Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 514
Filtrar
1.
Ned Tijdschr Tandheelkd ; 128(1): 53-58, 2021 Jan.
Artigo em Holandês | MEDLINE | ID: mdl-33449057

RESUMO

In a consensus meeting (September 2019) of the three Dutch and the two Flemish dental schools their current education programmes on gerodontology were presented and discussed. The aim was to examine if these programmes were in line with the most recent (inter)national guidelines, such as those of the European College of Gerodontology and the recently introduced Dutch framework Oral Health Care (2020). Therefore, the competences regarding the domain of gerodontology were analysed to assess if students were prepared adequately to meet the oral health care needs of the ageing population. In the consensus meeting a new set of competences was formulated together with a new outline for the gerodontology-programme applicable for the Dutch and Flemish dental schools.


Assuntos
Educação Continuada em Odontologia , Faculdades de Odontologia , Currículo , Educação em Odontologia , Humanos , Estudantes
2.
J Environ Radioact ; 226: 106354, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33046265

RESUMO

Tritium, the radioactive isotope of hydrogen, has been used to understand groundwater recharge processes for decades. The current variation of tritium in the atmosphere is largely attributed to stratospheric production and fall out rates as well as global circulation phenomena controlling the hydrological cycle. Global controls on the variability in atmospheric tritium activity are poorly suited to explain local variation and tritium activities in precipitation are often assumed to be uniform over both local and regional catchments and watersheds. This assumption can result in both over and under estimation of modern recharge within an aquifer when using tritium as the recharge proxy. In order to minimize the inherent prediction residuals associated with tritium based recharge investigations, the variability of tritium in precipitation was modelled from 127 spatial precipitation samples taken over a two year period, combined with a 76 precipitation sample group-set taken over a one year period in a single location. Precipitation events were traced backward in time, from the point of collection, using HYSPLIT modelling to ascertain the origins of moisture content as well as the altitudes of moisture origin reached along the particle track. Tritium activities, collected over a one year period in Paarl, range from 0.45 to 4.16 TU and have a mean of 1.59 TU. Spatial storm events in the Western Cape in 2017 and 2018 had a range from 0 to 2.2 and 0.37 to 3.27 TU, respectively, with mean activities of 1.18 (n = 34) and 1.25 TU (n = 32). Both storm events had similar tritium variability (σ = 0.5 n = 35 and 0.48 n = 32). Regional precipitation events had the largest range of tritium activities (0.55-12.2 TU). Although not all tritium activities can be explained by interrogating the water mass origin, this study suggests that approximately 90% of events can be completely or partially attributed to the origin of the water mass. The variability of tritium, both spatially and temporally, was higher than expected, confirming that when uniform tritium inputs are used, the groundwater system would provide inaccurate modern recharge estimates. Higher spatial resolution of tritium variation in precipitation for a particular region will improve our ability to relate tritium activities in groundwater to local precipitation.


Assuntos
Monitoramento de Radiação , Trítio/análise , Água Subterrânea , Hidrologia , África do Sul
3.
BMC Oral Health ; 20(1): 185, 2020 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-32615975

RESUMO

BACKGROUND: It is unclear how many community-dwelling elderly (≥75 years) experience oral health problems (e.g. pain, dry mouth, chewing problems) and how they manage their dental care needs. This study aimed to assess self-reported oral health problems in elderly who are frail or have complex care needs, and their ability to organize dental care when reporting oral pain. METHODS: Three thousand five hundred thirty-three community-dwelling elderly participating in the "Embrace" project were asked to complete questionnaires regarding oral status and oral health problems. Frailty was assessed with the Groningen Frailty Indicator (GFI). Intermed for Elderly Self-Assessment (IM-E-SA) was used to determine complexity of care needs. Next, elderly who reported oral pain were interviewed about their oral pain complaints, their need for dental care, and their ability to organize and receive dental care. For statistical analyses Chi2-tests and the one-way ANOVA were used. RESULTS: One thousand six hundred twenty-two elderly (45.9%) completed the questionnaires. Dry mouth (11.7%) and oral pain (6.2%) were most frequently reported. Among the elderly reporting oral pain, most were registered at a local dentist and could go there when needed (84.3%). Robust elderly visited the dentist independently (87%), frail (55.6%) and complex (26.9%) elderly more often required assistance from caregivers. CONCLUSIONS: Dry mouth and oral pain are most reported oral health problems among community-dwelling elderly. Elderly with complex care needs report most oral health problems. In case an elderly seeks dental treatment to alleviate an oral pain complaint, most elderly in this study were able to organize dental care and transport to the dentist. Frail and complex elderly often need assistance from caregivers to visit the dentist. Therefore caretakers should keep in mind that when frailty progresses, visiting a dentist may become more and more difficult and the risk for poor oral health increases.


