlation between low performance in the test and global cognitive risk for the patients. Conclusion: Patients with DBS declined in Stroop performance and showed impairments in response inhibition and speed. These results are not related to the lack of cognitive security of DBS. The Stroop test can be combined with other cognitive instruments to ensure greater approximation of results with reality measures.

13.
BMC Musculoskelet Disord ; 22(1): 713, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34416881

RESUMO

BACKGROUND: The reduction of female sex hormones causes changes in the contractile properties of muscles as well as infiltration of fat in the muscle tissue. This results in a consequent decline in muscle strength. These changes are related to higher levels of functional impairment and physical disability. In this sense, several anthropometric indices have been used to quantify body and visceral fat. Thus, the objective of this paper is to propose cutoff points for adiposity anthropometric indices in order to identify low muscle mass, as well as to analyze the relationship between these indices and low muscle mass in middle-aged and older women. METHODS: Cross-sectional analytical study carried out in the Northeast of Brazil. The sample was formed by 593 women between 40-80 years old. Data collection included anthropometric assessment (BMI: Body Mass Index - WC: Waist Circumference - WHR: Waist-to-hip Ratio - WHtR: Waist-to-height Ratio - CI: Conicity Index - BAI: Body Adiposity Index - VAI: Visceral Adiposity Index - LAP: Lipid Accumulation Product), bioimpedance test and biochemical dosage. Moreover, sociodemographic data and practice of physical activity were collected. Descriptive statistics, Student's t-test, ROC curves, chi-squared and logistic regression were performed. RESULTS: The participants had a mean age of 53.11 (8.89) years, BMI of 28.49 (5.17) kg/m2 and WC of 95.35 (10.39). The prevalence of low muscle mass was 19.4%. Based on sensitivity and specificity of adiposity anthropometric indices, cutoff points were developed to identify the presence of low muscle mass (p < 0.05), except for VAI. After logistic regression, WC (OR = 6.2; CI 95%: 1.4-28.1), WHR (OR = 1.8; CI: 1.0-3.4), WHtR (OR = 5.0; CI 95%: 1.0-23.7) and BAI (OR = 14.5; CI 95%: 6.6-31.7) were associated with low muscle mass. CONCLUSIONS: All anthropometric indices, except VAI, showed adequate accuracy in identifying low muscle mass in women, especially those that took into account WC. This suggests that they can become accessible and also be cost-effective strategies for assessing and managing health outcomes related to muscle mass analysis.


Assuntos
Adiposidade , Obesidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Músculos
14.
Cien Saude Colet ; 26(2): 455-464, 2021 Feb.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33605323

RESUMO

Health education must be seen as an instrument used to promote quality of life. The objective of this study was to evaluate health education practices of nutritionists in a municipal health network. This is a qualitative study using Grounded Theory. Interviews and observation of educational activities were carried out. The use of materials was evaluated, together with attempts to engage the service users. Five analysis categories were applied. The intention of raising awareness and changing habits highlights the preference of professionals toward actions that are articulated and consistent with reality. Productivity valorization, insufficient training, and lack of physical structure were mentioned as restrictions. Most respondents did not evaluate results; they believe in sharing knowledge as a process that transforms reality; and defend the multidisciplinary approach and care by putting the concepts of integrality and equity into practice. The nutritionists' concepts of health education guide their professional performance, as they reflect the perspectives of the educational practices adopted.


A educação em saúde deve ser vista como instrumento de promoção da qualidade de vida. O objetivo do presente trabalho foi avaliar práticas de educação em saúde de nutricionistas de rede municipal de saúde, em uma cidade da região centro-oeste. Optou-se pela pesquisa qualitativa e, especificamente, pela teoria fundamentada nos dados. Foram realizadas entrevistas e observação de atividades educativas e, por meio dessas, avaliou-se a utilização de recursos materiais, estratégias e, ainda, a tentativa de envolver os usuários do serviço. Foram definidas cinco categorias de análise. A intenção da conscientização e a mudança de hábitos salienta a predileção do profissional por ações articuladas e coerentes com a realidade. Valorização da produtividade, insuficiência de capacitação, a falta de estrutura física foi citada como limitação. A maioria das entrevistadas não avalia resultados; acredita no compartilhamento de saberes como processo transformador da realidade e defende o trabalho multiprofissional e o cuidado em colocar em prática a integralidade e a equidade. As concepções de educação em saúde dos nutricionistas implicam em sua atuação profissional pois refletem a perspectiva das práticas educativas desenvolvidas.


