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1.
J Dent Res ; : 220345211011041, 2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33906518

RESUMO

Mutations in the PHEX gene lead to X-linked hypophosphatemia (XLH), a form of inherited rickets featuring elevated fibroblast growth factor 23 (FGF23), reduced 1,25-dihydroxyvitamin D (1,25D), and hypophosphatemia. Hyp mutant mice replicate the XLH phenotype, including dentin, alveolar bone, and cementum defects. We aimed to compare effects of 1,25D versus FGF23-neutralizing antibody (FGF23Ab) monotherapies on Hyp mouse dentoalveolar mineralization. Male Hyp mice, either injected subcutaneously with daily 1,25D or thrice weekly with FGF23 blocking antibody from 2 to 35 d postnatal, were compared to wild-type (WT) controls and untreated Hyp mice. Mandibles were analyzed by high-resolution micro-computed tomography (micro-CT), histology, and immunohistochemistry. Both interventions maintained normocalcemia, increased serum phosphate levels, and improved dentoalveolar mineralization in treated versus untreated Hyp mice. 1,25D increased crown dentin volume and thickness and root dentin/cementum volume, whereas FGF23Ab effects were limited to crown dentin volume. 1,25D increased bone volume fraction, bone mineral density, and tissue mineral density in Hyp mice, whereas FGF23Ab failed to significantly affect these alveolar bone parameters. Neither treatment fully attenuated dentin and bone defects to WT levels, and pulp volumes remained elevated regardless of treatment. Both treatments reduced predentin thickness and improved periodontal ligament organization, while 1,25D promoted a more profound improvement in acellular cementum thickness. Altered cell densities and lacunocanalicular properties of alveolar and mandibular bone osteocytes and cementocytes in Hyp mice were partially corrected by either treatment. Neither treatment normalized the altered distributions of bone sialoprotein and osteopontin in Hyp mouse alveolar bone. Moderate improvements from both 1,25D and FGF23Ab treatment regimens support further studies and collection of oral health data from subjects receiving a newly approved anti-FGF23 therapy. The inability of either treatment to fully correct Hyp mouse dentin and bone prompts further experiments into underlying pathological mechanisms to identify new therapeutic approaches.

3.
Med Oral Patol Oral Cir Bucal ; 26(2): e126-e135, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33609023

RESUMO

BACKGROUND:  The immunohistochemical expression of vascular endothelial growth factor is a prognostic marker in several cancer types. In salivary gland tumors, the association between vascular endothelial growth factor and prognosis remains unclear. The purpose of this study was to perform a systematic review and meta-analysis to assess whether the immunohistochemical expression of vascular endothelial growth factor in patients with salivary gland neoplasms presents prognostic value. MATERIAL AND METHODS: Immunohistochemical studies assessing the predictive value of vascular endothelial growth factor in salivary gland neoplasms were systematically reviewed using PubMed, Scopus, Embase, Cochrane Library, and Web of Science databases. It was assessed any survival rates. The fixed-effect model with an adjusted hazard ratio (HR) and 95% confidence intervals (95% CI) as effect measures were performed in the meta-analysis. The Quality in Prognosis Studies (QUIPS) tool was used to assess the quality of the included studies, and the evidence quality was assessed by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) system. RESULTS: The immunohistochemical overexpression of vascular endothelial growth factor in patients with salivary gland neoplasms was associated with shortened survival (HR=5.37, 95% CI: 2.67-10.83, P = 0.00001). In addition, the presence of vascular endothelial growth factor was tightly associated with tumor size, lymph node metastasis, clinical stage, perineural invasion, vascular invasion, poor local control of the disease, and recurrence. CONCLUSIONS: The immunohistochemical overexpression of vascular endothelial growth factor in patients with salivary gland neoplasms has prognostic value and was associated with decreased survival time. However, more primary well-designed studies are necessary to increase the level of evidence.


Assuntos
Neoplasias das Glândulas Salivares , Fator A de Crescimento do Endotélio Vascular , Biomarcadores Tumorais , Humanos , Recidiva Local de Neoplasia , Prognóstico , Fatores de Crescimento do Endotélio Vascular
4.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(supl.1): 287-292, Feb. 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1155306

RESUMO

Abstract In view of the current panorama of hospital nutritional care, it is necessary to review nutritional care practices in hospital units, in order to ensure nutritional monitoring and quality of care. Therefore, it is necessary to build flows of nutritional assistance practices at the pediatric hospital level, based on the recommendations of the Federal Council of Nutritionists and the Brazilian Society of Parenteral and Enteral Nutrition, aiming at not generating a deficit in the nutritional monitoring of the patient and in reducing the risk of contamination of the professional. When individual protection equipment is available, nutritional admission will be made in person and during hospitalization, monitoring can be performed using secondary data from electronic medical records and / or telecommunication with the multidisciplinary team. The implementation of nutritional routines in hospitals in times of Covid-19 pandemic generates more assertive conducts for the prevention and treatment of malnutrition and other nutritional implications, also guaranteeing the safety of professionals in assistance in pediatric units..