Assuntos
Assistência Odontológica para Idosos/estatística & dados numéricos , Assistência Odontológica/estatística & dados numéricos , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Inquéritos de Saúde Bucal , Feminino , Idoso Fragilizado , Avaliação Geriátrica , Serviços de Saúde para Idosos , Humanos , Vida Independente , Autorrelato
4.
Vaccine ; 38(19): 3610-3617, 2020 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-31911033

RESUMO

BACKGROUND: The live-attenuated yellow fever vaccine (YFV) is generally contraindicated in immunosuppressed patients. Our aim was to investigate if immunosuppressive therapy impairs the long-term protection against yellow fever virus in patients who had received YFV prior to the start of their immunosuppressive therapy. METHODS: Our study examined 35 healthy individuals and 40 immunosuppressed patients with autoimmune diseases or organ transplants. All individuals had received YFV prior to the onset of their immunosuppression. We analysed the long-term influence of the immunosuppressive therapy on the YFV protective immunity by measuring neutralising antibodies (NA) with the Plaque Reduction Neutralisation Test (PRNT). We assessed risk factors for a negative PRNT result (titre below 1: 10) and their influence on the magnitude of the NA. RESULTS: A median time interval of 21.1 years (interquartile range 14.4-31.3 years) after the YFV in all patients, a total of 35 immunosuppressed patients (88%) were seropositive (PRNT ≥ 1:10) compared to 31 patients (89%) in the control group. The geometric mean titres of NA did not differ between the groups. The duration of an underlying rheumatic disease was the only risk factor found for a lower magnitude of NA. An insufficient level of NA was found in nine subjects (12%) who had received a single dose of YFV (in one subject, the number of YFV doses was unknown). CONCLUSION: The use of an immunosuppressive drug started after the administration of the YFV did not affect long-term persistence of NA. A second dose of YFV may be necessary to secure long-term immunity.

5.
J Phys Condens Matter ; 32(2): 025603, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31574487

RESUMO

The Dirac semimetal PdTe2 was recently reported to be a type-I superconductor (T c = 1.64 K, [Formula: see text] mT) with unusual superconductivity of the surface sheath. We here report a high-pressure study, [Formula: see text] GPa, of the superconducting phase diagram extracted from ac-susceptibility and transport measurements on single crystalline samples. T c (p ) shows a pronounced non-monotonous variation with a maximum T c = 1.91 K around 0.91 GPa, followed by a gradual decrease to 1.27 K at 2.5 GPa. Surface superconductivity is robust under pressure as demonstrated by the large superconducting screening signal that persists for applied dc-fields [Formula: see text]. Surprisingly, for [Formula: see text] GPa the superconducting transition temperature at the surface [Formula: see text] is larger than T c of the bulk. Therefore surface superconductivity may possibly have a non-trivial topological nature. We compare the measured pressure variation of T c with recent results from band structure calculations and discuss the importance of a Van Hove singularity.

6.
Ned Tijdschr Tandheelkd ; 126(12): 637-645, 2019 Dec.
Artigo em Holandês | MEDLINE | ID: mdl-31840674

RESUMO

Oral care for older people is an underexposed topic in dentistry as well as in general healthcare, while oral care professionals are increasingly confronted with frail and multimorbid older people with complex care needs. The research agenda 'Oral care for the elderly' was developed to encourage the collaboration of researchers in the Netherlands and Flanders (Belgium) to do more research in this area and in this way, to achieve an expansion and implementation of knowledge. This will make possible the provision of a socially responsible and robust basis for sustainable oral care for frail older people. The focus of the agenda is on 3 themes, namely oral health and oral function for older people; multi/interdisciplinary collaboration within primary care and the costs, benefits and long-term effect(s) of oral care throughout the entire course of life. This article provides an overview of this research agenda and the way in which it has been established.


