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Gene ; 723: 144120, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31589964


PURPOSE: Matrix Gla protein (MGP) is a vitamin K-dependent, γ-carboxylated protein that was initially found to be a physiological inhibitor of ectopic calcifications affecting mainly cartilage and the vascular system. Mutations in the MGP gene were found to be responsible for a human pathology, the Keutel syndrome, characterized by abnormal calcifications in cartilage, lungs, brain and vascular system. MGP was recently implicated in tumorigenic processes such as angiogenesis and shown to be abnormally regulated in several tumors, including cervical, ovarian, urogenital and breast. This fact has triggered our interest in analyzing the expression of MGP and of its regulator, the transcription factor runt related transcription factor 2 (RUNX2), in colorectal cancer (CRC). METHODS: MGP and RUNX2 expression were analyzed in cancer and non-tumor biopsies samples from 33 CRC patients and 9 healthy controls by RT-qPCR. Consequently, statistical analyses were performed to evaluate the clinical-pathological significance of MGP and RUNX2 in CRC. MGP protein was also detected by immunohistochemical analysis. RESULTS: Showed an overall overexpression of MGP in the tumor mucosa of patients at mRNA level when compared to adjacent normal mucosa and healthy control tissues. In addition, analysis of the expression of RUNX2 mRNA demonstrated an overexpression in CRC tissue samples and a positive correlation with MGP expression (Pearson correlation coefficient 0.636; p ≤ 0.01) in tumor mucosa. However correlations between MGP gene expression and clinical-pathological characteristics, such as gender, age and pathology classification did not provide relevant information that may shed light towards the differences of MGP expression observed between normal and malignant tissue. CONCLUSIONS: We were able to associate the high levels of MGP mRNA expression with a worse prognosis and survival rate lower than five years. These results contributed to improve our understanding of the molecular mechanism underlying MGP deregulation in cancer.

Proteínas de Ligação ao Cálcio/genética , Proteínas de Ligação ao Cálcio/metabolismo , Neoplasias Colorretais/patologia , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Proteínas da Matriz Extracelular/genética , Proteínas da Matriz Extracelular/metabolismo , Regulação para Cima , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/genética , Neoplasias Colorretais/metabolismo , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Análise de Sobrevida
Food Chem ; 302: 125326, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31416003


Ruminant meat is considered an excellent source of proteins, dietary fatty acids and essential minerals. Grilling is a popular cooking method; however, the high temperatures employ could modify the grilled meat quality and safety. In this study, the effects of novel beer-based marinades infused with herbs and spices on the quality, safety, and sensory perception of grilled beef and moose meat is examined. Unmarinated meat showed high content of volatile lipid oxidation and Maillard reaction products compared to the marinated samples, which contained higher number and abundance of terpenes and sulfur based compounds. Strong relationships between Maillard products and heterocyclic amines formation, as well as between volatile terpenes and the lipophilic antioxidant activity, were observed in the grilled meats. The findings suggest the unfiltered beer-based marinades were effective in reducing lipid oxidation and Maillard reaction compounds formation, while improving the nutritional quality, safety and sensory preference of grilled ruminant meats.

Cerveja , Culinária/métodos , Carne , Ruminantes , Adolescente , Adulto , Aminas/análise , Aminas/química , Animais , Bovinos , Qualidade dos Alimentos , Cromatografia Gasosa-Espectrometria de Massas , Compostos Heterocíclicos/análise , Temperatura Alta , Humanos , Reação de Maillard , Carne/análise , Pessoa de Meia-Idade , Valor Nutritivo , Carne Vermelha , Especiarias , Paladar , Compostos Orgânicos Voláteis/análise
Einstein (Sao Paulo) ; 18: eGS4913, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31531556


OBJECTIVE: To evaluate indications, results and strategy of retinal exams requested at Primary Care Units. METHODS: A retrospective study that analyzed the indications and results of retinal exams, in the modalities clinical dilated fundus exams and color fundus photographs. In the following situations, patients were considered eligible for color fundus photographs if visual acuity was normal and ocular symptoms were absent: diabetes mellitus and/or hypertension, in use of drugs with potential retinal toxicity, diagnosis or suspicion of glaucoma, stable and asymptomatic retinopathies, except myopia greater than -3.00 diopters. RESULTS: A total of 1,729 patients were evaluated (66% female, age 63.5±15.5 years), and 1,190 underwent clinical dilated fundus exam and 539 underwent color fundus photographs. Diabetes was present in 32.2%. The main indications were diabetes (23.7%) and glaucoma evaluation (23.5%). In 3.4% of patients there was no apparent indication. The main results were a large cup/disc ratio (30.7%) and diabetic retinopathy (13.2%). Exam was normal in 9.6%, detected peripheral changes in 7% and could not be performed in 1%. Considering patients eligible for fundus photographs (22.4%), more than half underwent clinical dilated fundus exams. CONCLUSION: Regarding exam modality, there were no important differences in the distribution of indications or diagnosis. Color fundus photograph is compatible with telemedicine and more cost-effective, and could be considered the strategy of choice in some scenarios. Since there are no clear guidelines for retinal exams indications or the modality of choice, this study may contribute to such standardization, in order to optimize public health resources.