Resumo Diante do panorama atual da assistência nutricional hospitalar, torna-se necessário a revisão das práticas de assistência nutricional em unidades hospitalares, visando garantir monitoramento nutricional e qualidade assistencial. Portanto, faz-se necessário a construção de fluxos de práticas da assistência nutricional em nível hospitalar pediátrico, baseados nas recomendações do Conselho Federal de Nutricionistas e da Sociedade Brasileira de Nutrição Parenteral e Enteral, visando não gerar déficit no monitoramento nutricional ao paciente e em reduzir o risco de contaminação do profissional. Quando há a disponibilidade de equipamento de proteção individual a admissão nutricional será feita presencialmente e durante o internamento poderá ser realizado monitoramento por meio de dados secundários provenientes do prontuário eletrônico e/ou telecomunicação com a equipe multidisciplinar. A implantação de rotinas nutricionais em âmbito hospitalar em tempos de pandemia da COVID-19 gera condutas mais assertivas para a prevenção e tratamento da desnutrição e de outras implicações nutricionais, garantindo também a segurança do profissional na assistência em unidades pediátricas.


Assuntos
Humanos , Masculino , Feminino , Criança , Medidas de Segurança , Saúde do Trabalhador , Fluxo de Trabalho , Segurança do Paciente , COVID-19/prevenção & controle , COVID-19/epidemiologia , Telecomunicações , Brasil/epidemiologia , Estado Nutricional , Estudos de Coortes , Pessoal de Saúde , Registros Eletrônicos de Saúde , Nutricionistas , Equipamento de Proteção Individual , Hospitais Pediátricos
5.
Environ Pollut ; 268(Pt B): 115832, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33120152

RESUMO

Sodium percarbonate (SPC, 2Na2CO3∙3H2O2), is a compound that can be used under multiple environmental applications. In this work, SPC was employed as oxidant in the treatment of soil contaminated with diesel oil. The soil samples were collected during the earthmoving stage of RNEST Oil Refinery (Petrobras), Brazil. Then, the samples were air-dried, mixed and characterized. Subsequently, raw soil was contaminated with diesel and treated by photo-Fenton reaction (H2O2/Fe2+/UV). SPC played a significant role in the generation of hydroxyl radicals under the catalytic effect of ferrous ions (Fe2+), hydrogen peroxide (H2O2) and radiation. These radicals provoked the photodegradation of polycyclic aromatic hydrocarbons (PAHs), in the soil remediation. A factorial design 33 was carried out to assess the variables which most influenced the decrease in total organic carbon (TOC). The study was performed with the following variables: initial concentration of [H2O2] and [Fe2+], between 190.0 and 950.0 mmol L-1 and 0.0-14.4 mmol L-1, respectively. UV radiation was supplied from sunlight, blacklight lamps, and system without radiation. All experiments were performed with 5.0 g of contaminated soil in 50.0 mL of solution. The initial concentration of Fe2+ showed the statistically most significant effect. The oxidation efficiency evaluated in the best condition showed a decrease from 34,765 mg kg-1 to 15,801 mg kg-1 in TOC and from 85.750 mg kg-1 to 20.770 mg kg-1 in PAHs content. Moreover, the sums of low and high molecular weight polycyclic aromatic hydrocarbons (LMW-PAHs and HMW-PAHs) were 19.537 mg kg-1 and 1.233 mg kg-1, respectively. Both values are within the limits recommended by the United Sates Environmental Protection Agency (USEPA) and evidenced the satisfactory removal of PAHs from contaminated soil, being an alternative to classic oxidation protocols.


Assuntos
Hidrocarbonetos Policíclicos Aromáticos , Poluentes do Solo , Brasil , Carbonatos , Peróxido de Hidrogênio , Oxidantes , Fotólise , Hidrocarbonetos Policíclicos Aromáticos/análise , Solo , Poluentes do Solo/análise
6.
Bone ; 143: 115732, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33160095

RESUMO

ALPL encodes tissue-nonspecific alkaline phosphatase (TNAP), an enzyme expressed in bone, teeth, liver, and kidney. ALPL loss-of-function mutations cause hypophosphatasia (HPP), an inborn error-of-metabolism that produces skeletal and dental mineralization defects. Case reports describe widely varying dental phenotypes, making it unclear how HPP comparatively affects the three unique dental mineralized tissues: enamel, dentin, and cementum. We hypothesized that HPP affected all dental mineralized tissues and aimed to establish quantitative measurements of dental tissues in a subject with HPP. The female proband was diagnosed with HPP during childhood based on reduced alkaline phosphatase activity (ALP), mild rachitic skeletal effects, and premature primary tooth loss. The diagnosis was subsequently confirmed genetically by the presence of compound heterozygous ALPL mutations (exon 5: c.346G>A, p.A116T; exon 10: c.1077C>G, p.I359M). Dental defects in 8 prematurely exfoliated primary teeth were analyzed by high resolution micro-computed tomography (micro-CT) and histology. Similarities to the Alpl-/- mouse model of HPP were identified by additional analyses of murine dentoalveolar tissues. Primary teeth from the proband exhibited substantial remaining root structure compared to healthy control teeth. Enamel and dentin densities were not adversely affected in HPP vs. control teeth. However, analysis of discrete dentin regions revealed an approximate 10% reduction in the density of outer mantle dentin of HPP vs. control teeth. All 4 incisors and the molar lacked acellular cementum by micro-CT and histology, but surprisingly, 2 of 3 prematurely exfoliated canines exhibited apparently normal acellular cementum. Based on dentin findings in the proband's teeth, we examined dentoalveolar tissues in a mouse model of HPP, revealing that the delayed initiation of mineralization in the incisor mantle dentin was associated with a broader lack of circumpulpal dentin mineralization. This study describes a quantitative approach to measure effects of HPP on dental tissues. This approach has uncovered a previously unrecognized novel mantle dentin defect in HPP, as well as a surprising and variable cementum phenotype within the teeth from the same HPP subject.


