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1.
Pan Afr Med J ; 36: 206, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32963672

RESUMO

The intense global efforts are directed towards development of vaccines to halt the COVID-19 virus pandemic. There are 160 candidate vaccines under clinical trials across the world using different molecular targets and techniques. This race for the vaccine has several challenges and ethical issues like compressed timelines, generation and proper management of resources and finances, risks to the participating volunteers due to curtailed research trial processes, geopolitical contentions, misinformation through social media and parallel race with drugs. We feel that the fundamental principles of ethics: autonomy, beneficence, non-maleficence and justice should not be violated in this hastened vaccine development process. We recommend constitute a Consortium on a global platform to formulate, provide and monitor a comprehensive ethical umbrella to the process of vaccine development.


Assuntos
Betacoronavirus/imunologia , Ensaios Clínicos como Assunto/ética , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vacinas Virais/uso terapêutico , Temas Bioéticos , Comunicação , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Voluntários Saudáveis , Humanos , Internacionalidade , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Alocação de Recursos , Mídias Sociais , Fatores de Tempo , Vacinas Virais/economia , Vacinas Virais/provisão & distribução
2.
Sci Rep ; 10(1): 14568, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32884016

RESUMO

Magnetic resonance neurography (MRN) has been used extensively to study pathological conditions affecting the peripheral nervous system (PNS). However, tissue damage is assessed qualitatively with little information regarding the underlying pathophysiological processes involved. Magnetisation transfer ratio (MTR) is a quantitative magnetic resonance imaging method which is sensitive to tissue macromolecular content and may therefore have an important role in the study of pathologies affecting the PNS. This study explored the feasibility of obtaining reliable MTR measurements in the proximal lumbar plexus of healthy volunteers using MRN to identify and segment each lumbar segment (L2-L5) and regions (preganglionic, ganglionic and postganglionic). Reproducibility of the MTR measurements and of the segmentation method were assessed from repeated measurements (scan-rescan), and from the reanalysis of images (intra- and inter-rater assessment), by calculating the coefficient of variation (COV). In all segments combined (L2-L5), mean (± SD) MTR was 30.5 (± 2.4). Scan-rescan, intra- and inter-rater COV values were 3.2%, 4.4% and 5.3%, respectively. One-way analysis of variance revealed a statistically significant difference in MTR between the preganglionic and postganglionic regions in all lumbar segments. This pilot study in healthy volunteers demonstrates the feasibility of obtaining reliable MTR measurements in the proximal lumbar plexus, opening up the possibility of studying a broad spectrum of neurological conditions in vivo.


Assuntos
Imageamento Tridimensional/métodos , Plexo Lombossacral/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Adulto , Análise de Variância , Estudos de Viabilidade , Feminino , Voluntários Saudáveis , Humanos , Região Lombossacral/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes
3.
Nat Commun ; 11(1): 4487, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32900998

RESUMO

An important aspect of precision medicine is to probe the stability in molecular profiles among healthy individuals over time. Here, we sample a longitudinal wellness cohort with 100 healthy individuals and analyze blood molecular profiles including proteomics, transcriptomics, lipidomics, metabolomics, autoantibodies and immune cell profiling, complemented with gut microbiota composition and routine clinical chemistry. Overall, our results show high variation between individuals across different molecular readouts, while the intra-individual baseline variation is low. The analyses show that each individual has a unique and stable plasma protein profile throughout the study period and that many individuals also show distinct profiles with regards to the other omics datasets, with strong underlying connections between the blood proteome and the clinical chemistry parameters. In conclusion, the results support an individual-based definition of health and show that comprehensive omics profiling in a longitudinal manner is a path forward for precision medicine.


Assuntos
Envelhecimento Saudável/metabolismo , Metaboloma , Proteoma/metabolismo , Idoso , Estudos de Coortes , Feminino , Envelhecimento Saudável/genética , Voluntários Saudáveis , Humanos , Lipidômica , Estudos Longitudinais , Masculino , Metabolômica , Pessoa de Meia-Idade , Medicina de Precisão , Estudos Prospectivos , Proteômica , Suécia , Transcriptoma
4.
J Cardiovasc Magn Reson ; 22(1): 63, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32892751