Técnicas de Diagnóstico Oftalmológico , Atenção Primária à Saúde/estatística & dados numéricos , Retina , Doenças Retinianas/diagnóstico , Idoso , Retinopatia Diabética/diagnóstico , Técnicas de Diagnóstico Oftalmológico/economia , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Fotografação , Exame Físico , Estudos Retrospectivos , Telemedicina , Acuidade Visual
Einstein (Sao Paulo) ; 18: eRC4582, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31531557


The correct identification of erythrocyte antibodies is fundamental for the searching for compatible blood and haemolytic transfusion reactions prevention. Antibodies against antigens of high prevalence are difficult to identify because of the rarity of their occurrence and unavailability of negative red cells for confirmation. We report a case of 46-years-old woman, diagnosed with hemoglobinopathy, and who had symptomatic fall in hemoglobin levels (5.3g/dL) after blood transfusion suggestive of transfusion reaction. The patient's blood type was O RhD-positive. Irregular antibody screening was positive and demonstrated a panreaction against all erythrocytes tested, but this result was not reactive with dithiothreitol. Using negative red cells for antigens of high prevalence of our inventory we could identify in the serum of the same erythrocytes an anti-Holley antibody associated with anti-E. Molecular analysis confirmed that the patient was negative for E and Holley antigens. The crossmath with compatible units confirmed the results. Holley is a high prevalence antigen of the Dombrock blood system whose negative phenotype is extremely rare in all populations and is associated with hemolytic transfusion reactions. This is an antibody that is difficult to identify because laboratories need to have experience in solving complex cases, and have available a large stock of rare sera and erythrocytes, as well other tools such as enzymes, thiol reagents and molecular tests. The correct identification of a rare antibody is initial and mandatory for searching of compatible donors, and to guarantee a satisfactory transfusional support.

Anticorpos/imunologia , Antígenos de Grupos Sanguíneos/imunologia , Incompatibilidade de Grupos Sanguíneos/imunologia , Reação Transfusional/imunologia , Anticorpos/sangue , Eritrócitos/imunologia , Feminino , Testes Hematológicos/métodos , Humanos , Imunoglobulinas/sangue , Isoanticorpos/imunologia , Pessoa de Meia-Idade
Acta Neurochir Suppl ; 127: 179-183, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31407082


From 2013 to 2017, at the Burdenko Institute of Neurosurgery, intra-arterial verapamil for treatment of cerebral vasospasm following intracranial hemorrhage after aneurysm rupture was administered to 35 patients (total 75 procedures). The age is from 8 to 77 years. All ruptured aneurysms were treated: in 26 cases with open approach-clipping-and in 9 cases with endovascular occlusion. The procedure was carried out from 0 to 11 days after the operation. Severity of spasm was assessed by angiography and TCDU. Efficacy of the administration was assessed by TCDU 1 h after the procedure and by clinical evaluation of the patient's condition. The dose of verapamil was 15-50 mg (on average 40 mg) per procedure/per carotid pool and depended on the data of TCDU and clinical and radiological picture. The procedure was performed repeatedly (1-5 times) according to the indications and depending on the patient's condition, with an interval of 24 h. The procedure was effective as a preventive measure for care of patients in the initial stage of cerebral ischemia and was ineffective with a formed focus of ischemia. Endovascular administration of verapamil for treatment of cerebral vasospasm is a safe technique which positively affects the overall recovery of such patients.

Aneurisma Roto , Hemorragia Subaracnóidea , Vasodilatadores , Vasoespasmo Intracraniano , Verapamil , Adolescente , Adulto , Idoso , Criança , Humanos , Pessoa de Meia-Idade , Hemorragia Subaracnóidea/tratamento farmacológico , Hemorragia Subaracnóidea/prevenção & controle , Resultado do Tratamento , Vasodilatadores/uso terapêutico , Vasoespasmo Intracraniano/tratamento farmacológico , Verapamil/uso terapêutico , Adulto Jovem
Gene ; 722: 144098, 2020 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-31494241


This study evaluated the possible association between SNPs in cytokines coding genes, namely IL10, IL6 and IFNG, cytokines serum levels and clinical assessment' scores in patients with Rheumatoid Arthritis(RA). SNPs genotyping was performed in 126 RA patients and 177 healthy individuals with Taqman probes specific for IL10 -1082 (T>C, rs1800896);INFG -1616 (A>G, rs2069705) and IL6 -174 (G>C, rs1800795) variants,positioned in regulatory regions. Cytokine Bead Array (CBA) was used to measure cytokine levels. We found association between INFG -1616 G allele(p = 0.0210; OR = 1.605) and INFG -1616 GG genotype (p = 0.0268; OR =2.609) and RA susceptibility. We also observed association between IL10 -1082 TT genotype and high clinical disease activity index (CDAI) values (p = 0.026; OR = 1.906; 95% CI = 1.082 - 3.359), IL10 -1082 CC genotype and low CDAI values (p = 0.016; OR = 0.256) and INFG -1616 AA and high CDAI values (p = 0.025; OR = 2.919). IL10 -1082 CC also exhibited the lowest IL-10 levels than IL10 -1082 TT (p = 0.020) and IL10 -1082 TC (p = 0.032). Finally, we verified higher IL-6 value in the RA patients than healthy control group (p = 0.007) and an association between high IL-6 levels and increased CDAI (r = 0.4648, p = 0.0015); DAS 28 (r = 0.3933, p= 0.0091), presence of bone erosions (r = 0.3170, p = 0.0361), ESR levels(r = 0.3041, p = 0.0448) and IFN-γ levels (r = 0.3049, p = 0.0468).Altogether, we suggest that IL10 -1082 (T>C, rs1800896) and INFG -1616(A>G, rs2069705) polymorphisms as well as IL-6 levels alterations may play a role for prognostic and disease follow-up.