Assuntos
Nutricionistas , Escolaridade , Educação em Saúde , Humanos , Pesquisa Qualitativa , Qualidade de Vida
15.
Ciênc. Saúde Colet. (Impr.) ; 26(2): 455-464, fev. 2021. tab
Artigo em Inglês, Português | LILACS | ID: biblio-1153796

RESUMO

Resumo A educação em saúde deve ser vista como instrumento de promoção da qualidade de vida. O objetivo do presente trabalho foi avaliar práticas de educação em saúde de nutricionistas de rede municipal de saúde, em uma cidade da região centro-oeste. Optou-se pela pesquisa qualitativa e, especificamente, pela teoria fundamentada nos dados. Foram realizadas entrevistas e observação de atividades educativas e, por meio dessas, avaliou-se a utilização de recursos materiais, estratégias e, ainda, a tentativa de envolver os usuários do serviço. Foram definidas cinco categorias de análise. A intenção da conscientização e a mudança de hábitos salienta a predileção do profissional por ações articuladas e coerentes com a realidade. Valorização da produtividade, insuficiência de capacitação, a falta de estrutura física foi citada como limitação. A maioria das entrevistadas não avalia resultados; acredita no compartilhamento de saberes como processo transformador da realidade e defende o trabalho multiprofissional e o cuidado em colocar em prática a integralidade e a equidade. As concepções de educação em saúde dos nutricionistas implicam em sua atuação profissional pois refletem a perspectiva das práticas educativas desenvolvidas.


Abstract Health education must be seen as an instrument used to promote quality of life. The objective of this study was to evaluate health education practices of nutritionists in a municipal health network. This is a qualitative study using Grounded Theory. Interviews and observation of educational activities were carried out. The use of materials was evaluated, together with attempts to engage the service users. Five analysis categories were applied. The intention of raising awareness and changing habits highlights the preference of professionals toward actions that are articulated and consistent with reality. Productivity valorization, insufficient training, and lack of physical structure were mentioned as restrictions. Most respondents did not evaluate results; they believe in sharing knowledge as a process that transforms reality; and defend the multidisciplinary approach and care by putting the concepts of integrality and equity into practice. The nutritionists' concepts of health education guide their professional performance, as they reflect the perspectives of the educational practices adopted.


Assuntos
Humanos , Nutricionistas , Qualidade de Vida , Educação em Saúde , Pesquisa Qualitativa , Escolaridade
16.
Menopause ; 28(4): 467-475, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33399317

RESUMO

IMPORTANCE: Menopause at younger ages is associated with a greater risk of adverse health outcomes such as osteoporosis, chronic diseases, and death. However, the association with physical function has not been well established. OBJECTIVE: Assess the association between timing of menopause and different measures of physical function. EVIDENCE REVIEW: Searches on the PubMed, Cochrane Library, SciELO, LILACS, and Web of Science databases were conducted. Observational studies on the association between age at menopause and measures of physical function were included, with no restriction for publication date or language. Methodological quality was assessed by the "Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies." FINDINGS: Four cross-sectional studies were included, totaling 13,846 participants. These investigated five measures of physical function: gait speed, grip strength, standing balance, chair stand, and self-reported functional limitations. Poor physical function was associated with premature (<40 y) or early menopause (<45 y) in all the studies, with significant results only for grip strength, gait speed, and functional limitation. Premature and early menopause were associated with weaker grip strength [between 2.58 kg (95% CI = 0.74 to 4.43) and 5.21 kg (2.18 to 8.25)], and lower gait speed [between 0.03 m/s (0.01 to 0.06) and 0.06 m/s (0.02 to 0.09)]. Menopause after the age of 50 is associated with less likelihood of functional limitation [OR between 0.52 (95% CI = 0.29 to 0.95) and 0.61 (0.40 to 0.95)] compared with premature and early menopause. Two measures of physical function (chair stand test and standing balance) were not significantly associated with age at menopause. CONCLUSION: Only four cross-sectional studies showed that earlier ages at menopause are associated with poor physical function (grip strength, gait speed, and self-reported functional limitations), but given the high heterogeneity of the studies, no consensus is possible. Longitudinal studies are needed to explore the association between age at menopause and different measures of physical function as well as the influence of different socioeconomic conditions between countries on functioning.