Assuntos
Assistência à Saúde , Atenção Primária à Saúde , Idoso , Idoso de 80 Anos ou mais , Bélgica , Idoso Fragilizado , Humanos , Países Baixos , Saúde Bucal
7.
Ned Tijdschr Tandheelkd ; 126(12): 657-664, 2019 Dec.
Artigo em Holandês | MEDLINE | ID: mdl-31840677

RESUMO

Current data show many older adults to have poor oral health, deteriorating even more when they become frail or care dependent. In order to achieve a structural and sustained improvement of this situation, it is necessary to have a clear view of the factors determining oral health in older adults, such as (endogenous (biological, lifestyle), environmental determinants and determinants associated with the organisation of healthcare. The various determinants show oral health in older adults is the result of thecombined effects of very diverse factors and for that reason, a solution will have to be based on a multidisciplinary approach, also involving people outside of clinical care. To promote good oral health over the full course of life, it is important to invest in a good start in life, that helps accumulate oral health gains, and at the same time it is essential to adapt the healthcare system and prevention strategies to the individual's needs in order to make oral care effective for the full course of life.


Assuntos
Assistência à Saúde , Saúde Bucal , Idoso , Humanos
8.
Ned Tijdschr Tandheelkd ; 126(12): 673-678, 2019 Dec.
Artigo em Holandês | MEDLINE | ID: mdl-31840679

RESUMO

Oral health in frail older people is often poor. There are a number of reasons for this, such as increased morbity and decreased motivation for (self) care. Good oral health is, however, very important. Studies have revealed poor oral health to cause or aggravate several medical and psychological problems. Illness and medication can, in turn, damage oral health. Oral health among the elderly should therefore be carefully monitored and maintained. This requires multidisciplinary and interprofessional collaboration on the part of healthcare professionals and others involved. Such collaboration is now still very limited; hardly anything has been written about how such collaboration in the area of oral care for frail older people should or could be organised. This article provides an overview of the possibilities and the relevant factors in the area of oral care for the elderly in promoting collaboration among healthcare professionals and others involved. All of this is under the banner of 'united we stand'.


Assuntos
Idoso Fragilizado , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Pessoal de Saúde , Humanos , Autocuidado
9.
Osteoarthritis Cartilage ; 27(12): 1761-1767, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31450004

RESUMO

OBJECTIVES: To investigate associations of leptin and adiponectin levels with knee and hand osteoarthritis, and explore whether these mediate the association between adiposity and osteoarthritis. METHODS: This is a cross-sectional analysis of baseline data from the population-based Netherlands Epidemiology of Obesity study. Adiposity was assessed with body mass index (BMI) and percentage total body fat (%TBF). Osteoarthritis, defined as hand or knee osteoarthritis, was determined using American College of Rheumatology criteria. Fasting serum adipokine levels were measured using immunoassays. Associations between adiposity and osteoarthritis were examined with logistic regression, adjusted for age, sex, ethnicity and education, and additionally for leptin and adiponectin as potential mediators. RESULTS: In 6408 participants (56% women, median age 56 years), prevalence of osteoarthritis was 22% (10% isolated knee and 8% isolated hand osteoarthritis). Leptin levels were positively associated with osteoarthritis, while adiponectin levels were not. Leptin partially mediated the association of adiposity with osteoarthritis (OR 1.40 (95%CI 1.30; 1.52) attenuated to 1.38 (1.24; 1.54) per 5 units BMI and OR 1.25 (1.17; 1.35) to 1.20 (1.10; 1.32) per 5 units %TBF, representing 4% and 17% mediation, respectively). Larger proportion mediation by leptin was found in knee (13%/27%) than in hand osteoarthritis (9%/18%). Sex-stratified analyses generally showed stronger associations between adiposity, leptin and osteoarthritis in women than in men. CONCLUSIONS: Serum leptin levels were associated with osteoarthritis, and partially mediated the association between adiposity and osteoarthritis, while adiponectin levels were not associated with osteoarthritis. These findings provide evidence for systemic effects of adipose tissue in osteoarthritis.


