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1.
Proc Natl Acad Sci U S A ; 119(40): e2110374119, 2022 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-36161905

RESUMO

Lipodystrophy syndromes (LDs) are characterized by loss of adipose tissue, metabolic complications such as dyslipidemia, insulin resistance, and fatty liver disease, as well as accelerated atherosclerosis. As a result of adipose tissue deficiency, the systemic concentration of the adipokine leptin is reduced. A current promising therapeutic option for patients with LD is treatment with recombinant leptin (metreleptin), resulting in reduced risk of mortality. Here, we investigate the effects of leptin on endothelial to mesenchymal transition (EndMT), which impair the functional properties of endothelial cells and promotes atherogenesis in LD. Leptin treatment reduced inflammation and TGF-ß2-induced expression of mesenchymal genes and prevented impairment of endothelial barrier function. Treatment of lipodystrophic- and atherosclerosis-prone animals (Ldlr-/-; aP2-nSrebp1c-Tg) with leptin reduced macrophage accumulation in atherosclerotic lesions, vascular plaque protrusion, and the number of endothelial cells with mesenchymal gene expression, confirming a reduction in EndMT in LD after leptin treatment. Treatment with leptin inhibited LD-mediated induction of the proatherosclerotic cytokine growth/differentiation factor 15 (GDF15). Inhibition of GDF15 reduced EndMT induction triggered by plasma from patients with LD. Our study reveals that in addition to the effects on adipose tissue function, leptin treatment exerts beneficial effects protecting endothelial function and identity in LD by reducing GDF15.


Assuntos
Células Endoteliais , Transição Epitelial-Mesenquimal , Fator 15 de Diferenciação de Crescimento , Leptina , Lipodistrofia , Animais , Aterosclerose/genética , Células Endoteliais/efeitos dos fármacos , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Fator 15 de Diferenciação de Crescimento/metabolismo , Leptina/farmacologia , Leptina/uso terapêutico , Lipodistrofia/tratamento farmacológico , Lipodistrofia/genética , Camundongos , Fator de Crescimento Transformador beta2/metabolismo
2.
Dig Dis Sci ; 69(7): 2530-2539, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38709421

RESUMO

BACKGROUND AND AIMS: Monoclonal antibodies (MAbs) have clinical benefits for treating several atopic diseases. However, consensus on its use for eosinophilic esophagitis (EoE) is lacking. The present meta-analysis aimed to compare the efficacy and safety of MAbs versus placebo for treating EoE. METHODS: We searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs). The primary outcomes were changes in peak esophageal eosinophils count/high power field (HPF) and mean esophageal eosinophils count/HPF. The secondary outcomes were changes in the EoE-Histology Scoring System (EoE-HSS), Endoscopic Reference Score (EREFS), dysphagia score, and adverse events (AEs). We compared binary outcomes using risk ratio (RR) and continuous outcomes using mean difference (MD) or standardized mean difference (SMD), with 95% confidence interval (CI). Considering the diversity of mechanistic properties of MAbs, a pre-specified subgroup analysis by MAb mechanism of action was performed for all outcomes, provided that at least two studies were in each subgroup. Heterogeneity was assessed using Cochran's Q test and I2 statistics. RESULTS: 6 RCTs were included (533 patients). Compared to placebo, MAbs led to a significant reduction in peak esophageal eosinophils count/HPF (MD -0.78; CI 95% -0.87, -0.6801) and mean esophageal eosinophils count/HPF (SMD -0.79; CI 95% -1.5, -0.08). Moreover, MAbs significantly reduced EoE-HSS scores (grade score: SMD -9.31; 95% CI -13.95, -4.6701; stage score: SMD -10.18; 95% CI -15.06, -5.31), EREFS (SMD -5.95; CI 95% -9.19, -2.71) and dysphagia score (SMD -1.79; CI 95% -3.36, -0.23) without increasing AEs compared to placebo. Among those MAbs whose mechanism of action includes the blockage of the receptor for IL-13 (Dupilumab, QAX576, and RPC4046), the scores of EoE-HSS grade, EoE-HSS stage, EREFS, and dysphagia were significantly reduced, and they presented a similar risk of overall and serious AEs compared to placebo. CONCLUSION: MAbs seem effective and safe in reducing esophageal eosinophil infiltrate, EoE-HSS score, EREFS score, and dysphagia symptoms in patients with EoE. However, further evidence is needed to establish its place in EoE management.