Artrite Reumatoide/genética , Interferon gama/genética , Interleucina-10/genética , Interleucina-6/genética , Polimorfismo de Nucleotídeo Único , Adulto , Artrite Reumatoide/sangue , Artrite Reumatoide/diagnóstico , Feminino , Frequência do Gene , Genótipo , Humanos , Interferon gama/sangue , Interleucina-10/sangue , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade
Gene ; 722: 144127, 2020 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-31525397


Complement factor H (CFH) serves as a major down-regulator in the complement system, often utilized by bacterial pathogens to evade complement attack. Yet, little is currently known about the genetic correlation of CFH polymorphisms with sepsis due to various microbial infections. A case-control method (488 septic patients and 527 healthy individuals) was carried out in this study to investigate the genetic relationship between CFH polymorphisms (rs3753394 C/T, rs1065489 G/T and rs1061170 C/T) and susceptibility to sepsis caused by bacterial infections in Chinese Han populations. Our findings indicated that the frequency of rs3753394 CT/TT genotype in the septic patients with P. aeruginosa was significantly higher than that in the control individuals (P = 0.033, OR = 2.668, 95%CI = 1.072-6.334). The rs3753394 T allele frequency in the P. aeruginosa-infected patients was significantly increased, compared to that in the healthy controls (P = 0.014, OR = 1.68, 95%CI = 1.118-2.538). Moreover, these significant differences of rs3753394 genotype and allele frequencies remained after multiple testing corrections [P (corr.) = 0.033 for genotype; P (corr.) = 0.033 for allele]. The current study highlighted the significance of CFH polymorphism rs3753394 as a potential biomarker for targeting P. aeruginosa infection in critically ill patients.

Predisposição Genética para Doença , Infecções por Pseudomonas/genética , Pseudomonas aeruginosa , Sepse/genética , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China/etnologia , Fator H do Complemento/genética , Frequência do Gene , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/diagnóstico , Infecções por Pseudomonas/etnologia , Sepse/diagnóstico , Sepse/etnologia , Sepse/microbiologia
Toxicol Lett ; 318: 65-73, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31654803


OBJECTIVE: The optimal measuring timing of serum/plasma Cystatin C (CysC) for early detection of contrast-induced acute kidney injury (CIAKI) remains un-studied. We elucidated further on this issue. METHODS: We searched PubMed, MEDLINE, and Embase from inception until March 2018 for studies evaluating diagnostic accuracy of CysC for detecting CIAKI in patients exposed to contrast agents during diagnostic examinations or cardiac/peripheral catheterizations. RESULTS: A total of 10 relevant studies, comprising 2554 patients, were included and divided into the <24 -h and 24 -h groups based on CysC measuring timing (i.e., hours after contrast agent exposure). Compared with creatinine, pooled diagnostic odds ratio of CysC for detecting CIAKI of the <24 -h and 24 -h groups was 7.59 (95 % confidence interval [CI]: 1.31-44.08) and 53.81 (95 % CI: 13.57-213.26). Pooled sensitivity of the <24 -h and 24 -h groups was 0.81 and 0.88. Pooled specificity of the <24 -h and 24 -h groups was 0.64 and 0.88, respectively. Area under the hierarchical summary receiver operating characteristic curve of the <24 -h and 24 -h groups was 0.75 and 0.93. CONCLUSIONS: Measuring CysC at 24 h after contrast agent exposure shows higher diagnostic accuracy for early detection of CIAKI than measuring CysC at <24 h after contrast agent exposure.

Lesão Renal Aguda/diagnóstico , Meios de Contraste/efeitos adversos , Cistatina C/sangue , Lesão Renal Aguda/sangue , Lesão Renal Aguda/induzido quimicamente , Idoso , Biomarcadores/sangue , Diagnóstico Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Fatores de Tempo
N Engl J Med ; 382(2)2020 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-31733181


BACKGROUND: The timing and indications for surgical intervention in asymptomatic patients with severe aortic stenosis remain controversial. METHODS: In a multicenter trial, we randomly assigned 145 asymptomatic patients with very severe aortic stenosis (defined as an aortic-valve area of ≤0.75 cm2 with either an aortic jet velocity of ≥4.5 m per second or a mean transaortic gradient of ≥50 mm Hg) to early surgery or to conservative care according to the recommendations of current guidelines. The primary end point was a composite of death during or within 30 days after surgery (often called operative mortality) or death from cardiovascular causes during the entire follow-up period. The major secondary end point was death from any cause during follow-up. RESULTS: In the early-surgery group, 69 of 73 patients (95%) underwent surgery within 2 months after randomization, and there was no operative mortality. In an intention-to-treat analysis, a primary end-point event occurred in 1 patient in the early-surgery group (1%) and in 11 of 72 patients in the conservative-care group (15%) (hazard ratio, 0.09; 95% confidence interval [CI], 0.01 to 0.67; P = 0.003). Death from any cause occurred in 5 patients in the early-surgery group (7%) and in 15 patients in the conservative-care group (21%) (hazard ratio, 0.33; 95% CI, 0.12 to 0.90). In the conservative-care group, the cumulative incidence of sudden death was 4% at 4 years and 14% at 8 years. CONCLUSIONS: Among asymptomatic patients with very severe aortic stenosis, the incidence of the composite of operative mortality or death from cardiovascular causes during the follow-up period was significantly lower among those who underwent early aortic-valve replacement surgery than among those who received conservative care. (Funded by the Korean Institute of Medicine; RECOVERY number, NCT01161732.).

Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Tratamento Conservador , Idoso , Estenose da Valva Aórtica/mortalidade , Estenose da Valva Aórtica/terapia , Doenças Assintomáticas/terapia , Doenças Cardiovasculares/mortalidade , Feminino , Seguimentos , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gravidade do Paciente , Complicações Pós-Operatórias/mortalidade
Einstein (Sao Paulo) ; 18: eAO4739, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553355


OBJECTIVE: To use magnetic resonance imaging to assess the prevalence of foot and ankle ligament injuries and fractures associated with ankle sprain and not diagnosed by x-ray. METHODS: We included 180 consecutive patients with a history of ankle sprain, assessed at a primary care service in a 12-month period. Magnetic resonance imaging findings were recorded and described. RESULTS: Approximately 92% of patients had some type of injury shown on the magnetic resonance imaging. We found 379 ligament injuries, 9 osteochondral injuries, 19 tendinous injuries and 51 fractures. Only 14 magnetic resonance imaging tests (7.8%) did not show any sort of injury. We observed a positive relation between injuries of the lateral complex, syndesmosis and medial ligaments. However, there was a negative correlation between ankle ligament injuries and midfoot injuries. CONCLUSION: There was a high rate of injuries secondary to ankle sprains. We found correlation between lateral ligament injuries and syndesmosis and deltoid injuries. We did not observe a relation between deltoid and syndesmosis injuries or between lateral ligamentous and subtalar injuries. Similarly, no relation was found between ankle and midfoot injuries.

Traumatismos do Tornozelo/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Traumatismos do Tornozelo/diagnóstico por imagem , Brasil/epidemiologia , Cartilagem Articular/lesões , Criança , Feminino , Humanos , Ligamentos Laterais do Tornozelo/lesões , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
Food Chem ; 302: 125370, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31442699


Four Arabica coffees (Brazil, Colombia, Ethiopia, and Guatemala) yield highly variant odours, attesting to the complexities of coffee aroma that command advanced analytical tools. In this study, their volatiles were extracted using solvent-assisted flavour evaporation (SAFE) and headspace solid-phase microextraction (HS-SPME). Due to matrix complexity, some trace odourants were detected in SAFE extracts by aroma extract dilution analysis (AEDA) but remained difficult to quantify by gas chromatography-mass spectrometry (GC-MS). This prompted the application of low energy electron ionisation (EI) coupled with GC-quadrupole time-of-flight (GC-QTOF). Optimal low EI GC-QTOF parameters (EI energy: 15 eV, acquisition rate: 3 Hz) were applied to achieve improved molecular ion signal intensity and reproducibility (relative standard deviation < 10%) across five compounds, which resulted in good linearity (R2 ≥ 0.999) and lowered detection levels (e.g. 0.025 ±â€¯0.005 ng/mL for 4-hydroxy-5-methyl-3(2H)-furanone). Therefore, this method potentially improves the measurement of trace odourants in complex matrices by increasing specificity and sensitivity.

Café/química , Análise de Alimentos/métodos , Odorantes/análise , Compostos Orgânicos Voláteis/análise , Adulto , Brasil , Coffea/química , Colômbia , Etiópia , Feminino , Análise de Alimentos/estatística & dados numéricos , Cromatografia Gasosa-Espectrometria de Massas/métodos , Guatemala , Humanos , Masculino , Pessoa de Meia-Idade , Olfatometria/métodos , Extratos Vegetais/química , Análise de Componente Principal , Reprodutibilidade dos Testes , Microextração em Fase Sólida/métodos , Paladar , Compostos Orgânicos Voláteis/isolamento & purificação
Food Chem ; 302: 125348, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31442704


Tropomyosin (TM) is the main allergen of shrimp. Glycation reportedly reduced the allergenicity of TM, and the allergenicity reduction was heavily dependent upon the sources of saccharides. In this work we investigated, how glycation of tropomyosin by functional oligosaccharides affected the allergenicity. Compared to TM, the TM glycated by galacto-oligosaccharide (TM-GOS), mannan-oligosaccharide (TM-MOS) and maltopentaose (TM-MPS) had lower allergenicity and induced weaker mouse allergy responses. While the TM glycated by fructo-oligosaccharide (TM-FOS) had stronger allergenicity and induced severe mouse allergy symptoms, due to the generation of neoallergns that belonged to advanced glycation end products (e.g. CML). Therefore, GOS, MOS and MPS could be applied to desensitize shrimp TM-induced food allergy through glycation, while FOS was not suitable to reduce TM allergenicity. Glycation of TM by GOS, MOS and MPS, especially for MPS, significantly reduced allergenicity and alleviated allergy symptoms, which could be potentially explored for immunotherapy for shrimp-allergic patients.