Assuntos
Adiponectina/metabolismo , Articulação da Mão , Leptina/metabolismo , Obesidade/metabolismo , Osteoartrite do Joelho/metabolismo , Adiposidade , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Obesidade/epidemiologia , Osteoartrite/epidemiologia , Osteoartrite/metabolismo , Osteoartrite do Joelho/epidemiologia
10.
S Afr Med J ; 109(2b): 12569, 2019 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-31084681

RESUMO

Recent research on the standard of care and related quality of life of the spinal cord-afflicted community in South Africa (SA) has revealed significant gaps in practice, and challenges regarding levels of care and access to services and supplies specifically related to the neurogenic bladder.


Assuntos
Acesso aos Serviços de Saúde/organização & administração , Traumatismos da Medula Espinal/complicações , Bexiga Urinaria Neurogênica/terapia , Protocolos Clínicos , Hospitalização , Humanos , Guias de Prática Clínica como Assunto , África do Sul , Bexiga Urinaria Neurogênica/etiologia
11.
J Phys Condens Matter ; 30(50): 505602, 2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30474615

RESUMO

Superconductivity in the topological non-trivial Dirac semimetal PdTe2 was recently shown to be type-I. We hereby report measurements of the relative magnetic penetration depth, [Formula: see text], on several single crystals using a high precision tunnel diode oscillator technique. The temperature variation [Formula: see text] follows an exponential function for [Formula: see text], consistent with a fully-gapped superconducting state and weak or moderately coupling superconductivity. By fitting the data we extract a [Formula: see text]-value of ∼500 nm. The normalized superfluid density is in good agreement with the computed curve for a type-I superconductor with nonlocal electrodynamics. Small steps are observed in [Formula: see text], which possibly relates to a locally lower [Formula: see text] due to defects in the single crystalline sample.

12.
Colorectal Dis ; 20(10): 897-904, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29956442

RESUMO

AIM: Most people who are at increased familial colorectal cancer (FCRC) risk are not identified, despite the need for enhanced surveillance colonoscopy for effective CRC prevention. An online self-test may enhance this identification. We assessed whether taking an online self-test to identify increased FCRC risk increases anxiety, distress or CRC risk perception in population-based CRC screening. METHOD: After the precolonoscopy consultation, patients who had a positive immunohistochemical occult faecal blood test (iFOBT+) in population-based CRC screening were invited by email to take an online self-test at home which returned details of family history. Anxiety (STAI-DY), distress (HADS) and CRC risk perception were assessed immediately before and after taking the online self-test and 2 weeks later. RESULTS: Of 250 participants invited, 177 (71%) completed the online self-test and psychological questionnaires and 153 (61%) completed questionnaires 2 weeks later. The median age was 65 years (range 61-75). The FCRC risk was increased in 17 participants (9.6%). Of these, 12 (6.8%) had a highly increased FCRC risk and may benefit from germline genetic testing for Lynch syndrome. In 7 of 17 participants (40%) the self-test obtained novel information on family history. Anxiety and distress levels were, and remained, below a clinically relevant level. Perception of CRC risk remained unchanged. Most participants (83%) would recommend the online self-test to others. CONCLUSION: Of those with a iFOBT+, 9.6% had a previously unidentified increasedFCRC risk and require an enhanced surveillance colonoscopy instead of iFOBT. As screening for this risk did not increase anxiety or distress, and was highly acceptable, we recommend adding the online self-test to population-based CRC screening.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/psicologia , Predisposição Genética para Doença/psicologia , Vigilância da População/métodos , Medição de Risco/métodos , Adulto , Neoplasias Colorretais/psicologia , Autoavaliação Diagnóstica , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Internet , Masculino , Anamnese , Pessoa de Meia-Idade , Inquéritos e Questionários , Escala de Ansiedade Frente a Teste
13.
Clin Oral Investig ; 22(7): 2615-2622, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29450736