RESUMO

BACKGROUND: Myocardial native T1 and T2 relaxation time mapping are sensitive to pathological increase of myocardial water content (e.g. myocardial edema). However, the influence of physiological hydration changes as a possible confounder of relaxation time assessment has not been studied. The purpose of this study was to evaluate, whether changes in myocardial water content due to dehydration and hydration might alter myocardial relaxation times in healthy subjects. METHODS: A total of 36 cardiovascular magnetic resonance (CMR) scans were performed in 12 healthy subjects (5 men, 25.8 ± 3.2 years). Subjects underwent three successive CMR scans: (1) baseline scan, (2) dehydration scan after 12 h of fasting (no food or water), (3) hydration scan after hydration. CMR scans were performed for the assessment of myocardial native T1 and T2 relaxation times and cardiac function. For multiple comparisons, repeated measures ANOVA or the Friedman test was used. RESULTS: There was no change in systolic blood pressure or left ventricular ejection fraction between CMR scans (P > 0.05, respectively). T1 relaxation times were significantly reduced with dehydration (987 ± 27 ms [baseline] vs. 968 ± 29 ms [dehydration] vs. 986 ± 28 ms [hydration]; P = 0.006). Similar results were observed for T2 relaxation times (52.9 ± 1.8 ms [baseline] vs. 51.5 ± 2.0 ms [dehydration] vs. 52.2 ± 1.9 ms [hydration]; P = 0.020). CONCLUSIONS: Dehydration may lead to significant alterations in relaxation times and thereby may influence precise, repeatable and comparable assessment of native T1 and T2 relaxation times. Hydration status should be recognized as new potential confounder of native T1 and T2 relaxation time assessment in clinical routine.


Assuntos
Composição Corporal , Coração/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética , Estado de Hidratação do Organismo , Função Ventricular Esquerda , Equilíbrio Hidroeletrolítico , Adulto , Desidratação , Diástole , Feminino , Voluntários Saudáveis , Coração/fisiologia , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Adulto Jovem
5.
Medicine (Baltimore) ; 99(39): e22411, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991471

RESUMO

BACKGROUND: Acute exercise leads to an immediate drop in blood pressure (BP), also called post-exercise hypotension (PEH). Exercise in hypoxia is related to additional vasodilation, potentially contributing to more profound PEH. Therefore, we investigated the impact of hypoxia versus normoxia on the magnitude of PEH. Second, we examined whether these changes in PEH relate to the BP-lowering effects of 12-week exercise training under hypoxia. METHODS: In this prospective study, 21 healthy individuals (age 22.2 ±â€Š3.0 years, 14 male) performed a 45-minute high-intensity running exercise on 2 different days in a random order, under hypoxia (fraction of inspired oxygen 14.5%) and normoxia (fraction of inspired oxygen 20.9%). BP was examined pre-exercise (t = 0) and at t = 15, t = 30, t = 45, and t = 60 minutes post-exercise. Afterward, subjects took part in a 12-week hypoxic running exercise training program. Resting BP was measured before and after the 12-week training program. RESULTS: Acute exercise induced a significant decrease in systolic BP (systolic blood pressure [SBP], P = .001), but not in diastolic BP (diastolic blood pressure [DBP], P = .113). No significant differences were observed in post-exercise BP between hypoxic and normoxic conditions (SBP, P = .324 and DBP, P = .204). Post-exercise changes in SBP, DBP, and mean arterial pressure significantly correlated to the 12-week exercise training-induced changes in SBP (r = 0.557, P = .001), DBP (r = 0.615, P < .001), and mean arterial pressure (r = 0.458, P = .011). CONCLUSION: Our findings show that hypoxia does not alter the magnitude of PEH in healthy individuals, whilst PEH relates to the BP-lowering effects of exercise. These data highlight the strong link between acute and chronic changes in BP.


Assuntos
Pressão Sanguínea , Treino Aeróbico , Hipóxia , Hipotensão Pós-Exercício/etiologia , Estudos Cross-Over , Feminino , Voluntários Saudáveis , Humanos , Masculino , Adulto Jovem
6.
BMC Infect Dis ; 20(1): 685, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32948127

RESUMO

BACKGROUND: Recombinant fusion protein ESAT6-CFP10 (EC) is a newly developed skin test reagent for detecting Mycobacterium tuberculosis (M. tuberculosis) infection. In this study, we evaluated whether induration and erythema could be used as diagnostic indicators for EC skin test to detect M. tuberculosis infection. METHODS: A total of 743 tuberculosis patients and 1514 healthy volunteers underwent an EC skin test. The diameters of induration and erythema were measured with Vernier caliper, 24 h, 48 h, and 72 h after skin testing. Related indicators of EC reagent diagnostic test were tested, and the diagnostic effects of the four diagnostic indicators for EC skin test were compared. RESULTS: The sensitivity of induration / erythema measurement was lower at 24 h after EC skin test than at 48 h or 72 h (P<0.01). There was no difference in consistency (P = 0.16) between induration with clinical diagnosis, and erythema with clinical diagnosis at 48 h (88.88 and 90.16%, Kappa value was 0.75 and 0.78, respectively). In patients, the sensitivity of erythema measurement was higher than induration measurement (P<0.01). In healthy volunteers, the specificity of erythema measurement was lower than induration at 24 h after skin test, but there was no difference at 48 h after skin test (P = 0.22). In BCG vaccination volunteers, the specificity of induration and erythema were higher than 90%. In addition, there was a high consistency of induration and erythema. When induration or erythema was used as a positive diagnostic indicator, the sensitivity of the EC skin test was improved, and was no different from the other three indicators in terms of specificity and consistency with clinical diagnosis. CONCLUSIONS: Induration or erythema diameter not less than 5 mm could be used as a diagnostic indicator for detecting M. tuberculosis infection. TRIAL REGISTRATION: Phase III clinical trial of recombinant Mycobacterium tuberculosis ESAT6-CFP10 allergen; CTR20150695 ; registered in December 16, 2015.


