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Effective ocean management and the conservation of highly migratory species depend on resolving the overlap between animal movements and distributions, and fishing effort. However, this information is lacking at a global scale. Here we show, using a big-data approach that combines satellite-tracked movements of pelagic sharks and global fishing fleets, that 24% of the mean monthly space used by sharks falls under the footprint of pelagic longline fisheries. Space-use hotspots of commercially valuable sharks and of internationally protected species had the highest overlap with longlines (up to 76% and 64%, respectively), and were also associated with significant increases in fishing effort. We conclude that pelagic sharks have limited spatial refuge from current levels of fishing effort in marine areas beyond national jurisdictions (the high seas). Our results demonstrate an urgent need for conservation and management measures at high-seas hotspots of shark space use, and highlight the potential of simultaneous satellite surveillance of megafauna and fishers as a tool for near-real-time, dynamic management.
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Migração Animal , Pesqueiros/estatística & dados numéricos , Mapeamento Geográfico , Oceanos e Mares , Tubarões/fisiologia , Análise Espaço-Temporal , Animais , Densidade Demográfica , Medição de Risco , Tubarões/classificação , Navios , Fatores de TempoRESUMO
BACKGROUND: As the world becomes increasingly urbanised, there is recognition that public and planetary health relies upon a ubiquitous transition to sustainable cities. Disentanglement of the complex pathways of urban design, environmental exposures, and health, and the magnitude of these associations, remains a challenge. A state-of-the-art account of large-scale urban health studies is required to shape future research priorities and equity- and evidence-informed policies. OBJECTIVES: The purpose of this review was to synthesise evidence from large-scale urban studies focused on the interaction between urban form, transport, environmental exposures, and health. This review sought to determine common methodologies applied, limitations, and future opportunities for improved research practice. METHODS: Based on a literature search, 2958 articles were reviewed that covered three themes of: urban form; urban environmental health; and urban indicators. Studies were prioritised for inclusion that analysed at least 90 cities to ensure broad geographic representation and generalisability. Of the initially identified studies, following expert consultation and exclusion criteria, 66 were included. RESULTS: The complexity of the urban ecosystem on health was evidenced from the context dependent effects of urban form variables on environmental exposures and health. Compact city designs were generally advantageous for reducing harmful environmental exposure and promoting health, with some exceptions. Methodological heterogeneity was indicative of key urban research challenges; notable limitations included exposure and health data at varied spatial scales and resolutions, limited availability of local-level sociodemographic data, and the lack of consensus on robust methodologies that encompass best research practice. CONCLUSION: Future urban environmental health research for evidence-informed urban planning and policies requires a multi-faceted approach. Advances in geospatial and AI-driven techniques and urban indicators offer promising developments; however, there remains a wider call for increased data availability at local-levels, transparent and robust methodologies of large-scale urban studies, and greater exploration of urban health vulnerabilities and inequities.
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Cidades , Humanos , Exposição Ambiental , Meios de Transporte , Saúde da População Urbana , Saúde Ambiental/métodosRESUMO
Recent advances in data science and urban environmental health research utilise large-scale databases (100s-1000s of cities) to explore the complex interplay of urban characteristics such as city form and size, climate, mobility, exposure, and environmental health impacts. Cities are still hotspots of air pollution and noise, suffer urban heat island effects and lack of green space, which leads to disease and mortality burdens preventable with better knowledge. Better understanding through harmonising and analysing data in large numbers of cities is essential to identifying the most effective means of disease prevention and understanding context dependencies important for policy.