RESUMO

OBJECTIVE: To assess oral health, health, and quality of life (QoL) of care-dependent community-living older people with and without remaining teeth who recently received formal home care. MATERIALS AND METHODS: For this cross-sectional observational study, community-living older people (≥ 65 years), who recently (< 6 months) received formal home care, were interviewed with validated questionnaires and underwent an oral examination. Oral health, general health, medicines usage, frailty (Groningen Frailty Indicator), cognition (Minimal Mental State Examination), QoL (RAND 36), and oral health-related QoL (Oral Health Impact Profile-14) were assessed. RESULTS: One hundred three out of 275 consecutive eligible older people (median age 79 [IQR (Inter Quartile Range) 72-85 years] participated in the study. Thirty-nine patients had remaining teeth and 64 were edentulous. Compared with edentulous older people, older people with remaining teeth scored significantly better on frailty, QoL, physical functioning, and general health. No significant differences were seen in cognition. Dental and periodontal problems were seen in more than half of the patients with remaining teeth. Two third of the edentulous patients did not visit their dentist regularly or at all. CONCLUSIONS: Care-dependent home-dwelling older people with remaining teeth generally were less frail, scored better on physical functioning and general health and had better QoL than edentulous older people. Dental and periodontal problems were seen in approximately 50% of the elderly. CLINICAL RELEVANCE: Notwithstanding their common dental problems, frailty, health, and QoL are better in home-dwelling older people with remaining teeth. To maintain this status, we advise not only dentists, but also health care workers and governments, to encourage people to maintain good oral health.


Assuntos
Avaliação Geriátrica , Serviços de Assistência Domiciliar , Vida Independente , Saúde Bucal , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Idoso Fragilizado , Humanos , Masculino , Boca Edêntula , Inquéritos e Questionários
14.
Clin Genet ; 93(1): 67-77, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28632915

RESUMO

Lynch syndrome (LS) mutation carriers may reduce their cancer risk by adhering to lifestyle recommendations for cancer prevention. This study tested the effect of providing LS mutation carriers with World Cancer Research Fund-the Netherlands (WCRF-NL) health promotion materials on awareness and knowledge of and adherence to these recommendations. In this randomized controlled trial (n = 226), the intervention group (n = 114) received WCRF-NL health promotion materials. All LS mutation carriers were asked to fill out questionnaires at 2 weeks before (baseline, T0) and at 2 weeks (T1) and 6 months (T2) after the intervention. Linear mixed models were performed on awareness (0-7) and knowledge (0-7) of the recommendations, and on the secondary outcomes, that is adherence, distress, cancer worry, and risk perception. Compared with the control group, the intervention group became significantly more aware (overall mean difference = 1.24; 95%CI = 0.82-1.67) and obtained significantly improved knowledge of the recommendations (overall mean difference = 1.65; 95%CI = 1.27-2.03). Differences were significantly larger for T1 (Pinteraction = .003 and ≤.001, respectively) but remained significant for T2. No effect on secondary outcomes was found. In conclusion, provision of WCRF-NL health promotion materials increases awareness and knowledge of lifestyle recommendations for cancer prevention among LS mutation carriers without causing additional distress, but does not affect adherence.


Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/genética , Guias como Assunto , Promoção da Saúde/métodos , Estilo de Vida , Mutação , Neoplasias/prevenção & controle , Adulto , Neoplasias Colorretais Hereditárias sem Polipose/complicações , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Heterozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/genética , Avaliação de Resultados em Cuidados de Saúde/métodos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Fatores de Tempo
15.
Sci Rep ; 7(1): 17370, 2017 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-29234110

RESUMO

The compound Sr0.5Ce0.5FBiS2 belongs to the intensively studied family of layered BiS2 superconductors. It attracts special attention because superconductivity at T sc = 2.8 K was found to coexist with local-moment ferromagnetic order with a Curie temperature T C = 7.5 K. Recently it was reported that upon replacing S by Se T C drops and ferromagnetism becomes of an itinerant nature. At the same time T sc increases and it was argued superconductivity coexists with itinerant ferromagnetism. Here we report a muon spin rotation and relaxation study (µSR) conducted to investigate the coexistence of superconductivity and ferromagnetic order in Sr0.5Ce0.5FBiS2-x Se x with x = 0.5 and 1.0. By inspecting the muon asymmetry function we find that both phases do not coexist on the microscopic scale, but occupy different sample volumes. For x = 0.5 and x = 1.0 we find a ferromagnetic volume fraction of ~8 % and ~30 % at T = 0.25 K, well below T C = 3.4 K and T C = 3.3 K, respectively. For x = 1.0 (T sc = 2.9 K) the superconducting phase occupies most (~64 %) of the remaining sample volume, as shown by transverse field experiments that probe the Gaussian damping due to the vortex lattice. We conclude ferromagnetism and superconductivity are macroscopically phase separated.