Hipersensibilidade Alimentar/imunologia , Produtos Finais de Glicação Avançada/metabolismo , Palaemonidae/imunologia , Proteínas de Frutos do Mar/metabolismo , Tropomiosina/metabolismo , Adulto , Alérgenos/imunologia , Alérgenos/metabolismo , Animais , Pré-Escolar , Feminino , Hipersensibilidade Alimentar/sangue , Glicosilação , Humanos , Masculino , Camundongos Endogâmicos BALB C , Pessoa de Meia-Idade , Oligossacarídeos/imunologia , Oligossacarídeos/metabolismo , Proteínas de Frutos do Mar/química , Proteínas de Frutos do Mar/imunologia , Tropomiosina/química , Tropomiosina/imunologia
Orthop Clin North Am ; 51(1): 1-5, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739873


Using an age- and comorbidity-matched cohort, we compared patients who underwent unicompartmental knee arthroplasty in an ambulatory surgery center with those who underwent the procedure in a traditional hospital inpatient setting. Postoperatively, the ambulatory surgery center cohort had fewer major complications than the inpatient cohort. No ambulatory surgery center patients required acute hospital admission and none had major complications. Four major complications occurred in the inpatient cohort. There was no difference in complication rates. Our results suggest that outpatient unicompartmental knee arthroplasty in a freestanding ambulatory surgery center is a safe and reasonable alternative to the traditional inpatient hospital setting.

Procedimentos Cirúrgicos Ambulatórios/economia , Artroplastia do Joelho/economia , Análise Custo-Benefício/métodos , Procedimentos Cirúrgicos Ambulatórios/efeitos adversos , Procedimentos Cirúrgicos Ambulatórios/estatística & dados numéricos , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/estatística & dados numéricos , Estudos de Coortes , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Complicações Pós-Operatórias/epidemiologia , Resultado do Tratamento
Orthop Clin North Am ; 51(1): 27-36, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739877


Distal femoral replacement (DFR) is a reasonable treatment option when used for select indications. In the setting of comminuted intra-articular distal femoral fractures, distal femoral arthroplasty should be considered in low-demand patients with poor bone quality. This article summarizes the existing literature plus the authors' personal experience with DFR use for distal femoral fractures of the native knee.

Fraturas do Fêmur/cirurgia , Fêmur/cirurgia , Fraturas Cominutivas/cirurgia , Articulação do Joelho/cirurgia , Idoso , Humanos , Fraturas Intra-Articulares/cirurgia , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Implantação de Prótese/métodos , Reoperação/métodos , Reoperação/estatística & dados numéricos , Reimplante/métodos , Reimplante/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento
Rev. cuba. angiol. cir. vasc ; 20(2): e387, jul.-dic. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1003855


Introducción: Los pacientes con enfermedad arterial periférica sometidos a cirugía vascular no cardíaca programada presentan un riesgo significativo de complicaciones cardiovasculares, debido a la enfermedad cardíaca sintomática o asintomática subyacente. Objetivo: Valorar el riesgo coronario en los pacientes tributarios de cirugía vascular no cardíaca. Métodos: Estudio descriptivo prospectivo en 35 pacientes del Servicio de Angiología y Cirugía Vascular del Hospital Clínico Quirúrgico Hermanos Ameijeiras. El período de estudio osciló entre octubre de 2013 y mayo de 2016. Las variables cualitativas se expresaron como frecuencias absolutas y relativas. Se evaluó la asociación entre las variables mediante el test de Fischer, se usó el coeficiente de Pearson para relacionar los valores del índice de presiones tobillo brazo y los niveles del calcio score. Resultados: Predominó el sexo masculino y la edad menor de 60 años. El tabaquismo y la hipertensión arterial fueron los factores de riesgo de mayor frecuencia. A pesar de no existir diferencia significativa (p = 0,563) al asociar el calcio score y el índice de presiones tobillo-brazo, sí existió una correlación lineal negativa entre ellos. Las complicaciones perioperatorias presentadas en el grupo de moderado-alto riesgo quirúrgico fueron la fibrilación ventricular, el infarto agudo de miocardio y el paro cardíaco. Conclusiones: La valoración del riesgo coronario es una herramienta útil en la detección de lesiones coronarias significativas que pueden favorecer la aparición de complicaciones perioperatorias en los pacientes que son tributarios de tratamiento quirúrgico revascularizador no cardíaco(AU)

Introduction: Patients with peripheral arterial disease undergoing scheduled non-cardiac vascular surgery present a significant risk of cardiovascular complications due to underlying symptomatic or asymptomatic heart disease. Objective: To assess coronary risk in patients eligible for non-cardiac vascular surgery. Methods: A prospective descriptive study was carried out in 35 patients of the Angiology and Vascular Surgery service in Hermanos Ameijeiras Hospital. The study was conducted between October 2013 and May 2016. Qualitative variables were summarized as absolute and relative frequencies. It was assessed the association between the variables using the Fischer´s test; Pearson´s coefficient was used to relate the values of the index of ankle- arm pressure and the levels of calcium score. Results: Male sex predominated; and ages less than 60 years. Smoking habit and high blood pressure were the most common risk factors. Although there is no significant difference (p= 0,563) when associating the calcium score and the ankle-brachial pressure index, there was a negative linear correlation between them. The peri-operative complications presented in the moderate to high surgical risk group were ventricular fibrillation, acute myocardial infarction and cardiac arrest. Conclusions: Identification of coronary risk is a useful tool in the detection of significant coronary lesions that may favor the emergence of peri-operative complications in patients who are scheduled for non-cardiac revascularization's surgical treatment(AU)

Masculino , Pessoa de Meia-Idade , Doenças Cardiovasculares/prevenção & controle , Doença Arterial Periférica/complicações , Epidemiologia Descritiva , Estudos Prospectivos , Estudos Longitudinais , Doença Arterial Periférica/terapia
Rev. Esc. Enferm. USP ; 53: e03464, Jan.-Dez. 2019.
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1020376


RESUMEN Objetivo Explorar la construcción social que sobre violencia obstétrica han elaborado mujeres Tének y Náhuatl de México. Método Estudio cualitativo-sociocrítico, mediante gupos focales se profundizó en las experiencias de parto de quienes vivieron un parto en el periodo 2015-2016. Resultados Participaron 57 mujeres. Mediante análisis de discurso se identificó que las participantes no poseen suficiente información sobre violencia obstétrica y/o derechos sexuales y reproductivos, lo que las imposibilita para asociar sus experiencias negativas al término legal "violencia obstétrica". Sus discursos corresponden en su mayoría a lo que desde el marco legal se ha denominado "violencia obstétrica", sin embargo, experiencias como el ayuno prolongado o el uso de tecnologías para la invasión de su intimidad fueron narradas como algo que conciben violento y que no se ha incorporado dentro del término legal. Conclusión Múltiples acciones que atentan contra los derechos humanos de las mujeres tienen lugar dentro de las salas de parto, la mayor parte no son identificadas por las usuarias, puesto que no han construido socialmente la imagen de la violencia obstétrica, ello no las hace menos susceptibles sin embargo, a sentirse agredidas y denigradas en sus partos.

RESUMO Objetivo Explorar a construção social que as mulheres Tének e Náhuatl do México elaboraram sobre a violência obstétrica. Método Estudo qualitativo-sociocrítico; por meio de grupos focais, houve um aprofundamento nas experiências de parto daquelas que passaram por um parto no período de 2015 a 2016. Resultados Participaram 57 mulheres. Mediante análise do discurso, foi identificado que as participantes não possuem informação suficiente sobre violência obstétrica e/ou direitos sexuais e reprodutivos, o que as impossibilita de associar suas experiências negativas ao termo legal "violência obstétrica". Seus discursos correspondem na sua maioria ao que, a partir do marco legal, foi denominado "violência obstétrica"; entretanto, experiências como jejum prolongado ou uso de tecnologias para a invasão da sua intimidade foram narradas como algo que concebem ser violento e que não foi incorporado ao termo legal. Conclusão Múltiplas ações que atentam contra os direitos humanos das mulheres têm lugar dentro das salas de parto, a maior parte não é identificada pelas usuárias, visto que não construíram socialmente a imagem da violência obstétrica, mas isso não as faz menos suscetíveis de sentir-se agredidas e denegridas nos seus partos.

ABSTRACT Objective To explore the social construction of obstetric violence developed by Tenek and Nahuatl women in Mexico. Method Qualitative, socio-critical study conducted through focal groups in which were deepened the childbirth experiences lived in the period 2015-2016. Results Participation of 57 women. Through discourse analysis, it was identified that participants do not have enough information about obstetric violence and/or sexual and reproductive rights. This makes the association of their negative experiences with the legal term "obstetric violence" impossible. Most of their speeches correspond to the legal denomination of "obstetric violence". Experiences like prolonged fasting or the use of technologies for invading their privacy were narrated like situations they perceive as violent, but have not been incorporated within the legal term. Conclusion Multiple actions against women's human rights take place within delivery rooms. Most remain unidentified by users, since they have not socially constructed the image of obstetric violence. However, that fact does not make them less susceptible to feel attacked and denigrated during their childbirth experiences.

Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Salas de Parto , Parto , População Indígena , Violência contra a Mulher , México , Grupos Focais , Pesquisa Qualitativa , Enfermagem Obstétrica
Acta colomb. psicol ; 22(2): 53-69, July-Dec. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1019276


Abstract Different studies with university students show the presence of a negative image about the elderly and an absence of positive stereotypes regarding this age group. With the increase of the older population, these stereotypes must disappear in order to work with aged people without a negative view of them. The aim of this paper was to identify the existence of negative stereotypes towards old age in students who are pursuing health-related and not related university degree courses. A total of 262 students were assessed with the CENVE questionnaire. In order to find out whether there were differences between students with respect to negative stereotypes, an ANOVA and a post-hoc comparison test were carried out. Results were significant at the 5% level. These show evidence of the existence of negative stereotypes about old age in students pursuing university degrees related and not related to the field of health. ANOVAs showed differences in total CENVE (F3 259 = 3.574; p = 0.015; r2 = 0.040), Social Motivation dimension (F3259 = 3.697; p = 0.012; rf = 0.042), and Personality dimension (F3259 = 5.157; p = 0.002; r2 = 0.057). The post-hoc tests show the existence of differences in stereotypes depending on the course that is being studied, where the health related courses show the lower level of negative stereotypes.

Resumo Diversos estudos sobre estereótipos com estudantes universitários mostram que as pessoas idosas são percebidas mais frequentemente a partir de uma imagem negativa do que com estereótipos positivos. Levando em consideração o crescente aumento da população idosa na atualidade e como o fim de trabalhar com pessoas mais velhas a partir de uma visão positiva de si mesmos, é preciso que esses estereótipos desapareçam. O objetivo deste trabalho foi determinar se existem estereótipos negativos com respeito à velhice em estudantes de cursos universitários relacionados e não relacionados com o campo da saúde. No total, 262 estudantes foram avaliados com o questionário CENVE e, para saber se existiam diferenças de estereótipos negativos entre os estudantes de acordo com sua habilitação, foi realizada uma análise ANOVA, além de comparações post hoc. Os resultados foram significativos com um nível de 5% e evidenciaram a existência de estereótipos negativos com respeito à velhice em estudantes de habilitações universitárias relacionadas e não relacionadas com o campo da saúde. Os ANOVA mostraram diferenças para o CENVE total (F3259 = 3.574; p = .015; n2 = .040), para a dimensão de motivação social (F3259 = 3.697; p = .012; n2 = .042) e para a dimensão de personalidade (F3259 = 5.157; p = .002; n2 = .057). As provas post hoc mostraram a existência de diferenças no grau de estereótipos negativos de acordo com as habilitações em curso, sendo que as habilitações de saúde mostraram menor grau em comparação com as demais.

Resumen Diversos estudios sobre estereotipos con estudiantes universitarios muestran que las personas mayores son percibidas más desde una imagen negativa que con estereotipos positivos. Teniendo en cuenta el creciente aumento de la población mayor en la actualidad, y con el fin de trabajar con personas mayores desde una visión positiva de sí mismos, es necesario que estos estereotipos desaparezcan. El objetivo de este trabajo fue determinar si existen estereotipos negativos hacia la vejez en estudiantes de carreras universitarias relacionadas y no relacionadas con el campo de la salud. En total, se evaluó a 262 estudiantes con el cuestionario CENVE, y, para saber si existían diferencias de estereotipos negativos entre los estudiantes según su titulación, se realizó un análisis ANOVA, además de comparaciones post hoc. Los resultados fueron significativos al nivel del 5 % y evidenciaron la existencia de estereotipos negativos hacia la vejez en estudiantes de títulos universitarios relacionados y no relacionados con el campo de la salud. Los ANOVA mostraron diferencias para el CENVE total (F3259 = 3.574; p = .015; η 2 = .040), para la dimensión de motivación social (F3259 = 3.697; p = .012; η2 = .042) y para la dimensión de personalidad (F3259 = 5.157; p = .002; η 2 = .057). Las pruebas post hoc mostraron la existencia de diferencias en el grado de estereotipos negativos según las titulaciones en curso, donde las titulaciones sanitarias mostraron menor grado en comparación con las demás.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Ageismo
Acta colomb. psicol ; 22(2): 148-177, July-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019280


Abstract The objective of the present study was to design, validate and obtain the reliability of the Maternal Attitudes Towards Overweight and Childhood Obesity Scale. The validation of this instrument was carried out in four stages: a) Study 1: Exploratory, with N= 95 mothers and grandmothers aged 20 to 46 years (M age = 32.43, SD = 7.9) which used the semantic networks technique to inquire about the psychological meaning of overweight and obesity; b) Study 2: Content Validity, where 33 items were written and the content validity was obtained through five judges; c) Study 3: First Validation, which included 346 mothers aged 18 to 62 (M age = 33.08, SD = 6.8) with preschool children; 11 items were obtained distributed in three factors denominated: negative attitude (α = .72), meaning (α = .63) and importance (α = .56), with α = .77 of the total scale and an explained variance of 54.50%; d) Study 4: Second Validation, in which 369 mothers and grandmothers (3 %) aged between17 and 63 years (M age = 32.43, SD = 7.9) participated. The final scale was two-dimensional, composed of 11 items with an α =.85 and an explained variance of 46%, which evaluates the negative attitudes perceived towards obesity and its consequences.

Resumo O objetivo do presente estudo foi desenhar e validar a Escala de atitudes maternas com respeito ao sobrepeso e à obesidade infantil. Em particular, a validação consistiu de quatro etapas: (a) um estudo exploratório (Estudo 1) com 95 mães e avós de 20 a 46 anos (M idade = 32.43, DP = 7.9), no qual se utilizou a técnica de redes semânticas para conhecer o significado psicológico do sobrepeso e da obesidade; (b) um estudo de validade de conteúdo (Estudo 2), no qual 33 reativos foram escritos e a validade de conteúdo foi obtida por meio do conceito de cinco juizes; (c) um estudo para uma primeira validação (Estudo 3) com 346 mães de 18 a 62 anos (M idade = 33.08, DP = 6.8) com filhos em idade pré-escolar, com a qual foram obtidos 11 reativos distribuidos em três fatores, denominados atitude negativa (α = .72), significado (α = .63) e importância (α = .56), com um α = .77 na escala total e uma variância explicada de 54,50%, e (d) um estudo para uma segunda validação (Estudo 4), no qual participaram 369 mães e avós (3 %) de 17 a 63 anos (M idade = 32.43, DE = 7.9). Como resultado, a escala foi bidimensional, composta por 11 reativos, com um α = .85 e uma variância explicada de 46%, que avalia as atitudes negativas percebidas com respeito à obesidade e suas consequências.

Resumen El objetivo del presente estudio fue diseñar y validar la escala de actitudes maternas hacia el sobrepeso y la obesidad infantil. En particular, la validación consistió en cuatro etapas: (a) un estudio exploratorio (Estudio 1) con 95 madres y abuelas de 20 a 46 años (M edad = 32.43, DE = 7.9), en el que se utilizó la técnica de redes semánticas para conocer el significado psicológico del sobrepeso y la obesidad; (b) un estudio de validez de contenido (Estudio 2), en el que se redactaron 33 reactivos, y la validez de contenido se obtuvo mediante el concepto de cinco jueces; (c) un estudio para una primera validación (Estudio 3) con 346 madres de 18 a 62 años (M edad = 33.08, DE = 6.8), con hijos en edad preescolar, con el cual se obtuvieron 11 reactivos distribuidos en tres factores, denominados actitud negativa (α = .72), significado (α = .63) e importancia (α = .56), con un α = .77 en la escala total y una varianza explicada del 54.50 %; y (d) un estudio para una segunda validación (Estudio 4), en el que participaron 369 madres y abuelas (3 %) de 17 a 63 años (M edad = 32.43, DE = 7.9). Como resultado, la escala fue bidimensional, compuesta por 11 reactivos, con un α = .85 y una varianza explicada del 46 %, que evalúa las actitudes negativas percibidas hacia la obesidad y las consecuencias de esta.

Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Sobrepeso , Mães , Obesidade
Acta colomb. psicol ; 22(2): 267-291, July-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019285


Abstract The aim of this research was to analyze the shaping of the meaning of the academic profession in 160 scholars, from public and private universities in four Colombian cities. The instrument QPW-5 (Questionnaire on Quality of Work life in Human Service Organizations) was applied. It was composed of 173 items distributed in five scales: Working Conditions, Perceived Workload, General Working Well-being, Maslach Burnout Inventory and Engagement, and five key words that define the work experience. This study was carried out following a quantitative approach, a non - experimental design with a cross-sectional descriptive correlation. A correlational analysis and Principal Component Analysis were performed to establish the pattern of the dimensions evaluated. The teachers surveyed showed general tendencies to shape their meaning of the academic profession in an ambivalent manner in a positive and negative pole, where the presence of fragmented working conditions that denote exhaustion, cynicism and collateral effects, as well as a new configuration of academic professionalism are highlighted. It is pointed out that the temporality of the contractual relationship is naturalized as a condition of precarious working conditions, placing a focus on the psychosocial risks of university teachers.

Resumo Enquadrada no contexto das transformações do trabalho acadêmico, em especial com a explosão do capitalismo acadêmico, e situada nas organizações universitárias, a presente pesquisa teve como objetivo analisar a configuração da percepção da profissão acadêmica em 160 professores universitários pertencentes a universidades públicas e privadas de cinco cidades colombianas. Este estudo foi quantitativo, não experimental, transversal e descritivo. Aplicou-se o instrumento QPW-5 -questionário sobre a qualidade da vida laboral em organizações de serviços humanos, composto por 173 itens que medem as escalas de condições de trabalho e bem-estar laboral geral-, o inventário de Burnout de Maslach e um questionário de Engagement, além de uma parte qualitativa com cinco palavras-chave que definem a experiência de trabalhar. Realizou-se uma análise correlacionai e uma análise de componentes principais para estabelecer o padrão das dimensões avaliadas. Como resultado, descobriu-se que os docentes participantes evidenciaram tendências gerais para configurar uma percepção da profissão acadêmica de forma ambivalente, em um polo positivo e negativo, no qual se destaca a presença de condições de trabalho fragmentadas que denotam esgotamento, cinismo e efeitos colaterais, bem como uma nova configuração do profissionalismo acadêmico. Além disso, indica-se que a temporalidade do vínculo contratual é naturalizada como condições de trabalho precárias que chamam a atenção para os riscos psicossociais dos docentes universitários.

Resumen Enmarcada en el contexto de las transformaciones del trabajo académico, en especial con la irrupción del capitalismo académico, y situada en las organizaciones universitarias, la presente investigación tuvo como objetivo analizar la configuración del sentido de la profesión académica en 160 profesores universitarios pertenecientes a universidades públicas y privadas de cinco ciudades colombianas. Este estudio fue cuantitativo, no experimental, transversal y descriptivo. Se aplicó el instrumento QPW-5 -cuestionario sobre la calidad de vida laboral en organizaciones de servicios humanos, compuesto por 173 ítems que miden las escalas de condiciones de trabajo y bienestar laboral general-, el inventario de Burnout de Maslach, y un cuestionario de engagement, además de una parte cualitativa con cinco palabras clave que definen la experiencia de trabajar. Se realizó un análisis correlacional y un análisis de componentes principales para establecer el patrón de las dimensiones evaluadas. Como resultados, se encontró que los docentes encuestados evidenciaron tendencias generales a configurar un sentido de la profesión académica de forma ambivalente, en un polo positivo y negativo, donde se destaca la presencia de condiciones de trabajo fragmentadas que denotan agotamiento, cinismo y efectos colaterales, así como una nueva configuración del profesionalismo académico. Además de esto, se señala que la temporalidad del vínculo contractual se naturaliza como condiciones de trabajo precarias que colocan como foco de atención a los riesgos psicosociales de los docentes universitarios.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Condições de Trabalho , Docentes , Estresse Ocupacional
Autops. Case Rep ; 9(4): e2019107, Oct.-Dec. 2019.
Artigo em Inglês | LILACS | ID: biblio-1023992