Assuntos
Hipofosfatasia , Fosfatase Alcalina/genética , Animais , Feminino , Hipofosfatasia/diagnóstico por imagem , Hipofosfatasia/genética , Camundongos , Mutação/genética , Dente Decíduo , Microtomografia por Raio-X
7.
Brazilian Journal of Health Review ; 4(3): 10827-10847, 2021. tab, graf
Artigo em Português | MOSAICO - Saúde integrativa | ID: biblio-1283369

RESUMO

A fototerapia é um método eficaz, não invasivo de alto impacto, sem restrições enquanto a sua utilização independente da idade gestacional, comorbidades ou nível de pigmentação cutânea, tratamento utilizado para redução de bilirrubina usado devido a sua alta eficiência e ausência de efeitos adversos. Analisar as evidências científicas publicadas sobre as indicações da fototerapia em recém­nascidos com icterícia. Trata de uma revisão bibliográfica do método revisão integrativa de literatura, realizado no período compreendido entre os meses de janeiro a abril de 2021. A busca efetuou-se, através da BVS, utilizando as bases de dados LILACS, MEDLINE, e por meio do SCIELO. Aderindo-se através dos descritores/palavras chaves: "Fototerapia", "Icterícia Neonatal", "Terapêutica", "Diagnóstico", "Cuidados de Enfermagem", combinados entre si com o operador booleano "AND". Os profissionais da equipe de enfermagem são responsáveis pelo recebimento e preparação do recém-nascido para a terapêutica, bem como, preparam os aparelhos que serão usados para a fototerapia, como os focos de luz, as incubadoras, entre outros. Evidenciou-se que a fototerapia é utilizada como forma de tratamento mais eficaz no controle da hiperbilirrubinemia. Sendo indicada nas doenças hemolíticas ou não, incompatibilidade fator Rh e grupo ABO. Embora seja frequente o uso da técnica em neonatos, deve-se enquanto profissionais se atentar aos sinais e sintomas, como também os fatores de risco no manejo da técnica, intervir elaborando uma rotina para o controle e manutenção dos equipamentos, observando criteriosamente o tipo de aparelhos utilizados e se atentar a distância ideal das lâmpadas sob o RN, avaliando sempre possíveis complicações durante o tratamento.


Phototherapy is an effective, non-invasive, high-impact method, with no restrictions as long as its use regardless of gestational age, comorbidities or skin pigmentation level, treatment used to reduce bilirubin used due to its high efficiency and absence of adverse effects. Analyze the published scientific evidence on the indications for phototherapy in newborns with jaundice. This is a bibliographic review of the integrative literature review method, carried out between January and April 2021. The search was carried out, through the VHL, using the LILACS, MEDLINE databases, and through SCIELO . Adhering to the descriptors / keywords: "Phototherapy", "Neonatal Jaundice", "Therapeutics", "Diagnosis", "Nursing Care", combined with the Boolean operator "AND". The professionals of the nursing team are responsible for receiving and preparing the newborn for therapy, as well as preparing the devices that will be used for phototherapy, such as spotlights, incubators, among others. It became evident that phototherapy is used as the most effective treatment for controlling hyperbilirubinemia. Being indicated in hemolytic diseases or not, incompatibility Rh factor and ABO group. Although the technique is frequently used in neonates, professionals should pay attention to the signs and symptoms, as well as the risk factors in the management of the technique, to intervene by elaborating a routine for the control and maintenance of equipment, carefully observing the type of equipment. devices used and pay attention to the ideal distance of the lamps under the NB, always evaluating possible complications during treatment.