Assuntos
Proteínas Recombinantes de Fusão , Teste Tuberculínico/métodos , Tuberculose/diagnóstico , Adulto , Alérgenos , Eritema/etiologia , Eritema/patologia , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/patogenicidade , Sensibilidade e Especificidade , Fatores de Tempo , Teste Tuberculínico/efeitos adversos , Tuberculose/microbiologia , Adulto Jovem
7.
mBio ; 11(5)2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32978311

RESUMO

The high susceptibility of humans to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the cause of coronavirus disease 2019 (COVID-19), reflects the novelty of the virus and limited preexisting B cell immunity. IgG against the SARS-CoV-2 spike (S) protein, which carries the novel receptor binding domain (RBD), is absent or at low levels in unexposed individuals. To better understand the B cell response to SARS-CoV-2 infection, we asked whether virus-reactive memory B cells (MBCs) were present in unexposed subjects and whether MBC generation accompanied virus-specific IgG production in infected subjects. We analyzed sera and peripheral blood mononuclear cells (PBMCs) from non-SARS-CoV-2-exposed healthy donors and COVID-19 convalescent subjects. Serum IgG levels specific for SARS-CoV-2 proteins (S, including the RBD and S2 subunit, and nucleocapsid [N]) and non-SARS-CoV-2 proteins were related to measurements of circulating IgG MBC levels. Anti-RBD IgG was absent in unexposed subjects. Most unexposed subjects had anti-S2 IgG, and a minority had anti-N IgG, but IgG MBCs with these specificities were not detected, perhaps reflecting low frequencies. Convalescent subjects had high levels of IgG against the RBD, S2, and N, together with large populations of RBD- and S2-reactive IgG MBCs. Notably, IgG titers against the S protein of the human coronavirus OC43 were higher in convalescent subjects than in unexposed subjects and correlated strongly with anti-S2 titers. Our findings indicate cross-reactive B cell responses against the S2 subunit that might enhance broad coronavirus protection. Importantly, our demonstration of MBC induction by SARS-CoV-2 infection suggests that a durable form of B cell immunity is maintained even if circulating antibody levels wane.IMPORTANCE The recent rapid worldwide spread of SARS-CoV-2 has established a pandemic of potentially serious disease in the highly susceptible human population. Key issues are whether humans have preexisting immune memory that provides some protection against SARS-CoV-2 and whether SARS-CoV-2 infection generates lasting immune protection against reinfection. Our analysis focused on pre- and postinfection IgG and IgG memory B cells (MBCs) reactive to SARS-CoV-2 proteins. Most importantly, we demonstrate that infection generates both IgG and IgG MBCs against the novel receptor binding domain and the conserved S2 subunit of the SARS-CoV-2 spike protein. Thus, even if antibody levels wane, long-lived MBCs remain to mediate rapid antibody production. Our study results also suggest that SARS-CoV-2 infection strengthens preexisting broad coronavirus protection through S2-reactive antibody and MBC formation.


Assuntos
Linfócitos B/imunologia , Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Imunoglobulina G/imunologia , Pneumonia Viral/imunologia , Glicoproteína da Espícula de Coronavírus/imunologia , Adulto , Anticorpos Antivirais/imunologia , Linfócitos B/virologia , Convalescença , Reações Cruzadas , Feminino , Voluntários Saudáveis , Humanos , Memória Imunológica , Masculino , Pessoa de Meia-Idade , Proteínas do Nucleocapsídeo/imunologia , Pandemias , Domínios e Motivos de Interação entre Proteínas , Subunidades Proteicas , Glicoproteína da Espícula de Coronavírus/química
8.
Front Immunol ; 11: 1836, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32983097