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Constriction kinetics of the cytokinetic ring are expected to depend on dynamic adjustment of contractile ring composition, but the impact of ring component abundance dynamics on ring constriction is understudied. Computational models generally assume that contractile networks maintain constant total amounts of components, which is not always true. To test how compositional dynamics affect constriction kinetics, we first measured F-actin, non-muscle myosin II, septin, and anillin during Caenorhabditis elegans zygotic mitosis. A custom microfluidic device that positioned the cell with the division plane parallel to a light sheet allowed even illumination of the cytokinetic ring. Measured component abundances were implemented in a three-dimensional agent-based model of a membrane-associated contractile ring. With constant network component amounts, constriction completed with biologically unrealistic kinetics. However, imposing the measured changes in component quantities allowed this model to elicit realistic constriction kinetics. Simulated networks were more sensitive to changes in motor and filament amounts than those of crosslinkers and tethers. Our findings highlight the importance of network composition for actomyosin contraction kinetics.
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Citoesqueleto de Actina , Citocinese , Animais , Cinética , Citocinese/fisiologia , Citoesqueleto de Actina/metabolismo , Actinas/metabolismo , Citoesqueleto/metabolismo , Actomiosina/metabolismo , Caenorhabditis elegansRESUMO
OBJECTIVES: Patellar tendon injuries occur via various mechanisms such as overuse, or due to surgical graft harvest for anterior cruciate ligament reconstruction (ACLR). Quantified patellar tendon stiffness after injury may help guide clinical care. Continuous shear wave elastography (cSWE) allows for the assessment of viscosity and shear modulus in tendons. The reliability of the measure, however, has not been established in the patellar tendon. The purpose of this study was to investigate the interrater reliability, intrarater reliability, and between-day stability of cSWE in both healthy and pathological patellar tendons. METHODS: Participants with patellar tendinopathy (n = 13), history of ACLR using bone-patellar tendon-bone autograft (n = 9), and with no history of patellar tendon injury (n = 13) were recruited. cSWE was performed 4 times by multiple raters over 2 days. Intraclass correlations (ICC) and minimum detectable change (MDC95% ) were calculated. RESULTS: Good to excellent between-day stability were found for viscosity (ICC = 0.905, MDC95% = 8.3 Pa seconds) and shear modulus (ICC = 0.805, MDC95% = 27.4 kPa). The interrater reliability measures, however, were not as reliable (ICC = 0.591 and 0.532). CONCLUSIONS: cSWE is a reliable assessment tool for quantifying patellar tendon viscoelastic properties over time. It is recommended, however, that a single rater performs the measure as the interrater reliability was less than ideal.
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Reconstrução do Ligamento Cruzado Anterior , Técnicas de Imagem por Elasticidade , Ligamento Patelar , Traumatismos dos Tendões , Humanos , Reprodutibilidade dos Testes , Ligamento Patelar/diagnóstico por imagem , Tendões , Traumatismos dos Tendões/cirurgiaRESUMO
OBJETIVO: Describir el proceso de diseño de Vida Saludable, un nuevo programa de estudios para la educación básica en México. Material y métodos. Se conformó un equipo de trabajo entre especialistas en salud y la Secretaría de Educación Pública. Se establecieron las bases científicas de Vida Saludable, se seleccionaron y evaluaron materiales para Vida Saludable, y se revisaron contenidos vigentes de salud incluidos en otras asignaturas. RESULTADOS: Alimentación, actividad física e higiene y limpieza fueron definidos como los tres ejes temáticos para Vida Saludable. Se aprobaron 3 de 228 insumos para usarse en Vida Saludable y 71.7% de los con-tenidos vigentes en educación básica sobre salud requieren ediciones. CONCLUSIONES: Vida Saludable es un parteaguas hacia la alfabetización en materia de salud en educación básica en México, que se alinea con la agenda global para preservar la salud humana y planetaria.
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Promoção da Saúde , Humanos , México , Estudos RetrospectivosRESUMO
Radiofrequency ablation of the medial branch is commonly used to treat chronic low back pain involving facet joints, which accounts for 12% to 37% of the total cases of chronic low back pain. An adverse effect of this procedure is the denervation of the multifidus muscle, which may lead to its atrophy which can affect the spine and possibly disc degeneration. This study aims to quantify changes in joint angles and loading caused by multifidus denervation after radiofrequency ablation. AnyBody model of the torso was used to evaluate intervertebral joints in flexion, lateral bending, and torsion. Force-dependent kinematics was used to calculate joint angles and forces. These dependent variables were investigated in intact multifidus, unilateral, and bilateral ablations of L3L4, L4L5, and L5S1 joints. The results showed pronounced angular joint changes, especially in bilateral ablations in flexion, when compared with other cases. The same changes' trend from intact to unilaterally then bilaterally ablated multifidus occurred in joint angles of lateral bending. Meanwhile, joint forces were not adversely affected. These results suggest that multifidus denervation after radiofrequency ablation affects spinal mechanics. Such changes may be associated with abnormal tissue deformations and stresses that can potentially alter their mechanobiology and homeostasis, thereby possibly affecting the health of the spine.
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Dor Lombar , Ablação por Radiofrequência , Articulação Zigapofisária , Humanos , Dor Lombar/etiologia , Dor Lombar/cirurgia , Fenômenos Biomecânicos/fisiologia , Músculos Paraespinais , Articulação Zigapofisária/cirurgia , Articulação Zigapofisária/inervação , Articulação Zigapofisária/fisiologia , Ablação por Radiofrequência/efeitos adversos , Denervação/efeitos adversos , Denervação/métodos , Vértebras Lombares/cirurgia , Vértebras Lombares/fisiologiaRESUMO
Smooth muscle is found around organs in the digestive, respiratory, and reproductive tracts. Cancers arising in the bladder, prostate, stomach, colon, and other sites progress from low-risk disease to high-risk, lethal metastatic disease characterized by tumor invasion into, within, and through the biophysical barrier of smooth muscle. We consider here the unique biophysical properties of smooth muscle and how cohesive clusters of tumor use mechanosensing cell-cell and cell-ECM (extracellular matrix) adhesion receptors to move through a structured muscle and withstand the biophysical forces to reach distant sites. Understanding integrated mechanosensing features within tumor cluster and smooth muscle and potential triggers within adjacent adipose tissue, such as the unique damage-associated molecular pattern protein (DAMP), eNAMPT (extracellular nicotinamide phosphoribosyltransferase), or visfatin, offers an opportunity to prevent the first steps of invasion and metastasis through the structured muscle.
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Músculo Liso/patologia , Invasividade Neoplásica , Neoplasias , Matriz Extracelular , Humanos , Neoplasias/patologiaRESUMO
Meiotic spindles are positioned perpendicular to the oocyte cortex to facilitate segregation of chromosomes into a large egg and a tiny polar body. In C. elegans, spindles are initially ellipsoid and parallel to the cortex before shortening to a near-spherical shape with flattened poles and then rotating to the perpendicular orientation by dynein-driven cortical pulling. The mechanistic connection between spindle shape and rotation has remained elusive. Here, we have used three different genetic backgrounds to manipulate spindle shape without eliminating dynein-dependent movement or dynein localization. Ellipsoid spindles with flattened or pointed poles became trapped in either a diagonal or a parallel orientation. Mathematical models that recapitulated the shape dependence of rotation indicated that the lower viscous drag experienced by spherical spindles prevented recapture of the cortex by astral microtubules emanating from the pole pivoting away from the cortex. In addition, maximizing contact between pole dynein and cortical dynein stabilizes flattened poles in a perpendicular orientation, and spindle rigidity prevents spindle bending that can lock both poles at the cortex. Spindle shape can thus promote perpendicular orientation by three distinct mechanisms.
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Caenorhabditis elegans/metabolismo , Fuso Acromático/metabolismo , Polos do Fuso/metabolismo , Animais , Cromossomos/metabolismo , Dineínas/metabolismo , Feminino , Imunofluorescência , Meiose/fisiologia , Microtúbulos/metabolismoRESUMO
OBJECTIVES: To review the current literature on the evidence and the underlying characteristics of glucocorticoids (type, dosage, and duration) associated with myopathy in asthma. DATA SOURCES: Four electronic databases were searched to October 19, 2020. STUDY SELECTION: Inclusion criteria: adults or adolescents with asthma, taking systemic glucocorticoids, and measures of muscle impairments. RESULTS: Nine studies met the eligibility criteria. The methodologic quality of most studies was fair or good. Two studies reported significantly lower inspiratory muscle function in outpatients taking daily oral glucocorticoids (≥10 mg), but one study reported no such difference. No differences was found in limb muscle strength in one study. Only 11-36% patients with acute exacerbation taking glucocorticoids intravenously suffered from limb muscle weakness during/after critical care admissions. Two studies reported significant associations between dosage of oral glucocorticoid use and inspiratory and limb muscle function, whereas seven studies did not find any significant correlations among the characteristics of systemic glucocorticoids and myopathy. Two studies comparing people with non-glucocorticoid dependent asthma taking inhaled glucocorticoid and healthy people did not find any significant differences in their inspiratory muscle strength and endurance. CONCLUSIONS: There were limited studies and inconsistent results on glucocorticoid-induced myopathy in people with asthma, and its association with the characteristics of glucocorticoids use. We recommended future studies should use a commonly accepted operational definition of myopathy, utilize a cohort study design, measure the cumulative dosage of glucocorticoids, and integrate possible confounding factors in the analysis.
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Asma , Doenças Musculares , Adolescente , Adulto , Asma/tratamento farmacológico , Estudos de Coortes , Glucocorticoides/efeitos adversos , Humanos , Doenças Musculares/induzido quimicamente , Doenças Musculares/epidemiologiaRESUMO
We aimed to (1) compare pain, tendon structure, lower limb function, and Achilles tendon loads while running between limbs in runners with Achilles tendinopathy, and (2) explore the relations of pain, tendon structure, and lower limb function to Achilles tendon loads while running. Twenty runners with Achilles tendinopathy participated in this pilot study. Pain was assessed with questionnaires, quantitative sensory testing, and functional testing. Tendon morphology and mechanical properties were evaluated with ultrasound imaging, continuous shear wave elastography, and ultrasound imaging combined with dynamometry. Lower limb function was assessed with an established test battery. Achilles tendon loads were estimated from biomechanical data acquired during running. Compared to the least symptomatic limb, the most symptomatic limb had lower scores on the Victorian Institute of Sports Assessment - Achilles questionnaire and worse pain during drop countermovement jumping, hopping, and running. Tendon thickness and cross-sectional area were greater, and Young's modulus, drop countermovement jump height, and plyometric quotient during hopping were lower on the most symptomatic limb. Side-to-side differences in drop countermovement jump height were significantly associated with side-to-side differences in Achilles tendon peak forces and average loading rates during running. Various measures of pain, structure, and function differ between limbs in runners with Achilles tendinopathy during return-to-sport. Tendon forces, however, do not differ between limbs during comfortable running. In addition to measures that differ between limbs, measures of performance during drop countermovement jumping may aid in clinical decision-making during return-to-sport because they are associated with tendon forces while running.
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Tendão do Calcâneo , Doenças Musculoesqueléticas , Corrida , Tendinopatia , Tendão do Calcâneo/diagnóstico por imagem , Humanos , Dor , Projetos Piloto , Volta ao Esporte , Tendinopatia/diagnóstico por imagemRESUMO
DESCRIPTION: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease with an estimated prevalence of 1 in 5000 that is characterized by the presence of vascular malformations (VMs). These result in chronic bleeding, acute hemorrhage, and complications from shunting through VMs. The goal of the Second International HHT Guidelines process was to develop evidence-based consensus guidelines for the management and prevention of HHT-related symptoms and complications. METHODS: The guidelines were developed using the AGREE II (Appraisal of Guidelines for Research and Evaluation II) framework and GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The guidelines expert panel included expert physicians (clinical and genetic) in HHT from 15 countries, guidelines methodologists, health care workers, health care administrators, patient advocacy representatives, and persons with HHT. During the preconference process, the expert panel generated clinically relevant questions in 6 priority topic areas. A systematic literature search was done in June 2019, and articles meeting a priori criteria were included to generate evidence tables, which were used as the basis for recommendation development. The expert panel subsequently convened during a guidelines conference to conduct a structured consensus process, during which recommendations reaching at least 80% consensus were discussed and approved. RECOMMENDATIONS: The expert panel generated and approved 6 new recommendations for each of the following 6 priority topic areas: epistaxis, gastrointestinal bleeding, anemia and iron deficiency, liver VMs, pediatric care, and pregnancy and delivery (36 total). The recommendations highlight new evidence in existing topics from the first International HHT Guidelines and provide guidance in 3 new areas: anemia, pediatrics, and pregnancy and delivery. These recommendations should facilitate implementation of key components of HHT care into clinical practice.
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Telangiectasia Hemorrágica Hereditária/diagnóstico , Telangiectasia Hemorrágica Hereditária/terapia , Anemia/etiologia , Anemia/terapia , Malformações Arteriovenosas/etiologia , Malformações Arteriovenosas/terapia , Criança , Epistaxe/etiologia , Epistaxe/terapia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Doenças Genéticas Inatas/etiologia , Doenças Genéticas Inatas/terapia , Humanos , Fígado/irrigação sanguínea , Telangiectasia Hemorrágica Hereditária/complicaçõesRESUMO
Molecular motors drive cytoskeletal rearrangements to change cell shape. Myosins are the motors that move, cross-link, and modify the actin cytoskeleton. The primary force generator in contractile actomyosin networks is nonmuscle myosin II (NMMII), a molecular motor that assembles into ensembles that bind, slide, and cross-link actin filaments (F-actin). The multivalence of NMMII ensembles and their multiple roles have confounded the resolution of crucial questions, including how the number of NMMII subunits affects dynamics and what affects the relative contribution of ensembles' cross-linking versus motoring activities. Because biophysical measurements of ensembles are sparse, modeling of actomyosin networks has aided in discovering the complex behaviors of NMMII ensembles. Myosin ensembles have been modeled via several strategies with variable discretization or coarse graining and unbinding dynamics, and although general assumptions that simplify motor ensembles result in global contractile behaviors, it remains unclear which strategies most accurately depict cellular activity. Here, we used an agent-based platform, Cytosim, to implement several models of NMMII ensembles. Comparing the effects of bond type, we found that ensembles of catch-slip and catch motors were the best force generators and binders of filaments. Slip motor ensembles were capable of generating force but unbound frequently, resulting in slower contractile rates of contractile networks. Coarse graining of these ensemble types from two sets of 16 motors on opposite ends of a stiff rod to two binders, each representing 16 motors, reduced force generation, contractility, and the total connectivity of filament networks for all ensemble types. A parallel cluster model, previously used to describe ensemble dynamics via statistical mechanics, allowed better contractility with coarse graining, though connectivity was still markedly reduced for this ensemble type with coarse graining. Together, our results reveal substantial tradeoffs associated with the process of coarse graining NMMII ensembles and highlight the robustness of discretized catch-slip ensembles in modeling actomyosin networks.
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Actomiosina , Miosina Tipo II , Citoesqueleto de Actina , Actinas , Contração Muscular , MiosinasRESUMO
Cytokinesis is the fundamental and ancient cellular process by which one cell physically divides into two. Cytokinesis in animal and fungal cells is achieved by contraction of an actomyosin cytoskeletal ring assembled in the cell cortex, typically at the cell equator. Cytokinesis is essential for the development of fertilized eggs into multicellular organisms and for homeostatic replenishment of cells. Correct execution of cytokinesis is also necessary for genome stability and the evasion of diseases including cancer. Cytokinesis has fascinated scientists for well over a century, but its speed and dynamics make experiments challenging to perform and interpret. The presence of redundant mechanisms is also a challenge to understand cytokinesis, leaving many fundamental questions unresolved. For example, how does a disordered cytoskeletal network transform into a coherent ring? What are the long-distance effects of localized contractility? Here, we provide a general introduction to 'modeling for biologists', and review how agent-based modeling and continuum mechanics modeling have helped to address these questions.
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Citoesqueleto de Actina/metabolismo , Actomiosina/metabolismo , Citocinese/fisiologia , Hipersensibilidade a Ovo/metabolismo , Animais , Citoesqueleto/metabolismo , Desenvolvimento Embrionário/fisiologia , HumanosRESUMO
BACKGROUND: Hepatic encephalopathy (HE) in patients with chronic liver disease (CLD) is one of the main causes of reentry to the emergency department. Oxidative stress (OxS) regulated by ammonia leads to cerebral edema and astrocytes senescence in animal models, but seems to be different in humans. OBJECTIVE: To analyze if OxS and ammonia in plasma are related to each other in the different grades of HE-CLD and to compare them with healthy volunteers (HV). METHODS: In a cross-sectional study, we included 60 subjects in 2 groups: (a) 30 HV and (b) 30 HE patients. Plasma levels of oxidation lipids/proteins, ammonia, and West-Haven score were evaluated. Student t test, Spearman's correlation, and ANOVA with Dunn's post hoc test were performed. RESULTS: Ammonia in HV and HE patients was 39-49 vs. 95-345 µmol/L, respectively (p < 0.0001). Malondialdehyde (MDA) in HV was 6.58 ± 3.11 compared to 16.69 ± 6.19 µmol/L in HE (p < 0.0001). Protein oxidation by osazone (carbonyls), formazan, and dityrosines was higher in HE than in HV (p < 0.0001). Ammonia level was directly associated to HE severity, but without correlation with lipid MDA or protein OxS formazan, carbonyls, and dityrosines. Lipid peroxidation showed higher levels at degree 2 and protein oxidation at degree 3 of HE. CONCLUSIONS: We confirm that OxS accompanies hyperammonemia in HE; however they contribute in different proportions to their natural progression. Early reduction of OxS in HE could contribute to minimize the neurotoxicity into CLD.
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Amônia/metabolismo , Encefalopatia Hepática/metabolismo , Encefalopatia Hepática/patologia , Estresse Oxidativo , Adulto , Idoso , Amônia/sangue , Animais , Biomarcadores/sangue , Doença Crônica , Estudos Transversais , Feminino , Voluntários Saudáveis , Encefalopatia Hepática/sangue , Encefalopatia Hepática/etiologia , Humanos , Lipídeos/química , Fígado/metabolismo , Fígado/patologia , Masculino , Malondialdeído/sangue , Pessoa de Meia-Idade , Oxirredução , Proteínas/metabolismoRESUMO
BACKGROUND: Modern imaging plays a central role in the care of obese patients, and there is an integral focus on its use and accessibility in individuals who have alterations of various in various organs. The objective in this study was to perform an echographic analysis of musculoskeletal system disorders, endothelial dysfunction and the left ventricle (LV) in obese rats. METHODS: Sprague Dawley rats (250 ± 5 g) were obtained and divided into two groups: the control (C) group was fed with a standard diet, and the obese (Ob) group was fed hyper caloric diet with a high fructose-fat content for 4 months. Body weight, cholesterol, triglycerides, glucose, inflammatory cytokines and adhesion molecules (ICAM-1, VCAM-1) were measured. Additionally, two-dimensional echocardiography, abdominal ultrasound and musculoskeletal system studies were performed in the lower extremities. RESULTS: The body weight in the Ob group was increased compared to that in the control group, (p < 0.001); in addition, increased glucose, cholesterol and triglyceride concentrations (p < 0.05) as well as increased levels of the adhesion molecules ICAM-1 and, VCAM-1 (p < 0.01) were found in the Ob group vs the C group. On ultrasound, 75% of the Ob group presented fatty liver and distal joint abnormalities. CONCLUSION: Obese rats exhibit endothelial dysfunction and musculoskeletal changes, also, fatty liver and articular cysts in the posterior region of the distal lower- extremity joints.
Assuntos
Endotélio Vascular/diagnóstico por imagem , Coração/diagnóstico por imagem , Fígado/diagnóstico por imagem , Sistema Musculoesquelético/diagnóstico por imagem , Obesidade/diagnóstico , Anatomia Transversal , Animais , Endotélio Vascular/patologia , Endotélio Vascular/fisiopatologia , Coração/fisiopatologia , Molécula 1 de Adesão Intercelular/metabolismo , Fígado/fisiopatologia , Masculino , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/etiologia , Doenças Musculoesqueléticas/patologia , Doenças Musculoesqueléticas/fisiopatologia , Sistema Musculoesquelético/patologia , Sistema Musculoesquelético/fisiopatologia , Miocárdio/patologia , Obesidade/complicações , Obesidade/fisiopatologia , Ratos , Ratos Sprague-Dawley , Ultrassonografia , Doenças Vasculares/diagnóstico , Doenças Vasculares/etiologia , Doenças Vasculares/patologia , Doenças Vasculares/fisiopatologia , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/patologia , Disfunção Ventricular Esquerda/fisiopatologiaRESUMO
BACKGROUND: Small intestinal bacterial overgrowth (SIBO) affects up to 60% of patients with systemic sclerosis (SSc), and it improves with antibiotics. The addition of probiotics could lead to better results. AIMS: To evaluate the efficacy and safety of Saccharomyces boulardii (SB) versus metronidazole (M) versus M + SB for 2 months, to reduce gastrointestinal symptoms and SIBO assessed with hydrogen breath test in SSc. METHODS: An open pilot clinical trial performed in forty patients with SIBO and SSc (ACR-EULAR 2013) who signed informed consent. Three groups were assigned: M, SB, and M + SB, for 2 months. Hydrogen was measured in parts per million with a hydrogen breath test to evaluate SIBO. The National Institutes of Health Patient-Reported Outcomes Measurement Information System (NIH-PROMIS) questionnaire was applied to quantify gastrointestinal symptoms with a raw score of eight symptoms. This study is registered in ClinicalTrials.gov with the following ID: NCT03692299. RESULTS: Baseline characteristics were similar between groups. The average age was 53.2 ± 9.3 years, and the evolution of SSc was 13.5 (1-34) years. After 2 months of treatment, SIBO was eradicated in 55% of the M + SB group: 33% of SB, and 25% of M. The SB and M + SB groups had decreased diarrhea, abdominal pain, and gas/bloating/flatulence, but M remained unchanged. Reductions in expired hydrogen at 45 to 60 min were as follows: M + SB 48% and 44%, M 18% and 20%, and SB 53% and 60% at the first and second months, respectively (p < 0.01). Adverse effects were epigastric burning and constipation in M (53%) and M + SB (36%), and flatulence/diarrhea in SB (22%). CONCLUSIONS: Metronidazole treatment is partially effective in SIBO, but S. boulardii in monotherapy or in combination improves the gastrointestinal outcomes in SSc.
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Infecções Bacterianas/terapia , Intestino Delgado/microbiologia , Metronidazol/administração & dosagem , Saccharomyces boulardii , Escleroderma Sistêmico/microbiologia , Escleroderma Sistêmico/terapia , Adulto , Antibacterianos/administração & dosagem , Infecções Bacterianas/diagnóstico , Feminino , Humanos , Intestino Delgado/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Probióticos/administração & dosagem , Escleroderma Sistêmico/diagnóstico , Resultado do TratamentoRESUMO
In the following paper, we present a nonlinear model of an atomic force microscope considering the potential of Lennard-Jones and the nonlinear friction produced by the squeeze film damping effect, between the cantilever and the sample. Specifically, we study the existence and stability of periodic solutions using the lower and upper solution method in the system without friction. The condition for persistence of the homocline orbit was established by Melnikov method when the model has nonlinear friction. In this sense, the analytic and numerical approach is presented to verify the solutions of the model.