Assuntos
Humanos , Recém-Nascido , Fototerapia , Icterícia Neonatal , Brasil , Bibliotecas Digitais , Cuidados de Enfermagem
8.
Texto & contexto enferm ; 30: e20200494, 2021. tab
Artigo em Inglês | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1341745

RESUMO

ABSTRACT Objective: to analyze prevalence and the factors associated with locomotive syndrome in community-dwelling older adults. Method: a cross-sectional study, developed in a municipal center for the care of older adults in Teresina, Piauí, Brazil. The sample was for convenience and comprised 204 older adults aged 60 years or more, of both genders and with preserved cognitive capacity, according to parameters of the Mini Mental State Examination. Data collection occurred from March to November 2018, by applying a form for sociodemographic, clinical and falls occurrence characterization and the 25-item Geriatric Locomotive Function Scale. To measure the strength of the associations between the variables, odds ratios and 95% confidence intervals were adopted. The statistical significance level was set at 5% for the analyses. Results: the prevalence of locomotive syndrome found was 37.2%. The factors associated with the presence of locomotive syndrome were individual monthly income (p=0.005); existence of one of the following comorbidities: systemic arterial hypertension (p=0.039), osteoporosis (p=0.016), arthrosis (p<0.001) or obesity (p=0.014); and history of hospitalization in the last year (p=0.007). Conclusion: the prevalence of locomotive syndrome found in this study was low and presented higher levels in older adults, with an individual monthly income of two to three minimum wages; who reported having hypertension, osteoporosis, arthrosis or obesity; and with a history of hospitalization in the last year. The health condition investigated showed to be related to aging, with significant repercussions on functionality.


RESUMEN Objetivo: analizar la prevalencia y los factores asociados al síndrome locomotor en adultos mayores de la comunidad. Método: estudio de tipo transversal, desarrollado en un centro de atención para adultos mayores de Teresina, Piauí, Brasil. La muestra fue por conveniencia y estuvo compuesta por 204 adultos mayores de 60 o más años de edad, de ambos sexos y con capacidad cognitiva preservada, según parámetros del Mini Examen de Estado Mental. Los datos se recolectaron entre marzo y noviembre de 2018 aplicando un formulario para la caracterización sociodemográfica, clínica y de caídas y la Escala Geriátrica de la Función Locomotora de 25 ítems. Para medir la fuerza de las asociaciones entre las variables, se adoptaron odds ratios e intervalos de confianza del 95%. El nivel de significancia estadística se estableció en 5% para los análisis. Resultados: la prevalencia del síndrome locomotor fue del 37,2%. Los factores asociados a la presencia del síndrome locomotor fueron los siguientes: ingreso mensual individual (p=0,005); presencia de una de las comorbilidades: hipertensión arterial sistémica (p=0,039), osteoporosis (p=0,016), artrosis (p<0,001) u obesidad (p=0,014); y antecedentes de internación en el último año (p=0,007). Conclusión: la prevalencia del síndrome locomotor que se encontró en este estudio fue baja y demostró ser superior en adultos mayores, con ingresos mensuales individuales de de dos a tres salarios mínimos; que indicaron sufrir hipertensión, osteoporosis, artrosis u obesidad; y con antecedentes de internación en el último año. La condición de salud investigada demostró estar relacionada con el envejecimiento, con repercusiones significativas sobre la funcionalidad.


RESUMO Objetivo: analisar a prevalência e os fatores associados à síndrome locomotora em idosos comunitários. Método: estudo do tipo transversal, desenvolvido em núcleo de atenção ao idoso, em Teresina, Piauí, Brasil. A amostra foi por conveniência e constituída por 204 idosos com idade igual ou superior a 60 anos, de ambos os sexos, com capacidade cognitiva preservada, segundo parâmetros do Mini Exame do Estado Mental. A coleta de dados ocorreu de março a novembro de 2018, por meio da aplicação de um formulário para caracterização sociodemográfica, clínica e de ocorrência de quedas e da Escala Geriátrica da Função Locomotora de 25 itens. Para aferição da força das associações entre as variáveis, adotaram-se razão de chances e intervalos de confiança de 95%. Nível de significância estatística estabelecido de 5% para as análises. Resultados: a prevalência da síndrome locomotora encontrada foi de 37,2%. Os fatores associados à presença da síndrome locomotora foram renda mensal individual (p=0,005); existência de uma das comorbidades: hipertensão arterial sistêmica (p=0,039), osteoporose (p=0,016), artrose (p<0,001) ou obesidade (p=0,014); e histórico de hospitalização, no último ano (p=0,007). Conclusão: a prevalência da síndrome locomotora encontrada no presente estudo foi baixa e apresentou-se maior em idosos, com renda mensal individual de dois a três salários mínimos; que referiram ter hipertensão, osteoporose, artrose ou obesidade; e com histórico de hospitalização, no último ano. A condição de saúde investigada se mostrou relacionada ao envelhecimento, com repercussões significativas sobre a funcionalidade.

9.
Ciênc. rural (Online) ; 51(2): e20191008, 2021. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1153848

RESUMO

ABSTRACT: One of the relevant economic importances of the "umbuzeiro" (Spondias tuberosa Arruda) to the northeastern semiarid region of Brazil is the fruit processing to obtaining preserves. However, there are limitations in the production and standardization of this product, such as color, taste and texture, which are problems in the quality, identity, making it harder to achieve new markets. This study was carried out aiming to evaluate the potential of "umbu" genotypes (Access 37, Access 44, BRS 48, BRS 52, BRS 55 and BRS 68) registered by Embrapa in the development of preserves. It was evaluated the product pH, total acidity, water activity, soluble solids, moisture, firmness, color (L*, a*, b*), reducing and non-reducing sugars, vitamin C, syneresis and consumer acceptance regarding the overall impression. The CATA method was applied to describe the sensorial profile of the samples. According to the results, it was observed a significant difference (p≤0.05) in the physico-chemical composition of the samples, being samples produced from the access 37 and BRS 68 more appropriated for processing of preserves (in bars), with greater firmness and less syneresis. Consumers indicated products from the genotypes 37, 44, BRS 52 and BRS 55 as the ones with highest acceptance regarding the overall impression; the consumers associated the samples in different characterizations, associating the access 37 and BRS 68 with the characteristics of firm and delicious; the commercial sample was characterized as acid, adstringent and terrible.