RESUMO

Examining CD8+ and CD4+ T cell responses after primary Yellow Fever vaccination in a cohort of 210 volunteers, we have identified and tetramer-validated 92 CD8+ and 50 CD4+ T cell epitopes, many inducing strong and prevalent (i.e., immunodominant) T cell responses. Restricted by 40 and 14 HLA-class I and II allotypes, respectively, these responses have wide population coverage and might be of considerable academic, diagnostic and therapeutic interest. The broad coverage of epitopes and HLA overcame the otherwise confounding effects of HLA diversity and non-HLA background providing the first evidence of T cell immunodomination in humans. Also, double-staining of CD4+ T cells with tetramers representing the same HLA-binding core, albeit with different flanking regions, demonstrated an extensive diversification of the specificities of many CD4+ T cell responses. We suggest that this could reduce the risk of pathogen escape, and that multi-tetramer staining is required to reveal the true magnitude and diversity of CD4+ T cell responses. Our T cell epitope discovery approach uses a combination of (1) overlapping peptides representing the entire Yellow Fever virus proteome to search for peptides containing CD4+ and/or CD8+ T cell epitopes, (2) predictors of peptide-HLA binding to suggest epitopes and their restricting HLA allotypes, (3) generation of peptide-HLA tetramers to identify T cell epitopes, and (4) analysis of ex vivo T cell responses to validate the same. This approach is systematic, exhaustive, and can be done in any individual of any HLA haplotype. It is all-inclusive in the sense that it includes all protein antigens and peptide epitopes, and encompasses both CD4+ and CD8+ T cell epitopes. It is efficient and, importantly, reduces the false discovery rate. The unbiased nature of the T cell epitope discovery approach presented here should support the refinement of future peptide-HLA class I and II predictors and tetramer technologies, which eventually should cover all HLA class I and II isotypes. We believe that future investigations of emerging pathogens (e.g., SARS-CoV-2) should include population-wide T cell epitope discovery using blood samples from patients, convalescents and/or long-term survivors, who might all hold important information on T cell epitopes and responses.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Epitopos de Linfócito T/imunologia , Vacinação , Vacina contra Febre Amarela/imunologia , Febre Amarela/prevenção & controle , Vírus da Febre Amarela/imunologia , Betacoronavirus/imunologia , Estudos de Coortes , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Voluntários Saudáveis , Antígenos de Histocompatibilidade Classe I/imunologia , Antígenos de Histocompatibilidade Classe II/imunologia , Humanos , Imunogenicidade da Vacina , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Febre Amarela/virologia
10.
Medicine (Baltimore) ; 99(36): e21981, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899040

RESUMO

Early life family relationships affect the sexuality in adulthood, and these influences might be reflected in sexual dreams. The present study was designed to investigate the exact associations between family relationships and sexual dream experience. We therefore invited 62 frequent sexual dreamers (dreamers) and 104 healthy volunteers (controls) to answer the Sexual Dream Experience Questionnaire (SDEQ) and the Family Relationship Questionnaire (FRQ). Compared to controls, dreamers scored higher on all SDEQ factors and sexual dream frequency, higher on FRQ Paternal Abuse, and lower on FRQ General Attachment and Maternal Freedom Release. In controls, Paternal Abuse was associated with Joyfulness, Maternal Dominance with Aversion, and Maternal Abuse with dream frequency (-). In dreamers, Paternal Abuse was associated with Aversion, Bizarreness and dream frequency, and Maternal Freedom Release with Aversion (-). In conclusion, there were pronounced associations between sexual dreams and family relationships in frequent sexual dreamers. Paternal Abuse in particular was associated with sexual dream experience. Adverse family relationships might induce frequent sexual dream occurrence, and family therapy or early intervention of Paternal Abuse might alleviate the negative sexual dream experience.


Assuntos
Sonhos , Relações Familiares , Sexualidade , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Voluntários Saudáveis , Humanos , Masculino , Adulto Jovem
11.
Medicine (Baltimore) ; 99(36): e22048, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899065