Assuntos
Anticorpos Monoclonais , Esofagite Eosinofílica , Ensaios Clínicos Controlados Aleatórios como Assunto , Esofagite Eosinofílica/tratamento farmacológico , Esofagite Eosinofílica/imunologia , Humanos , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais/efeitos adversos , Resultado do Tratamento , Esôfago/patologia , Esôfago/imunologia
3.
Spinal Cord ; 59(10): 1111-1119, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33972700

RESUMO

DESIGN: Retrospective cohort study. OBJECTIVES: To investigate paid work status and return to work (RTW) pathways after spinal cord injury (SCI). SETTING: SARAH Network of Rehabilitation Hospitals. METHODS: Participants were adults with traumatic SCI, aged between 18 and 60 years at the time of the injury, admitted between 2000 and 2017. In the first stage, socio-demographic, injury-related, and functional status data were collected from medical records. In the second stage, data on paid work, means of mobility, driving ability, return to study, ability to work, and satisfaction with the work status were collected through an online survey conducted between January and March 2020. RESULTS: A total of 154 participants were included in the sample. Of these, 90% were working at the time of SCI and 23% were engaged in paid work at the time of the study. Three RTW pathways were identified among those who were working at the time of the injury and: did not return to work (78%); returned to a different occupation (12%) and returned to the same occupation (9%). Number of post-injury complications, returning to study, good work ability, and satisfaction with the work status were predictors of paid work. The model's adjusted coefficient was 56.5% (p = 0.001). CONCLUSION: Working-age people with SCI who underwent rehabilitation in Brazil had a low rate of paid work. Fewer complications at the time of the injury, returning to study, good ability to work and greater satisfaction with the work status increased the likelihood of being engaged in paid work.


Assuntos
Retorno ao Trabalho , Traumatismos da Medula Espinal , Adolescente , Adulto , Brasil/epidemiologia , Humanos , Pessoa de Meia-Idade , Satisfação Pessoal , Estudos Retrospectivos , Traumatismos da Medula Espinal/epidemiologia , Adulto Jovem
4.
Aging Ment Health ; 25(12): 2279-2285, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33307781

RESUMO

OBJECTIVES: Accumulating evidence shows depression as a risk factor for frailty, but studies are mainly population-based and widely differ in their assessment of either depression or frailty. We investigated the association between depression and frailty among geriatric outpatients using different assessment instruments for both conditions. METHOD: Among 315 geriatric outpatients (mean age 72.1 years, 68.3% female sex) participating the MiMiCS-FRAIL cohort study, major and subthreshold depression were measured with psychiatric diagnostic interview according to DSM-5 criteria (SCID-5) as well as with instruments to screen and measure severity of depressive symptoms (GDS-15 and PHQ-9). Frailty was assessed according to a screening instrument (FRAIL-BR) and a multidimensional Frailty Index (FI-36 items). Multiple logistic and linear regression were performed to assess the association between depression (independent variable) and frailty (dependent variable) adjusted for confounders. RESULTS: Frailty prevalence in patients with no, subthreshold or major depressive disorder increases from either 14.5%, 46.5% to 65.1% when using the FRAIL-BR questionnaire, and from 10.2%, 20.9%, to 30.2% when using the FI-36 index. These association remain nearly the same when adjusted for covariates. Both the FRAIL-BR and the FI-36 were strongly associated with major depressive disorder, subthreshold depression, and depressive symptoms by PHQ-9 and GDS-15. CONCLUSION: Late life depression and frailty are associated in a dose-dependent manner, irrespective of the used definitions. Nonetheless, to avoid residual confounding, future research on underlying biological mechanisms should preferably be based on formal psychiatric diagnoses and objectively assessment frailty status.


Assuntos
Transtorno Depressivo Maior , Fragilidade , Idoso , Estudos de Coortes , Depressão/epidemiologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Feminino , Idoso Fragilizado , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Avaliação Geriátrica , Humanos , Masculino
5.
Clin Gerontol ; 44(2): 143-153, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33100186

RESUMO

OBJECTIVES: This study aimed to investigate whether frailty could be an explanatory factor of the association between depression and the number of geriatric syndromes. METHODS: Cross-sectional baseline data from a cohort study (MiMiCS-FRAIL) were analyzed in a sample of 315 older adults. Depression was measured according to DSM-5 criteria and a self-report questionnaire (PHQ-9). Frailty was assessed according to the FRAIL questionnaire and a 30-item Frailty Index (FI). We considered six geriatric syndromes. Multiple linear regression analyses were performed and adjusted for potential confounders. RESULTS: Multiple linear regression analyses yielded significant associations between depression and geriatric syndromes. These associations decreased substantially in strength when frailty was added to the models. Findings were consistent for different definitions of depression and frailty. CONCLUSIONS: Among depressed patients, frailty may be hypothesized as a causal pathway toward adverse health outcomes associated with depression. Longitudinal studies should explore the causality of this association. CLINICAL IMPLICATIONS: Frailty should be treated or prevented in order to minimize the impact of other geriatric syndromes among depressed older adults. Screening for frailty would be of utmost importance in mental health care, as frailty is neglected especially in this field. Integrated care models are crucial for clinical practice in mental illness care.