Assuntos
Menopausa Precoce , Equilíbrio Postural , Estudos Transversais , Feminino , Força da Mão , Humanos , Estudos Longitudinais , Menopausa
17.
Biomolecules ; 11(9)2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34572473

RESUMO

The aim of this study was to promote bioactivity of the PEEK surface using sulfuric acid and piranha solution. PEEK was functionalized by a sulfuric acid treatment for 90 s and by piranha solution for 60 and 90 s. Chemical modification of the PEEK surface was evaluated by infrared spectroscopy, contact angle analysis, cytotoxicity, cell adhesion and proliferation. The spectroscopy characteristic band associated with sulfonation was observed in all treated samples. PEEK with piranha solution 60 s showed an increase in the intensity of the bands, which was even more significant for the longer treatment (90 s). The introduction of the sulfonic acid functional group reduced the contact angle. In cytotoxicity assays, for all treatments, the number of viable cells was higher when compared to those of untreated PEEK. PEEK treated with sulfuric acid and piranha solution for 60 s were the treatments that showed the highest percentage of cell viability with no statistically significant differences between them. The modified surfaces had a greater capacity for inducing cell growth, indicative of effective cell adhesion and proliferation. The proposed chemical modifications are promising for the functionalization of PEEK-based implants, as they were effective in promoting bioactivation of the PEEK surface and in stimulating cell growth and proliferation.


Assuntos
Benzofenonas/química , Polímeros/química , Ácidos Sulfúricos/química , Adesão Celular , Morte Celular , Proliferação de Células , Fibroblastos/citologia , Humanos , Soluções , Espectroscopia de Infravermelho com Transformada de Fourier
18.
Drug Saf ; 44(10): 1099-1107, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34536187

RESUMO

INTRODUCTION: The prevalence of epilepsy increases in elderly patients aged > 65 years, and treatment is challenging because clinical data are limited. OBJECTIVE: Our objective was to evaluate the safety of eslicarbazepine acetate (ESL) in patients aged ≥ 65 years versus non-elderly patients with focal seizures. METHODS: The safety data of seven phase II and III, double-blind, open-label, randomized clinical studies of ESL in adults were pooled. At least possibly related treatmentemergent adverse events (TEAEs) and ESL post-marketing adverse drug reactions (ADRs) were analyzed separately by age categories. RESULTS: The most frequently reported at least possibly related TEAEs in elderly (N = 120) versus non-elderly patients (N = 1863) were dizziness (10.8 vs. 20.3%), somnolence (9.2 vs. 12.6%), and hyponatremia (6.7 vs. 1.5%). Elderly patients presented a higher incidence of serious TEAEs (22.5 vs. 7.6%) and at least possibly related serious TEAEs (6.7 vs. 2.5%), probably because treatment was complicated by comorbidities and comedications. After an estimated cumulative exposure of over 2 million patient-months worldwide and 8 years of post-marketing surveillance, hyponatremia was the most frequently reported ADR (n = 232), accounting for 14.6% and 6.8% of the ADRs reported in elderly (n = 473) and non-elderly patients (n = 2406), respectively. This was followed by ADR/safety information such as drug-dose titration not performed (7.0 vs. 5.4%), product use in unapproved indication (4.9 vs. 1.9%), off-label use (3.4 vs. 2.2%), dizziness (3.4 vs. 3.5%), and seizure (2.1 vs. 5.8%). CONCLUSION: No specific safety issue was identified from the pooled studies for elderly compared with non-elderly patients. After 8 years of post-marketing surveillance, the qualitative safety of ESL remains similar to that observed in the clinical studies.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Hiponatremia , Adulto , Idoso , Anticonvulsivantes/efeitos adversos , Dibenzazepinas , Tontura/induzido quimicamente , Tontura/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Humanos , Hiponatremia/induzido quimicamente , Hiponatremia/tratamento farmacológico , Marketing , Pessoa de Meia-Idade , Convulsões/induzido quimicamente , Convulsões/tratamento farmacológico , Convulsões/epidemiologia , Resultado do Tratamento
19.
J Appl Behav Anal ; 54(2): 744-759, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33164227