RESUMO

Owing to hormonal changes, women experience various psychophysiological alterations over a wide age range, which may result in decreased quality of life as well as in increased risks of diseases, such as cardiovascular diseases. Although studies have been performed to research complementary methods, such as meditation, the research field still requires an adequate amount of studies for public health guidelines. This pilot cross-sectional study aims to investigate a potential association of meditation with menopausal symptoms and blood chemistry for healthy women. In this study, data of 65 healthy women (age range 25-67) including 33 meditation practitioners and 32 meditation-naïve controls were analyzed to compare the Menopausal Rating Scale scores and blood chemistry with 7 more dropouts in the blood chemistry. For blood chemistry, nine components including glucose (GLU) and high-density lipoprotein cholesterol (HDL) were measured. Two-way analysis of variance was performed by dividing the total participants into 2 groups: premenopausal and postmenopausal participants. Compared to the control group, the meditation group showed a trend of reductions in the Menopausal Rating Scale total score (P = .054) and its 2 subcomponents: depressive mood (P = .064) and irritability (P = .061). In HDL level, there was a significant interaction between group and menopausal state (P = .039) with following post hoc results: among the premenopausal participants, a significant increase in the meditation group compared to the control group (P = .005); among the control group, a significant increase in the postmenopausal compared to the premenopausal participants (P = .030). In GLU level, there was a mild interaction between group and menopausal state (P = .070) with following post hoc results: among the postmenopausal participants, a trend of increase in the control group compared to the meditation group (P = .081); among the control group, a significant increase in the postmenopausal compared to the premenopausal participants (P = .040). Our research suggests a potential association of practicing meditation with alleviations in menopausal symptoms and changes in blood chemistry, warranting further studies with a longitudinal study design and larger populations to understand the underlying causal relationships.


Assuntos
Análise Química do Sangue/métodos , Meditação/métodos , Menopausa/sangue , Menopausa/psicologia , Adulto , Glicemia , Estudos de Casos e Controles , HDL-Colesterol/sangue , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Pós-Menopausa/sangue , Pós-Menopausa/psicologia , Pré-Menopausa/sangue , Pré-Menopausa/psicologia , Qualidade de Vida
12.
Transl Behav Med ; 10(4): 835-842, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-32926160

RESUMO

There are various health benefits of regular physical activity (PA) and health risks of sedentariness. The Covid-19 pandemic may have decreased PA and increased sedentariness for several reasons (e.g., closure of gyms, family-related time constraints, and reduced outdoor mobility). Yet, to date, there are no longitudinal studies that examined whether the pandemic affects PA levels and what factors help people remain physically active during lockdown. This study aims to investigate changes in U.S. residents' PA during (vs. before) the Covid-19 pandemic and predictors of changes, with a focus on PA smartphone applications (apps) and their features (i.e., motivational, educational, or gamification related). The study utilized a two-wave longitudinal survey design with an online panel. Healthy adults (N = 431) from 45 U.S. states self-reported their PA levels before and during lockdown. PA app use and app feature ratings were assessed. t-tests and regression analyses were conducted. Moderate PA, vigorous PA, and PA measured in metabolic equivalent of task (MET) minutes per week decreased during lockdown (all p < .01). Controlling for PA before lockdown and individuals' PA intentions, PA app use was positively related to overall change in PA, measured in MET minutes per week (ß = 15.68, standard error = 7.84, p < .05). PA decreased less with increasing app use frequency. When app features were added to the model, a buffering effect for gamification features was identified. The Covid-19-caused lockdown decreased U.S. residents' PA levels by 18.2%. The use of PA apps may help buffer the decline, and gamification-related app features may be particularly helpful in this context.


Assuntos
Infecções por Coronavirus , Exercício Físico , Aplicativos Móveis/tendências , Pandemias , Pneumonia Viral , Smartphone , Isolamento Social/psicologia , Adulto , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Voluntários Saudáveis , Humanos , Estudos Longitudinais , Masculino , Equivalente Metabólico , Motivação , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Estados Unidos/epidemiologia
13.
Medicine (Baltimore) ; 99(31): e21458, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756166

RESUMO

BACKGROUND: Parkinson disease (PD) is a common neurodegenerative disorder. Elevations of neurofilament light chain (NfL) concentrations in the cerebrospinal fluid (CSF) and blood are a marker of neuronal/axonal injury and degeneration. However, CSF and blood NfL alterations in patients with PD from existing studies remain inconclusive. To better understand these conflicting data, we will conduct a meta-analysis. METHODS: We will comprehensively search PubMed, Embase, and Web of Science databases from each database's inception to 7th June, 2020. This protocol will conform to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols. We will only include original studies published in English that evaluated differences of NfL concentrations in the CSF or blood between idiopathic PD patients and healthy controls. The Newcastle-Ottawa Scale will be used to evaluate the quality of the included studies. Meta-analyses will be carried out using the STATA software version 13.0. Between-group difference of NfL concentrations in the CSF and blood will be expressed as the weighted standardized mean difference. A random-effects model will be used. Supplementary analyses, such as heterogeneity analysis, sensitivity analysis, publication bias, subgroup analysis, and meta-regression analysis will be performed. RESULTS: The meta-analysis will provide the differences of NfL concentrations in the CSF and blood between patients with PD and healthy controls and will show the magnitudes of their effect sizes. CONCLUSIONS: This meta-analysis will provide the evidence of NfL concentrations in the CSF and blood in PD and we hope that our study has an important impact on clinical practice. REGISTRATION NUMBER: INPLASY202060025.


Assuntos
Proteínas de Neurofilamentos/sangue , Proteínas de Neurofilamentos/líquido cefalorraquidiano , Doença de Parkinson/metabolismo , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Estudos de Casos e Controles , Feminino , Voluntários Saudáveis , Humanos , Masculino , Doença de Parkinson/diagnóstico , Análise de Regressão , Sensibilidade e Especificidade
14.
Medicine (Baltimore) ; 99(31): e21467, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756168

RESUMO

BACKGROUND: This study aimed to evaluate the scleral thickness and corneal parameters of patients with systemic lupus erythematosus (SLE). METHODS: Forty-seven eyes of 47 SLE patients and 44 eyes of healthy controls were included in this cross-sectional study. Anterior segment optical coherence tomography (AS-OCT) was used to measure the corneal and scleral thickness. Scleral thickness (ST) was measured based upon the segmentation at 1000 to 5000 µm from the scleral spur. Pentacam HR was used to measure corneal parameters. RESULTS: There was no statistically significant difference between SLE group and control group according to age and sex (P > .05). The ST measurements at all distances from scleral spur were found to be thicker in patients with SLE (P < .05). Central corneal thickness (CCT), cornea volume (CV), corneal densitometry (CD), and peripheral corneal thickness (PCT) measurements were similar between the groups (P > .05). CONCLUSION: ST was thicker in SLE patients compared with healthy controls. AS-OCT seems helpful in selecting optimal sites for pharmaceutical or surgical intervention in SLE patients, since it shows thickness variations in anterior sclera.


Assuntos
Córnea/diagnóstico por imagem , Lúpus Eritematoso Sistêmico/complicações , Esclera/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto , Estudos de Casos e Controles , Córnea/patologia , Paquimetria Corneana/métodos , Estudos Transversais , Densitometria , Feminino , Voluntários Saudáveis , Humanos , Lúpus Eritematoso Sistêmico/patologia , Masculino , Pessoa de Meia-Idade , Esclera/patologia , Turquia/epidemiologia
15.
Medicine (Baltimore) ; 99(30): e21302, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791715

RESUMO

INTRODUCTION: By detecting the metabolic difference of the Heart and Lung meridians, the present study aims to investigate the specificity of different meridians and verify whether functional near infrared spectroscopy is validated as an add-on technique to assist diagnosis of chronic obstructive pulmonary disease (COPD). METHODS AND ANALYSIS: The Lung and Heart meridians are chosen as the target for comparison; accordingly, 120 eligible participants will be included and divided into the COPD group, healthy control group, and healthy intervention group. Functional near infrared spectroscopy will be adopted to measure the metabolic characteristics of the Heart and Lung meridians. On one hand, the specificity of the meridian-visceral association will be investigated by comparing the metabolic difference in the Heart and Lung meridians between the healthy control group and COPD group. On the other hand, the specificity of site-to-site association will be determined by comparing the metabolic change between the 2 meridians that induced by moxibustion in the Heart meridian and Lung meridian, respectively, in the healthy control group. The primary outcome will be regional oxygen saturation of corresponding regions along the Heart and Lung meridians. TRIAL REGISTRATION: ClinicalTrials.gov NCT04046666.


Assuntos
Coração/fisiologia , Pulmão/metabolismo , Moxibustão/métodos , Doença Pulmonar Obstrutiva Crônica/terapia , Espectrofotometria Infravermelho/métodos , Pontos de Acupuntura , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Voluntários Saudáveis , Humanos , Masculino , Meridianos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Oxigênio/metabolismo , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Sensibilidade e Especificidade
16.
PLoS One ; 15(8): e0235948, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785216

RESUMO

INTRODUCTION: Surgical site infection is one of the most severe complications of surgical treatments. However, the optimal procedure to prevent such infections remains uninvestigated. Ultraviolet radiation C (UVC) with a short wavelength has a high bactericidal effect; however, it is cytotoxic. Nonetheless, given that UVC with a wavelength of 222 nm reaches only the stratum corneum, it does not affect the skin cells. This study aimed to investigate the safety of 222-nm UVC irradiation and to examine its skin sterilization effect in healthy volunteers. METHODS: This trial was conducted on 20 healthy volunteers. The back of the subject was irradiated with 222-nm UVC at 50-500 mJ/cm2, and the induced erythema (redness of skin) was evaluated. Subsequently, the back was irradiated with a maximum amount of UVC not causing erythema, and the skin swabs before and after the irradiation were cultured. The number of colonies formed after 24 hours was measured. In addition, cyclobutene pyrimidine dimer (CPD) as an indicator of DNA damage was measured using skin tissues of the nonirradiated and irradiated regions. RESULTS: All subjects experienced no erythema at all doses. The back of the subject was irradiated at 500 mJ/cm2, and the number of bacterial colonies in the skin swab culture was significantly decreased by 222-nm UVC irradiation. The CPD amount produced in the irradiated region was slightly but significantly higher than that of the non-irradiated region. CONCLUSION: A 222-nm UVC at 500 mJ/cm2 was a safe irradiation dose and possessed bactericidal effects. In the future, 222-nm UVC irradiation is expected to contribute to the prevention of perioperative infection.