Assuntos
Fragilidade , Idoso , Estudos de Coortes , Estudos Transversais , Depressão/complicações , Depressão/epidemiologia , Idoso Fragilizado , Fragilidade/complicações , Fragilidade/epidemiologia , Avaliação Geriátrica , Humanos , Síndrome
6.
Fungal Genet Biol ; 140: 103368, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32201128

RESUMO

Ergosterol is the most important membrane sterol in fungal cells and a component not found in the membranes of human cells. We identified the ERG6 gene in the AIDS-associated fungal pathogen, Cryptococcus neoformans, encoding the sterol C-24 methyltransferase of fungal ergosterol biosynthesis. In this work, we have explored its relationship with high-temperature growth and virulence of C. neoformans by the construction of a loss-of-function mutant. In contrast to other genes involved in ergosterol biosynthesis, C. neoformans ERG6 is not essential for growth under permissive conditions in vitro. However, the erg6 mutant displayed impaired thermotolerance and increased susceptibility to osmotic and oxidative stress, as well as to different antifungal drugs. Total lipid analysis demonstrated a decrease in the erg6Δ strain membrane ergosterol content. In addition, this mutant strain was avirulent in an invertebrate model of C. neoformans infection. C. neoformans Erg6 was cyto-localized in the endoplasmic reticulum and Golgi complex. Our results demonstrate that Erg6 is crucial for growth at high temperature and virulence, likely due to its effects on C. neoformans membrane integrity and dynamics. These pathogen-focused investigations into ergosterol biosynthetic pathway components reinforce the multiple roles of ergosterol in the response of diverse fungal species to alterations in the environment, especially that of the infected host. These studies open perspectives to understand the participation of ergosterol in mechanism of resistance to azole and polyene drugs. Observed synergistic growth defects with co-inhibition of Erg6 and other components of the ergosterol biosynthesis pathway suggests novel approaches to treatment in human fungal infections.


Assuntos
Criptococose/genética , Cryptococcus neoformans/genética , Ergosterol/biossíntese , Metiltransferases/genética , Antifúngicos/farmacologia , Azóis/farmacologia , Vias Biossintéticas/efeitos dos fármacos , Criptococose/tratamento farmacológico , Criptococose/microbiologia , Cryptococcus neoformans/patogenicidade , Retículo Endoplasmático/efeitos dos fármacos , Ergosterol/genética , Regulação Fúngica da Expressão Gênica/efeitos dos fármacos , Humanos , Mutação/efeitos dos fármacos , Virulência/genética
7.
Lipids Health Dis ; 19(1): 45, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32178673

RESUMO

BACKGROUND: Adipose tissue is involved in several metabolic changes. This study investigated the association between the fatty acid (FA) composition of subcutaneous (SAT) and visceral (VAT) adipose tissue pre-surgery and the postsurgical response regarding the evolution of weight and concentrations of tumour necrosis factor alpha (TNF) and interleukin 6 (IL-6) in adult women who underwent Roux-en-Y gastric bypass (RYGB, n = 14) or sleeve gastrectomy (SG, n = 19) at one (T1), three (T3) and six (T6) years after surgery. METHODS: Blood samples were collected to obtain plasma for the measurement of IL-6 and TNF. Anthropometric measurements were performed, collecting samples of VAT and SAT during surgery to assess the FA profiles. RESULTS: Weight loss had a positive correlation with the percentage of VAT-C17:0 (T1, T3) and SAT-C18:2 (T1, T3, T6), and it had a negative correlation with SAT-C22:0 (T1, T3) and VAT-C22:0 (T3). Regarding the inflammatory response, SAT-C14:0 (T6), VAT-C14:0 (T6), SAT-C14:1 (baseline), SAT-C15:0 (T6), SAT-C16:1 (T6), VAT-C16:1 (baseline), SAT-C17:1 (T6), VAT-C17:1 (baseline), VAT-C18:1 (T6), and VAT-C20:1 (T6) exhibited positive correlations with the concentration of IL-6, which were different from the correlations of IL-6 concentrations with SAT-C18:2, VAT-C18:2 (T6), and VAT-C18:3 (T6). The FA SAT-C18:0 (T1) was negatively correlated with TNF concentrations. CONCLUSIONS: Saturated FAs were predominantly proinflammatory, primarily in the late postoperative period. Alternately, the polyunsaturated FAs exhibited anti-inflammatory potential and predicted weight loss. Thus, the FA profile of the adipose tissue of obese adult women may be a predictor of the ponderal and inflammatory response 6 years after bariatric surgery. TRIAL REGISTRATION: This study was approved by the ethics committee of Federal University of Viçosa; Registration n. 17287913.2.0000.5153; Date: 07/05/2013.