16.
Ned Tijdschr Tandheelkd ; 124(12): 645-652, 2017 Dec.
Artigo em Holandês | MEDLINE | ID: mdl-29257837

RESUMO

In the coming decades the western world will experience a double ageing of its population; there will be an increase in both the number of older people and the average age. The increase in life expectancy will also mean more and more older people who suffer from multiple systemic diseases that are treated with medications. At this moment, 45% of those over 65 use 5 or more medications and 20% of those over 75 use as many as 10 or more. The more medications used, the greater the risk of side effects and therefore oral side effects, like symptoms of dry mouth or the development of candidiasis, angioedema, gingival hyperplasia, lichenoid reaction of the oral mucosa, dysgeusia, halitosis and osteonecrosis. Considering the wide range of oral side effects, it is important for dentists to be well aware of the medications being used by older patients as well as having a thorough knowledge of their oral side effects.


Assuntos
Assistência Odontológica para Idosos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Doenças da Boca/epidemiologia , Doenças Periodontais/epidemiologia , Doenças Dentárias/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Feminino , Humanos , Expectativa de Vida , Masculino , Mucosa Bucal , Xerostomia/epidemiologia
17.
Ned Tijdschr Tandheelkd ; 124(5): 265-270, 2017 May.
Artigo em Holandês | MEDLINE | ID: mdl-28501881

RESUMO

Polypharmacy is the consequence of multimorbidity. Both phenomena may cause functional limitations and/or frailty and/or care dependency in older people. In the human body, a medicament undergoes at least 3 important actions: absorption, distribution and elimination. These actions may proceed aberrantly in older people. Following interaction with receptors, a medicament triggers a chain reaction in the human body. The receptors and each link of the chain reaction may be subject to changes due to diseases as well as ageing. This, particularly, is the case with regard to medications directed towards the central nervous system and the cardiovascular system. Furthermore, interactions may occur between various medications mutually and between medications on the one hand and on the other hand food and water intake, self-medication with herbs, and diseases. Moreover, older people usually experience more adverse effects of medications when compared to younger people. This is due to altered body actions and reactions, polypharmacy and the many possible interactions. In older people, utilisation and intake of medications often give rise to problems that can be divided into medicament-related, patient-related, care- and care provider-related and other problems.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Idoso Fragilizado , Saúde Bucal , Polimedicação , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Interações Medicamentosas , Humanos
18.
Phys Chem Chem Phys ; 19(18): 11380-11389, 2017 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-28422208

RESUMO

Complex coacervate core micelles (C3Ms) are colloidal structures useful for encapsulation of biomacromolecules. We previously demonstrated that enhanced green fluorescent protein (EGFP) can be encapsulated into C3Ms using the diblock copolymer poly(2-methyl-vinyl-pyridinium)41-b-poly(ethylene-oxide)205. This packaging resulted in deviating spectroscopic features of the encapsulated EGFP molecules. Here we show that for monomeric EGFP variant (mEGFP) micellar encapsulation affects the absorption and fluorescence properties to a much lesser extent, and that changes in circular dichroism characteristics are specific for encapsulated EGFP. Time-resolved fluorescence anisotropy of encapsulated (m)EGFP established the occurrence of homo-FRET (Förster resonance energy transfer) with larger transfer correlation times in the case of EGFP. Together, these findings support that EGFP dimerizes whereas the mEGFP mainly remains as a monomer in the densely packed C3Ms. We propose that dimerization of encapsulated EGFP causes a reorientation of Glu222, resulting in a pKa shift of the chromophore, which is fully reversible after release of EGFP from the C3Ms at a high ionic strength.