RESUMO

Regular moderate-to-vigorous physical activity (MVPA) has been linked to improved bone health, muscular fitness, cognitive function, sleep, and a reduced risk of depression and obesity. Many children are not engaging in the recommended amount of physical activity. Furthermore, children with autism spectrum disorder (ASD) were found to engage in less physical activity than their peers of typical development. We extended previous research by conducting a physical activity context assessment, which included a comparison of indoor to outdoor activities to evaluate which environment produced the lowest percent of MVPA as recorded by the Observational System for Recording Physical Activity in Children. Given the utility of activity schedules to increase self-management and independent engagement during unstructured and low-preferred tasks, we then taught 3 preschool children diagnosed with ASD to use photographic activity schedules to increase the number of different activities that met the definition of MVPA in the 2 lowest-responding conditions of the physical activity context assessment. MVPA remained low during baseline sessions for all participants and immediately increased with the introduction of activity schedule teaching. All participants quickly met activity schedule teaching mastery criterion and demonstrated high levels of MVPA in generalization and maintenance probes without additional teaching.


Assuntos
Transtorno do Espectro Autista , Pré-Escolar , Exercício Físico , Humanos , Fotografação , Sono
20.
Reprod Sci ; 28(3): 675-682, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33140327

RESUMO

The aim of this study was to evaluate progression of the bowel endometriosis lesion over time. We performed a retrospective cohort with 164 patients with rectosigmoid endometriosis identified by transvaginal ultrasound (TVUS) with bowel preparation waiting for surgical treatment. Length and circumference of the bowel lesion evaluated by TVUS, painful symptoms (dysmenorrhea, dyspareunia, noncyclic pelvic pain, dyschezia, dysuria), and menopausal status were assessed at baseline and 6, 12, 24, 36, and > 36 months. A linear mixed model was used and p values < 0.05 were considered significant. We considered the length and the circumference as the main parameter; the characteristics were considered as fixed effects and the patient as random effect. This model allows to deal with missing data from longitudinal studies. All painful symptoms significantly improved during follow-up. Overall, the mean length and circumference of the greatest bowel lesion were 2.9 ± 1.8 cm and 27 ± 10%, respectively, and those did not change over time (p > 0.05). Patients with severe dyspareunia had significant greater circumference (p = 0.037) and those with severe dyschezia had significant greater length (p = 0.047) of bowel lesions. Symptoms were not related with progression of the lesion over time. The bowel lesion length significantly decreased over time in patients in menopause (p = 0.009). There was no difference in the bowel lesion length between patients with and without hormonal treatment (p > 0.05). The results suggest that bowel endometriosis does not increase over time during reproductive age and reduces after menopause. Symptoms are also not related to the bowel lesion progression.


Assuntos
Endometriose/diagnóstico por imagem , Doenças Retais/diagnóstico por imagem , Doenças do Colo Sigmoide/diagnóstico por imagem , Ultrassonografia , Adulto , Fatores Etários , Progressão da Doença , Feminino , Seguimentos , Humanos , Menopausa , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...