RESUMO: Uma das relevantes importâncias econômicas do umbuzeiro (Spondias tuberosa Arruda) ao semiárido nordestino pode ser atribuída ao beneficiamento do fruto na forma do tradicional doce em massa. Entretanto, existem limitações na produção e padronização deste derivado quanto sua cor, sabor e textura, o que prejudica sua qualidade, identidade e alcance de outros mercados. Este trabalho foi conduzido buscando analisar o potencial de genótipos de umbu (Acesso 37, Acesso 44, BRS 48, BRS 52, BRS 55 e BRS 68), registrados pela Embrapa, para o desenvolvimento de doce em massa. Avaliou-se a qualidade dos produtos obtidos, diante de uma amostra comercial, quanto a composição físico-química (pH, acidez total, atividade de água, sólidos solúveis, umidade, firmeza, cor (L*, a*, b*), açúcares redutores e não-redutores, vitamina C e sinérese) e aceitação por consumidores quanto a impressão global. O método CATA foi aplicado para descrever o perfil sensorial das amostras. Os resultados mostraram diferença significativa (p≤0.05) na composição físico-química das amostras, sendo as amostras Acesso 37 e BRS 68 as mais apropriados ao processamento de doce em massa, com a maior firmeza e menor sinérese. Os consumidores indicaram os genótipos 37, 44, BRS 52 e BRS 55 com maiores médias de aceitação na impressão global; associaram as amostras em distintas caracterizações, indicando o Acesso 37 e BRS 68 como mais gostosos e firmes, e a amostra comercial como a mais ácida, adstringente e terrível.

10.
Esc. Anna Nery Rev. Enferm ; 25(2): e20200051, 2021. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1149290

RESUMO

Resumo Objetivo analisar o perfil sociodemográfico, clínico e epidemiológico dos casos de HIV/Aids em idosos no estado do Piauí. Método estudo descritivo, com coleta retrospectiva, a partir de dados secundários do Sistema de Informações de Agravos de Notificação, referentes ao período de 2008 a 2018. Coleta realizada de agosto a setembro de 2019, com processamento dos dados realizados por meio do programa TabWin, versão 3.6. Realizou-se cálculo das frequências absoluta e relativa, assim como o cálculo de incidência, utilizando-se do Programa Excel, versão 7.0. Resultados de 2008 a 2018, notificaram-se 262 casos novos de HIV/Aids em idosos no estado, 4,5% do número total de casos, com tendência de crescimento no período, sendo 76,0% da faixa etária entre 60 e 69 anos de idade, 64,9% do sexo masculino, 64,8% pardos, 54,5% com baixa escolaridade, 53,4% residentes em Teresina e 70,9% com transmissão pela relação heterossexual. Conclusão e Implicações para a prática verificou-se tendência de crescimento dos casos de HIV/Aids em idosos, no estado do Piauí, ao longo dos últimos 10 anos. Os resultados deste estudo contribuem para o conhecimento da dinâmica epidemiológica desse agravo no estado e a elaboração de estratégias de prevenção e controle da infecção.


Resumen Objetivo analizar el perfil sociodemográfico, clínico y epidemiológico de casos de VIH/SIDA en ancianos del estado de Piauí. Método estudio descriptivo, con recolección retrospectiva, utilizándose datos secundarios del "Sistema de Informações de Agravos de Notificação", referente al período de 2008 a 2018. Recolección realizada de agosto a septiembre de 2019, con procesamiento de datos realizado en el Programa TabWin, versión 3.6. Se realizó el cálculo de frecuencias absolutas y relativas, así como el cálculo de incidencia, utilizándose del Programa Excel, versión 7.0. Resultados de 2008 a 2018 se notificaron 262 nuevos casos de VIH/SIDA en ancianos en el estado, 4.5% del total de casos, con tendencia creciente en el período, siendo 76.0% entre 60 y 69 años, 64,9% hombres, 64,8% morenos, 54,5% con baja escolaridad, 53,4% residentes en Teresina y 70,9% por transmisión heterosexual. Conclusión e implicaciones para la práctica hubo tendencia de crecimiento en los casos de VIH/SIDA en ancianos, en Piauí, durante los últimos 10 años. Los resultados de este estudio contribuyen al conocimiento de la dinámica epidemiológica de esta condición en el estado y al desarrollo de estrategias para prevención y control de la infección.


Abstract Objective this study aimed to analyze the sociodemographic, clinical and epidemiological profile of HIV/AIDS cases in older adults in the state of Piauí, Brazil. Method this is a descriptive study with retrospective collection, using secondary data from the Brazilian Information System for Notifiable Diseases, from 2008 to 2018. Data collection occurred from August to September 2019, with data processing and mapping performed using the TabWin software, version 3.6. Absolute and relative frequencies were calculated, as well as the incidence, using Microsoft Excel, version 7.0. Results from 2008 to 2018, there were 262 new cases of HIV/AIDS reported among older adults in the state, representing 4.5% of the total number of cases, with a growth trend in the period, in which 76.0% were aged 60-69 years old, 64.9% were male, 64.8% brown-skinned, 54.5% had low schooling, 53.4% lived in the city of Teresina, and 70.9% with transmission through heterosexual relationships. Conclusion and implications for the practice a growth trend in HIV/AIDS cases in older adults in the state of Piauí over the past 10 years was identified. The results of this study contribute to knowing the epidemiological dynamics of this condition in the state and to developing prevention and control strategies for this infection.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Perfil de Saúde , Infecções por HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida , Estudos Retrospectivos , Notificação de Doenças/estatística & dados numéricos
11.
Ann Cardiol Angeiol (Paris) ; 69(5): 227-232, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33059875

RESUMO

The COVID-19 pandemic has swept through our hospitals which have had to adapt as a matter of urgency. We are aware that a health crisis of this magnitude is likely to generate mental disorders particularly affecting exposed healthcare workers. Being so brutal and global, this one-of the kind pandemic has been impacting the staff in their professional sphere but also within their private circle. The COV IMPACT study is an early assessment survey conducted for 2 weeks in May 2020, of the perception by all hospital workers of the changes induced in their professional activity by the pandemic. The study was carried out by a survey sent to the hospital staff of Béziers and Montfermeil. The readjusted working conditions were source of increased physical fatigue for 62 % of the respondents. Moral exhaustion was reported by 36 %. It was related to the stress of contracting the infection (72 %) but above all of transmitting it to relatives (89 %) with a broad perception of a vital risk (41 %). This stress affected all socio-professional categories (CSP) and was independent of exposure to COVID. Change in organisation, lack of information and protective gear and equipment were major factors of insecurity at the start of the epidemic. Work on supportive measures is necessary. It should focus on the spread of information, particularly towards the youngest, as well as bringing more psychological support and a larger amount of medical equipment, beyond healthcare workers and the COVID sectors.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Recursos Humanos em Hospital/psicologia , Pneumonia Viral/epidemiologia , Estresse Psicológico/etiologia , Adulto , COVID-19 , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/transmissão , Família , Fadiga/etiologia , Fadiga/psicologia , França/epidemiologia , Inquéritos Epidemiológicos , Humanos , Disseminação de Informação , Pessoa de Meia-Idade , Moral , Doenças Profissionais/etiologia , Doenças Profissionais/psicologia , Inovação Organizacional , Pandemias , Equipamento de Proteção Individual/provisão & distribuição , Pneumonia Viral/psicologia , Pneumonia Viral/transmissão , SARS-CoV-2 , Estresse Psicológico/psicologia , Adulto Jovem
12.
Global Spine J ; : 2192568220950337, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32964731

RESUMO

STUDY DESIGN: Basic science animal research study. OBJECTIVES: Using T10 spinal contused rats, we sought to identify molecular and circulating, metabolic and immune biomarkers during the subchronic and chronic recovery periods that may inform us concerning neurorehabilitation. METHODS: Gene expression of the cord and ELISA were performed in 28 and 100 days in T10 injured rats and compared to sham-injured rats. Hundred-day injured rats were placed on either a low-fat or high-fat diet following the recovery phase. Linear regression analysis was performed between markers and locomotor score, body weight, body composition, and blood cholesterol and triglycerides. RESULTS: Gene expression in the thoracic cord for complement marker, C1QC, dendritic cell marker, ITGAX, and cholesterol biosynthesis genes, FDFT1, HMCGR, LDLR, and SREBP1, were significantly associated with BBB score, body weight, composition, and other metabolic parameters. Circulating levels of these proteins, however, did not vary by injury or predict the level of locomotor recovery. CONCLUSIONS: Identification of reliable circulating biomarkers that are durable and based on level of spinal injury are complicated by immune and metabolic comorbidities. Continued work is necessary to identify stable markers of disease progression.

13.
Eur Biophys J ; 49(7): 571-589, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32939610

RESUMO

Cyclodextrins (CDs) are well-known carriers for encapsulating hydrophobic molecules, while among cannabinoids, cannabidiol (CBD) has attracted considerable attention due to its therapeutic capability. In this framework, we employed molecular dynamics and docking techniques for investigating the interaction energy and thermodynamical issues between different CDs (α, ß, and γ type) and CBD immersed in water and a solution mimicking a physiological environment. We quantified the energetic aspects, for different thermal conditions, in which both aqueous solutions interact with CBDs and CDs and the CBD-CDs complex itself. In order to approximate the physiological conditions, our simulations also included the mammalian temperature. The calculations revealed significant interaction energy between lactate and the CD surface and a movement of lactate toward CD as well. We observed an almost constant number of lactate molecules forming clusters without exhibiting a temperature dependence. Next, the degree of CBD-CDs complexation at four different temperatures was analyzed. The results showed that the complexation depends on the medium, becoming weaker with the temperature increment. Our findings highlighted that the entropy contribution is relevant for CBD-α-CD and CBD-ß-CD, while CBD-γ-CD is practically insensitive to temperature changes for both solutions. In both water and artificial physiological solutions, the γ-CD appears more stable than the other complexes. Overall, CBD achieved partial encapsulation considering α-CD and ß-CD, showing a temperature dependence, while γ-CD remained fully immersed no matter the thermal level assumed. We also discuss the pharmacological relevance and physiological implications of these findings.

14.
Braz J Anesthesiol ; 70(2): 165-170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32834194

RESUMO

The 2020 pandemic caused by the novel coronavirus, COVID-19, had its headquarters in China. It causes Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and presents a broad spectrum of clinical manifestations, ranging from entirely asymptomatic through severe acute respiratory failure and death. Presuming a significant quantity of ventilator-dependent patients, several institutions strategically delayed elective surgeries. Particularly procedures performed involving the nasal mucosa, such as a transsphenoidal approach of the pituitary gland, considering the tremendous level of viral shedding. Nevertheless, critical cases demand expeditious resolution. Those situations are severe pituitary apoplexy, declining consciousness level, or risk of acute visual loss. This case presents a successful urgent perioperative management of a 47 year-old male COVID-19 positive patient who presented to the Emergency Department with a left frontal headache that culminated with diplopia, left eye ptosis, and left visual acuity loss after 5 days. Transsphenoidal hypophysectomy was uneventfully performed, and the patient was discharged from the hospital on postoperative day four. It additionally describes in detail the University of Mississippi Medical Center airway management algorithm for patients infected with the novel coronavirus who need emergent surgical attention.

15.
Av. enferm ; 38(2): 216-225, May-Aug. 2020. tab
Artigo em Português | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1114691

RESUMO

Resumo Objetivo: relacionar o desejo de doar leite materno aos aspectos socio-demográficos, clínicos e obstétricos. Materiais e métodos: estudo transversal e analítico com abordagem quantitativa, realizado com 226 mulheres durante o puerpério imediato, em um Hospital de Referência do interior do Piauí, Brasil, entre dezembro de 2016 e junho de 2018. Na estatística analítica, realizaram-se os testes de Kolmogorov-Smirnov, Qui-quadrado de Pearson, Razão de verossimilhança e o teste t-Student. Resultados: a caracterização sociodemográfica revelou que as participantes do estudo eram predominantemente casadas (n = 165; 73 %), pardas (n = 145; 64,1 %) e 79 (34,9 %) praticavam atividade física. Das entrevistadas, 78,3 % (n = 177) desejavam ser doadoras de leite materno, o que indica relação significativa com os anos de estudo (p = 0,038) e com as que receberam orientações sobre o assunto durante o pré-natal (p = 0,028). Conclusões: o desejo de doar leite materno esteve significativamente relacionado às variáveis de maior escolaridade da mulher e às orientações recebidas no pré-natal sobre o assunto, o que demonstra a relevância da educação em saúde dentro do contexto.


Resumen Objetivo: relacionar el deseo de donar leche materna con aspectos sociode-mográficos, clínicos y obstétricos. Materiales y métodos: estudio transversal y analítico con enfoque cuantitativo, realizado con 226 mujeres durante el puerperio inmediato en un hospital de referencia en el interior de Piauí, Brasil, desde diciembre de 2016 hasta junio de 2018. En estadística analítica, se realizaron las pruebas de Kolmogorov-Smirnov, Chi-cuadrado de Pearson, razón de probabilidad y t de Student. Resultados: la caracterización sociodemográfica reveló que las participantes del estudio eran predominantemente casadas (n = 165; 73 %), mestizas (n = 145; 64,1 %) y 79 (34,9 %) practicaban actividad física. El 78,3 % (n = 177) de las entrevistadas deseaba ser donante de leche materna, lo que evidenció una relación significativa con los años de estudio (p = 0,038) y con aquellas que recibieron orientación sobre el tema durante la atención prenatal (p = 0,028). Conclusiones: el deseo de donar leche materna se relacionó significativamente con las variables de más alto nivel de escolaridad y la orientación prenatal sobre el tema, lo que demuestra la relevancia de la educación para la salud en el contexto.


Abstract Objective: To relate the desire to donate breastmilk to sociodemographic, clinical, and obstetric aspects. Materials and methods Cross-sectional and analytical study with quantitative approach, conducted with 226 women during the immediate postpartum period at a referral hospital in the interior of Piauí (Brazil) from December 2016 to June 2018. For analytical statistics, the Kolmogorov-Smirnov, Pearson's Chi-square, Likelihood Ratio and Student's t-tests were performed. Results: Sociodemographic characterization revealed that the study participants were predominantly married (n = 165; 73 %); mixed race (n = 145; 64.1 %), and 79 (34.9 %) practiced physical activity. Out of the total number on interviewees, 78.3 % (n = 177) wanted to be breast milk donors, showing a significant relationship with their years of study (p = 0.038) and being provided guidance on the subject during prenatal care (p = 0.028). Conclusions: The desire to donate breastmilk was significantly related to the variables of higher education of women and prenatal guidance on the subject, demonstrating the relevance of health education within this context.


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Cuidado Pré-Natal , Aleitamento Materno , Bancos de Leite , Período Pós-Parto , Pasteurização , Leite Humano , Mulheres , Brasil
18.
Braz J Anesthesiol ; 70(2): 165-170, 2020.
Artigo em Português | MEDLINE | ID: mdl-32605826

RESUMO

The 2020 pandemic caused by the novel coronavirus, COVID-19, had its headquarters in China. It causes Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and presents a broad spectrum of clinical manifestations, ranging from entirely asymptomatic through severe acute respiratory failure and death. Presuming a significant quantity of ventilator-dependent patients, several institutions strategically delayed elective surgeries. Particularly procedures performed involving the nasal mucosa, such as a transsphenoidal approach of the pituitary gland, considering the tremendous level of viral shedding. Nevertheless, critical cases demand expeditious resolution. Those situations are severe pituitary apoplexy, declining consciousness level, or risk of acute visual loss. This case presents a successful urgent perioperative management of a 47 year-old male COVID-19 positive patient who presented to the Emergency Department with a left frontal headache that culminated with diplopia, left eye ptosis, and left visual acuity loss after 5 days. Transsphenoidal hypophysectomy was uneventfully performed, and the patient was discharged from the hospital on postoperative day four. It additionally describes in detail the University of Mississippi Medical Center airway management algorithm for patients infected with the novel coronavirus who need emergent surgical attention.


Assuntos
Manuseio das Vias Aéreas/métodos , Infecções por Coronavirus/complicações , Neoplasias Hipofisárias/cirurgia , Pneumonia Viral/complicações , Betacoronavirus/isolamento & purificação , COVID-19 , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Assistência Perioperatória , Neoplasias Hipofisárias/diagnóstico , SARS-CoV-2 , Resultado do Tratamento
19.
Osteoporos Int ; 31(11): 2251-2257, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32572521

RESUMO

Using genetic, clinical, biochemical, and radiographic assessment and bioinformatic approaches, we present an unusual case of adult HPP caused by a novel de novo heterozygous nonsense mutation in the alkaline phosphatase (ALPL). INTRODUCTION: Hypophosphatasia (HPP) is caused by genetic alterations of the ALPL gene, encoding the tissue-nonspecific isozyme of alkaline phosphatase (TNSALP). Here, the purpose was to perform clinical and molecular investigation in a 36-year-old Caucasian woman suspected to present adult HPP. METHODS: Medical and dental histories were obtained for the proposita and family members, including biochemical, radiographic, and dental assessments. ALPL mutational analysis was performed by the Sanger sequencing method, and the functional impact prediction of the identified mutations was assessed by bioinformatic methods. RESULTS: We identified a novel heterozygous nonsense mutation in the ALPL gene (NM_000478.6:c.768G>A; W[TGG]>*[TGA]) associated with spontaneous vertebral fracture, severe back pain, musculoskeletal pain, low bone density, and short-rooted permanent teeth loss. Functional prediction analysis revealed that the Trp256Ter mutation led to a complete loss of TNSALP crown domain and extensive loss of other functional domains (calcium-binding domain, active site vicinity, and zinc-binding site) and over 60% loss of homodimer interface residues, suggesting that the mutant TNSALP molecules are nonfunctional and form unstable homodimers. Genotyping of the ALPL in the proposita's parents, sister, and niece revealed that in this case, HPP occurred due to a de novo mutation. CONCLUSION: The present study describes a novel genotype-phenotype and structure-function relationship for HPP, contributing to a better molecular comprehension of HPP etiology and pathophysiology.


Assuntos
Fosfatase Alcalina , Hipofosfatasia , Adulto , Fosfatase Alcalina/genética , Códon sem Sentido , Análise Mutacional de DNA , Feminino , Heterozigoto , Humanos , Hipofosfatasia/diagnóstico por imagem , Hipofosfatasia/genética , Mutação
20.
Case Rep Anesthesiol ; 2020: 9792580, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32328312

RESUMO

A 31-year-old G5P1 patient with unremarkable past medical history at 29 weeks of gestation was diagnosed with a gigantic left frontotemporal brain mass. Initial clinical management as an inpatient achieved an improvement in the symptoms. The patient and surgical team agreed to schedule a cesarean delivery at 32 weeks of gestation if no neurological deterioration was observed. Intraoperative course with general endotracheal anesthesia and bilateral transversus abdominis plane block was uneventful and promoted efficient postoperative pain control. Seven days after delivery, the patient underwent craniotomy for brain tumor resection. This report describes the anesthetic management of a patient with an intracranial tumor during pregnancy.

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