Assuntos
Tecido Adiposo/imunologia , Tecido Adiposo/metabolismo , Cirurgia Bariátrica , Gordura Intra-Abdominal/imunologia , Gordura Intra-Abdominal/metabolismo , Gordura Subcutânea/imunologia , Gordura Subcutânea/metabolismo , Feminino , Gastrectomia , Humanos , Interleucina-6/metabolismo , Obesidade Mórbida/imunologia , Obesidade Mórbida/metabolismo , Obesidade Mórbida/cirurgia , Fator de Necrose Tumoral alfa/metabolismo , Redução de Peso
8.
Spinal Cord ; 58(4): 484-489, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31784672

RESUMO

STUDY DESIGN: Retrospective study OBJECTIVES: To describe the epidemiological and clinical profile in a retrospective chart review of individuals with spinal cord injury (SCI) and osteoporosis-related fractures. SETTING: A Brazilian rehabilitation hospital. METHODS: This is a retrospective chart review that included 325 individuals with SCI and osteoporosis-related fractures who were admitted to a Brazilian rehabilitation hospital between January 1997 and December 2017. RESULTS: Overall, 52% were males with a mean (SD) age of 44.8 (±16.7) years at the time of first fracture. Overall, 82% had paraplegia and 56% had a thoracic neurological level. The mean (SD) time between SCI and fracture was 9.7 (±9.3) years. In 59% of cases the immediate cause of the fracture was a fall. The locations of the fractures were distal femur (27%), proximal femur (27%), and tibia and/or distal fibula (28%). The fractures occurred mostly at home (63%). Complications occurred in 19% of individuals and 25% reported worse performance in activities of daily living and 29% a deterioration in ambulation after they had recovered from the fracture. A second fracture was described in 15% of individuals, and five individuals had a third fracture. The mean (SD) level of 25 hydroxyvitamin D [25 (OH) D] was 25.6 (±15.2) ng/ml, and only 11 individuals (3%) underwent dual energy X-ray absorptiometry (DEXA), and 26 individuals (8%) were treated with antiresorptive drugs after fracture. CONCLUSION: Little is done to prevent fractures in individuals with SCI and understanding the clinical and epidemiological profiles will help identify risk factors and establish prevention programs and appropriate treatment.


Assuntos
Absorciometria de Fóton/estatística & dados numéricos , Fraturas por Osteoporose/etiologia , Traumatismos da Medula Espinal/complicações , Vitamina D/análogos & derivados , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/prevenção & controle , Estudos Retrospectivos , Traumatismos da Medula Espinal/epidemiologia , Vitamina D/sangue
9.
Dent Traumatol ; 35(2): 101-108, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30561893

RESUMO

BACKGROUND/AIM: Dental trauma is a common emergency in children with primary teeth. The aim of this study was to determine stress propagation to the permanent tooth germ and surrounding bone and soft tissues during dental trauma to primary central incisors with three levels of physiological root resorption. MATERIAL AND METHODS: Stresses were determined using finite element analysis (FEA). Cross-sectional models were created using cone-beam computed tomography images of 3.5, 5, and 6 years olds, representing three different physiological root resorption stages of a maxillary primary central incisor. The models included periodontal ligament, bone, and soft tissues. An impact with an asphalt block moving at 1 m/s,was simulated for two impact two directions, frontal on the labial tooth surface, and on the incisal edge. Stresses and strains were recorded during impact. RESULTS: The impact caused stress concentrations in the surrounding bone and soft tissues and permanent tooth germ, regardless of the direction of impact and the primary tooth resorption stage. Impact stresses in dental follicles and surrounding bone increased in models with more physiological root resorption of the primary tooth. Incisal impact generated higher stress concentrations in surrounding bone and soft tissues and permanent tooth germ regardless of physiological root resorption stage. The primary incisor with no physiological root resorption showed high stress concentrations at its root apex. CONCLUSION: During impact to a primary incisor, stresses most significant for potential damage to the formation of permanent enamel and dentin were at the dental follicle and surrounding bone tissue with the three levels of physiological root resorption.


Assuntos
Análise de Elementos Finitos , Reabsorção da Raiz , Germe de Dente , Dente Decíduo/lesões , Criança , Estudos Transversais , Humanos , Maxila , Raiz Dentária
10.
BMC Genomics ; 15: 943, 2014 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-25351875

RESUMO

BACKGROUND: The fungal genus Sporothrix includes at least four human pathogenic species. One of these species, S. brasiliensis, is the causal agent of a major ongoing zoonotic outbreak of sporotrichosis in Brazil. Elsewhere, sapronoses are caused by S. schenckii and S. globosa. The major aims on this comparative genomic study are: 1) to explore the presence of virulence factors in S. schenckii and S. brasiliensis; 2) to compare S. brasiliensis, which is cat-transmitted and infects both humans and cats with S. schenckii, mainly a human pathogen; 3) to compare these two species to other human pathogens (Onygenales) with similar thermo-dimorphic behavior and to other plant-associated Sordariomycetes. RESULTS: The genomes of S. schenckii and S. brasiliensis were pyrosequenced to 17x and 20x coverage comprising a total of 32.3 Mb and 33.2 Mb, respectively. Pair-wise genome alignments revealed that the two species are highly syntenic showing 97.5% average sequence identity. Phylogenomic analysis reveals that both species diverged about 3.8-4.9 MYA suggesting a recent event of speciation. Transposable elements comprise respectively 0.34% and 0.62% of the S. schenckii and S. brasiliensis genomes and expansions of Gypsy-like elements was observed reflecting the accumulation of repetitive elements in the S. brasiliensis genome. Mitochondrial genomic comparisons showed the presence of group-I intron encoding homing endonucleases (HE's) exclusively in S. brasiliensis. Analysis of protein family expansions and contractions in the Sporothrix lineage revealed expansion of LysM domain-containing proteins, small GTPases, PKS type1 and leucin-rich proteins. In contrast, a lack of polysaccharide lyase genes that are associated with decay of plants was observed when compared to other Sordariomycetes and dimorphic fungal pathogens, suggesting evolutionary adaptations from a plant pathogenic or saprobic to an animal pathogenic life style. CONCLUSIONS: Comparative genomic data suggest a unique ecological shift in the Sporothrix lineage from plant-association to mammalian parasitism, which contributes to the understanding of how environmental interactions may shape fungal virulence. . Moreover, the striking differences found in comparison with other dimorphic fungi revealed that dimorphism in these close relatives of plant-associated Sordariomycetes is a case of convergent evolution, stressing the importance of this morphogenetic change in fungal pathogenesis.


Assuntos
Doenças do Gato/microbiologia , Proteínas Fúngicas/genética , Sporothrix/genética , Esporotricose/transmissão , Fatores de Virulência/genética , Adaptação Biológica , Animais , Doenças do Gato/transmissão , Gatos , Evolução Molecular , Especiação Genética , Genoma Mitocondrial , Humanos , Filogenia , Sporothrix/classificação , Sporothrix/patogenicidade , Esporotricose/microbiologia , Esporotricose/veterinária
11.
Med Mycol ; 52(1): 19-28, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23768243

RESUMO

Paracoccidioides lutzii, formerly known as 'Pb01-like' strains in the P. brasiliensis complex, is proposed as a new species based on phylogenetic and comparative genomics data, recombination analysis, and morphological characteristics. Conidia of P. lutzii are elongated, different from those of P. brasiliensis. P. lutzii occurs in the central and northern regions of Brazil. Studies comparing P. brasiliensis and P. lutzii may have significant clinical consequences for the diagnosis and treatment of paracoccidioidomycosis.


Assuntos
Paracoccidioides/classificação , Paracoccidioides/isolamento & purificação , Brasil , Análise por Conglomerados , Proteínas Fúngicas/genética , Humanos , Microscopia , Dados de Sequência Molecular , Paracoccidioides/citologia , Paracoccidioides/genética , Paracoccidioidomicose/microbiologia , Filogenia , Análise de Sequência de DNA
12.
Hepatol Res ; 44(9): 956-63, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24033861

RESUMO

AIM: Evaluate efficacy/safety of oral l-ornithine-l-aspartate (LOLA) in controlling minimal hepatic encephalopathy (MHE). METHODS: Consecutive cirrhotic outpatients with MHE (defined by psychometric number connection tests A/B [NCT-A/B] and digit symbol substitution test [DSST] score of >2 standard deviations) were randomized to a 60-day oral LOLA (5 g t.i.d) or placebo group. Critical flicker frequency test (CFF), quantitative electroencephalogram (qEEG), arterial ammonia (NH3), Beck's anxiety-depression forms and liver disease quality of life (LD-QOL) were assessed. Patients were followed for 6 months after the end of the study to assess LOLA prophylactic role on overt hepatic encephalopathy (OHE). RESULTS: Sixty-four patients were included, 63 (98.4%) with MHE. In six of these patients, CFT was less than 39 Hz (9.52%); NH3 was increased in 32 (50.8%); 25% had abnormal qEEG. Age, sex, scholarship, Child-Pugh (CP), Model for End-Stage Liver Disease, NCT-A/B, DSST, CFF and NH3 were similar in both groups at the baseline. LOLA led to a significant improvement in NCT-B age-controlled z-score (3.4 ± 3.4 vs 1.5 ± 2.3, P = 0.01) and CFF (42.2 ± 5.8 vs 45.2 ± 5.8, P = 0.02), comparing the first and the last visit, but there were no differences between LOLA and placebo regarding the whole psychometric battery, CFF, LD-QOL and Beck's forms. No serious adverse effects occurred. Patients taking LOLA had less episodes of OHE at 6 months (5% vs 37.9%, P = 0.016), as they have significant improvement on liver function assessed by CP (P < 0.001). CONCLUSION: A 60-day oral LOLA course was not better than placebo in treating MHE, but was useful in preventing further episodes of OHE.

13.
Heliyon ; 10(4): e26003, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38384521

RESUMO

This study investigated how a standard could become reality-based in a workplace where certain types of deviations are not permitted, such as a radiopharmaceutical production unit. Compliance with standards is necessary to ensure the safety of individuals who manufacture such substances as well as the security of patients receiving treatment. In this qualitative case study, an ergonomic analysis of work (also known as activity analysis) was performed, with noncompliance recorded in internal audits as a starting point: the lack of double-checking in radiopharmaceutical synthesis cassette assembly. Field observations and self-confrontation interviews with workers from a production unit were conducted to analyze the activities. Although a double-check did not occur, the radiopharmaceutical synthesis operator apparently developed another risk control strategy, focusing his attention to the equipment assembly details, which necessitated continuous control and verification actions to ensure that there were no problems at this stage of production. A multilevel approach was used to demonstrate how the safety and quality of production processes based on standard compliance only become effective and adherent to the activity after resolving various conflicts at work, including control systems (external and internal audits), work collectives, the contradiction of the activity itself, and the discussion of singular situations arising daily. This study contributes to the discussion on workplace safety considering standardization and advances the discussion on changing perspectives regarding rule compliance.

14.
Eur J Nutr ; 52(3): 1233-42, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22890505

RESUMO

PURPOSE: It has been demonstrated that reabsorption of Na⁺ in the thick ascending limb is reduced and the ability to concentrate urine can be compromised in undernourished individuals. Alterations in phospholipid and cholesterol content in renal membranes, leading to Na⁺ loss and the inability to concentrate urine, were investigated in undernourished rats. METHODS: Sixty-day-old male Wistar rats were utilized to evaluate (1) phospholipid and cholesterol content in the membrane fraction of whole kidneys, (2) cholesterol content and the levels of active Na⁺ transporters, (Na⁺ + K⁺)ATPase and Na⁺-ATPase, in basolateral membranes of kidney proximal tubules, and (3) functional indicators of medullary urine concentration. RESULTS: Body weight in the undernourished group was 73 % lower than in control. Undernourishment did not affect the levels of cholesterol in serum or in renal homogenates. However, membranes of whole kidneys revealed 56 and 66 % reduction in the levels of total phospholipids and cholesterol, respectively. Furthermore, cholesterol and (Na⁺ + K⁺)ATPase activity in proximal tubule membranes were reduced by 55 and 68 %, respectively. Oxidative stress remained unaltered in the kidneys of undernourished rats. In contrast, Na⁺-ATPase activity, an enzyme with all regulatory components in membrane, was increased in the proximal tubules of undernourished rats. Free water clearance and fractional Na⁺ excretion were increased by 86 and 24 %, respectively, and urinary osmolal concentration was 21 % lower in undernourished rats than controls. CONCLUSION: Life-long undernutrition reduces the levels of total phospholipids and cholesterol in membranes of renal tubular cells. This alteration in membrane integrity could diminish (Na⁺ + K⁺)ATPase activity resulting in reduced Na⁺ reabsorption and urinary concentrating ability.


Assuntos
Membrana Celular/metabolismo , Colesterol/metabolismo , Regulação para Baixo , Capacidade de Concentração Renal , Desnutrição/metabolismo , Insuficiência Renal/etiologia , Adenosina Trifosfatases/metabolismo , Animais , Proteínas de Transporte de Cátions/metabolismo , Membrana Celular/enzimologia , Feminino , Rim/citologia , Rim/enzimologia , Rim/metabolismo , Rim/fisiopatologia , Túbulos Renais Proximais/enzimologia , Túbulos Renais Proximais/metabolismo , Túbulos Renais Proximais/fisiopatologia , Lactação , Masculino , Desnutrição/congênito , Desnutrição/fisiopatologia , Desnutrição/urina , Fenômenos Fisiológicos da Nutrição Materna , Fosfolipídeos/metabolismo , Gravidez , Ratos , Ratos Wistar , Sódio/urina , ATPase Trocadora de Sódio-Potássio/metabolismo
15.
Environ Sci Pollut Res Int ; 30(56): 118149-118160, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37936035

RESUMO

Humans are constantly exposed to radioactivity present in rocks, soils, and water, mainly from materials in the Earth's crust that contain chemical elements belonging to the radioactive series of uranium and thorium. An important anthropogenic source of these natural radioisotopes to the environment is fertilizers, widely used to increase agricultural productivity. Exposure to ionizing radiation can become a public health problem worldwide, since it is related to the development of different cancers in humans. The present study aimed to survey research on the radioactive content in different types of mineral phosphate fertilizers used around the world through a comprehensive review of the Scopus and Web of Science databases. About 80 scientific articles fit the purpose of this review. The concentration activity values found varied widely from one country to another, and there is no specific legislation that determines the maximum allowed limits of radioisotopes in these agricultural inputs. In addition, there are still uncertainties regarding the impact of natural radioactivity from fertilizers on human health, highlighting the need for further investigations on the subject.


Assuntos
Radioatividade , Rádio (Elemento) , Poluentes Radioativos do Solo , Urânio , Humanos , Fertilizantes/análise , Fosfatos , Radioisótopos , Minerais , Urânio/análise , Tório/análise , Poluentes Radioativos do Solo/análise , Radioisótopos de Potássio , Rádio (Elemento)/análise
16.
Work ; 74(3): 1027-1033, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36463473

RESUMO

BACKGROUND: Health promotion is an important strategy for companies as it helps identify risks at work and the health needs of workers. Nursing, as a profession committed to promoting decent work, plays an important role in this strategy. OBJECTIVE: This manuscript aims to discuss the experience of the Nursing Service in the construction of knowledge about work, to support actions in favor of health promotion. METHODS: This is a discussion article in the field of occupational health conducted at a Research Center in the nuclear area. RESULTS: Based on actions centered on guidelines on lifestyles and scheduling visits to the workplace, with the Internal Public Health Commission, limitations were identified that allowed us to discuss and understand the role of nurses as occupational health professionals. CONCLUSION: Knowing the work and understanding it in its specificities and limitations of the production process has allowed to expand the possibilities of action with workers to transform working conditions and promote health.


Assuntos
Saúde Ocupacional , Humanos , Promoção da Saúde , Local de Trabalho , Condições de Trabalho , Saúde Pública
17.
Front Cell Neurosci ; 17: 1165887, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37201162

RESUMO

Pericytes (PCs) are essential components of the blood brain barrier. Brain PCs are critical for dynamically regulating blood flow, for maintaining vascular integrity and their dysregulation is associated with a myriad of disorders such as Alzheimer's disease. To understand their physiological and molecular functions, studies have increasingly focused on primary brain PC isolation and culture. Multiple methods for PC culture have been developed over the years, however, it is still unclear how primary PCs compare to their in vivo counterparts. To address this question, we compared cultured brain PCs at passage 5 and 20 to adult and embryonic brain PCs directly isolated from mouse brains via single cell RNA-seq. Cultured PCs were highly homogeneous, and were most similar to embryonic PCs, while displaying a significantly different transcriptional profile to adult brain PCs. Cultured PCs downregulated canonical PC markers and extracellular matrix (ECM) genes. Importantly, expression of PC markers and ECM genes could be improved by co-culture with brain endothelial cells, showing the importance of the endothelium in maintaining PC identity and function. Taken together, these results highlight key transcriptional differences between cultured and in vivo PCs which should be considered when performing in vitro experiments with brain PCs.

18.
Anim Reprod ; 19(4): e20220012, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36381270

RESUMO

Although studies have shown positive effects of gonadotropin releasing hormone (GnRH) or prostaglandin F2α (PGF2α) at the moment of fixed-time artificial insemination (FTAI) in the conception rate (CR) of cattle, its effects on treatments based on progesterone (P4) and estradiol benzoate (EB) is still not conclusive. The objective of this study was (1) to evaluate the effect of a PGF2α analogue at FTAI in the CR of crossbred beef cows submitted to a 11d FTAI protocol based on P4 and EB; and (2) to describe the CR between PGF2α-treated and control cows in different body condition scores (BCS) and parity categories. Crossbred (½ Nellore and ½ Angus) beef cows were submitted to a synchronization protocol and randomly assigned into 2 groups: Control (n = 163), at FTAI cows received 2 mL of saline solution as a placebo, and PGF2α (n = 163), at FTAI cows were treated with PGF2α analogue (10 mg of dinoprost tromethamine). Pregnancy diagnosis was performed 33d post-FTAI. Binary logistic regression model was used to analyze the effect of PGF2α treatment on CR. There was no difference in CR between PGF2α and control groups (P > 0.05; odds ratio (OR) = 0.92; confidence interval (CI) = 0.59-1.4). A greater CR was found in heifers (P = 0.0006, OR = 2.65, CI = 1.61 - 4.38) and multiparous (P = 0.0006, OR = 2.12, CI = 1.04 - 4.3) when compared to primiparous cows. Cows with low BCS (4; 9-point scale) showed lower CR when compared with moderate BCS (5-6; 9-point scale) (P < 0.05; OR = 0.10; CI = 0.06 - 0.18). There was no numerical difference on CR between PGF2α-treated and control cows in different BCS and parity categories. The results suggested that the CR in this study was not influenced by 10 mg PGF2α analogue at FTAI.

19.
J Dent Child (Chic) ; 89(3): 168-193, 2022 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37149872

RESUMO

Purpose: Fetal alcohol syndrome (FAS) results from the teratogenic effects of alcohol on the fetus. Oral manifestations are commonly found in FAS and contribute to the diagnosis. The purpose of this study was to provide a review of the literature and describe two cases of FAS.
Methods: Electronic searches were conducted in August 2021 in multiple databases. The cases of two children with FAS are reported.
Results: One hundred sixty-six articles were included. The oral features frequently reported were micrognathia, cleft palate, high arched palate, maxillary hypoplasia, prognathia and crowding. The first patient had systemic and orofacial changes, such as delayed physical and cognitive development, micrognathia, tooth impaction, malocclusion and enamel hypoplasia. The second child had cognitive, and speech and behavioral deficits, but no oral and dental abnormalities.
Conclusion: Dentists should be aware of clinical findings since they may take part in the diagnosis and management of FAS.


Assuntos
Fissura Palatina , Hipoplasia do Esmalte Dentário , Transtornos do Espectro Alcoólico Fetal , Má Oclusão , Micrognatismo , Criança , Gravidez , Feminino , Humanos , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Fissura Palatina/diagnóstico , Fala
20.
Rev Paul Pediatr ; 41: e2021286, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36102402

RESUMO

OBJECTIVE: To analyze the association between phenotypic and genotypic characteristics and disease severity in individuals with cystic fibrosis treated at a reference center in Minas Gerais, Brazil. METHODS: This is a retrospective study that collected clinical and laboratory data, respiratory and gastrointestinal manifestations, type of treatment, Shwachman-Kulczycki score, and mutations from the patients' medical records. RESULTS: The sample included 50 participants aged one to 33 years, 50% of whom were female. Out of the one hundred alleles of the Cystic Fibrosis Transmembrane Conductance Regulator gene, the most prevalent mutations were DeltaF508 (45%) and S4X (18%). Mutation groups were only associated with pancreatic insufficiency (p=0.013) and not with disease severity (p=0.073). The latter presented an association with colonization by Pseudomonas aeruginosa and Staphylococcus aureus (p=0.007) and with underweight (p=0.036). Death was associated with age at diagnosis (p=0.016), respiratory symptomatology (p=0.013), colonization (p=0.024), underweight (p=0.017), and hospitalization (p=0.003). CONCLUSIONS: We could identify the association of mutations with pancreatic insufficiency; the association of Staphylococcus aureus colonization and underweight with disease severity; and the lack of association between mutations and disease severity. Environmental factors should be investigated more thoroughly since they seem to have an important effect on disease severity.


Assuntos
Fibrose Cística , Insuficiência Pancreática Exócrina , Fibrose Cística/diagnóstico , Fibrose Cística/genética , Insuficiência Pancreática Exócrina/genética , Feminino , Humanos , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença , Magreza
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