Assuntos
Dano ao DNA/efeitos da radiação , Microbiota/efeitos da radiação , Pele/efeitos da radiação , Esterilização/métodos , Raios Ultravioleta/efeitos adversos , Adulto , Dorso , Biópsia , Contagem de Colônia Microbiana , Eritema/diagnóstico , Eritema/etiologia , Voluntários Saudáveis , Humanos , Masculino , Dímeros de Pirimidina/análise , Dímeros de Pirimidina/efeitos da radiação , Pele/microbiologia , Infecção da Ferida Cirúrgica/microbiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Resultado do Tratamento
17.
Anesthesiology ; 133(3): 559-568, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32788558

RESUMO

BACKGROUND: To improve understanding of the respiratory behavior of oliceridine, a µ-opioid receptor agonist that selectively engages the G-protein-coupled signaling pathway with reduced activation of the ß-arrestin pathway, the authors compared its utility function with that of morphine. It was hypothesized that at equianalgesia, oliceridine will produce less respiratory depression than morphine and that this is reflected in a superior utility. METHODS: Data from a previous trial that compared the respiratory and analgesic effects of oliceridine and morphine in healthy male volunteers (n = 30) were reanalyzed. A population pharmacokinetic-pharmacodynamic analysis was performed and served as basis for construction of utility functions, which are objective functions of probability of analgesia, P(analgesia), and probability of respiratory depression, P(respiratory depression). The utility function = P(analgesia ≥ 0.5) - P(respiratory depression ≥ 0.25), where analgesia ≥ 0.5 is the increase in hand withdrawal latency in the cold pressor test by at least 50%, and respiratory depression ≥ 0.25 is the decrease of the hypercapnic ventilatory response by at least 25%. Values are median ± standard error of the estimate. RESULTS: The two drugs were equianalgesic with similar potency values (oliceridine: 27.9 ± 4.9 ng/ml; morphine 34.3 ± 9.7 ng/ml; potency ratio, 0.81; 95% CI, 0.39 to 1.56). A 50% reduction of the hypercapnic ventilatory response by morphine occurred at an effect-site concentration of 33.7 ± 4.8 ng/ml, while a 25% reduction by oliceridine occurred at 27.4 ± 3.5 ng/ml (potency ratio, 2.48; 95% CI, 1.65 to 3.72; P < 0.01). Over the clinically relevant concentration range of 0 to 35 ng/ml, the oliceridine utility function was positive, indicating that the probability of analgesia exceeds the probability of respiratory depression. In contrast, the morphine function was negative, indicative of a greater probability of respiratory depression than analgesia. CONCLUSIONS: These data indicate a favorable oliceridine safety profile over morphine when considering analgesia and respiratory depression over the clinical concentration range.


Assuntos
Analgésicos Opioides/farmacologia , Morfina/farmacologia , Insuficiência Respiratória/induzido quimicamente , Compostos de Espiro/farmacologia , Tiofenos/farmacologia , Adulto , Analgésicos Opioides/efeitos adversos , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Morfina/efeitos adversos , Valores de Referência , Medição de Risco , Compostos de Espiro/efeitos adversos , Tiofenos/efeitos adversos , Adulto Jovem
18.
PLoS One ; 15(8): e0233244, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32797080