Assuntos
Proteínas de Fluorescência Verde/química , Micelas , Polietilenoglicóis/química , Polivinil/química , Dicroísmo Circular , Fluorescência , Polarização de Fluorescência , Conformação Proteica , Multimerização Proteica , Espectrometria de Fluorescência
19.
Eur J Cancer ; 78: 45-52, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28412588

RESUMO

INTRODUCTION: Identifying high familial breast cancer (FBC) risk improves detection of yet unknown BRCA1/2-mutation carriers, for whom BC risk is both highly likely and potentially preventable. We assessed whether a new online self-test could identify women at high FBC risk in population-based BC screening without inducing anxiety or distress. METHODS: After their visit for screening mammography, women were invited by email to take an online self-test for identifying highly increased FBC risk-based on Dutch guidelines. Exclusion criteria were previously diagnosed as increased FBC risk or a personal history of BC. Anxiety (State-Trait Anxiety Inventory Dutch Version), distress (Hospital Anxiety Depression Scale) and BC risk perception were assessed using questionnaires, which were completed immediately before and after taking the online self-test and 2 weeks later. RESULTS: Of the 562 women invited by email, 406 (72%) completed the online self-test while 304 also completed questionnaires (response rate 54%). After exclusion criteria, 287 (51%) were included for data analysis. Median age was 56 years (range 50-74). A high or moderate FBC risk was identified in 12 (4%) and three (1%) women, respectively. After completion of the online self-test, anxiety and BC risk perception were decreased while distress scores remained unchanged. Levels were below clinical relevance. Most women (85%) would recommend the self-test; few (3%) would not. CONCLUSION: The online self-test identified previously unknown women at high FBC risk (4%), who may carry a BRCA1/2-mutation, without inducing anxiety or distress. We therefore recommend offering this self-test to women who attend population-based screening mammography for the first time.


Assuntos
Ansiedade/prevenção & controle , Neoplasias da Mama/diagnóstico , Internet , Autocuidado/métodos , Estresse Psicológico/prevenção & controle , Idoso , Proteína BRCA2/genética , Neoplasias da Mama/psicologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/psicologia , Feminino , Aconselhamento Genético , Humanos , Mamografia/psicologia , Pessoa de Meia-Idade , Satisfação do Paciente , Medição de Risco/métodos , Autocuidado/psicologia , Proteínas Supressoras de Tumor/genética , Ubiquitina Tiolesterase/genética
20.
Oral Dis ; 23(4): 526-536, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28120363

RESUMO

OBJECTIVE: To assess oral status and self-reported oral health in community-living elderly and to determine differences between relevant subgroups of oral status (remaining teeth, edentulous, implant-retained overdentures) and case complexity (robust, frail, complex care needs). SUBJECTS AND METHODS: In this cross-sectional descriptive study, 1325 Dutch community-living elderly (≥75 years of age) were asked to complete validated questionnaires on frailty, activities of daily living (ADL), complexity of care needs, and QoL. Data on oral status, self-reported oral health, dental care, general health, and medication use were assessed. Differences between relevant subgroups were determined. RESULTS: Data of 1026 (77%) elderly (median 80 years, IQR 77-84) were analyzed: 39% had remaining teeth, 51% were edentulous, and 10% had implant-supported overdentures. Elderly with complex care needs (n = 225, 22%) and frail elderly (n = 217, 21%) were more often edentulous and reported more oral problems than robust elderly (n = 584, 57%). Elderly persons with remaining teeth were less frail, had better QoL and ADL, and used fewer medicines than edentulous elderly. Elderly with implant-supported overdentures performed better on frailty and QoL than edentulous elderly with conventional dentures. CONCLUSION: Community-living elderly commonly suffer from oral health problems, in particular elderly with complex care needs. QoL, ADL, and general health are higher among community-living elderly with remaining teeth and implant-supported overdentures than in edentulous elderly.


Assuntos
Idoso Fragilizado/estatística & dados numéricos , Fragilidade/etiologia , Nível de Saúde , Boca Edêntula/complicações , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Fragilidade/epidemiologia , Avaliação Geriátrica , Indicadores Básicos de Saúde , Humanos , Vida Independente , Masculino , Boca Edêntula/epidemiologia , Países Baixos/epidemiologia , Fatores de Risco , Autorrelato
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA