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1.
Medicine (Baltimore) ; 100(35): e27067, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477139

RESUMO

BACKGROUND: There is no clear information on the efficacy of corticosteroids, and splints in the treatment of patients with diabetes mellitus (DM). The aim of this study was to compare the outcomes of isolated corticosteroid injection therapy with splint treatment with corticosteroid injection in patients with and without DM. METHODS: 84 diabetics, and 84 healthy patients with a diagnosis of de Quervain's tenosynovitis were included in our study. The patients were randomly distributed into four subgroups with and without DM. Groups 1 and group 2 consisted of diabetic patients, while group 3 and group 4 consisted of healthy patients. Corticosteroid injections were administered to groups 1 and 3, and corticosteroid injection and splint treatment were administered to groups 2 and 4. RESULTS: There was no significant difference in terms of age, gender, dominant/non-dominant hand, pre-treatment Quick Disabilities of the Arm, Shoulder and Hand score and visual analog scale scores score between the four groups. Quick Disabilities of the Arm, Shoulder and Hand and visual analog scale scores in the four groups were found to be significantly better than pre-treatment at the 12th month. Finkelstein test results were positive in 37.5% of the patients in the first group, 35% of the patients in the second group, 20% of the patients in the third group and 9.5% of the patients in the fourth group. Groups 1 and 2 and, groups 3 and 4 were compared to evaluate the effect of the splint. While forearm-based thumb splint affected the results positively in healthy individuals, it was determined that it had no effect on the results in diabetic patients. CONCLUSION: Although corticosteroid treatment is effective in the treatment of de Quervain's tenosynovitis in healthy and diabetic individuals, the results are worse in diabetic patients than in healthy patients. In addition, the use of splint with corticosteroid injection in healthy individuals positively affects the results, while it does not affect the results in diabetic patients.


Assuntos
Corticosteroides/farmacologia , Doença de De Quervain/tratamento farmacológico , Contenções/normas , Tenossinovite/tratamento farmacológico , Corticosteroides/uso terapêutico , Adulto , Idoso , Análise de Variância , Doença de De Quervain/complicações , Doença de De Quervain/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Contenções/estatística & dados numéricos , Estatísticas não Paramétricas , Tenossinovite/complicações , Tenossinovite/fisiopatologia
2.
Int J Mol Sci ; 22(15)2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-34361020

RESUMO

A stochastic model of the flow cytometer measurement process was developed to assess the nature of the observed coefficient of variation (CV%) of the mean fluorescence intensity (MFI) from a population of labeled microspheres (beads). Several sources of variability were considered: the total number of labels on a bead, the path through the laser beam, the optical absorption cross-section, the quantum yield, the numerical aperture of the collection optics, and the photoelectron conversion efficiency of the photomultiplier (PMT) cathode. The variation in the number of labels on a bead had the largest effect on the CV% of the MFI of the bead population. The variation in the path of the bead through the laser beam was minimized using flat-top lasers. The variability in the average optical properties of the labels was of minor importance for beads with sufficiently large number of labels. The application of the bead results to the measured CV% of labeled B cells indicated that the measured CV% was a reliable measure of the variability of antibodies bound per cell. With some modifications, the model can be extended to multicolor flow cytometers and to the study of CV% from cells with low fluorescence signal.


Assuntos
Linfócitos B/citologia , Citometria de Fluxo/normas , Microesferas , Análise de Variância , Citometria de Fluxo/métodos , Humanos , Reprodutibilidade dos Testes , Processos Estocásticos
3.
Nutrients ; 13(8)2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34444901

RESUMO

Nutrient deficiency is a common cause of underperformance in endurance athletes, and supplement intake is frequently considered compensatory for vegan and vegetarian athletes specifically. This study aimed to investigate the patterns of supplement intake among vegan, vegetarian, and omnivorous distance (>10 km) runners and its association with age, sex, and race distance. From a total of 317 runners who participated in an online survey, 220 distance runners (mean age: 38.5 years; mean BMI: 21.75 kg/m2) were selected for the final sample after data clearance and assigned to 100 omnivores, 40 vegetarians, or 80 vegans. Sociodemographic information, racing experience, and patterns of supplement intake, including type, frequency, dosage, etc., were collected using a questionnaire. Macronutrient intake was assessed using a food frequency questionnaire. ANOVA and logistic regression were used for data analysis. The prevalence of supplement intake was 51% for total runners and 72% among vegan runners. Age, sex, and race distance had no significant effect on the type of supplement intake (p > 0.05). Compared to omnivores and vegetarians, vegan runners reported consuming more vitamin (but not carbohydrate/protein or mineral) supplements (p < 0.05). Vitamin B12, magnesium, and multivitamin had the most prevalent use amongst micronutrient supplements. This study points to a central role for supplementary nutritional strategies in different groups of distance runners. The present findings may help future investigations by design to identify specific requirements of endurance runners when adhering to specific kinds of diet particularly plant-based diets.


Assuntos
Atletas/estatística & dados numéricos , Suplementos Nutricionais/estatística & dados numéricos , Corrida/estatística & dados numéricos , Veganos/estatística & dados numéricos , Vegetarianos/estatística & dados numéricos , Adulto , Análise de Variância , Estudos Transversais , Dieta/métodos , Inquéritos sobre Dietas , Ingestão de Alimentos , Feminino , Humanos , Modelos Logísticos , Masculino , Substâncias para Melhoria do Desempenho/uso terapêutico , Resistência Física , Inquéritos e Questionários
4.
BMC Med Res Methodol ; 21(1): 150, 2021 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-34303343

RESUMO

BACKGROUND: Randomized pre-post designs, with outcomes measured at baseline and after treatment, have been commonly used to compare the clinical effectiveness of two competing treatments. There are vast, but often conflicting, amount of information in current literature about the best analytic methods for pre-post designs. It is challenging for applied researchers to make an informed choice. METHODS: We discuss six methods commonly used in literature: one way analysis of variance ("ANOVA"), analysis of covariance main effect and interaction models on the post-treatment score ("ANCOVAI" and "ANCOVAII"), ANOVA on the change score between the baseline and post-treatment scores ("ANOVA-Change"), repeated measures ("RM") and constrained repeated measures ("cRM") models on the baseline and post-treatment scores as joint outcomes. We review a number of study endpoints in randomized pre-post designs and identify the mean difference in the post-treatment score as the common treatment effect that all six methods target. We delineate the underlying differences and connections between these competing methods in homogeneous and heterogeneous study populations. RESULTS: ANCOVA and cRM outperform other alternative methods because their treatment effect estimators have the smallest variances. cRM has comparable performance to ANCOVAI in the homogeneous scenario and to ANCOVAII in the heterogeneous scenario. In spite of that, ANCOVA has several advantages over cRM: i) the baseline score is adjusted as covariate because it is not an outcome by definition; ii) it is very convenient to incorporate other baseline variables and easy to handle complex heteroscedasticity patterns in a linear regression framework. CONCLUSIONS: ANCOVA is a simple and the most efficient approach for analyzing pre-post randomized designs.


Assuntos
Modelos Estatísticos , Projetos de Pesquisa , Análise de Variância , Correlação de Dados , Humanos , Resultado do Tratamento
5.
Res Nurs Health ; 44(5): 776-786, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34196029

RESUMO

The COVID-19 pandemic poses significant challenges to healthcare systems worldwide. A key consideration is the adverse psychological impact on healthcare workers (HCWs). This study aimed to investigate the variable levels of psychological distress, perceived safety, trust, and self- and collective-efficacy during the COVID-19 crisis amongst varied HCWs. A survey was disseminated to nurses, physicians, interns, and administrative and logistical staff at an acute-care hospital in Israel during the first wave of COVID-19. The survey consisted of items on a 5-point Likert scale, measuring HCW's perceptions concerning the aforementioned variables as well as demographic information. A total of 716 hospital personnel completed the survey. Nurses reported higher levels of psychological distress and lower levels of trust in the hospital's COVID-19 guidelines compared to physicians (2.3 vs. 2.0 and 3.7 vs. 4.0, respectively). Nurses and interns felt the least safe when working in the hospital. Nurses reported the highest levels of concern regarding fear of uncontrollable spread, infection, and family transmission of the virus. Interns reported the lowest levels of self- and collective-efficacy. In a regression model, the variables that predicted 32% of distress among nurses were age, gender, level of religiosity, indices of perceived safety, and self-efficacy. This study demonstrated differences in distress and perceived safety, trust, and efficacy between varied HCWs during COVID-19. This variability should be considered when designing policies to protect HCWs' wellbeing during future pandemics.


Assuntos
COVID-19/complicações , Pessoal de Saúde/psicologia , Percepção , Adulto , Análise de Variância , COVID-19/prevenção & controle , COVID-19/psicologia , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente/normas , Segurança do Paciente/estatística & dados numéricos , Autoeficácia , Estresse Psicológico , Inquéritos e Questionários , Confiança/psicologia
6.
Ceska Slov Farm ; 70(2): 66-78, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34237946

RESUMO

The aim of this work was to develop anti-stress compressed lozenges containing 100 mg of glycine and 250 mg of magnesium citrate obtained by the direct compression method. To choose optimal excipient composition providing the sufficient pharmaco-technical properties of the tablet blend, mechanical strength of tablets and non-disintegrating, slow-dissolving behavior of compressed lozenges during sucking, 27 experimental formulations according to fractional factorial Latin cube design were prepared and tested. The excipients used in the study were: Mannogem® EZ, Cellactose® 80 and GalenIQ 721 (fillers); Plasdone S-630, Kollidon® 90 F and Avicel® PH-101 (dry binders); Metolose® 90SH-4000SR and guar gum (gel-forming binders); PRUV®, Neusilin® US2, and Compritol® 888 CG ATO (antifriction excipients). The following parameters were investigated as responses: bulk density, Carrs index, friability, resistance to crushing, and in vitro disintegration time. ANOVA approach was applied for statistical processing, which allowed to reveal the individual effects of each excipient and several interaction effects observed for the excipient amounts used in this study. Isomalt (GalenIQ 721), copovidone (Plasdone S-630), and glyceryl behenate (Compritol® 888 CG ATO) were selected to be incorporated in the final formulation of compressed lozenges.


Assuntos
Celulose , Excipientes , Análise de Variância , Solubilidade , Comprimidos
7.
BMC Plant Biol ; 21(1): 307, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34193031

RESUMO

BACKGROUND: Maize rough dwarf disease (MRDD), a widespread disease caused by four pathogenic viruses, severely reduces maize yield and grain quality. Resistance against MRDD is a complex trait that controlled by many quantitative trait loci (QTL) and easily influenced by environmental conditions. So far, many studies have reported numbers of resistant QTL, however, only one QTL have been cloned, so it is especially important to map and clone more genes that confer resistance to MRDD. RESULTS: In the study, a major quantitative trait locus (QTL) qMrdd2, which confers resistance to MRDD, was identified and fine mapped. qMrdd2, located on chromosome 2, was consistently identified in a 15-Mb interval between the simple sequence repeat (SSR) markers D184 and D1600 by using a recombinant inbred line (RIL) population derived from a cross between resistant ("80007") and susceptible ("80044") inbred lines. Using a recombinant-derived progeny test strategy, qMrdd2 was delineated to an interval of 577 kb flanked by markers N31 and N42. We further demonstrated that qMrdd2 is an incompletely dominant resistance locus for MRDD that reduced the disease severity index by 20.4%. CONCLUSIONS: A major resistance QTL (qMrdd2) have been identified and successfully refined into 577 kb region. This locus will be valuable for improving maize variety resistance to MRDD via marker-assisted selection (MAS).


Assuntos
Resistência à Doença/genética , Doenças das Plantas/genética , Doenças das Plantas/virologia , Locos de Características Quantitativas/genética , Zea mays/genética , Zea mays/virologia , Análise de Variância , Ligação Genética , Endogamia , Modelos Genéticos , Fenótipo , Mapeamento Físico do Cromossomo
8.
Nutrients ; 13(6)2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34207655

RESUMO

Lower resting energy expenditure (REE) may partially explain the disproportionate prevalence of overweight/obesity among black African women. As no previous studies have investigated the REE of Southern African (South. Afr.) children, we aimed to determine, by sex and population group, the REE of 6- to 9-year-old urban school children. In a cross-sectional study with quota sampling, REE was measured with indirect calorimetry (IC). Confounders considered were: body composition (BC) (fat-free mass (FFM), FFM index, fat mass (FM), FM index), assessed using multifrequency bioelectrical impedance analysis, and physical activity (PA) measured with a pedometer. Multivariate regression was used to calculate REE adjusted for phenotypes (BC, z-scores of weight-for-age, height-for-age, body mass index-for-age) and PA. Sex and population differences in REE were determined with two-way ANOVA. Ninety-four healthy children (59.6% girls; 52.1% black) with similar socioeconomic status and PA opportunities participated. Despite BC variations, sex differences in REE were not significant (41 kcal/day; P = 0.375). The REE of black participants was lower than of white (146 kcal/day; P = 0.002). When adjusted for FFM and HFA z-score, the differences in REE declined but remained clinically meaningful at 91 kcal/day (P = 0.039) and 82 kcal/day (P = 0.108), respectively. We recommend the development of population-specific REE prediction equations for South. Afr. children.


Assuntos
Metabolismo Basal , Saúde da Criança/estatística & dados numéricos , Obesidade Pediátrica/epidemiologia , Saúde da População/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Acelerometria/métodos , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Análise de Variância , Composição Corporal , Calorimetria Indireta , Criança , Estudos Transversais , Impedância Elétrica , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Exercício Físico , Feminino , Humanos , Masculino , Obesidade Pediátrica/etnologia , Prevalência , Análise de Regressão , Fatores de Risco , Fatores Sexuais , África do Sul/epidemiologia , África do Sul/etnologia
9.
Nutrients ; 13(7)2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34202394

RESUMO

Parents are important agents in shaping children's eating habits. However, the associations between children's and parents' eating behaviors are complex and may be convoluted for various reasons, such as parenting feeding styles, stressful mealtimes, and children's neurodevelopmental disorders (ND), such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). The purpose of this study was to analyze associations between parents and their children's fussy eating, in a cross-sectional sample of children, with and without ND. Ninety-seven parents answered screening questionnaires prior to an intervention study. Associations were investigated using two-way ANOVAs and chi-square analyses. Overall, children with ND accepted fewer food items and consumed unhealthier foods more frequently than children without ND. Fussy eating parents had children who accepted fewer food items and consumed unhealthier foods more frequently than children whose parents were not fussy eaters. Interaction effects were not significant. A higher proportion of fussy eating parents, than non-fussy eating parents, had children who had difficulties with combined foods and hidden ingredients. The findings highlight the need for further investigation into the relationships between parents' influence on their children's eating behavior and food consumption, as well as possible reciprocal impacts.


Assuntos
Comportamento Infantil/psicologia , Seletividade Alimentar , Transtornos do Neurodesenvolvimento/psicologia , Poder Familiar/psicologia , Pais/psicologia , Adulto , Análise de Variância , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Espectro Autista/psicologia , Distribuição de Qui-Quadrado , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Relações Pais-Filho , Inquéritos e Questionários
10.
Commun Biol ; 4(1): 863, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-34267313

RESUMO

Organisms comprise multiple interacting parts, but few quantitative studies have analysed multi-element systems, limiting understanding of phenotypic evolution. We investigate how disparity of vertebral morphology varies along the axial column of mammalian carnivores - a chain of 27 subunits - and the extent to which morphological variation have been structured by evolutionary constraints and locomotory adaptation. We find that lumbars and posterior thoracics exhibit high individual disparity but low serial differentiation. They are pervasively recruited into locomotory functions and exhibit relaxed evolutionary constraint. More anterior vertebrae also show signals of locomotory adaptation, but nevertheless have low individual disparity and constrained patterns of evolution, characterised by low-dimensional shape changes. Our findings demonstrate the importance of the thoracolumbar region as an innovation enabling evolutionary versatility of mammalian locomotion. Moreover, they underscore the complexity of phenotypic macroevolution of multi-element systems and that the strength of ecomorphological signal does not have a predictable influence on macroevolutionary outcomes.


Assuntos
Adaptação Fisiológica/fisiologia , Evolução Biológica , Carnivoridade/fisiologia , Locomoção/fisiologia , Mamíferos/fisiologia , Coluna Vertebral/fisiologia , Análise de Variância , Animais , Atividade Motora/fisiologia , Coluna Vertebral/anatomia & histologia , Coluna Vertebral/diagnóstico por imagem , Fatores de Tempo , Tomografia Computadorizada por Raios X , Microtomografia por Raio-X
11.
Int J Mol Sci ; 22(13)2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34202141

RESUMO

Intestinal symbiotic bacteria have played an important role in the digestion, immunity detoxification, mating, and reproduction of insects during long-term coevolution. The oriental fruit moth, Grapholita molesta, is an important fruit tree pest worldwide. However, the composition of the G. molesta microbial community, especially of the gut microbiome, remains unclear. To explore the differences of gut microbiota of G. molesta when reared on different host plants, we determined the gut bacterial structure when G. molesta was transferred from an artificial diet to different host plants (apples, peaches, nectarines, crisp pears, plums, peach shoots) by amplicon sequencing technology. The results showed that Proteobacteria and Firmicutes are dominant in the gut microbiota of G. molesta. Plum-feeding G. molesta had the highest richness and diversity of gut microbiota, while apple-feeding G. molesta had the lowest. PCoA and PERMANOVA analysis revealed that there were significant differences in the gut microbiota structure of G. molesta on different diets. PICRUSt2 analysis indicated that most of the functional prediction pathways were concentrated in metabolic and cellular processes. Our results confirmed that gut bacterial communities of G. molesta can be influenced by host diets and may play an important role in host adaptation.


Assuntos
Microbioma Gastrointestinal , Lepidópteros/microbiologia , Análise de Variância , Animais , Biologia Computacional/métodos , Interações Hospedeiro-Parasita , Metagenômica/métodos , Plantas/parasitologia , RNA Ribossômico 16S/genética
12.
Fisioter. Bras ; 22(3): 412-424, Jul 15, 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1284564

RESUMO

Objective: To compare in neonates with transitory tachypnea if chest rebalancing thoraco-abdominal method (RTA) increased immediate pain. Methods: This was a randomized controlled clinical trial. Forty-nine neonates with transitory tachypnea and aged < 72 hours were included to receive either conventional physiotherapy (CP) or RTA method. Participants received usual care and one 15- minute session of chest physiotherapy. Neonatal Infant Pain Scale (NIPS), peripheral oxygen saturation, heart rate, respiratory rate, axillary temperature before and after chest physiotherapy were recorded. Kruskal-Wallis ANOVA and Mc Nemar test were used to compare differences between measures. The relative risk (RR) for pain after interventions was calculated using a Poisson regression model (robust estimation). A significance level of 5% (p < 0.05) was adopted for all analyses. Results: RTA was not associated to pain. After chest physiotherapy, NIPS reduced (2 versus 3, p < 0.001) and number of neonates with pain reduced (10.2% versus 28.6%, p = 0.02). RR for pain after chest physiotherapy in comparison to before was 0.3 (95% CI 0.15-0.41; p = 0.02); respiratory frequency decreased after chest physiotherapy (58 versus 70, p < 0.001) and peripheral oxygen saturation increased (98% versus 96%, p < 0.001). Conclusion: In neonates with transitory tachypnea, in the first 72 hours of life, RTA did not influence pain evaluation, chest physiotherapy was safe and reduced immediate pain. (AU)


Objetivo: Comparar em recém-nascidos com taquipneia transitória se o método reequilíbrio tóraco-abdominal (RTA) aumentou a dor imediatamente após. Métodos: Estudo de ensaio clínico randomizado. Quarenta e nove recémnascidos com diagnóstico de taquipneia transitória com menos de 72 horas de vida, foram incluídos para receber fisioterapia respiratória. Os participantes receberam os cuidados usuais e uma sessão de fisioterapia convencional ou do método reequilíbrio tóraco-abdominal. Foram registradas a escala NIPS (Neonatal Infant Pain Scale), a saturação periférica de oxigênio, a frequência cardíaca, a frequência respiratória e a temperatura axilar antes e depois da fisioterapia. Para as comparações entre as medidas, foram utilizados o teste de ANOVA de Kruskal-Wallis e o teste de McNemar. O risco relativo de dor após os procedimentos foi calculado usando o modelo de regressão de Poisson (estimação robusta). Foi considerado o nível de significância de 5% para todas as análises (p < 0,05). Resultados: O método RTA não foi associado a dor. Após a fisioterapia respiratória, a escala NIPS reduziu (2 versus 3, p < 0,001) e a proporção de recém-nascidos com dor também reduziu (10,2% versus 28,6%, p = 0,02). O risco relativo de dor após a fisioterapia respiratória em comparação a antes, foi de 0,3 (IC 95% 0,15-0,41; p = 0,02), a frequência respiratória diminuiu (58 versus 70, p < 0,001) e a saturação periférica de oxigênio aumentou (98% versus 96%, p < 0,001). Conclusão: Em recém-nascidos com taquipneia transitória nas primeiras 72 horas de vida, o método RTA não influenciou a avaliação da dor, a fisioterapia respiratória foi segura e reduziu a dor imediatamente após. (AU)


Assuntos
Humanos , Recém-Nascido , Medição da Dor , Recém-Nascido , Modalidades de Fisioterapia , Dor , Respiração , Tórax , Análise de Variância , Taxa Respiratória
13.
Molecules ; 26(9)2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-34064506

RESUMO

E-noses are innovative tools used for exhaled volatile organic compound (VOC) analysis, which have shown their potential in several diseases. Before obtaining a full validation of these instruments in clinical settings, a number of methodological issues still have to be established. We aimed to assess whether variations in breathing rhythm during wash-in with VOC-filtered air before exhaled air collection reflect changes in the exhaled VOC profile when analyzed by an e-nose (Cyranose 320). We enrolled 20 normal subjects and randomly collected their exhaled breath at three different breathing rhythms during wash-in: (a) normal rhythm (respiratory rate (RR) between 12 and 18/min), (b) fast rhythm (RR > 25/min) and (c) slow rhythm (RR < 10/min). Exhaled breath was collected by a previously validated method (Dragonieri et al., J. Bras. Pneumol. 2016) and analyzed by the e-nose. Using principal component analysis (PCA), no significant variations in the exhaled VOC profile were shown among the three breathing rhythms. Subsequent linear discriminant analysis (LDA) confirmed the above findings, with a cross-validated accuracy of 45% (p = ns). We concluded that the exhaled VOC profile, analyzed by an e-nose, is not influenced by variations in breathing rhythm during wash-in.


Assuntos
Testes Respiratórios/métodos , Nariz Eletrônico , Expiração/fisiologia , Compostos Orgânicos Voláteis/análise , Adulto , Análise de Variância , Feminino , Humanos , Masculino , Análise de Componente Principal
14.
Cochrane Database Syst Rev ; 5: CD013540, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-34097766

RESUMO

BACKGROUND: Medications with anticholinergic properties are commonly prescribed to older adults. The cumulative anticholinergic effect of all the medications a person takes is referred to as the 'anticholinergic burden' because of its potential to cause adverse effects. It is possible that high anticholinergic burden may be a risk factor for development of cognitive decline or dementia. There are various scales available to measure anticholinergic burden but agreement between them is often poor. OBJECTIVES: To assess whether anticholinergic burden, as defined at the level of each individual scale, is a prognostic factor for future cognitive decline or dementia in cognitively unimpaired older adults. SEARCH METHODS: We searched the following databases from inception to 24 March 2021: MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), CINAHL (EBSCOhost), and ISI Web of Science Core Collection (ISI Web of Science). SELECTION CRITERIA: We included prospective and retrospective longitudinal cohort and case-control observational studies with a minimum of one year' follow-up that examined the association between an anticholinergic burden measurement scale and future cognitive decline or dementia in cognitively unimpaired older adults. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion, and undertook data extraction, assessment of risk of bias, and GRADE assessment. We extracted odds ratios (OR) and hazard ratios, with 95% confidence intervals (CI), and linear data on the association between anticholinergic burden and cognitive decline or dementia. We intended to pool each metric separately; however, only OR-based data were suitable for pooling via a random-effects meta-analysis. We initially established adjusted and unadjusted pooled rates for each available anticholinergic scale; then, as an exploratory analysis, established pooled rates on the prespecified association across scales. We examined variability based on severity of anticholinergic burden. MAIN RESULTS: We identified 25 studies that met our inclusion criteria (968,428 older adults). Twenty studies were conducted in the community care setting, two in primary care clinics, and three in secondary care settings. Eight studies (320,906 participants) provided suitable data for meta-analysis. The Anticholinergic Cognitive Burden scale (ACB scale) was the only scale with sufficient data for 'scale-based' meta-analysis. Unadjusted ORs suggested an increased risk for cognitive decline or dementia in older adults with an anticholinergic burden (OR 1.47, 95% CI 1.09 to 1.96) and adjusted ORs similarly suggested an increased risk for anticholinergic burden, defined according to the ACB scale (OR 2.63, 95% CI 1.09 to 6.29). Exploratory analysis combining adjusted ORs across available scales supported these results (OR 2.16, 95% CI 1.38 to 3.38), and there was evidence of variability in risk based on severity of anticholinergic burden (ACB scale 1: OR 2.18, 95% CI 1.11 to 4.29; ACB scale 2: OR 2.71, 95% CI 2.01 to 3.56; ACB scale 3: OR 3.27, 95% CI 1.41 to 7.61); however, overall GRADE evaluation of certainty of the evidence was low. AUTHORS' CONCLUSIONS: There is low-certainty evidence that older adults without cognitive impairment who take medications with anticholinergic effects may be at increased risk of cognitive decline or dementia.


Assuntos
Antagonistas Colinérgicos/efeitos adversos , Disfunção Cognitiva/induzido quimicamente , Demência/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Viés , Antagonistas Colinérgicos/farmacologia , Intervalos de Confiança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Observacionais como Assunto , Razão de Chances , Prognóstico , Síndrome , Resultado do Tratamento
15.
Radiol Med ; 126(9): 1149-1158, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34105102

RESUMO

PURPOSE: This study aimed to explore the impact of different acquisition times on the evaluation of liver function levels in chronic hepatitis B using Gd-EOB-DTPA-enhanced T1 positioning technology under 3.0 Tesla magnetic resonance imaging (MRI). METHODS: A total of 146 patients with chronic hepatitis B (CHB) were classified into four groups as follows: chronic hepatitis B without liver cirrhosis (CH, 22 cases), liver cirrhosis with Child-Pugh classification A (LCA 63 cases), Child-Pugh B (LCB 47 cases) and Child-Pugh C (LCC 14 cases). Normal liver function (NLF) group was composed of 23 persons who had healthy liver and no medical histories of hepatitis. T1 mapping images were performed before and after administration of Gd-EOB-DPTA using Look-Locker sequence. Changes in T1 relaxation time (T1rt), the reduction rate of T1 relaxation time (ΔT1) and the increase in T1 relaxation rate (ΔR1) of liver over time (at 5, 10, 15 and 20 min) were investigated and compared among all five groups using a one-way analysis of variance (ANOVA). The Spearman's rank correlation coefficient (r) was used to show the correlations of these parameters in different liver function groups. RESULTS: In the NLF, CH, LCA and LCB groups, postT1 gradually decreased, while the ΔT1 and ΔR1 gradually increased with time. The parameters were compared between different liver function levels at the same time point, and the differences were statistically significant except for NLF-CH, NLF-LCA and CH-LCA. There was no significant difference in the area under the ROC curve of other parameters at 10, 15 and 20 min. At each time point, no correlation was found between preT1rt and the degrees of liver function. PostT1rt was positively correlated with liver function classification, while ΔT1 and ΔR1 were negatively correlated with liver function classification. CONCLUSION: Gd-EOB-DTPA-enhanced T1 mapping magnetic resonance imaging is beneficial to assess liver function. Using the Gd-EOB-DTPA to enhance T1 mapping imaging to assess liver function can shorten the observation time of the hepatobiliary period and 10 min after enhancement may be the best time point.


Assuntos
Meios de Contraste , Gadolínio DTPA , Hepatite B Crônica/diagnóstico por imagem , Fígado/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adulto , Análise de Variância , Estudos de Viabilidade , Feminino , Hepatite B Crônica/fisiopatologia , Humanos , Fígado/fisiologia , Fígado/fisiopatologia , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/fisiopatologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Curva ROC , Valores de Referência , Sensibilidade e Especificidade
16.
Radiol Med ; 126(9): 1216-1225, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34156592

RESUMO

OBJECTIVES: To predict placental accreta spectrum (PAS) in patients with placenta previa (PP) evaluating clinical risk factors (CRF), ultrasound (US) and magnetic resonance imaging (MRI) findings. METHODS: Seventy patients with PP were retrospectively selected. CRF were retrieved from medical records. US and MRI images were evaluated to detect imaging signs suggestive of PAS. Univariable analysis was performed to identify CRF, US and MRI signs associated with PAS considering histology as standard of reference. Receiver operating characteristic curve (ROC) analysis was performed, and the area under the curve (AUC) was calculated. Multivariable analysis was also performed. RESULTS: At univariable analysis, the number of previous cesarean section, smoking, loss of the retroplacental clear space, myometrial thinning < 1 mm, placental lacunae, intraplacental dark bands (IDB), focal interruption of myometrial border (FIMB) and abnormal vascularity were statistically significant. The AUC in predicting PAS progressively increased using CRF, US and MRI signs (0.69, 0.79 and 0.94, respectively; p < 0.05); the accuracy of MRI alone was similar to that obtained combining CRF, US and MRI variables (AUC = 0.97) and was significantly higher (p < 0.05) than that combining CRF and US (AUC = 0.83). Multivariable analysis showed that only IDB (p = 0.012) and FIMB (p = 0.029) were independently associated with PAS. CONCLUSIONS: MRI is the best modality to predict PAS in patients with PP independently from CRF and/or US finding. It is reasonable to propose the combined assessment of CRF and US as the first diagnostic level to predict PAS, sparing MRI for selected cases in which US findings are uncertain for PAS.


Assuntos
Imageamento por Ressonância Magnética , Placenta Acreta , Placenta Prévia/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adulto , Análise de Variância , Área Sob a Curva , Feminino , Humanos , Pessoa de Meia-Idade , Placenta Acreta/diagnóstico por imagem , Gravidez , Curva ROC , Estudos Retrospectivos , Fatores de Risco
17.
Crit Care ; 25(1): 217, 2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34167575

RESUMO

BACKGROUND: The viral load of asymptomatic SAR-COV-2 positive (ASAP) persons has been equal to that of symptomatic patients. On the other hand, there are no reports of ST-elevation myocardial infarction (STEMI) outcomes in ASAP patients. Therefore, we evaluated thrombus burden and thrombus viral load and their impact on microvascular bed perfusion in the infarct area (myocardial blush grade, MBG) in ASAP compared to SARS-COV-2 negative (SANE) STEMI patients. METHODS: This was an observational study of 46 ASAP, and 130 SANE patients admitted with confirmed STEMI treated with primary percutaneous coronary intervention and thrombus aspiration. The primary endpoints were thrombus dimension + thrombus viral load effects on MBG after PPCI. The secondary endpoints during hospitalization were major adverse cardiovascular events (MACEs). MACEs are defined as a composite of cardiovascular death, nonfatal acute AMI, and heart failure during hospitalization. RESULTS: In the study population, ASAP vs. SANE showed a significant greater use of GP IIb/IIIa inhibitors and of heparin (p < 0.05), and a higher thrombus grade 5 and thrombus dimensions (p < 0.05). Interestingly, ASAP vs. SANE patients had lower MBG and left ventricular function (p < 0.001), and 39 (84.9%) of ASAP patients had thrombus specimens positive for SARS-COV-2. After PPCI, a MBG 2-3 was present in only 26.1% of ASAP vs. 97.7% of SANE STEMI patients (p < 0.001). Notably, death and nonfatal AMI were higher in ASAP vs. SANE patients (p < 0.05). Finally, in ASAP STEMI patients the thrombus viral load was a significant determinant of thrombus dimension independently of risk factors (p < 0.005). Thus, multiple logistic regression analyses evidenced that thrombus SARS-CoV-2 infection and dimension were significant predictors of poorer MBG in STEMI patients. Intriguingly, in ASAP patients the female vs. male had higher thrombus viral load (15.53 ± 4.5 vs. 30.25 ± 5.51 CT; p < 0.001), and thrombus dimension (4.62 ± 0.44 vs 4.00 ± 1.28 mm2; p < 0.001). ASAP vs. SANE patients had a significantly lower in-hospital survival for MACE following PPCI (p < 0.001). CONCLUSIONS: In ASAP patients presenting with STEMI, there is strong evidence towards higher thrombus viral load, dimension, and poorer MBG. These data support the need to reconsider ASAP status as a risk factor that may worsen STEMI outcomes.


Assuntos
COVID-19/complicações , Trombose Coronária/virologia , Coração/fisiopatologia , Microcirculação/fisiologia , Infarto do Miocárdio/fisiopatologia , Idoso , Análise de Variância , Infecções Assintomáticas/epidemiologia , COVID-19/epidemiologia , Estudos de Coortes , Angiografia Coronária/métodos , Trombose Coronária/epidemiologia , Ecocardiografia/métodos , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia
18.
J Sports Sci ; 39(sup1): 125-131, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34180373

RESUMO

In Paralympic judo for athletes with vision impairment (VI judo) all eligible athletes (i.e. B1, B2 and B3 classes) compete against each other in the same competition. Evidence suggests that athletes with more impairment may be disadvantaged, but that more sensitive measures of performance are necessary to understand the impact of impairment on performance. The aim of this study was to investigate the relationship between Para sport class and technical variation, time-motion variables, and performance in Paralympic judo. All 175 judo matches from the Rio 2016 Paralympic Games were analysed across 129 competitors (82 male and 47 female). The main results indicated that athletes who demonstrated less technical variation also experienced less competitive success, with the functionally blind athletes (class B1) demonstrating less technical variation than partially sighted (class B2 and B3) athletes (p < 0.05). There was no difference in the time-motion variables between sport classes (p > 0.05). We conclude that measures of technical variation are sensitive to differences in impairment and are suitable for studies that investigate the impairment-performance relationship in VI judo. Results further confirm that some athletes with impairment are disadvantaged under the current rules of VI judo.


Assuntos
Desempenho Atlético/fisiologia , Artes Marciais/fisiologia , Paratletas , Esportes para Pessoas com Deficiência/psicologia , Transtornos da Visão/fisiopatologia , Análise de Variância , Desempenho Atlético/estatística & dados numéricos , Cegueira/fisiopatologia , Brasil , Feminino , Humanos , Internacionalidade , Masculino , Artes Marciais/classificação , Artes Marciais/estatística & dados numéricos , Paratletas/classificação , Fatores Sexuais , Esportes para Pessoas com Deficiência/classificação , Esportes para Pessoas com Deficiência/estatística & dados numéricos , Estatísticas não Paramétricas , Estudos de Tempo e Movimento , Acuidade Visual , Pessoas com Deficiência Visual/classificação
19.
Nutrients ; 13(5)2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-34066958

RESUMO

OBJECTIVE: Dietary intakes must cover protein and essential amino acid (EAA) requirements. For this purpose, different methods have been developed such as the nitrogen balance method, factorial method, or AA tracer studies. However, these methods are either invasive or imprecise, and the Food and Agriculture Organization of the United Nations (FAO, 2013) recommends new methods and, in particular, metabolomics. The aim of this study is to determine total protein/EAA requirement in the plasma and urine of growing rats. METHODS: 36 weanling rats were fed with diets containing 3, 5, 8, 12, 15, and 20% protein for 3 weeks. During experimentation, urine was collected using metabolic cages, and blood from the portal vein and vena was taken at the end of the experiment. Metabolomics analyses were performed using LC-MS, and the data were analyzed with a multivariate analysis model, partial least Squares (PLS) regression, and independent component-discriminant analysis (ICDA). Each discriminant metabolite identified by PLS or ICDA was tested by one-way ANOVA to evaluate the effect of diet. RESULTS: PLS and ICDA allowed us to identify discriminating metabolites between different diet groups. Protein deficiency led to an increase in the AA catabolism enzyme systems inducing the production of breakdown metabolites in the plasma and urine. CONCLUSION: These results indicate that metabolites are specific for the state of EAA deficiency and sufficiency. Some types of biomarkers such as AA degradation metabolites appear to be specific candidates for protein/EAA requirement.


Assuntos
Aminoácidos Essenciais/sangue , Aminoácidos Essenciais/urina , Deficiências Nutricionais/diagnóstico , Proteínas na Dieta/sangue , Proteínas na Dieta/urina , Metabolômica/métodos , Aminoácidos Essenciais/deficiência , Análise de Variância , Ração Animal/análise , Animais , Biomarcadores/sangue , Biomarcadores/urina , Análise Discriminante , Modelos Animais de Doenças , Análise dos Mínimos Quadrados , Análise Multivariada , Avaliação Nutricional , Necessidades Nutricionais , Deficiência de Proteína/diagnóstico , Ratos
20.
Pain Res Manag ; 2021: 6612175, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34136057

RESUMO

Reduction of intravenous line placement pain is one of the most important nursing priorities in the pediatric wards. The present study was aimed at comparing the effect of Hugo's point massage and play on the severity of IV-line placement pain in hospitalized children aged 3-6 years in the pediatric ward. 72 children were selected and assigned randomly to three groups, i.e., control, play, and Hugo point massage. In the massage group, the middle angle between the first and second bones of the palm of the opposite hand was massaged, and the playgroup encouraged bubble-making play. The one-way analysis of variance (ANOVA) did not show a statistically significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups before interventions (p=0.838; p > 0.05). However, the ANOVA test revealed a significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups after the interventions (p=0.006; p < 0.05). The result of the post hoc Scheffe test also showed a statistically significant difference between the mean intensity of IV-line placement pain in both play therapy and Hugo's point massage groups (p=0.028; p < 0.05). Moreover, this test showed that the playgroup children felt less pain than Hugo's point and control group children. This study showed that, in comparison with Hugo's point massage, the play was a more effective way for reducing pain caused by IV-line placement in children, and pediatric nurses can play a significant role in reducing and managing children's pain by using it.


Assuntos
Administração Intravenosa/efeitos adversos , Massagem/estatística & dados numéricos , Manejo da Dor/métodos , Jogos e Brinquedos , Análise de Variância , Criança , Pré-Escolar , Feminino , Mãos/fisiologia , Humanos , Masculino , Dor/etiologia
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