RESUMO

The role of white matter in reading has been established by diffusion tensor imaging (DTI), but DTI cannot identify specific microstructural features driving these relationships. Neurite orientation dispersion and density imaging (NODDI), inhomogeneous magnetization transfer (ihMT) and multicomponent driven equilibrium single-pulse observation of T1/T2 (mcDESPOT) can be used to link more specific aspects of white matter microstructure and reading due to their sensitivity to axonal packing and fiber coherence (NODDI) and myelin (ihMT and mcDESPOT). We applied principal component analysis (PCA) to combine DTI, NODDI, ihMT and mcDESPOT measures (10 in total), identify major features of white matter structure, and link these features to both reading and age. Analysis was performed for nine reading-related tracts in 46 neurotypical 6-16 year olds. We identified three principal components (PCs) which explained 79.5% of variance in our dataset. PC1 probed tissue complexity, PC2 described myelin and axonal packing, while PC3 was related to axonal diameter. Mixed effects regression models did not identify any significant relationships between principal components and reading skill. Bayes factor analysis revealed that the absence of relationships was not due to low power. Increasing PC1 in the left arcuate fasciculus with age suggest increases in tissue complexity, while increases of PC2 in the bilateral arcuate, inferior longitudinal, inferior fronto-occipital fasciculi, and splenium suggest increases in myelin and axonal packing with age. Multimodal white matter imaging and PCA provide microstructurally informative, powerful principal components which can be used by future studies of development and cognition. Our findings suggest major features of white matter undergo development during childhood and adolescence, but changes are not linked to reading during this period in our typically-developing sample.


Assuntos
Neuroimagem Funcional/métodos , Imageamento por Ressonância Magnética Multiparamétrica/métodos , Leitura , Substância Branca/anatomia & histologia , Adolescente , Desenvolvimento do Adolescente/fisiologia , Axônios/ultraestrutura , Teorema de Bayes , Criança , Desenvolvimento Infantil/fisiologia , Imagem de Tensor de Difusão/estatística & dados numéricos , Feminino , Neuroimagem Funcional/estatística & dados numéricos , Voluntários Saudáveis , Humanos , Imageamento Tridimensional , Masculino , Modelos Anatômicos , Modelos Neurológicos , Imageamento por Ressonância Magnética Multiparamétrica/estatística & dados numéricos , Bainha de Mielina/metabolismo , Análise de Componente Principal/métodos , Análise de Regressão , Substância Branca/crescimento & desenvolvimento , Substância Branca/fisiologia
19.
Medicina (B Aires) ; 80(4): 339-347, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32841137

RESUMO

The six-minute walk test has been generally applied in people with pathologies and some studies have proposed models to predict maximum oxygen consumption. Our objective was to elaborate on an equation to predict the maximum oxygen consumption in the six-minute walking test for university students. A hundred and forty people participated in this study. The six-minute walking test was applied and after on a gradual exercise test was performed to determine the maximum oxygen consumption. A multivariate equation was developed and the analysis was done using the SPSS v.22 program (p < 0.05). The predictive model include gender, age, body mass index, distance performed and heart rate recovery (r = 0.83; p < 0.001). The equation fulfilled the assumptions of independence (p = 0.13), normality (p = 0.49) and homoscedasticity (p = 0.64). The Bland-Altman diagram indicated that there were no significant differences between the equation and the measurement of the maximum oxygen consumption (p = 0.89), with a confidence interval of 0.054 ml·kg·min-1 (95% CI [-0.72; 0.83]). The equation predicts the maximum oxygen consumption. It is suggested to evaluate university students considering biological and environmental differences between countries.


Assuntos
Teste de Esforço , Tolerância ao Exercício , Voluntários Saudáveis , Frequência Cardíaca , Humanos , Consumo de Oxigênio , Teste de Caminhada , Caminhada
20.
Plast Reconstr Surg ; 146(2): 277-280, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740574

RESUMO

BACKGROUND: Despite the widespread use of the Cottle maneuver as a finding to define nasal valve collapse, no studies have confirmed the association between a positive Cottle maneuver and need for nasal valve repair. This study demonstrates the low construct validity of the Cottle maneuver. METHODS: One hundred healthy volunteer students and employees at Boston Medical Center were recruited for this study. Participants were asked to evaluate their breathing on a 10-point scale, rating their subjective airflow in each nostril while occluding the contralateral nostril, where 0 indicated complete obstruction and 10 indicated complete patency. Following the baseline ratings, participants were asked to rate their breathing once again while examiners preformed the Cottle and modified Cottle maneuvers. RESULTS: Overall, 97 percent of participants reported improved airflow in each nostril following the Cottle maneuver (p < 0.00001); 98 percent reported improved airflow in each nostril following the modified Cottle maneuver (p < 0.00001). CONCLUSIONS: If the clinical consensus regarding the observed improvement in nasal airflow is to be followed, nearly all the participants recruited are experiencing some surgically correctable nasal obstruction. Given the population from which our cohort was collected-students and residents from a medical campus-such a conclusion seems extremely unlikely. We believe the more likely explanation for the high positive test rate is flawed assumptions of the Cottle and modified Cottle maneuvers. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.


Assuntos
Obstrução Nasal/diagnóstico , Septo Nasal/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico , Rinoplastia/efeitos adversos , Adulto , Coleta de Dados , Feminino , Seguimentos , Voluntários Saudáveis , Humanos , Masculino , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Estudos Prospectivos
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